"Science and Innovation Board Daily" (Shanghai, reporter Xu Hong) reported , Recently, the "Aifen incident" placed Aier Eye Hospital (300015.SZ) in the whirlpool of public opinion, which may bring development opportunities to high-end ultra-wide-angle fundus cameras, an ophthalmic medical device.
Fundus photography is one of the basic ophthalmic examinations. Fundus examination not only plays an important role in the diagnosis of ophthalmic diseases, but also can serve as the early diagnosis basis for many diseases throughout the body, such as coronary heart disease, diabetes, hypertension, etc.
With the development of medicine, fundus examination has also begun to have more advanced equipment - ultra-wide-angle fundus cameras. Compared with traditional fundus photography, the advantage of ultra-wide-angle fundus cameras is that they have a larger imaging range and can be used for smaller pupils.
"Aifen incident": What checks may be missing?
Regarding the ins and outs of the "Aifen incident", a reporter from "Science and Innovation Board Daily" previously reported that "Found|The market value of the first year evaporated by 27.4 billion yuan! Medical White Horse is complained by "anti-epidemic doctors". What is the problem with Aier's ophthalmology? 》
According to Ai Fen, the core of the contradiction in this incident is that Ai Fen believes that Ai Fen did not conduct a comprehensive fundus examination on his cataract surgery before and after, including the fact that although the fundus was examined before and after the operation, it only examined the center of the fundus and did not examine the periphery of the fundus, which was not thorough enough.
According to public information, before the cataract operation, Ai Fen had performed preoperative examinations such as eye ultrasound and fundus OCT at Wuhan Central Hospital according to the requirements of Aier's ophthalmologist assistant.
According to , Zhao Yang, deputy chief physician of the ophthalmology department of Beijing Tongren Hospital affiliated to Capital Medical University, said in a popular science article that the fundus is indeed necessary to be checked before cataract surgery, and relevant clinical guidelines have also made corresponding requirements for this. However, fundus examinations are also divided into levels, and peripheral retina examinations are not common pre-cataract routine examinations.
According to Zhao Yang's further explanation, simply put, fundus examination is divided into posterior pole examination and whole retinal examination. Among them:
posterior pole examination, includes routine examinations such as fundus photography, OCT, etc. The advantage is that it is non-invasive and does not require pupil dilation (Note: Pupil dilation is a routine examination and treatment method in ophthalmology. It usually refers to the use of ciliary muscle paralysis agent to dilate the pupil and then perform corresponding examination and treatment). Therefore, it is widely used in clinical practice and can detect most fundus diseases.
Full retinal examination, includes peripheral retinal examination, so the pupil must be dilated, and then the examination is performed using indirect ophthalmoscopes (sometimes the eyeball is pressed), trilateral lenses and other equipment. This is a contact-type invasive examination. In addition, in the past two years, Oubao's total retinal photography equipment (referred to as "Oubao") has been introduced in China. It can take pictures of the peripheral retina after dilating my pupils. In addition to the need for dilatation, this is a non-invasive non-contact examination.
Zhao Yang said that among the currently preoperative cataract examinations, most public hospitals, including patients with high myopia (Note: Dr. Ai Fen's eye condition is relatively complicated, integrating history of high myopia, cataracts, and eye trauma. Among them, due to trauma, the pupil is not dilated, that is, the pupil cannot dilate), preoperative fundus examinations include 3 items: B-ultrasound (check for serious fundus lesions), fundus photography (i.e., traditional fundus photography, fundus around 45° of the posterior pole), and OCT (check for macular function). These examinations can detect most fundus lesions, and the main purpose is to help doctors predict postoperative vision so as to give patients a relatively accurate vision expectation before surgery.
However, examinations for peripheral retina include indirect lenses of mydriasis, trilateral lenses, Oubao, etc., which are not preoperative routine examinations for cataracts in most hospitals.
That is to say, according to existing public information, although Aifen completed routine preoperative examinations such as B-ultrasound and OCT before cataract surgery, he may not have done "unconventional" examinations for the peripheral retina such as indirect lenses, trilateral lenses or Obao.
At the same time, another ophthalmologist pointed out to the reporter of "Science and Innovation Board Daily" that although the three methods of indirect lens, trilateral lens and Oubu fundus photography can all check the retinal condition of the surrounding area, the three have their own advantages and disadvantages, and none of them is perfect and thorough.
"In addition, Ai Fen's condition is also quite special. Because the pupils of his right eye are very small and not dispersed, indirect and trilateral mirror examinations are actually not suitable. Although Oubao can take pictures under the small pupil, the premise is that the crystals must be transparent. If there is cataract opaque, the surroundings cannot be seen." The other party said.
Ultra-wide-angle fundus camera is going to be popular?
Due to the stimulation of the "Aifen incident", Director Zhao Yang believes that the current cataract diagnosis and treatment standards in China are expected to be further upgraded. In the future, before cataract surgery, mydriasis checking the peripheral fundus is expected to become a routine diagnosis and treatment.
This means that relevant inspection items and equipment may be popularized at a faster pace.
According to an ophthalmologist, due to the relatively expensive price, most hospitals in China have not yet introduced Oubo. However, indirect ophthalmoscopes and trilateral lenses have a high popularity rate because of their relatively cheap prices. They are currently equipped in most hospitals.
"In the Aier incident, the biggest winner is the 'Obao' all-retinal camera. I believe that 'Obao' will be rapidly popularized in various ophthalmology hospitals afterwards, but what is brought about is the investment in national medical equipment and the increase in medical expenditure of all patients." Director Zhao Yang speculated so.
"I used to open an 'Oeburg' and I had to think about asking patients to do such expensive examinations at their own expense. Will the patients think I'm 'exciting'? There may be no pressure in the future." He added.
Fundus cameras on the Chinese market, especially high-end fundus cameras, still rely on imports to a considerable extent.
public information shows that the Ouber ultra-wide-angle laser fundus camera (Daytona) is currently the most popular ultra-wide-angle fundus camera in China. It was developed and produced by the British Ouber Company (Ouber Optos was later acquired by Nikon, Japan).
Compared with traditional fundus cameras, it can only display a range of 45 degrees. It can display a range of up to 200 degrees, covering about 80% of the entire fundus area. It can avoid missed diagnosis through a larger range of fundus photos, and at the same time improve diagnosis and treatment accuracy and convenience.
"Science and Innovation Board Daily" reporter learned that in addition to outpatient departments and some county-level hospitals, most of Aier Eye Hospitals have introduced Oubao. "I estimate that among the more than 600 Aier ophthalmic hospitals across the country, more than 400 have Oubao." An insider told the reporter of "Science and Innovation Board Daily".
In terms of domestic brands, according to a reporter from the Science and Technology Innovation Board Daily, most domestic fundus camera manufacturers are currently distributed in East China and South China, such as Suzhou Weiqing Medical and Guangdong Fudi New Vision.
In the high-end market segment of ultra-wide-angle fundus cameras, in addition to Oubao, Suzhou Weiqing Medical is the second company after Oubao and the only domestic company to obtain a registration certificate. In May 2020, Weiqing Medical Laser Confocal Fundament Analog Device (CRO) was approved for launch, which is the first ultra-wide-angle confocal laser funda multimode imager in China.
According to people from Weiqing Medical Company, after being approved for listing, Weiqingzheng has increased its marketing efforts for this product.
