Philadelphia Telemedicine Glaucoma Detection and Follow-up Study: Intraocular Pressure Measurements Found in a...

Area of Science:

• Ophthalmology
• Telemedicine
• Public Health

Background:

• Glaucoma diagnosis relies on comprehensive eye examinations.
• Telemedicine offers a scalable approach to eye screening.
• Integrating diagnostic tools into telemedicine is crucial for expanding access to care.

Purpose of the Study:

• To evaluate the utility of intraocular pressure (IOP) measurements as an adjunct to nonmydriatic fundus photography in glaucoma telemedicine screening.
• To determine if IOP measurements improve the accuracy of glaucoma detection via telemedicine.

Main Methods:

• 902 high-risk individuals underwent telemedicine screening across primary care settings.
• Screening included nonmydriatic fundus photography, family history assessment, and IOP measurement using a rebound tonometer.
• Participants with suspicious findings or elevated IOP (>21 mmHg) were referred for ophthalmologist follow-up.

Main Results:

• 19.6% of screened individuals had elevated IOP (>21 mmHg).
• Individuals with suspicious nerve findings and elevated IOP had a 4.48 times higher odds of a glaucoma diagnosis compared to those with neither.
• Follow-up revealed glaucoma in 10.9% and ocular hypertension in 7.2% of attendees.

Conclusions:

• Elevated IOP during telemedicine screening increases the likelihood of a subsequent glaucoma diagnosis.
• Incorporating IOP measurements with portable tonometers into vision screening programs for high-risk populations is recommended.
• This approach enhances the diagnostic yield of telemedicine-based eye screenings.