Asynchronous Teleophthalmology for Monitoring Glaucoma Patients in a Rural German Region: A Retrospective Observational Pilot Study

Background: 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. Objective: 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. Methods: 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. Results: 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. Conclusion: 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.