April 2010
Volume 51, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2010
A Novel Way of Identifying Stable Glaucoma and Ocular Hypertension Using an Electronic Medical Record System (Medisoft®ERS)
Author Affiliations & Notes
  • S. Jungkim
    Glaucoma Research Unit, Western Eye Hospital, London, United Kingdom
  • F. Ahmed
    Glaucoma Research Unit, Western Eye Hospital, London, United Kingdom
  • J. Levy
    Medisoft UK, Leeds, United Kingdom
  • D. Johnston
    Medisoft UK, Leeds, United Kingdom
  • P. Bloom
    Glaucoma Research Unit, Western Eye Hospital, London, United Kingdom
  • C. Migdal
    Glaucoma Research Unit, Western Eye Hospital, London, United Kingdom
  • M. F. Cordeiro
    Glaucoma Research Unit, Western Eye Hospital, London, United Kingdom
    Glaucoma & Retinal Neurodegeneration Research Group, UCL Institute of Ophthalmology, London, United Kingdom
  • Footnotes
    Commercial Relationships  S. Jungkim, None; F. Ahmed, None; J. Levy, Medisoft UK, E; D. Johnston, Medisoft UK, E; P. Bloom, None; C. Migdal, None; M.F. Cordeiro, None.
  • Footnotes
    Support  None.
Investigative Ophthalmology & Visual Science April 2010, Vol.51, 182. doi:
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      S. Jungkim, F. Ahmed, J. Levy, D. Johnston, P. Bloom, C. Migdal, M. F. Cordeiro; A Novel Way of Identifying Stable Glaucoma and Ocular Hypertension Using an Electronic Medical Record System (Medisoft®ERS). Invest. Ophthalmol. Vis. Sci. 2010;51(13):182.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Introduction:
 

Recent NICE guidelines have led to a review of the role of primary healthcare in glaucoma management. In the UK, glaucoma clinics are continually expanding and the ability to identify the "stable" glaucoma patient who may be monitored in the community has become a priority. In this study, we have devised a new glaucoma summary chart as part of the Medisoft Ophthalmology ERS incorporating all the currently acceptable individually measured parameters to identify non-progressing, stable glaucoma patients.

 
Methods:
 

Standard methods of monitoring glaucoma include the assessment of IOP, the vertical cup-to-disc ratio (CDR) and Humphrey visual field (HVF) analysis. Most clinics now also use confocal laser scanning ophthalmoscopy (HRT II) and scanning laser polarimetry (GDx-VCC). We incorporated into a summary chart the following parameters: IOP, HVF mean deviation (MD) and pattern standard deviation (PSD), HRT II CDR ratio, rim area and volume, and the GDx nerve fiber index (NFI). Medical and surgical intervention were also recorded.

 
Results:
 

Of the 50 glaucoma patients followed up on average for 8.43 years (+/- 3.36 years SD), 25 patients were non-progressive. These were defined as stable according to whether on average a flat line was apparent. Although fluctuations in individual parameters were seen, it was possible to show agreement between several parameters over time. Rim volume changes, as calculated by HRT II, was found to be the correlate best with HVF MD.

 
Conclusions:
 

We believe the newly devised glaucoma summary sheet provides an easily interpretable multifactorial trend analysis . Furthermore we have shown that it can be readily applied to identifying stability in glaucoma patients who would therefore require less frequent follow-up and be appropriate for monitoring in a primary care setting.  

 
Keywords: imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • imaging/image analysis: non-clinical • clinical (human) or epidemiologic studies: natural history 
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