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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 )



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.


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)|




































































































































































































































































































































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