Evaluating community vs. hospital-based multidisciplinary gl
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A variety of shared care models have been developed, which aim to stratify glaucoma patients according to risk of disease progression. Researchers aimed to compare rates of glaucomatous visual field progression in the Cambridge Community Optometrist Glaucoma Scheme (COGS) and Addenbrooke’s Hospital Glaucoma Clinic (AGC).

A retrospective comparative cohort review was performed. Patients with 5 or more visual field tests were included. Zeiss Forum software was used to calculate the MD progression rate (dB/year). Loss of sight years (LSY) were also calculated for both COGS and AGC. Overall, 8465 visual field tests from 854 patients were reviewed.

--In all, 362 eyes from the AGC group and 210 eyes from COGS were included.

--The MD deterioration rate was significantly lower in the COGS patients compared with the AGC group (-0.1 vs -0.3dB/year).

--No patients in the COGS group were predicted to become blind within their lifetime by LSY analysis. 15 patients were at risk in the AGC group.

In conclusion, this service assessment demonstrates that COGS is an efficient scheme for stratifying lower risk glaucoma patients, thus increasing capability within hospital eye services. As compared to AGC patients, COGS patients have a lower incidence of visual field degradation. Effective coordination between community and tertiary schemes is needed to promote the secure and efficient transfer of patients needing more hospital management, with the potential for low-risk patients to be followed safely in the community.

Source: https://www.nature.com/articles/s41433-021-01492-3?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed:+eye/rss/current+(Eye+-+Issue)