Abstract

SO.15.01

Relevance of telemedicine in diagnostics of glaucoma

Antal S.¹, Tost F.^2
1Department of Ophthalmology, University of Rostock, ²Department of Ophthalmology, University of Greifswald

Objective: The long-time-treatment of glaucoma requires a diagnostic tool, that describes the illness as exactly as possible. What is the advantage of the glaucoma-diagnostics by the use of telemetric self-measurement?
Methods: In a prospective study on health care a mobile device system for self-measurement of intra-ocular pressure (IOP) and blood pressure (BP) was placed at glaucoma-patients disposal at the Dept. of Ophthalmology, University of Greifswald. If BP- and IOP-recording were executed within the pre-determined time-interval, measuring-data enabled calculation of the ocular perfusion pressure (OPP) by the formula [2/3x (2/3xDBP+1/3xSBP)] - IOP automatically. The IOP- and OPP-range, occurring side-differences, as well as the individually highest eye-pressure- and blood pressure-values were represented in an electronic patient-file (EPF).
Results: Altogether, measurement-enrolments were registered at 153 patients. The measuring-frequency moved during a measuring-period of 2-7 months between 3-9 days. 61 patients, who had measured blood pressure and IOP frequently and regularly enough, were at the focus of interest. With such data an OPP-diurnal profile (DP) could be analyzed at least four times in the course. In this group between four and eleven IOP-DP were available and up to 11 OPP-DP had been documented. By this study on out-patient self-measurements information about the correlation between IOP, OPP and BP could be analysed. A significant correlation between the middle arterial blood pressure (MAP) and the OPP appeared; the highest significant correlation appeared between MAP and diastolic blood pressure.
Conclusions: The application of tele-medicine can improve glaucoma-diagnostics by out-patient self-measurements; in addition increase of frequency and diurnal variability of time course as well as continuity and regularity of the monitoring. Finally out-patient recording of IOP- and OPP-diurnal profiles is available. More over the telemetric information about hemodynamic auto-regulation may be of high assistance during monitoring of the course and beginning or changing the therapy.

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