Referral for first glaucoma surgery in Europe, the ReF-GS study

Area of Science:

• Ophthalmology
• Glaucoma Research
• Public Health

Background:

• Open-angle glaucoma is a leading cause of irreversible blindness worldwide.
• Timely surgical intervention is crucial for preserving vision in glaucoma patients.
• Referral patterns for glaucoma surgery can vary significantly across different healthcare systems.

Purpose of the Study:

• To assess the appropriateness and timeliness of referrals for incisional glaucoma surgery across Europe.
• To identify potential disparities in glaucoma care and referral practices among European countries.

Main Methods:

• Analysis of 294 referrals for first open-angle glaucoma surgery between January and October 2017.
• Inclusion of data from 18 European countries, categorized into 'old' EU, 'new' EU, and non-EU.
• Evaluation of referral appropriateness, timing, patient demographics, disease severity, and treatment history.

Main Results:

• Only 41.5% of referrals were appropriate and timely; 35.0% were appropriate but delayed, and 17.6% were too late.
• Most patients presented with advanced glaucoma (mean deviation -13.8 dB) and no prior structural progression analysis.
• Significant variations in treatment duration and referral patterns were observed between different European country groups.

Conclusions:

• A substantial proportion of glaucoma surgery referrals in Europe are suboptimal, with many patients presenting with advanced disease.
• Considerable variation in care quality and referral practices exists across European nations.
• Enhanced strategies and standardized protocols are essential to improve glaucoma management and patient outcomes throughout Europe.