Tele-ophthalmology for the monitoring of choroidal and iris nevi: a pilot study

Abstract

ObjectiveTo investigate the validity and safety of tele-ophthalmology evaluations as a clinical assessment tool when performed by an ophthalmologist to detect lesion growth in patients with low-, medium-, and high-risk choroidal and iris nevi. DesignRetrospective observational pilot study. MethodsConsecutive patients with low-/medium-/high-risk choroidal or iris nevi who underwent tele-oncology examinations over 5 months. All patients had a dilated fundus or anterior segment photography, A- and B-scan ultrasonography or ultrasound biomicroscopy (UBM), and spectral domain optical coherence tomography (SD-OCT) depending on the nature of their lesion. Patients who followed up with in-person examinations had an additional ophthalmoscopic examination. ResultsSeventy-one eyes of 71 patients were included. The diagnoses were 47 low-risk choroidal nevi, 10 medium-risk choroidal nevi, 5 high-risk choroidal nevi, and 9 iris nevi. The tele-ophthalmology examinations found a sensitivity of 100%, specificity of 92%, positive predictive value of 57%, and negative predictive value of 100% to detect growth of a lesion. ConclusionsTele-ophthalmology assessment for choroidal and iris nevi is a sensitive clinical tool to evaluate growth with 100% sensitivity and negative predictive value when performed by trained ultrasound technicians and reviewed by an ophthalmologist with expertise in ocular oncology. It has the potential to alleviate patient- and physician-related treatment burden.