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Mapping vision loss of patients in a glaucoma backlog following the COVID-19 pandemic: a real-world analysis using the Glauc-Strat-Fast risk stratification tool

Eye volume 38, pages 1005–1011 (2024)Cite this article

Subjects

Abstract

Introduction

Glauc-Strat-Fast is a clinical tool recommended by The Royal College of Ophthalmologists to classify glaucoma patients into strata of risk for significant future sight loss and an estimate of resource requirement. The aim of this study was to map the movement of glaucoma patients across stratification boundaries on Glauc-Strat-Fast during the COVID-19 pandemic.

Subjects and methods

Glauc-Strat-Fast was applied to a consecutive sample of 100 primary open angle glaucoma patients in a backlog at Worcestershire Acute Hospitals NHS Trust. Stratification outcomes were compared between clinic visits prior to the COVID-19 pandemic versus the follow-up visit. Patients were stratified twice separately based on their worse eye (i.e., most affected) and better eye (i.e., least affected) according to Glauc-Strat-Fast.

Results

Amount of slippage (difference between target follow-up and actual follow-up) ranged from 2 to 32 months. There was a statistically significant average reduction in visual field mean deviation for better and worse eyes between visits (p = <0.001). At follow-up, no worse eyes were classified as being low risk (green), while 96 were classified as high risk (red). For better eyes, elevation of risk into the highest strata of Glauc-Strat-Fast observed a three-fold increase in patients (19 versus 56) between visits.

Discussion

This retrospective real-world analysis highlights patients’ movement into the highest strata on the Glauc-Strat-Fast tool and demonstrates a significant deterioration in visual outcomes during a period of extensive appointment slippage. The findings demonstrate the utility of Glauc-Strat-Fast as a tool for improved patient management.

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Fig. 1: Glaucoma risk stratification tool ‘Glauc-Strat-Fast’.
Fig. 2: Jones-Shah boxplot showing distribution of stratification outcomes according to worse eye MD of 100 patients on Glauc-Strat-Fast between clinic appointments.
Fig. 3: Jones-Shah boxplot showing distribution of stratification outcomes according to better eye MD of 100 patients on Glauc-Strat-Fast between clinic appointments.

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Author information

Authors and Affiliations

  1. Medical School, University of Nottingham, Nottingham, UK

    Ojasvi Sharma

  2. University College London, Institute of Ophthalmology, London, UK

    Lee Jones & Peter Shah

  3. BRAVO VICTOR, Department of Research, London, UK

    Lee Jones

  4. Birmingham Institute for Glaucoma Research, Institute of Translational Medicine, Birmingham, UK

    Lee Jones, Freda Sii, Simon Dulku & Peter Shah

  5. Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK

    Freda Sii, Jonathan Whittaker, Simon Dulku & Peter Shah

  6. Department of Ophthalmology, Mater Hospital, Brisbane, QLD, Australia

    Graham Lee

  7. University of Queensland, Brisbane, QLD, Australia

    Graham Lee

  8. Department of Ophthalmology, Queen Alexandra Hospital, Portsmouth, UK

    James Kirwan

  9. Worcestershire Acute Hospitals NHS Trust, Ophthalmology Department, Worcester, UK

    Tarun Sharma

  10. University of Wolverhampton, Centre for Health and Social Care Improvement, Wolverhampton, UK

    Peter Shah

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  1. Ojasvi Sharma
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Contributions

OS: Data acquisition, Data analysis, Revising the manuscript. LJ: Data analysis, Data visualisation, Writing the manuscript. FS: Conceptualisation, Data analysis, Revising the manuscript. JW: Data analysis, Revising the manuscript. SD: Revising the manuscript. GL: Revising the manuscript. JK: Revising the manuscript. TS: Conceptualisation, Data acquisition, Revising the manuscript. PS: Conceptualisation, Data analysis, Data Visualisation, Revising the manuscript.

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Correspondence to Tarun Sharma.

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Sharma, O., Jones, L., Sii, F. et al. Mapping vision loss of patients in a glaucoma backlog following the COVID-19 pandemic: a real-world analysis using the Glauc-Strat-Fast risk stratification tool. Eye 38, 1005–1011 (2024). https://doi.org/10.1038/s41433-023-02821-4

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