Mapping vision loss of patients in a glaucoma backlog following the COVID-19 pandemic: a real-world analysis using the Glauc-Strat-Fast risk stratification tool,Eye

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Mapping vision loss of patients in a glaucoma backlog following the COVID-19 pandemic: a real-world analysis using the Glauc-Strat-Fast risk stratification tool
Eye ( IF 2.8 ) Pub Date : 2023-11-18 , DOI: 10.1038/s41433-023-02821-4
Ojasvi Sharma ₁ , Lee Jones _{2,

3,

4} , Freda Sii _{4,

5} , Jonathan Whittaker ₅ , Simon Dulku _{4,

5} , Graham Lee _{6,

7} , James Kirwan ₈ , Tarun Sharma ₉ , Peter Shah _{2,

4,

5,

10}

Affiliation

Introduction

Glauc-Strat-Fast is a clinical tool recommended by The Royal College of Ophthalmologists to classify glaucoma patients into strata of risk for significant future sight loss and an estimate of resource requirement. The aim of this study was to map the movement of glaucoma patients across stratification boundaries on Glauc-Strat-Fast during the COVID-19 pandemic.

Subjects and methods

Glauc-Strat-Fast was applied to a consecutive sample of 100 primary open angle glaucoma patients in a backlog at Worcestershire Acute Hospitals NHS Trust. Stratification outcomes were compared between clinic visits prior to the COVID-19 pandemic versus the follow-up visit. Patients were stratified twice separately based on their worse eye (i.e., most affected) and better eye (i.e., least affected) according to Glauc-Strat-Fast.

Results

Amount of slippage (difference between target follow-up and actual follow-up) ranged from 2 to 32 months. There was a statistically significant average reduction in visual field mean deviation for better and worse eyes between visits (p = <0.001). At follow-up, no worse eyes were classified as being low risk (green), while 96 were classified as high risk (red). For better eyes, elevation of risk into the highest strata of Glauc-Strat-Fast observed a three-fold increase in patients (19 versus 56) between visits.

Discussion

This retrospective real-world analysis highlights patients’ movement into the highest strata on the Glauc-Strat-Fast tool and demonstrates a significant deterioration in visual outcomes during a period of extensive appointment slippage. The findings demonstrate the utility of Glauc-Strat-Fast as a tool for improved patient management.

中文翻译：

绘制 COVID-19 大流行后青光眼积压中患者的视力丧失图：使用 Glauc-Strat-Fast 风险分层工具进行真实世界分析

介绍

Glauc-Strat-Fast 是皇家眼科医师学院推荐的一种临床工具，用于将青光眼患者分为未来严重视力丧失的风险层和资源需求的估计值。本研究的目的是绘制 COVID-19 大流行期间青光眼患者在 Glauc-Strat-Fast 上跨分层边界的移动。

主题和方法

Glauc-Strat-Fast 应用于伍斯特郡急症医院 NHS 信托基金积压的 100 名原发性开角型青光眼患者的连续样本。比较了 COVID-19 大流行前门诊就诊与随访之间的分层结果。根据 Glauc-Strat-Fast，根据患者较差的眼睛（即受影响最大）和较好的眼睛（即受影响最小）分别对患者进行两次分层。

结果

滑移量（目标随访与实际随访之间的差异）从 2 到 32 个月不等。在两次就诊之间，较好和较差的眼睛的视野平均偏差平均减少具有统计学意义（p = <0.001）。在随访中，没有较差的眼睛被归类为低风险（绿色），而 96 只被归类为高风险（红色）。为了获得更好的眼睛，将风险提升到 Glauc-Strat-Fast 的最高层观察到患者在两次就诊之间增加了三倍（19 对 56）。