Tele-Neuro-Ophthalmology During the Age of COVID-19

Lai, Kevin E; Ko, Melissa W.; Rucker, Janet C.; Odel, Jeffrey G.; Sun, Lillian; Winges, Kimberly M.; Ghosh, Arko; Bindiganavile, Shruthi Harish; Bhat, Nita; Wendt, Sydney; Scharf, J; Dinkin, Marc; Rasool, Nailyn; Galetta, Steven; Lee, Andrew G.

doi:10.1097/wno.0000000000001024

Cited by 30 publications

(26 citation statements)

References 20 publications

(22 reference statements)

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“…Telehealth modalities as a way to deliver neuro-ophthalmic care have been of interest in the profession for many years, as demonstrated by inclusion of symposia on this topic in the annual meetings of NANOS in 2013 and 2020 ( 4 , 5 ). During the COVID-19 pandemic, interest in and utilization in this area increased throughout the medical profession and in neuro-ophthalmology ( 3 , 6 ). In this study, we demonstrate increased telehealth utilization by neuro-ophthalmologists during the COVID-19 pandemic.…”

Section: Discussionmentioning

confidence: 99%

Survey of Telehealth Adoption by Neuro-ophthalmologists During the COVID-19 Pandemic: Benefits, Barriers, and Utility

Moss¹,

Lai

2020

Journal of Neuro-Ophthalmology

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Background: During the COVID-19 pandemic, telehealth modalities have come to prominence as a strategy for providing patient care when in-person care provision opportunities are limited. The degree of adoption by neuroophthalmologists has not been quantified. Methods: Telehealth utilization pre-COVID-19 and peri-COVID-19 was surveyed among practicing neuroophthalmologists in and outside the United States using an online platform. Demographics, perceived benefits, barriers, and utility for different neuro-ophthalmic conditions were collected. Data collection occurred over a 2-week period in May 2020. Results: Two hundred eight practicing neuroophthalmologists (81.3% United States, 50.2% females, age range ,35 to .65, mode 35-44 years) participated in the survey. Utilization of all telehealth modalities increased from pre-COVID to peri-COVID (video visit 3.9%-68.3%, P , 0.0005, remote interpretation of testing 26.7%-32.2%, P = 0.09, online second opinion 7.9%-15.3%, P = 0.001, and interprofessional e-consult 4.4%-18.7%, P , 0.0005, McNemar). The majority selected access, continuity, and patient efficiency of care as benefits and data quality as a barrier. Telehealth was felt to be most helpful for conditions relying on history, external examination, and previously collected ancillary testing and not helpful for conditions requiring funduscopic examination. Conclusions: Telehealth modality usage by neuroophthalmologists increased during the COVID-19 pandemic. Identified benefits have relevance both during and beyond COVID-19. Further work is needed to address barriers in their current and future states to maintain these modalities as viable care delivery options.

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Section: Discussionmentioning

confidence: 99%

Survey of Telehealth Adoption by Neuro-ophthalmologists During the COVID-19 Pandemic: Benefits, Barriers, and Utility

Moss¹,

Lai

2020

Journal of Neuro-Ophthalmology

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“…Telemedicine may offer a safe alternative to traditional office visits but only in appropriate patient and health care systems, 24 and can help to prevent treatment delay-related damage for maculopathies. This approach may be applied to other areas in ophthalmology such as oculoplastics, 25 neuro-ophthalmology, 26 and pediatrics ophthalmology, 27 in which many of these examinations can be performed externally and also in other fields in medicine such as radiology, cardiology, pathology and emergency services during the COVID-19 pandemic.…”

Section: Discussionmentioning

confidence: 99%

<p>Hybrid Telehealth Medical Retina Clinic Due to Provider Exposure and Quarantine During COVID-19 Pandemic</p>

Aweidah¹,

Safadi²,

Jotkowitz³

et al. 2020

OPTH

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To present our hybrid telehealth medical retina clinic service with intravitreal injections (IVI) treatment as a safe alternative to in-person visits and examination during COVID-19 pandemic disease. Methods: Due to exposure to a COVID-19 positive retina fellow, our retina service, in quarantine, evaluated patients' medical files and retinal scans using a telemedicine approach. A different protocol for patients coming for IVI during the COVID-19 pandemic was established for IVI administration. Results: During the 14-day quarantine period (between March 18th and March 31st 2020), the hybrid telehealth medical retina clinic performed 523 IVI to 394 patients with a mean age ± SD 70.96 ± 14.4 years. IVI were administered for neovascular age-related macular degeneration in 50.5% of the cases (199 patients), diabetic macular edema in 21.3% (84 patients), retinal vein occlusion in 17.5% (69 patients), and 10.7% for other retinal pathologies (42 patients). No ocular or systemic complications were observed. Conclusion: During disasters and pandemics, IVI can be provided safely using a hybrid telehealth medical retina clinic approach but only in the appropriate patient and health care system.

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“…Video visits, phone visits, online portal communication, provider-to-provider Consultation (“E-consult”), home testing with a smartphone for color vision and tablet for perimetry are all implementations of teleophthalmology that have been investigated and are utilized in neuro-ophthalmology practices, without replacing but facilitating clinical practice [ 98 ].…”

Section: Reviewmentioning

confidence: 99%

Teleophthalmology and Artificial Intelligence As Game Changers in Ophthalmic Care After the COVID-19 Pandemic

Nikolaidou¹,

Tsaousis

2021

Cureus

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The current COVID-19 pandemic has boosted a sudden demand for telemedicine due to quarantine and travel restrictions. The exponential increase in the use of telemedicine is expected to affect ophthalmology drastically. The aim of this review is to discuss the utility, effectiveness and challenges of teleophthalmological new tools for eyecare delivery as well as its implementation and possible facilitation with artificial intelligence. We used the terms: "teleophthalmology," "telemedicine and COVID-19," "retinal diseases and telemedicine," "virtual ophthalmology," "cost effectiveness of teleophthalmology," "pediatric teleophthalmology," "Artificial intelligence and ophthalmology," "Glaucoma and teleophthalmology" and "teleophthalmology limitations" in the database of PubMed and selected the articles being published in the course of 2015-2020. After the initial search, 321 articles returned as relevant. A meticulous screening followed and eventually 103 published manuscripts were included and used as our references. Emerging in the market, teleophthalmology is showing great potential for the future of ophthalmological care, benefiting both patients and ophthalmologists in times of pandemics. The spectrum of eye diseases that could benefit from teleophthalmology is wide, including mostly retinal diseases such as diabetic retinopathy, retinopathy of prematurity, age-related macular degeneration but also glaucoma and anterior segment conditions. Simultaneously, artificial intelligence provides ways of implementing teleophthalmology easier and with better outcomes, contributing as significant changing factors for ophthalmology practice after the COVID-19 pandemic.

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Tele-Neuro-Ophthalmology During the Age of COVID-19

Cited by 30 publications

References 20 publications

Survey of Telehealth Adoption by Neuro-ophthalmologists During the COVID-19 Pandemic: Benefits, Barriers, and Utility

Survey of Telehealth Adoption by Neuro-ophthalmologists During the COVID-19 Pandemic: Benefits, Barriers, and Utility

<p>Hybrid Telehealth Medical Retina Clinic Due to Provider Exposure and Quarantine During COVID-19 Pandemic</p>

Teleophthalmology and Artificial Intelligence As Game Changers in Ophthalmic Care After the COVID-19 Pandemic

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