Results from a study conducted during the COVID-19 pandemic found feasibility of patient-acquired measurement of intraocular pressure (IOP) when coupled with remote IOP monitoring by ophthalmologists, according to a study published in Ophthalmology Glaucoma. The patients evaluated used an implantable sensor, which helped physicians in clinical decision making, adjustment of ocular hypotensive therapy. Researchers say the devices helped eliminate unneeded office visits.
The cross-sectional study looked at the results of 37 eyes in 37 patients who were previously implanted with a telemetric IOP sensor. Of those, 16 patients had a sulcus-based sensor and 21 had a suprachoroidal sensor. Patients acquired the IOP measurements during lockdown, which were then collected remotely by physicians. Questionnaires were sent to 10 participating study centers to “evaluate the clinical impact of remote monitoring of IOP via the IOP sensor system.” The main outcome measurement was the number of patients who obtained home IOP measurements.
Investigators found that 34 patients obtained IOP measurements during the lockdown, for a total of 8415 IOP measurements from 370 measurement days. The mean age of patients was 69.3 ± 9.6 years. Nearly half (48.6%) were women. Thanks to the remote IOP measurements, 5 patients had their treatments changed. For another 5 patients, treatment changes were “considered.” Of the 10 study centers, 9 considered that remote IOP measurements had a clinical impact.
“We found that patients previously implanted with the telemetric IOP sensor were able to acquire their own IOP measurements,” according to investigators. “Moreover, in most cases, treating ophthalmologists had access to their patients’ data. During the COVID-19 lockdown period, these data impacted glaucoma management. For virtual glaucoma clinics to be a meaningful substitute for in-person care, future innovations in remote testing of visual fields and optic disc topography are needed to complement remote IOP monitoring.”
The study’s limitations included its small sample size and selective profile of patients — they might not represent all glaucoma patients, or even the average, as they already had the technology implanted prior to the pandemic. But even then: “The fact that 3 of 37 patients did not use their device to obtain IOP measurements because of perceived restrictions of daily activities or device handling difficulties suggests that universal acceptance of an IOP monitoring system may face practical difficulties.”
Also, some settings had more experience with the technology for several years with more patients, while others had more limited time involved with fewer patients, which might have impacted interpretation and handling of data.
Mansouri K, Kersten-Gomez I, Hoffmann EM, et al. Intraocular Pressure Telemetry for Managing Glaucoma during the COVID-19 Pandemic. Ophthalmol Glaucoma. Published online February 4, 2021. doi:10.1016/j.ogla.2020.12.008.