Asynchronous Teleophthalmology for Monitoring Glaucoma Patients in a Rural German Region: A Retrospective...

Coronavirus disease 2019 (COVID-19) has created an escalating need for limiting in-person examination and potential viral exposure. Under these circumstances, teleophthalmology allows ophthalmologists to continue providing care to patients while ensuring their safety and that of the medical staff.

The primary objective of this study was to assess patient satisfaction with an asynchronous teleconsultation for glaucoma patients in a rural German area. Secondary endpoints were patient adherence and the need to change the therapeutic regime.

This retrospective, observational, and monocentric study included 50 patients diagnosed with primary open-angle glaucoma (n = 49) and ocular hypertension (n = 1) requiring medication to lower intraocular pressure (IOP). Only patients with well-controlled diseases were included, and a brief questionnaire was evaluated, which was completed one year after the baseline visit. Best-corrected visual acuity (BCVA), IOP measurements, visual fields, optical coherence tomography images of the optic nerve head, ultra-widefield photographs of the fundus, and photographs of the anterior segment of the eye were taken at each visit by an experienced optometrist.

Of the 50 patients included, the mean number of follow-up visits in this observation period was 4.4. No patient was lost to follow-up, and there were a total of nine missed follow-up visits (but not lost to follow-up). No patients required a change in their treatment regime during the observational period. Regarding patient-focused assessment, the majority of patients were satisfied or very satisfied with teleconsultation in general.

Asynchronous teleophthalmology is a promising option and effective means to monitor glaucoma patients. The majority of teleophthalmology patients were satisfied with their teleconsultation and adhered to the follow-up schedule. However, prospective trials with a larger number of patients and a more focused examination on specific patient populations are required. Further trials should also focus on the aspect of cost-effectiveness.