Brandão-de-Resende Camilo, Alcântara Liliane de Abreu Rosa de, Vasconcelos-Santos Daniel Vítor, Diniz-Filho Alberto
Clinical Research Facility, Moorfields Eye Hospital, National Health Service Foundation Trust, London, UK.
Department of Ophthalmology and Otorhinolaryngology, School of Medicine, and Telehealth Center, Clinical Hospital, Federal University of Minas Gerais, Belo Horizonte, Brazil.
J Glaucoma. 2023 May 1;32(5):327-332. doi: 10.1097/IJG.0000000000002200. Epub 2023 Feb 28.
Teleglaucoma is the future, but there is a need for clearer regulation by government agencies and medical entities, as well as for studies to further demonstrate the cost-effectiveness and safety of teleglaucoma strategies at a global scale.
The coronavirus disease 2019 pandemic drastically impacted global health, forcing institutions to provide alternative models of safe and reliable health care. In this context, telemedicine has been successfully used to overcome distance barriers and improve access to medical services. Teleglaucoma is the application of telemedicine to screen and monitor glaucoma, a chronic and progressive optic neuropathy. Teleglaucoma screening aims to detect the disease at an earlier stage, especially in high-risk populations and underserved areas, also identifying patients who require more urgent treatment. Teleglaucoma monitoring seeks to provide remote management through virtual clinics, where classic in-person visits are replaced by synchronous data collection (clinical measurements) performed by non-ophthalmologists and asynchronous review (decision-making) by ophthalmologists. This may be employed for low-risk patients with early disease, improving health care logistics, reducing the number of face-to-face consultations, and saving time and costs. New technologies may also allow home monitoring of patients in teleglaucoma programs, with the addition of artificial intelligence methods, which are expected to increase the accuracy of remote glaucoma screening/monitoring and support clinical decision-making. However, for the incorporation of teleglaucoma into clinical practice, a complex system for collection, transfer, flow, and interpretation of data is still necessary, in addition to clearer regulatory markers by government agencies and medical entities.
远程青光眼诊疗是未来发展方向，但政府机构和医疗实体需要更清晰的监管，同时也需要开展研究，以在全球范围内进一步证明远程青光眼诊疗策略的成本效益和安全性。
2019年冠状病毒病疫情对全球健康产生了巨大影响，迫使各机构提供安全可靠的替代医疗模式。在此背景下，远程医疗已成功用于克服距离障碍并改善医疗服务的可及性。远程青光眼诊疗是将远程医疗应用于青光眼的筛查和监测，青光眼是一种慢性进行性视神经病变。远程青光眼筛查旨在更早地检测出该病，尤其是在高危人群和医疗服务不足的地区，同时识别出需要更紧急治疗的患者。远程青光眼监测旨在通过虚拟诊所提供远程管理，在虚拟诊所中，传统的面对面就诊被非眼科医生进行的同步数据收集（临床测量）和眼科医生进行的异步评估（决策）所取代。这可用于患有早期疾病的低风险患者，改善医疗后勤，减少面对面会诊次数，节省时间和成本。新技术还可能允许在远程青光眼项目中对患者进行家庭监测，并增加人工智能方法，预计这将提高远程青光眼筛查/监测的准确性并支持临床决策。然而，要将远程青光眼诊疗纳入临床实践，除了政府机构和医疗实体要有更清晰的监管标志外，还需要一个复杂的数据收集、传输、流转和解读系统。
