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Editors Selection IGR 17-4
Glaucoma in the COVID era: Will the pandemic boost telemedicine?
Comment by Jin Wook Jeoung on:
92395 Intraocular Pressure Telemetry for Managing Glaucoma during the COVID-19 Pandemic, Mansouri K; Kersten-Gomez I; Hoffmann EM et al., Ophthalmology. Glaucoma, 2021; 0:
Mansouri et al. evaluated the role of telemetry-obtained intraocular pressure (IOP) measurements to guide remote decision-making during the COVID-19 pandemic. This study included the glaucoma patients previously implanted with a telemetric IOP sensor (Eyemate; Implandata GmbH). Data were available from 37 eyes of 37 patients (16 patients with a sulcus-based sensor and 21 patients with a suprachoroidal sensor). The authors showed that 92% of patients who previously had been implanted with the IOP telemetric sensor were able to measure their IOP and provide these measurements to their physicians electronically during the COVID-19 lockdown. These results indicate the feasibility of patient-acquired measurement of IOP in conjunction with remote IOP monitoring by physicians with an implantable sensor.
The main strength of this study is the use of implantable IOP sensors and their substantial IOP data. In addition, an important finding was that physicians who had access to these remote IOP measurements adjusted their clinical decision making in five patients (14% of total), in three patients leading to a change in treatment, and in one patient leading to surgery. These findings suggest that the telemetry-obtained IOP measurements can impact clinical decision-making, including adjustment of glaucoma medications and virtual consultation to schedule glaucoma surgery.
This paper is important in providing evidence that continuous IOP monitoring has the potential to improve therapeutic decisionmaking in glaucoma patients
As pointed out by the authors, several factors limit this study's generalizability and clinical significance. The study might be underpowered due to its small sample size. The profile of study patients may differ from average glaucoma patients because of the innovative nature of the device and the need for intraoperative surgery for its implantation. In spite of these limitations, this paper is important in providing evidence that continuous IOP monitoring has the potential to improve therapeutic decision-making in glaucoma patients. Recent advances in continuous IOP monitoring and home-based perimetry may provide more comprehensive clinical options for remote glaucoma monitoring in the near future.
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