Evaluating multidisciplinary glaucoma care: visual field progression and loss of sight year analysis in the community versus hospital setting

Mushtaq, Yusuf and Panchasara, Binita and Nassehzadehtabriz, Nikou and Lim, Hong Kai and Mushtaq, Maryam and Kean, Jane and Farrell, Sarah and Bourne, Rupert R. A. and Shahid, Humma and Khatib, Tasneem and Martin, Keith R, (2021) Evaluating multidisciplinary glaucoma care: visual field progression and loss of sight year analysis in the community versus hospital setting. Eye. ISSN 1476-5454

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Official URL: https://doi.org/10.1038/s41433-021-01492-3

Abstract

Background: A variety of shared care models have been developed, which aim to stratify glaucoma patients according to risk of disease progression. However, there is limited published data on the rate of glaucoma progression in the hospital vs community setting. Here we aimed to compare rates of glaucomatous visual field progression in the Cambridge Community Optometrist Glaucoma Scheme (COGS) and Addenbrooke’s Hospital Glaucoma Clinic (AGC). Methods: A retrospective comparative cohort review was performed. Patients with five or more visual field tests were included. Zeiss Forum software was used to calculate the MD progression rate (dB/year). Loss of sight years (LSY) were also calculated for both COGS and AGC. Results: Overall, 8465 visual field tests from 854 patients were reviewed. In all, 362 eyes from the AGC group and 210 eyes from COGS were included. The MD deterioration rate was significantly lower in the COGS patients compared with the AGC group (−0.1 vs −0.3 dB/year; p < 0.0001). No patients in the COGS group were predicted to become blind within their lifetime by LSY analysis. Fifteen patients were at risk in the AGC group. Conclusion: This service evaluation shows that COGS is an effective scheme to stratify lower risk glaucoma patients, increasing the capacity within hospital eye services. COGS patients have a lower rate of visual field deterioration compared to AGC patients. Effective communication between community and tertiary schemes is essential to facilitate transfer of patients requiring further hospital management reliably and efficiently, with the potential for low-risk patients to be followed safely in the community.

Item Type: Journal Article
Keywords: Health services, Optic nerve diseases
Faculty: Faculty of Health, Education, Medicine & Social Care
Depositing User: Ian Walker
Date Deposited: 18 Jun 2021 13:50
Last Modified: 24 Jan 2022 16:11
URI: https://arro.anglia.ac.uk/id/eprint/706669

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