{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T12:41:23Z","timestamp":1780922483983,"version":"3.54.1"},"reference-count":26,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Klin Monbl Augenheilkd"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Purpose The study aimed to assess the reliability of tele-education in training a Malawian ophthalmology resident to interpret optical coherence tomography (OCT) images of patients with macular conditions.<\/jats:p>\n                  <jats:p>Methods This was a retrospective analysis of 1000 macula-centered OCT image series from 1000 eyes of 1000 consecutive patients from Malawi, which involved initial interpretation by a German retina specialist (observer 1) (T0). Observer 1 then trained a Malawian resident (observer 2) via email, and observer 2 independently interpreted images at T1, followed by face-to-face training in Malawi and reinterpretation at T2 and T3 (3-month intervals). The observers had to recognize, on OCT imaging, the normal macular structure, vitreofoveal traction (VFT), absent fovea depression (FD), epiretinal membrane (ERM), lamellar macular hole (LMH), full-thickness macular hole (FTMH), foveoschisis, intraretinal pseudocyst (IPC), intraretinal hyperreflective foci (IHF), subretinal fluid (SRF), pigment epithelial detachment (PED), and drusen. Cohen\u02bcs Kappa statistic measured inter-observer agreement.<\/jats:p>\n                  <jats:p>Results At T1 post-tele-education, almost perfect agreement (\u03ba\u2009=\u20090.86; 99.6% agreement) was observed for FTMH. Agreement remained high at T2 post-face-to-face training (\u03ba\u2009=\u20090.9; 99.7%) and decreased substantially at T3 (\u03ba\u2009=\u20090.77; 99.4%). Following tele-education (T1), substantial agreement (\u03ba range: 0.77\u200a\u2013\u200a0.86) was found for IPC, PED, IHF, and FD, while ERM showed fair agreement (\u03ba\u2009=\u20090.33; 81%). Face-to-face training notably improved agreement for SRF (T1 \u03ba\u2009=\u20090.6, T2 \u03ba\u2009=\u20090.63), LMH (T1 \u03ba\u2009=\u20090.6, T2 \u03ba\u2009=\u20090.67), and normal macular structure (T1 \u03ba\u2009=\u20090.6, T2 \u03ba\u2009=\u20090.62).<\/jats:p>\n                  <jats:p>Conclusion There was good agreement in the detection of the majority of the OCT features seen in most of the macular pathologies following training through tele-education and the results did not change significantly following face-to-face teaching. Tele-education could reliably complement training in vitreoretinal diagnostic skills in resource-limited settings.<\/jats:p>","DOI":"10.1055\/a-2441-7861","type":"journal-article","created":{"date-parts":[[2025,1,23]],"date-time":"2025-01-23T18:37:27Z","timestamp":1737657447000},"page":"146-152","source":"Crossref","is-referenced-by-count":1,"title":["Evaluation of Tele-Education in Malawi for Detection of Macular Features Using Optical Coherence Tomography"],"prefix":"10.1055","volume":"243","author":[{"given":"Thokozani","family":"Zungu","sequence":"additional","affiliation":[{"name":"Ophthalmology, Kamuzu University of Health Sciences, Blantyre, Malawi"},{"name":"Ophthalmology, Queen Elizabeth Central Hospital, Blantyre, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaffi","family":"Mdala","sequence":"additional","affiliation":[{"name":"Ophthalmology, Kamuzu University of Health Sciences, Blantyre, Malawi"},{"name":"Ophthalmology, Queen Elizabeth Central 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