ID
28289
Beschrijving
Documentation part 5f. Documentation form for intravitreal operative drug application in CNV by diseases other than neovascular age-related macular degeneration
Trefwoorden
Versies (1)
- 02-01-18 02-01-18 -
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Kassenärztliche Vereinigung Westfalen-Lippe (KVWL)
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2 januari 2018
DOI
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Licentie
Creative Commons BY-NC 3.0
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5f Documentation Form for Surgeon or Follow- Up Controller
2nd Therapy
- StudyEvent: ODM
Beschrijving
Befund bei 1. Verlaufskontrolle (ca. 4 Wochen nach letzter Injektion; SD-OCT/ggf. FAG des behandelten Auges beigefügt:
Alias
- UMLS CUI-1
- C0087111
- UMLS CUI-2
- C1511572
Beschrijving
Date of therapy
Datatype
date
Alias
- UMLS CUI [1]
- C2584899
Beschrijving
Visual Acuity Right eye
Datatype
text
Alias
- UMLS CUI [1,1]
- C0042812
- UMLS CUI [1,2]
- C0229089
Beschrijving
Visual Acuity Left eye
Datatype
text
Alias
- UMLS CUI [1,1]
- C0042812
- UMLS CUI [1,2]
- C0229090
Beschrijving
SD-OCT
Datatype
text
Alias
- UMLS CUI [1]
- C3876157
Beschrijving
Recommendation
Datatype
text
Alias
- UMLS CUI [1]
- C0034866
Beschrijving
date follow- up
Datatype
date
Alias
- UMLS CUI [1]
- C3694716
Beschrijving
Withdraw
Datatype
text
Alias
- UMLS CUI [1]
- C2349954
Beschrijving
Indication
Datatype
text
Alias
- UMLS CUI [1]
- C3146298
Beschrijving
Befund bei 2. Verlaufskontrolle (ca. 8 Wochen nach letzter Injektion; SD-OCT/ggf. FAG des behandelten Auges beigefügt:
Alias
- UMLS CUI-1
- C0087111
- UMLS CUI-2
- C1511572
Beschrijving
Date of therapy
Datatype
date
Alias
- UMLS CUI [1]
- C2584899
Beschrijving
Visual Acuity Right eye
Datatype
text
Alias
- UMLS CUI [1,1]
- C0042812
- UMLS CUI [1,2]
- C0229089
Beschrijving
Visual Acuity Left eye
Datatype
text
Alias
- UMLS CUI [1,1]
- C0042812
- UMLS CUI [1,2]
- C0229090
Beschrijving
SD-OCT
Datatype
text
Alias
- UMLS CUI [1]
- C3876157
Beschrijving
Recommendation
Datatype
text
Alias
- UMLS CUI [1]
- C0034866
Beschrijving
date follow- up
Datatype
date
Alias
- UMLS CUI [1]
- C3694716
Beschrijving
Withdraw
Datatype
text
Alias
- UMLS CUI [1]
- C2349954
Beschrijving
Indication
Datatype
text
Alias
- UMLS CUI [1]
- C3146298
Beschrijving
Befund bei 3. Verlaufskontrolle (ca. 12 Wochen nach letzter Injektion; SD-OCT/ggf. FAG des behandelten Auges beigefügt:
Alias
- UMLS CUI-1
- C0087111
- UMLS CUI-2
- C1511572
Beschrijving
Date of therapy
Datatype
date
Alias
- UMLS CUI [1]
- C2584899
Beschrijving
Visual Acuity Right eye
Datatype
text
Alias
- UMLS CUI [1,1]
- C0042812
- UMLS CUI [1,2]
- C0229089
Beschrijving
Visual Acuity Left eye
Datatype
text
Alias
- UMLS CUI [1,1]
- C0042812
- UMLS CUI [1,2]
- C0229090
Beschrijving
SD-OCT
Datatype
text
Alias
- UMLS CUI [1]
- C3876157
Beschrijving
Recommendation
Datatype
text
Alias
- UMLS CUI [1]
- C0034866
Beschrijving
date follow- up
Datatype
date
Alias
- UMLS CUI [1]
- C3694716
Beschrijving
Withdraw
Datatype
text
Alias
- UMLS CUI [1]
- C2349954
Beschrijving
Indication
Datatype
text
Alias
- UMLS CUI [1]
- C3146298
Beschrijving
Befund bei 4. Verlaufskontrolle (ca. 16 Wochen nach letzter Injektion; SD-OCT/ggf. FAG des behandelten Auges beigefügt:
Alias
- UMLS CUI-1
- C0087111
- UMLS CUI-2
- C1511572
Beschrijving
Date of therapy
Datatype
date
Alias
- UMLS CUI [1]
- C2584899
Beschrijving
Visual Acuity Right eye
Datatype
text
Alias
- UMLS CUI [1,1]
- C0042812
- UMLS CUI [1,2]
- C0229089
Beschrijving
Visual Acuity Left eye
Datatype
text
Alias
- UMLS CUI [1,1]
- C0042812
- UMLS CUI [1,2]
- C0229090
Beschrijving
SD-OCT
Datatype
text
Alias
- UMLS CUI [1]
- C3876157
Beschrijving
Recommendation
Datatype
text
Alias
- UMLS CUI [1]
- C0034866
Beschrijving
date follow- up
Datatype
date
Alias
- UMLS CUI [1]
- C3694716
Beschrijving
Withdraw
Datatype
text
Alias
- UMLS CUI [1]
- C2349954
Beschrijving
Indication
Datatype
text
Alias
- UMLS CUI [1]
- C3146298
Beschrijving
Befund bei 5. Verlaufskontrolle (ca. 20 Wochen nach letzter Injektion; SD-OCT/ggf. FAG des behandelten Auges beigefügt:
Alias
- UMLS CUI-1
- C0087111
- UMLS CUI-2
- C1511572
Beschrijving
Date of therapy
Datatype
date
Alias
- UMLS CUI [1]
- C2584899
Beschrijving
Visual Acuity Right eye
Datatype
text
Alias
- UMLS CUI [1,1]
- C0042812
- UMLS CUI [1,2]
- C0229089
Beschrijving
Visual Acuity Left eye
Datatype
text
Alias
- UMLS CUI [1,1]
- C0042812
- UMLS CUI [1,2]
- C0229090
Beschrijving
SD-OCT
Datatype
text
Alias
- UMLS CUI [1]
- C3876157
Beschrijving
Recommendation
Datatype
text
Alias
- UMLS CUI [1]
- C0034866
Beschrijving
date follow- up
Datatype
date
Alias
- UMLS CUI [1]
- C3694716
Beschrijving
Withdraw
Datatype
text
Alias
- UMLS CUI [1]
- C2349954
Beschrijving
Indication
Datatype
text
Alias
- UMLS CUI [1]
- C3146298
Beschrijving
Befund bei 6. Verlaufskontrolle (ca. 24 Wochen nach letzter Injektion; SD-OCT/ggf. FAG des behandelten Auges beigefügt:
Alias
- UMLS CUI-1
- C0087111
- UMLS CUI-2
- C1511572
Beschrijving
Date of therapy
Datatype
date
Alias
- UMLS CUI [1]
- C2584899
Beschrijving
Visual Acuity Right eye
Datatype
text
Alias
- UMLS CUI [1,1]
- C0042812
- UMLS CUI [1,2]
- C0229089
Beschrijving
Visual Acuity Left eye
Datatype
text
Alias
- UMLS CUI [1,1]
- C0042812
- UMLS CUI [1,2]
- C0229090
Beschrijving
SD-OCT
Datatype
text
Alias
- UMLS CUI [1]
- C3876157
Beschrijving
Recommendation
Datatype
text
Alias
- UMLS CUI [1]
- C0034866
Beschrijving
date follow- up
Datatype
date
Alias
- UMLS CUI [1]
- C3694716
Beschrijving
Withdraw
Datatype
text
Alias
- UMLS CUI [1]
- C2349954
Beschrijving
Indication
Datatype
text
Alias
- UMLS CUI [1]
- C3146298
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2nd Therapy
- StudyEvent: ODM
C0229089 (UMLS CUI [1,2])
C0229090 (UMLS CUI [1,2])
C1511572 (UMLS CUI-2)
C0229089 (UMLS CUI [1,2])
C0229090 (UMLS CUI [1,2])
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C1511572 (UMLS CUI-2)
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C0229090 (UMLS CUI [1,2])
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C1511572 (UMLS CUI-2)
C0229089 (UMLS CUI [1,2])
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(Comment:de)
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C1511572 (UMLS CUI-2)
C0229089 (UMLS CUI [1,2])
C0229090 (UMLS CUI [1,2])
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(Comment:de)
(Comment:de)
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C1511572 (UMLS CUI-2)
C0229089 (UMLS CUI [1,2])
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(Comment:de)
(Comment:de)
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C1511572 (UMLS CUI-2)
C0229089 (UMLS CUI [1,2])
C0229090 (UMLS CUI [1,2])
(Comment:de)
(Comment:de)
(Comment:de)
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(Comment:de)