Predictors of narrow angle detection rate—a longitudinal study of Massachusetts residents over 1.7 million person years

Lee, Cecilia S.; Lee, Michael L.; Yanagihara, Ryan T.; Lee, Aaron

doi:10.1038/s41433-020-1003-0

Cited by 7 publications

(1 citation statement)

References 24 publications

(9 reference statements)

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“…Both optometrists and ophthalmologists are critical in the delivery of eye care in the US, although their training requirements vary, and the impact of expanded access on quality of care and other outcomes should be investigated in future studies. Given concerns about quality of care per previous literature and the lack of evidence for improved access to care in our study, careful consideration should be given before supporting additional scope of practice expansion.…”

Section: Discussionmentioning

confidence: 99%

Evaluating Access to Laser Eye Surgery by Driving Times Using Medicare Data and Geographical Mapping

et al. 2023

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ImportanceRecently, several states have granted optometrists privileges to perform select laser procedures (laser peripheral iridotomy, selective laser trabeculoplasty, and YAG laser capsulotomy) with the aim of increasing access. However, whether these changes are associated with increased access to these procedures among each state’s Medicare population has not been evaluated.ObjectiveTo compare patient access to laser surgery eye care by estimated travel time and 30-minute proximity to an optometrist or ophthalmologist.Design, Setting, and ParticipantsThis retrospective cohort database study used Medicare Part B claims data from 2016 through 2020 for patients accessing new patient or laser eye care (laser peripheral iridotomy, selective laser trabeculoplasty, YAG) from optometrists or ophthalmologists in Oklahoma, Kentucky, Louisiana, Arkansas, and Missouri. Analysis took place between December 2021 and March 2023.Main Outcome MeasuresPercentage of each state’s Medicare population within a 30-minute travel time (isochrone) of an optometrist or ophthalmologist based on US census block group population and estimated travel time from patient to health care professional.ResultsThe analytic cohort consisted of 1 564 307 individual claims. Isochrones show that optometrists performing laser eye surgery cover a geographic area similar to that covered by ophthalmologists. Less than 5% of the population had only optometrists (no ophthalmologists) within a 30-minute drive in every state except for Oklahoma for YAG (301 470 [7.6%]) and selective laser trabeculoplasty (371 097 [9.4%]). Patients had a longer travel time to receive all laser procedures from optometrists than ophthalmologists in Kentucky: the shortest median (IQR) drive time for an optometrist-performed procedure was 49.0 (18.4-71.7) minutes for YAG, and the the longest median (IQR) drive time for an ophthalmologist-performed procedure was 22.8 (12.1-41.4) minutes, also for YAG. The median (IQR) driving time for YAG in Oklahoma was 26.6 (12.2-56.9) for optometrists vs 22.0 (11.2-40.8) minutes for ophthalmologists, and in Arkansas it was 90.0 (16.2-93.2) for optometrists vs 26.5 (11.8-51.6) minutes for ophthalmologists. In Louisiana, the longest median (IQR) travel time to receive laser procedures from optometrists was for YAG at 18.5 (7.6-32.6) minutes and the shortest drive to receive procedures from ophthalmologists was for YAG at 20.5 (11.7-39.7) minutes.Conclusions and RelevanceAlthough this study did not assess impact on quality of care, expansion of laser eye surgery privileges to optometrists was not found to lead to shorter travel times to receive care or to a meaningful increase in the percentage of the population with nearby health care professionals.

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Section: Discussionmentioning

confidence: 99%

Evaluating Access to Laser Eye Surgery by Driving Times Using Medicare Data and Geographical Mapping

et al. 2023

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Personalized Management of Physiologic/Ophthalmologic Particularities for Predictive Approach and Targeted Prevention of Primary Angle Closure Glaucoma Applied to Persons at Risk

Kurysheva,

Rodionova,

Pomerantsev

et al. 2024

Advances in Predictive, Preventive and Personalised Medicine

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Diagnostic accuracy of AS-OCT vs gonioscopy for detecting angle closure: a systematic review and meta-analysis

Desmond

Tran

Maharaj

et al. 2021

Graefes Arch Clin Exp Ophthalmol

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Purpose This study aims to review the literature that compares the accuracy of Anterior Segment-Optical Coherence Tomography (AS-OCT) against gonioscopy in detecting eyes with angle closure. It is currently unclear how AS-OCT fits into clinical practice for detecting angle closure. This is a systematic review and meta-analysis. Methods A literature search was performed on Medline, Embase, Scopus and the Cochrane Central Register of Controlled Trials to identify studies that investigated the diagnostic accuracy of AS-OCT in detecting eyes with angle closure as diagnosed by gonioscopy. Eligible studies included in the analysis met stringent inclusion criteria determining the sensitivity and specificity of AS-OCT. Results The initial search identified 727 studies, of which 23 were included in the final analysis. We found substantial variation in the parameters being studied and methodologies. The sensitivity of AS-OCT ranged from 46 to 100% (median 87%). Twenty-one studies identified parameters that showed sensitivity above 80%. The specificity ranged from 55.3 to 100% (median 84%). Conclusion AS-OCT demonstrates good sensitivity for detecting angle closure. It may provide an avenue to address high rates of undiagnosed angle closure, such as found in developing Asian countries. However, AS-OCT is not yet able to replace gonioscopy. Clinicians should consider whether the diagnostic accuracy of AS-OCT is acceptable for their specific clinical use before adopting it. More studies are needed to determine the utility of AS-OCT, including longitudinal studies to determine the significance of eyes classified to have closed angles by AS-OCT but open on gonioscopy. Supplementary Information The online version contains supplementary material available at 10.1007/s00417-021-05271-4.

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Predictors of narrow angle detection rate—a longitudinal study of Massachusetts residents over 1.7 million person years

Cited by 7 publications

References 24 publications

Evaluating Access to Laser Eye Surgery by Driving Times Using Medicare Data and Geographical Mapping

Evaluating Access to Laser Eye Surgery by Driving Times Using Medicare Data and Geographical Mapping

Personalized Management of Physiologic/Ophthalmologic Particularities for Predictive Approach and Targeted Prevention of Primary Angle Closure Glaucoma Applied to Persons at Risk

Diagnostic accuracy of AS-OCT vs gonioscopy for detecting angle closure: a systematic review and meta-analysis

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