June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Automated Puff Tonometry in Comprehensive Community Based Screening for Vision Threatening Diseases during SARS-CoV-2
Author Affiliations & Notes
  • Nicolas Zarbin
    Ophthalmology, Rutgers New Jersey Medical School Department of Ophthalmology & Visual Science, Newark, New Jersey, United States
  • Aretha Zhu
    Ophthalmology, Rutgers New Jersey Medical School Department of Ophthalmology & Visual Science, Newark, New Jersey, United States
  • Rashika Verma
    Ophthalmology, Rutgers New Jersey Medical School Department of Ophthalmology & Visual Science, Newark, New Jersey, United States
  • Priya Tailor
    Ophthalmology, Rutgers New Jersey Medical School Department of Ophthalmology & Visual Science, Newark, New Jersey, United States
  • Miriam Habiel
    Ophthalmology, Rutgers New Jersey Medical School Department of Ophthalmology & Visual Science, Newark, New Jersey, United States
  • Bernard Szirth
    Ophthalmology, Rutgers New Jersey Medical School Department of Ophthalmology & Visual Science, Newark, New Jersey, United States
  • Footnotes
    Commercial Relationships   Nicolas Zarbin None; Aretha Zhu None; Rashika Verma None; Priya Tailor None; Miriam Habiel None; Bernard Szirth None
  • Footnotes
    Support  New Jersey Lions Eye Research Foundation and the New Jersey Health Foundation
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 1386 – A0082. doi:
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    • Get Citation

      Nicolas Zarbin, Aretha Zhu, Rashika Verma, Priya Tailor, Miriam Habiel, Bernard Szirth; Automated Puff Tonometry in Comprehensive Community Based Screening for Vision Threatening Diseases during SARS-CoV-2. Invest. Ophthalmol. Vis. Sci. 2022;63(7):1386 – A0082.

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

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Abstract

Purpose : Over 50% of individuals with vision-threatening disease (VTD) (e.g., diabetic retinopathy, glaucoma, macular degeneration) are unaware of their condition, and once diagnosed, 80% will not follow up for clinical care, especially since the onset of SARS-CoV-2 in 2020. Remote teleophthalmology with real-time robotic teleconsultation was implemented to include automated puff-tonometry (APT) as pre-triage to identify patients who require more detailed clinical assessment and treatment.

Methods : 224 subjects (58% male) of average age 55 years were screened over 8 events. Following COVID-19 protocols screenings took place in New Jersey churches and health fairs featuring a high prevalence of African American and Hispanic subjects. Masked and self-reported vaccinated subjects underwent medical history, blood pressure, visual acuity (with pinhole), automated puff-tonometry (APT) for intraocular pressures (IOP), automated refraction, non-mydriatic retinal imaging, optical coherence tomography (OCT), and wearable visual field device (WVFD) testing. Face masks were fitted with surgical tape on the nose bridge to limit instrument fogging. To minimize equipment contact, all subjects were screened in the standing position, including APT and retinal imaging (Fig.1). Chi-square and t-tests were performed to assess factors associated with glaucoma referral. Subjects without IOP readings were excluded; significance was set at p<0.05.

Results : 10.29% of measured eyes had an IOP>18 and underwent additional testing including OCT-B of the optic nerve head, nerve fiber layer, and ganglion cell complex. 31.43% of eyes with IOP>18 underwent teleconsultation with a glaucoma specialist, vs. 8.85% of eyes with IOP≤18 ((p<0.001), Table 1). The difference in mean age in subjects with glaucoma referral vs. without (57.42 vs. 51.61 years) was significant (p=0.008).

Conclusions : APT was useful in supporting on-site OCT-B imaging and WVFD referral (37.67%, 8.52% of total subjects) that yielded 17.94% referral to on-site teleconsultation through a real-time telerobot. Future investigation will include larger and more diverse community-based populations.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

 

 

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