TEMPLATE Classification and treatment of glaucoma (122ca917-f7de-49cc-a6e0-9644ae05b46d)

TEMPLATE ID122ca917-f7de-49cc-a6e0-9644ae05b46d
ConceptClassification and treatment of glaucoma
DescriptionDetermine the current state of glaucoma and recommend a treatment accordingly.
PurposeDetermine the current state of glaucoma and recommend a treatment accordingly.
References
Authorsname: Aitor Eguzkitza; organisation: Universidad Pública de Navarra - Complejo Hospitalario de Navarra; email: aitor.eguzkiza@unavarra.es; date: 2016-07-20
Other Details Languagename: Aitor Eguzkitza; organisation: Universidad Pública de Navarra - Complejo Hospitalario de Navarra; email: aitor.eguzkiza@unavarra.es; date: 2016-07-20
OtherDetails Language Independent{MetaDataSet:Sample Set =MetaDataSet:Sample Set , Copyright=Copyright, Owner=Owner, Speciality=Speciality}
Language useden
Citeable Identifier1013.26.132
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Trigo, Universidad Pública de Navarra (UPNA), jesusdaniel.trigo@unavarra.es, tshis=[ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-SECTION.clinical_decision.v0], code=at0000, itemType=SECTION, level=0, text=Clinical decision, description=Defines the process of making a decision about the diagnosis of a specific disease., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=SECTION, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-SECTION.clinical_decision.v0]/items[openEHR-EHR-EVALUATION.clinical_synopsis.v1], code=at0000, itemType=EVALUATION, level=1, text=Clinical Synopsis, description=Narrative summary or overview about a patient, specifically from the perspective of a healthcare provider, and with or without associated interpretations., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=EVALUATION, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-SECTION.clinical_decision.v0]/items[openEHR-EHR-EVALUATION.clinical_synopsis.v1]/data[at0001], code=at0001, itemType=UNSUPPORTEDTOPLEVELATTRIBUTE, level=2, text=Data, description=, comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=UNSUPPORTEDTOPLEVELATTRIBUTE, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-SECTION.clinical_decision.v0]/items[openEHR-EHR-EVALUATION.clinical_synopsis.v1]/data[at0001]/items[at0002], code=at0002, itemType=ELEMENT, level=3, text=Synopsis, description=The summary, assessment, conclusions or evaluation of the clinical findings., comment=null, uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-SECTION.clinical_decision.v0]/items[openEHR-EHR-EVALUATION.problem_diagnosis.v1], code=at0000, itemType=EVALUATION, level=1, text=Problem/Diagnosis, description=Details about a single identified health condition, injury, disability or any other issue which impacts on the physical, mental and/or social well-being of an individual., comment=Clear delineation between the scope of a problem versus a diagnosis is not easy to achieve in practice. 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Use this data element to record precoordinated anatomical locations. If the requirements for recording the anatomical location are determined at run-time by the application or require more complex modelling such as relative locations then use the CLUSTER.anatomical_location or CLUSTER.relative_location within the 'Structured anatomical location' SLOT in this archetype. Occurrences for this data element are unbounded to allow for clinical scenarios such as describing a rash in multiple locations but where all of the other attributes are identical. 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Conversely, if it is set to false, it means that the patient is medically stable for now, since the ophthalmologist did not identify clear signs of disease progression., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_BOOLEAN, bindings=null, values=Assumed value: true, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-SECTION.clinical_decision.v0]/items[openEHR-EHR-EVALUATION.problem_diagnosis.v1]/data[at0001]/items[openEHR-EHR-CLUSTER.classification_glaucoma.v0]/items[openEHR-EHR-CLUSTER.findings_glaucoma.v0], code=at0000, itemType=CLUSTER, level=4, text=Findings in glaucoma, description=Clinical findings on eye related with the diagnose of glaucoma., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-SECTION.clinical_decision.v0]/items[openEHR-EHR-EVALUATION.problem_diagnosis.v1]/data[at0001]/items[openEHR-EHR-CLUSTER.classification_glaucoma.v0]/items[openEHR-EHR-CLUSTER.findings_glaucoma.v0]/items[at0014], code=at0014, itemType=CLUSTER, level=5, text=Anterior segment, description=Document the insertion level of the iris root before and during compression dynamic gonioscopy., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-SECTION.clinical_decision.v0]/items[openEHR-EHR-EVALUATION.problem_diagnosis.v1]/data[at0001]/items[openEHR-EHR-CLUSTER.classification_glaucoma.v0]/items[openEHR-EHR-CLUSTER.findings_glaucoma.v0]/items[at0014]/items[at0015], code=at0015, itemType=ELEMENT, level=6, text=Iris root, description=Insertion of iris root., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Anterior to Schwalbe  [Anterior to Schwalbe's line.]
  • Behind Schwalbe  [Behind Schwalbe's line.]
  • Scleral Spur  [On the Scleral Spur.]
  • Behind Scleral Spur  [Behind the Scleral Spur.]
  • Cillary Band  [On the Cillary Band.]
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  • Steep  [Steep, anteriorly convex.]
  • Regular  [Regular.]
  • Queer  [Queer, anteriorly concave.]
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  • Angle closed  [Ratio of slit thickness = 0.]
  • Angle closure likely (angle 10°)  [Ratio of slit thickness < 1/4.]
  • Angle clossure possible (angle 20°)  [Ratio of slit thickness 1/4.]
  • Angle closure unlikely  [Ratio of slit thickness 1/2.]
  • Angle closure very unlikely  [Ratio of slit thickness 1.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-SECTION.clinical_decision.v0]/items[openEHR-EHR-EVALUATION.problem_diagnosis.v1]/data[at0001]/items[openEHR-EHR-CLUSTER.classification_glaucoma.v0]/items[openEHR-EHR-CLUSTER.findings_glaucoma.v0]/items[at0002], code=at0002, itemType=CLUSTER, level=5, text=Retinal nerve fiber layer, description=Findings on RNFL supporting the current study of glaucoma., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-SECTION.clinical_decision.v0]/items[openEHR-EHR-EVALUATION.problem_diagnosis.v1]/data[at0001]/items[openEHR-EHR-CLUSTER.classification_glaucoma.v0]/items[openEHR-EHR-CLUSTER.findings_glaucoma.v0]/items[at0002]/items[at0006], code=at0006, itemType=ELEMENT, level=6, text=Parapapillary atrophy, description=Narrative description of diffuse or localized abnormalities of the peripapillary retinal nerve fiber layer, especially at the inferior or superior poles., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-SECTION.clinical_decision.v0]/items[openEHR-EHR-EVALUATION.problem_diagnosis.v1]/data[at0001]/items[openEHR-EHR-CLUSTER.classification_glaucoma.v0]/items[openEHR-EHR-CLUSTER.findings_glaucoma.v0]/items[at0002]/items[at0040], code=at0040, itemType=ELEMENT, level=6, text=RNFL thinning, description=Identification of retinal nerve fiber layer thinning defects., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Diffuse thinning  [Diffuse thinning of Retinal nerve fiber layer.]
  • Localized defects  [Focal (wedge and slit) defects.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-SECTION.clinical_decision.v0]/items[openEHR-EHR-EVALUATION.problem_diagnosis.v1]/data[at0001]/items[openEHR-EHR-CLUSTER.classification_glaucoma.v0]/items[openEHR-EHR-CLUSTER.findings_glaucoma.v0]/items[at0002]/items[at0048], code=at0048, itemType=ELEMENT, level=6, text=Hemorrhages RNFL, description=Identification of hemorrhages on the peripapillary retinal nerve fiber layer., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_BOOLEAN, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-SECTION.clinical_decision.v0]/items[openEHR-EHR-EVALUATION.problem_diagnosis.v1]/data[at0001]/items[openEHR-EHR-CLUSTER.classification_glaucoma.v0]/items[openEHR-EHR-CLUSTER.findings_glaucoma.v0]/items[at0004], code=at0004, itemType=CLUSTER, level=5, text=Optic disc, description=Findings on optic disc supporting the current study of glaucoma., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-SECTION.clinical_decision.v0]/items[openEHR-EHR-EVALUATION.problem_diagnosis.v1]/data[at0001]/items[openEHR-EHR-CLUSTER.classification_glaucoma.v0]/items[openEHR-EHR-CLUSTER.findings_glaucoma.v0]/items[at0004]/items[at0032], code=at0032, itemType=ELEMENT, level=6, text=Rim loss pattern, description=Description of the pattern of neuroretinal rim loss. It may take the form of diffuse thinning, focal narrowing, or localized notching of the optic disc rim, especially at the inferior or superior poles., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-SECTION.clinical_decision.v0]/items[openEHR-EHR-EVALUATION.problem_diagnosis.v1]/data[at0001]/items[openEHR-EHR-CLUSTER.classification_glaucoma.v0]/items[openEHR-EHR-CLUSTER.findings_glaucoma.v0]/items[at0004]/items[at0049], code=at0049, itemType=ELEMENT, level=6, text=Asymmetric rim, description=Optic disc neural rim asymmetry of the two eyes consistent with loss of neural tissue., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_BOOLEAN, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-SECTION.clinical_decision.v0]/items[openEHR-EHR-EVALUATION.problem_diagnosis.v1]/data[at0001]/items[openEHR-EHR-CLUSTER.classification_glaucoma.v0]/items[openEHR-EHR-CLUSTER.findings_glaucoma.v0]/items[at0004]/items[at0042], code=at0042, itemType=ELEMENT, level=6, text=Cupping, description=Identification of progressive thinning of the neuroretinal rim with an associated increase in cupping of the optic disc., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-SECTION.clinical_decision.v0]/items[openEHR-EHR-EVALUATION.problem_diagnosis.v1]/data[at0001]/items[openEHR-EHR-CLUSTER.classification_glaucoma.v0]/items[openEHR-EHR-CLUSTER.findings_glaucoma.v0]/items[at0004]/items[at0043], code=at0043, itemType=ELEMENT, level=6, text=Vessels, description=Description of any positional changes of the vessels at the optic disc with bending, bayoneting or baring of circumlinear vessels., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-SECTION.clinical_decision.v0]/items[openEHR-EHR-EVALUATION.problem_diagnosis.v1]/data[at0001]/items[openEHR-EHR-CLUSTER.classification_glaucoma.v0]/items[openEHR-EHR-CLUSTER.findings_glaucoma.v0]/items[at0004]/items[at0005], code=at0005, itemType=ELEMENT, level=6, text=Hemorrhages optic disc, description=Identification of hemorrhages on or bordering the optic disc., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_BOOLEAN, bindings=null, values=Assumed value: false, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-SECTION.clinical_decision.v0]/items[openEHR-EHR-EVALUATION.problem_diagnosis.v1]/data[at0001]/items[openEHR-EHR-CLUSTER.classification_glaucoma.v0]/items[openEHR-EHR-CLUSTER.findings_glaucoma.v0]/items[at0004]/items[at0047], code=at0047, itemType=ELEMENT, level=6, text=Optic nerve head, description=Description of features in optic nerve head (ONH)., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-SECTION.clinical_decision.v0]/items[openEHR-EHR-EVALUATION.problem_diagnosis.v1]/data[at0001]/items[openEHR-EHR-CLUSTER.classification_glaucoma.v0]/items[openEHR-EHR-CLUSTER.findings_glaucoma.v0]/items[at0009], code=at0009, itemType=CLUSTER, level=5, text=Visual field, description=Findings on visual field supporting the current study of glaucoma., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-SECTION.clinical_decision.v0]/items[openEHR-EHR-EVALUATION.problem_diagnosis.v1]/data[at0001]/items[openEHR-EHR-CLUSTER.classification_glaucoma.v0]/items[openEHR-EHR-CLUSTER.findings_glaucoma.v0]/items[at0009]/items[at0008], code=at0008, itemType=ELEMENT, level=6, text=Visual field defects, description=Visual field damage consistent with retinal nerve fiber layer damage., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Early glaucomatous loss  [Mean defect < -6dB; Fewer than 18 points depressed below the 5% probability level; Fewer than 10 points below the p < 1% level; No point in the central 5 degrees with a sensitivity of less than 15 dB.]
  • Moderate glaucomatous loss  [Mean defect < -12dB; Fewer than 37 points depressed below the 5% probability level; Fewer than 20 points below the p < 1% level; Only one hemifield with a sensitivity of less than 15 dB.]
  • Advanced glaucomatous loss  [Mean defect > -12dB; More than 37 points depressed below the 5% probability level; More than 20 points below the p < 1% level; Absolute deficit (0dB) in the 5 central degrees; Sensitivity <15dB in the 5 central degrees in both hemifields.]
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  • Glaucoma stable
  • Visual field loss
  • Progressive excavation of the papilla
  • IOP unstable
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