June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Comprehensive Tele-Ophthalmology Screening in Vision Threatening Diseases During COVID-19
Author Affiliations & Notes
  • Benjamin Zhou
    Rutgers New Jersey Medical School, Newark, New Jersey, United States
  • Isis Zhang
    Rutgers New Jersey Medical School, Newark, New Jersey, United States
  • Alisa Patton
    Rutgers New Jersey Medical School, Newark, New Jersey, United States
  • Catherine Ye
    Rutgers New Jersey Medical School, Newark, New Jersey, United States
  • Neelakshi Bhagat
    Rutgers New Jersey Medical School, Newark, New Jersey, United States
  • Bernard Szirth
    Rutgers New Jersey Medical School, Newark, New Jersey, United States
  • Albert S Khouri
    Rutgers New Jersey Medical School, Newark, New Jersey, United States
  • Footnotes
    Commercial Relationships   Benjamin Zhou, None; Isis Zhang, None; Alisa Patton, None; Catherine Ye, None; Neelakshi Bhagat, None; Bernard Szirth, None; Albert Khouri, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 1899. doi:
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      Benjamin Zhou, Isis Zhang, Alisa Patton, Catherine Ye, Neelakshi Bhagat, Bernard Szirth, Albert S Khouri; Comprehensive Tele-Ophthalmology Screening in Vision Threatening Diseases During COVID-19. Invest. Ophthalmol. Vis. Sci. 2021;62(8):1899.

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

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Abstract

Purpose : Vision Threatening Diseases (VTD) (age-related macular degeneration [AMD], cataract, diabetic retinopathy [DR], and glaucoma) account for 37% of all blindness. Screening and follow-up are crucial in preserving vision. During COVID-19, clinics reduced access, using telemedicine for diagnosis and follow-ups. The efficacy of remote screening and triage in the management of single or multiple VTDs was evaluated.

Methods : We screened 41 subjects (19-85 years, 37% male, 17% Caucasian) (20 controls, 21 subjects). Demographics, 45-degree retinal photos, ganglion cell complex (GCC), and optic nerve head (ONH) images were collected using a non-contact puff-tonometer, non-mydriatic retinal camera, and an OCTA. Demographics and images were transmitted to two readers (onsite telemedicine screener [TS] and remote ophthalmologist [RO]) for triage. Triage was categorized: immediate referral to specialist, follow-up in person via clinic or telemedicine visit, or no follow-up necessary during COVID.

Results : TS made 19 referrals (46%), 6 in person follow-ups (15%), 15 no follow-ups (37%); RO made 17 referrals (41%), 2 in person follow-ups (5%), 22 no follow-ups (54%). TS identified 12 subjects as possible VTD(s) while RO identified 11 subjects. TS and RO agreed on 8 glaucoma, 7 cataract, 3 DR, and 3 and 2 AMD cases, respectively. Glaucoma was identified using IOPs, retinal fundoscopy, and OCT imaging. Mean intraocular pressures were 12.9 and 15.7 (OD, OS) in glaucoma and 14.2 and 14.0 in controls. Fundoscopy was used for overall retinal health while OCT images were used to analyze GCC, ONH, nerve fiber layer, cup to disc ratio, and anterior chamber angles. AMD and DR were identified by fundoscopy and OCT imaging. 11 of the subjects were known clinic patients; both RO and TS referred all 11 to specialty clinics, matching the in-person clinic management.

Conclusions : During the COVID pandemic, triaging patients can minimize person-to-person contact and help control the spread of the virus. Both readers agreed on the management and triage of a variety of patients with TS and RO differing only on 2 referrals and 4 in person follow-ups. Telemedicine is a promising alternative to in-person patient care for management and triage of vision threatening diseases. Further enrollment and follow-up are needed to increase robustness.

This is a 2021 ARVO Annual Meeting abstract.

 

Triage of 41 patients by clinical ophthalmologist and telemedicine screener.

Triage of 41 patients by clinical ophthalmologist and telemedicine screener.

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