FBG of both digital photographic images and OCT scans.identification of all diabetic retinopathy and maculopathy levels.a formal assessment of 50 individual OCT scans as a minimum.The clinical lead must complete an assessment of competence before the grader can undertake unsupervised OCT grading. hospital clinical optometrist or an experienced OCT examiner who has a minimum of 2 years’ experience working in medical retina clinics, is approved by the clinical lead and understands and follows national grading criteria for DES.consultant ophthalmologist, associate specialist, staff grade or specialist registrar year III (or higher) who has at least one year’s experience of medical retina clinics and understands and follows national grading criteria for DES.There must be local training to make sure all OCT graders are competent in interpreting and grading OCT scans for diabetic retinopathy and incidental findings. assessed and ‘signed-off’ as competent by the local DES provider clinical lead.an active referral outcome grader ( ROG) who complies with the associated QA criteria.adequately trained in assessing OCT scans.OCT graders (ophthalmologists, optometrists and technicians) should be: Individuals performing OCT imaging must be adequately trained in obtaining appropriate quality OCT images. The clinical lead is responsible for the clinical governance of the OCT pathway and ensuring the quality standard is met for DS. The OCT grader must be able to escalate the scan within the pathway for additional grading or a second opinion. This may include a report output from the OCT of the relevant slice of the retina. The OCT scan quality, grade and outcome for the DS encounter must be recorded within the screening software using the features based grading ( FBG) form. Referral into and from these clinics will be counted in the pathway standards. High risk maculopathy and all R2M1 and R3AM1 grades must be referred to HES and follow the national referral pathway.ĭS clinics with OCT should provide both digital fundus photography consistent with national criteria and the additional OCT capture using either spectral domain ( SD) or swept source ( SS) OCT. Low risk maculopathy can be followed up in digital surveillance with an OCT. A consultant diabetologist clinical lead must appoint a consultant or senior specialty ophthalmologist with medical retina experience to provide dedicated support to the service.Ī cost effectiveness study for the use of OCT assessment in screening demonstrated that it is cost effective to use OCT in DS for maculopathy follow-up. The clinical lead is responsible for the clinical governance of the OCT pathway. Providers must implement additional quality assurance ( QA) and failsafe measures to maintain patient safety alongside existing failsafe arrangements. The commissioning of OCT services should involve commissioners, clinical care groups, general practice, HES and local screening providers. Any provision of OCT assessments must be commissioned separately. The use of OCT is not currently included in NHS England commissioned DES services. It also advises that DS clinics may link to OCT for the assessment of maculopathy. The national service specification states that people who need more frequent review but do not require referral to a hospital eye service ( HES) can be referred to DS clinics. This document provides consistent best practice guidance for local diabetic eye screening ( DES) services on the management of diabetic maculopathy in digital surveillance ( DS) clinics using optical coherence tomography ( OCT).
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |