Evaluation of remote assessment reliability in the follow-up of patients with diabetic macular edema

Author:

Bellot Lucas1ORCID,Anthony Norah2ORCID,Maucourant Yann1,Viana Michel1,Bussat Aurore3,Mouriaux Fréderic1

Affiliation:

1. Department of Ophthalmology, Centre hospitalo-universitaire de Rennes, Rennes, France

2. Department of Methodological Support and Biostatistics Unit, University Hospital, Saint Denis, Reunion Island

3. Department of Ophthalmology, Groupe hospitalier Bretagne Sud, Lorient, France

Abstract

Purpose To compare the reliability of office versus remote assessments in the decision to use intravitreal injection for patients with diabetic macular edema (DME). Method We retrospectively evaluated office and remote assessments for decision agreement regarding treatment by intravitreal injection or non-treatment for DME. Remote assessment consisted in remote evaluation of patient medical data by three reviewers with different skills. Two OCT analysis strategies were performed with the same office assessment data: 1) macular mapping with only two OCT B-scans passing through the fovea, and 2) macular mapping with complete macular scans. Agreement for treatment decisions and OCT analysis strategies were analysed using Cohen's Kappa coefficient (κ). Results Data from 49 patients (96 eyes) were included. Treatment decision agreement with two OCT B-scans passing through the fovea was considered excellent for all reviewers (κ between 0.80 and 0.85, varying between reviewers). Treatment decision agreement with complete macular scans was considered excellent (κ between 0.85 and 0.93, varying between reviewers). Agreement between the two OCT analysis strategies and reviewers was considered excellent. Conclusion Remote assessment in a telemedicine model can be a useful alternative for DME patient follow-up.

Publisher

SAGE Publications

Subject

Ophthalmology,General Medicine

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