Effectiveness of a Hybrid Telemedicine Model for Glaucoma Management

In a hybrid telemedicine model consisting of alternating in-person and telemedicine visits, ∼95% of telemedicine visits for glaucoma had findings and assessments consistent with in-person visits, suggesting this model's effectiveness in monitoring glaucoma.

A hybrid model of teleophthalmology involves an in-person visit for imaging with a technician, followed by a telemedicine visit with an ophthalmologist. At our institution, we alternate in-person visits with hybrid telemedicine visits. The purpose of this study is to evaluate the sensitivity and specificity of this novel telemedicine platform for identifying findings that can lead to management changes for glaucoma.

The medical records of patients seen by a telemedicine-using ophthalmologist at a tertiary eye center for a glaucoma-related condition from September 2023 to October 2024 were reviewed. The main outcome measures were cup-disc ratio, retinal nerve fiber layer thinning, visual field defects, and changes in findings or management between in-person and telemedicine visits. Sensitivity and specificity were calculated, and paired t tests and χ 2 testing were also used.

A total of 102 patients (mean age 65 y; 63% female) underwent 162 hybrid telemedicine visits for glaucoma-related concerns. The most common diagnoses were glaucoma suspect (36%) and moderate stage glaucoma (26%). Using a χ 2 test, telemedicine visits demonstrated significantly greater consistency in findings and assessments with in-person visits than would be expected by chance ( P <0.001). The sensitivity of telemedicine in detecting worsening clinical findings was 75%, and the specificity was 100%.

Approximately 95% of telemedicine visits had findings and assessments consistent with both preceding and subsequent in-person visits, indicating the effectiveness of a hybrid telemedicine model for monitoring and managing glaucoma progression.