Hybrid Ophthalmology Telemedicine Could Exist Beyond COVID-19

Samuel K. Steven Houston III, MD

Hybrid telemedicine practices, brought on by necessity during the COVID-19 pandemic, may have a permanent practice in modern ophthalmology care.

A new study presented at the American Society of Retina Specialists (ASRS) 2021 Scientific Meeting this weekend highlighted a multitude of benefits derived from ophthalmic care-tailored telemedicine offerings from the Wills Eye Hospital in Philadelphia during the pandemic.

Presented by Samuel K. Steven Houston III, MD, the retrospective analysis reviewed 500-plus patients who qualified for hybrid telemedicine offerings at the institution from April to November 2020. As Houston and colleagues noted, retina clinics worldwide were adversely impacted by COVID-19, forcing many to limit their capacity for in-person intravitreal injection care and emergency visits—all the while worrying patients from seeking consistent in-person care.

“We developed hybrid telemedicine protocols to allow patients with sight threatening conditions to be evaluated in a safe, efficient, and comprehensive manner,” investigators wrote.

Their assessment included 568 patients who were treated at non-physician staffed satellite clinics. Patients were provided technician-led visual acuity, intraocular pressure, spectral domain optical coherence tomography, and ultra-widefield imaging, all reviewed within 24 hours of assessment.

Physicians additionally conducted audio-visual teleconferencing with patients via Zoom within 24 hours of their imaging, obtaining patient history while reviewing imaging findings via screen-sharing and providing patients tailored education and follow-up.

This hybrid telemedicine practice was deemed a success by Houston and colleagues based on an “extremely high” level of overall patient satisfaction from recorded feedback; they reported the system’s efficiency, timeliness, safety, and successful simulation of an in-person visit as key benefits.

“In addition, we were able to effectively evaluate patients with a variety of complex retinal pathologies,” Houston and colleagues wrote. Patients varied from diabetic retinopathy (17.3%), dry age-related macular degeneration (AMD [10.2%]), inactive wet AMD (9.3%), macular pucker (9.3%), cystoid macular edema (4.4%), and retinal vein occlusion (3.2%), among others.

“Hybrid telemedicine offers a safe and efficient way to monitor patients with complex retinal pathologies during COVID-19,” investigators concluded. “These visits simulate an in-person visit and to date, we continue to utilize these protocols for our patients.”

The study, “Hybrid Telemedicine for Retina During COVID-19 and Beyond: Initial Experience With 500+ Patients,” was presented at ASRS 2021.