• Any other terminology or classification where the term exists
  • Date reported
  • Originally reported by
  • Peer-reviewed reference(s) to support proposal (published within last 10 years)
  • Suggestion/proposal - Ideas of the best way this issue could be addressed
    IDType of data (e.g. diagnosis, finding, procedure)Date reportedOriginally reported byDefinition (including details of the body structure(s) involved if not obvious from the name)Description of dataIs there a SNOMED code which is related but does not sufficientExisting SNOMED CT codeAny other terminology or classification where the term existsIf so, detailsAny other infoSuggestion/proposal - Ideas of the best way this issue could be addressedPeer-reviewed reference(s) to support proposal (published within last 10 years)Author of logReported to SNOMED (dated and details)Named and dated updatesResolved (dated and method of resolution)
    1Diagnosis


    superior or inferior hemi retinal vein occlusionYes

    N/AAB comment: 232043000 =  Hemispheric retinal vein occlusion.  Do you also want to request quadrants for BRVO? DH comment: Terms for superior HRVO and inferior HRVO desirable (as we have graphic entities that describe both).

    David Haider

    EWooler - Question:

    These can be added, but can I confirm the body structures where the occlusion occurs?  In SNOMED we have:

    • 70116008 |Structure of superior nasal retinal vein (body structure)|
    • 39078001 |Superior retinal temporal vein structure (body structure)|
    • 42578008 |Structure of inferior nasal retinal vein (body structure)|
    • 84228009 |Structure of inferior retinal temporal vein (body structure)|
    • IR 16/10/24 suggest 6 new terms:

    superior hemi-retinal vein occlusion (70116008 + 39078001 )

    inferior hemi-retinal vein occlusion (42578008 + 84228009 )

    superior nasal retinal vein occlusion (70116008 )

    superior temporal retinal vein occlusion (39078001 )

    inferior nasal retinal vein occlusion (42578008 )

    inferior temporal retinal vein occlusion (84228009 )


    Content added as suggested:

    1354422006 |Superior hemi-retinal vein occlusion (disorder)|

    1354425008 |Inferior hemi-retinal vein occlusion (disorder)|

    1354423001 |Superior nasal retinal vein occlusion (disorder)|

    1354424007 |Superior temporal retinal vein occlusion (disorder)|

    1354426009 |Inferior nasal retinal vein occlusion (disorder)|

    1354427000 |Inferior temporal retinal vein occlusion (disorder)|

    2Diagnosis


    Dome Shaped MaculopathyNo

    N/AI submitted a request for this, but it has not currently been accepted.

    Dec 2021 Update: My submission to SNOMED has now been accepted and new SNOMED code for DSM has now been created: 1366121000000108 


    David Haidercomplete

    EWooler 26/02/24

    This is a UK extension concept and not currently in the International release.  I can request this is promoted from the UK extension.  Though the PT would be Dome shaped macula with a synonym of Dome shaped maculopathy.

    Complete and UK extension concept added to international release.  Release date November 2024 
    3Diagnosis


    Partial thickness macular holeYes

    677921000119101, 677871000119105, 677971000119100, There are codes for left, right and bilateral partial thickness macular hole, but no non-lateralised term like these is for most other diagnoses. Our workaround has been to use 312701008 to represent partial thickness / lamellar hole. But this term is slight different, and used for Stage 1 / Impending macular hole. The difference is small, but present.

    David Haider

    EWooler 26/02/24

    This can be added.  Will advise when completed.


    Completed and release date 1 November 2024.
    4Diagnosis, Finding


    asymmetric optic disc cupping (anisoexcavation)Yes

    12451000We map this to the generic 'Optic cupping' finding in SNOMED as we have not found a closer match.

    Alex Brown, Medisoft

    Completed with anticipated release date of 1 Dec 2024
    5Diagnosis


    We have individual diagnoses for various secondary closed angle glaucoma due to:
     ROP, silicone oil, uveal effusion - increased choroidal venous pressure, uveal effusion - scleritis, uveal effusion - other, plateau iris, wound leak, aqueous misdirection, congenital anomaly, epithelial ingrowth, gas in vitreous, intraocular tumour, lens dislocation.
    Yes

    21571006We map all of these secondary closed angle glaucoma diagnoses to the parent term 'secondary angle-closure glaucoma' in SNOMED.

    Alex Brown, Medisoft

    EWooler 26/02/24 Questions:

    Some of these exist 

    715144004 |Glaucoma caused by silicone oil (disorder)| including left, right and bilateral. But do not state open or closed.

    15995591000119109 |Glaucoma of left eye due to plateau iris (disorder)|  but again do not state open or closed.

    Congenital - currently editing content in this area as some existed but and modelled as congenital but without that word in the description so are being updated: Glaucoma due to congenital chamber angle anomaly - including left/right/bilateral

    1231271005 |Glaucoma due to and following retinopathy of prematurity (disorder)| - no lateralised content yet.  Does not currently state open or closed. Is it always closed angle?

    If the group can confirm the list to be added and if the current concepts are still relevant even though they do not state open or closed and we can add subtypes to these.

    • IR  16/10/24 - am hoping most of these will be covered by our glaucoma work. Congenital glaucoma will need input from someone with more experience in this


    6Diagnosis


    We have individual diagnoses for various secondary closed angle glaucoma due to tumours/cysts:
     ciliary body cyst
     iris cyst
     uveal effusion - tumour related
    Yes

    27735002We map all of these secondary closed angle glaucoma diagnoses to the parent term 'Glaucoma associated with tumors AND/OR cysts' in SNOMED.

    Alex Brown, Medisoft

    EWooler - Questions:

    Existing 788947003 |Glaucoma due to intraocular neoplasm (disorder)| including left/right/bilateral.  This is modelled as open angle.  Is a closed angle version also required?

    275477002 |Glaucoma due to ocular cyst (disorder)| including left, right and bilateral.  Content also added for ciliary and iris cysts for release 1 July 2024

    27735002 |Glaucoma associated with tumors AND/OR cysts (disorder)| does not now conform to editorial guidance so I would like to inactivate and replace pointing to replacements Existing 788947003 |Glaucoma due to intraocular neoplasm (disorder)| and 275477002 |Glaucoma due to ocular cyst (disorder)| 

    • IR  16/10/24 - am hoping most of these will be covered by our glaucoma work. This we emailed about this


    7Diagnosis


    We have individual diagnoses for various secondary open angle glaucoma due to:
     silicone oil, acute anterior uveitis, chronic anterior uveitis, intermediate uveitis, ocular surgery or laser, panuveitis, trauma, retinal detachment, siderosis, tumour infiltration.
    Yes

    21928008We map our secondary open angle glaucoma diagnoses to the parent term 'secondary open angle glaucoma' in SNOMED, apart from for 'secondary open angle glaucoma (steroid induced)' for which there is a specific distinct code.

    Alex Brown, Medisoft

    EWooler - Questions

    715144004 |Glaucoma caused by silicone oil (disorder)| is modelled as open angle. I can include this in the descriptions if there is also a closed angle version.

    1285335004 |Open angle glaucoma due to ocular surgery (disorder)| exists with lateralised content.

    1111391000000107 |Open angle glaucoma due to ocular trauma (disorder)| exists with lateralised content.

    788948008 |Glaucoma due to retinal detachment (disorder)| exists but not modelled as open or closed.  Is this always open?

    Can add if the group agree but do they all need open and closed angle versions?

    Glaucoma due to acute anterior uveitis - can this be closed as well as open angle?

    Glaucoma due to chronic anterior uveitis - can this be closed as well as open angle?

    Glaucoma due to intermediate anterior uveitis - can this be closed as well as open angle?

    Glaucoma due to ocular laser surgery - can this be closed as well as open angle?

    Glaucoma due to panuveitis - can this be closed as well as open angle?

    Glaucoma due to siderosis - can this be closed as well as open angle?

    How is glaucoma due to tumour infiltration different from 788947003 |Glaucoma due to intraocular neoplasm (disorder)| ?

    • IR  16/10/24 - am hoping most of these will be covered by our glaucoma work. 


    8Diagnosis


    glaucoma suspectYes

    23986001SNOMED doesn't seem to offer 'glaucoma suspect' data items, so we currently map these to the non-suspect equivalent. Have found some reference in our old notes to a SNOMED code for glaucoma suspect but this doesn't seem to exist in my browser: 232079008

    Alex Brown, Medisoft

    EWooler 26/02/24

    232079008 |Glaucoma suspect (situation)| was inactivated and replaced with:

    833278008 |Glaucoma suspect (disorder)| which also has 14 subtypes e.g. 1003488007 |Angle closure glaucoma suspect (disorder)|, 1003530008 |Glaucoma suspect caused by corticosteroid (disorder)|, 1003614009 |Open angle glaucoma suspect (disorder)|



    Completed as replacement concepts already exist.
    9Diagnosis


    normal pressure glaucoma suspectYes

    50485007SNOMED doesn't seem to offer 'glaucoma suspect' data items, so we currently map these to the non-suspect equivalent.

    Alex Brown, Medisoft

    EWooler - Question.

    The current definition in SNOMED for 833278008 |Glaucoma suspect (disorder)| includes elevated IOP:

    At least 1 of these in 1 eye: optic nerve or nerve fiber layer suggestive of glaucoma; abnormal visual field consistent with glaucoma; an elevated IOP > 22 mm Hg.

    Can add if group agrees needed.

    • IR  16/10/24 - the current term is sufficient


    10Diagnosis


    primary juvenile glaucoma suspectYes

    71111008SNOMED doesn't seem to offer 'glaucoma suspect' data items, so we currently map these to the non-suspect equivalent.

    Alex Brown, Medisoft

    EWooler -Question

    This concept was in the earlier versions of the EGS Terminology and Guidelines for Glaucoma but is not in the latest version.  Would be useful to understand why this is and if it should be added?

    • IR  16/10/24 - Congenital glaucoma will need input from someone with more experience in this


    11Diagnosis


    We have indivudal diagnoses for various congenital glaucomas:
     Broad thumb syndrome
     chromosomal abnormality
    Yes

    204113001We map these congenital glaucoma diagnoses to the parent term 'congenital glaucoma' in SNOMED, there are child options of this term but not an exact match that we are aware of.

    Alex Brown, Medisoft

    Ewooler - Question

    Broad thumb syndrome is now referred to as Rubinstein-Taybi syndrome.  We can add a concept for glaucoma in this syndrome if agreed by the group.

    Regarding chromosomal abnormalities is it possible to narrow these down to specific chromosome abnormality syndromes?

    • IR  16/10/24 - Congenital glaucoma will need input from someone with more experience in this


    12Diagnosis


    rubeotic glaucoma associated with central retina artery occlusionYes

    232086000We map this to the parent term 'neovascular glaucoma' in SNOMED. There are some child options in SNOMED but not for this specific cause.

    Alex Brown, MedisoftThere is 1285643003 |Neovascular glaucoma due to central retinal vein occlusion (disorder)| which has a synonym of Rubeotic glaucoma due to central retinal vein occlusion.  We could add an artery version if agreed by the group.

    13Diagnosis


    risk of angle closure glaucomaYes

    314018004We map this to the parent term 'At risk of glaucoma' in SNOMED, which may be sufficient.

    Alex Brown, Medisoft314018004 |At increased risk of glaucoma (finding)| and could add At increased risk of angle closure glaucoma.
    Completed with anticipated release date 1 November 2024
    14Diagnosis


    closed angle glaucoma (intumescent lens)Yes

    392300000I think this mapping is fine but not sure if there is scope for this to be added as an explicit synonym to SNOMED?

    Alex Brown, Medisoft

    Ewooler - Question

    Could add a synonym here if this is truly a synonym of 392300000 |Phacomorphic angle closure glaucoma due to disorder of lens (disorder)|.  Though there is an existing concept - 95724003 |Intumescent cataract (disorder)|

    • IR  16/10/24 - synonym could be added to the current term (392300000)


    15Diagnosis, Finding


    no evidence of glaucoma
    no evidence of glaucoma or ocular hypertension
    No

    N/AAssumed it was an editorial decision that SNOMED CT does not support negatives and these should be handled via qualifiers, however a handful of 'no evidence of…' findings exist relating to neoplasms.

    Alex Brown, MedisoftWe do have 1109141000000102 |No evidence of glaucoma (situation)| with left and right versions.  But you are correct that negation is out of scope for the terminology and software vendors are encouraged to store this in the information model.

    16Finding

    is the natural formation of new blood vessels in the form of functional microvascular network, capable of perfusion of red blood cells, that form as collateral circulation in response to local poor perfusion or ischemia

    NeovascularizationYes

    Retinal neovascularization (disorder)


    61267008





    Investigative ophthalmology & visual science - 10.1167/iovs.65.1.22

    Scientific reports - 10.1038/s41598-023-49964-8

    Journal of opharmaceutical analysis - 10.1016/j.jpha.2023.05.002

    Fritz Kalaw

    1285475006 |Neovascularization of eye (finding)| exists with lateralised versions.


    Complete, content was added July 2023. 
    17Diagnosis

    based on clinical impression,
    1) Severe new vessels and severe fibrous proliferation
    2) Severe new vessels and red vitreous hemorrhage
    3) moderate new vessels, severe fibrous proliferations, and red vitreous hemorrhage

    Severe proliferative diabetic retinopathyYes

    Very severe proliferative diabetic retinopathy


    399865004





    Ophthalmic surgery, lasers and imaging retina –

    https://doi.org/10.3928/1542-8877-20030701-01

    Ophthalmology - 10.1016/s0161-6420(85)34002-2

    Archives of ophthalmology - doi:10.1001/archopht.1985.01050110038020

    Fritz Kalaw

    Could be added if there is an agreed international definition of what this is.

    Could also add a definition to the existing concept 399865004 |Very severe proliferative retinopathy due to diabetes mellitus (disorder)|.



    18Finding

    Any blood in the vitreous cavity; presence of extravasated blood within a space lined by posterior lens capsule anteriorly, internal limiting membrane posteriorly, and non-pigmented epithelium of ciliary body laterally

    Vitreous hemorrhageYes

    Vitreous hemorrhage due to diabetes mellitus


    312910009






    Survey of Ophthalmology - https://doi.org/10.1016/S0039-6257(97)84041-6

    Ophthalmology - https://doi.org/10.1016/S0161-6420(87)33528-6

    Canadian journal of ophthalmology - https://doi.org/10.1016/j.jcjo.2017.09.027

    Fritz KalawExists 31341008 |Vitreous hemorrhage (disorder)| with lateralised versions.
    Complete 
    19Finding

    have been described in persons with and without hypertension and associated with clinical and subclinical manifestations of atherosclerosis and a broad group of risk factors for vascular disease; described as focal and generalized narrowing and arteriovenous nicking

    Arteriolar abnormalities

    No






    Retina - 10.1097/IAE.0000000000003959

    Arteriosclerosis, thrombosis, and vascular biology -https://doi.org/10.1161/01.ATV.20.6.1644

    Clinical & experimental ophthalmology - https://doi.org/10.1111/j.1442-9071.2008.01825.x

    Fritz Kalaw

    EWooler - Question

    737161008 |Disorder of arteriole (disorder)| exists but very high level and we have 417019000 |Retinal arteriolitis (disorder)| which is inflammation.  

    Is a higher level Disorder of retinal arteriole needed?

    • IR  16/10/24 - the current terms are sufficient IMO as this is a vague diagnosis / finding


    20Finding

    occurs when retina does not have the efficient tissue perfusion seen using fundus color or fundus fluorescein angiography

    Capillary nonperfusionNo




    Bioimpacts - 10.15171/bi.2015.27

    Ophthalmology - doi: 10.1016/j.ophtha.2019.06.022.

    Scientific reports - 10.1038/s41598-020-71622-6.

    Fritz Kalaw

    EWooler - Question

    Would this be specifically - Capillary non-perfusion of retina?  Similar to the newly added 1351545003 |Perifoveal capillary nonperfusion (finding)|

    • IR  16/10/24 - yes very similar to (1351545003) except higher level probably as not specifically referring to the perifoveal retinal location


    21Diagnosis

    some retinal thickening or hard exudates in the posterior pole, distant from the center of the maculaMild diabetic macular edemaNo




    Ophthalmic and physiological optics - 10.1111/opo.13261

    Ophthalmic and physiological optics - 10.1111/opo.13261

    World journal of diabetes - 10.4239/wjd.v4.i6.290

    Fritz Kalaw

    Can add as consistent with ICD11 definition

    https://icd.who.int/dev11/l-m/en#/http://id.who.int/icd/entity/1116345240

    Mild diabetic macular edema = Some retinal thickening or hard exudates in posterior pole but distant from the centre of the macula



    22Diagnosis

    retinal thickening or hard exudates near the center of the macula but not involving the center

    Moderate diabetic macular edema

    No




    Ophthalmic and physiological optics - 10.1111/opo.13261

    Ophthalmic and physiological optics - 10.1111/opo.13261

    World journal of diabetes - 10.4239/wjd.v4.i6.290

    Fritz Kalaw

    Similar to above:

    Moderate diabetic macular edema definition = Retinal thickening or hard exudates approaching the centre of the macula but not involving the centre



    23Finding

    is the nonperfusion of the retina circumscribing the parafovea and fovea; perifovea is a belt that covers a 10 degree radius around the fovea and is 1.5 mm wide

    Perifoveal capillary nonperfusionNo




     International ophthalmology - doi.org/10.1007/s10792-023-02882-0

    Annals of eye science – 10.21037/aes.2017.06.08

     European journal of ophthalmology - https://doi.org/10.5301/ejo.5000948

    Fritz KalawCan add this.
    Completed with anticipated release date of 1 November.
    24Diagnosis

    retinal thickening or hard exudates involving the center of the macula

    Severe diabetic macular edemaNo




    Ophthalmology - https://doi.org/10.1016/S0161-6420(03)00475-5

    Ophthalmic and physiological optics - 10.1111/opo.13261

     World journal of diabetes - 10.4239/wjd.v4.i6.290

    Fritz Kalaw

    Similar to mild and moderate.

    ICD11 definition = Retinal thickening or hard exudates involving the centre of the macula



    25Finding

    hemorrhage of the retina located in various layers from the internal limiting membrane to the outer nuclear layer which can cause hypofluorescent blockage

    Intraretinal hemorrhagesYes

    Retinal hemorrhage (disorder)


    28998008





    Investigative ophthalmology & visual science - 10.1167/iovs.64.15.39

    Journal of vitreoretinal diseases - 10.1177/24741264231163395

    Romanian journal of ophthalmology - 10.22336/rjo.2023.51

    Fritz Kalaw

    EWooler - Question

    At present 'intraretinal hemorrhage' is a synonym on 28998008 |Retinal hemorrhage (disorder)|

    Is this synonym more specific than the FSN?

    • IR  16/10/24 - yes I think intraretinal haemorrhage should be a child term of retinal haemorrhage as it is more specific


    26Finding

    is a common complication of diabetic retinopathy that is associated with damage in the vessels that supply blood to the retina and the enlargement of the foveal avascular zoneMacular ischemiaYes

    Retinal ischemia


    26468004





    Ophthalmology and therapy - 10.1007/s40123-022-00546-3

    Ophthalmologica, International journal of ophthalmology - 10.1159/000515406

    Cureus - 10.7759/cureus.3064

    Fritz KalawExists as a synonym on 312913006 |Ischemic maculopathy (disorder)|

    27Finding

    is a yellow-white lesion in the superficial retina that usually occupies an area less than one fourth of that of the optic nerve

    Soft exudatesYes

    Retinal exudates


    193423005





    Computers in biology and medicine - 10.1016/j.compbiomed.2023.107854

     Journal of digital imaging - 10.1007/s10278-015-9793-5

    British medical journal case reports - https://doi.org/10.1136/bcr-2023-255723

    Fritz KalawExists as a synonym on 39832008 |Cotton wool spots (disorder)|