Intraocular Pressure Telemetry for Managing Glaucoma during the COVID-19 Pandemic

Abstract

Purpose: To evaluate in glaucoma patients the feasibility and use of remote monitoring of intraocular pressure (IOP) with an implanted telemetry sensor during the coronavirus disease 2019 (COVID-19) lockdown.

Design: Cross-sectional study.

Participants: Patients previously implanted with a telemetric IOP sensor (Eyemate; Implandata GmbH) were included.

Methods: Intraocular pressure measurements acquired by the patients during the lockdown were collected by physicians who were located remotely. A questionnaire was sent to 10 participating study centers to evaluate the clinical impact of remote monitoring of IOP via the IOP sensor system.

Main outcome measures: Number of patients who obtained home IOP measurements.

Results: Data were available from all centers and from 37 eyes of 37 patients (16 patients with a sulcus-based sensor and 21 patients with a suprachoroidal sensor). Thirty-four patients obtained IOP measurements during the lockdown. Mean age of the patients was 69.3 ± 9.6 years, and 48.6% were women. A total of 8415 IOP measurements from 370 measurement days were obtained. Based on remote IOP measurements, treatment was changed in 5 patients. In another 5 patients, treatment change was considered when physicians received the IOP measurements after the lockdown. Nine of the 10 study centers judged remote IOP measurements to have a clinical impact.

Conclusions: These results show the feasibility of patient-acquired measurement of IOP in conjunction with remote IOP monitoring by physicians with an implantable sensor. The data obtained impacted clinical decision making, including adjustment of ocular hypotensive therapy and avoiding unnecessary office visits during the COVID-19 pandemic.

Keywords: COVID-19; Glaucoma; IOP; Intraocular pressure; Lockdown; Monitoring; Telemetry.

Figure 1

Graph showing wide variability of intraocular pressure (IOP), despite topical treatment with a prostaglandin analog and α agonist. Average IOP values are less than the target of 15 mmHg.

Figure 2

Graph showing that despite evidence of intraocular pressure (IOP) lowering when an additional glaucoma drop was added on March 20, 2020, average IOP seemed to remain at more than the target of 15 mmHg.

Figure 3

Graph showing intraocular pressure (IOP) measurements that are consistently more than 21 mmHg. The decision was made to change IOP-lowering treatment.

Figure 4

Graph showing that intraocular pressure (IOP) measurements are consistently more than 21 mmHg. The decision was made via a virtual consultation to schedule glaucoma surgery.