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Example of monitoring measurements in a virtual eye clinic using ‘big data’
  1. Lee Jones1,
  2. Susan R Bryan1,
  3. Marco A Miranda2,3,
  4. David P Crabb1,
  5. Aachal Kotecha3,4
  1. 1 Division of Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, UK
  2. 2 NIHR Biomedical Research Centre (BRC), Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, UK
  3. 3 Department of Visual Neuroscience, Faculty of Brain Sciences, Institute of Ophthalmology, University College London, London, UK
  4. 4 Department of Glaucoma Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK
  1. Correspondence to Dr Aachal Kotecha, Glaucoma Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK; aachalkotecha{at}


Aim To assess the equivalence of measurement outcomes between patients attending a standard glaucoma care service, where patients see an ophthalmologist in a face-to-face setting, and a glaucoma monitoring service (GMS).

Methods The average mean deviation (MD) measurement on the visual field (VF) test for 250 patients attending a GMS were compared with a ‘big data’ repository of patients attending a standard glaucoma care service (reference database). In addition, the speed of VF progression between GMS patients and reference database patients was compared. Reference database patients were used to create expected outcomes that GMS patients could be compared with. For GMS patients falling outside of the expected limits, further analysis was carried out on the clinical management decisions for these patients.

Results The average MD of patients in the GMS ranged from +1.6dB to −18.9dB between two consecutive appointments at the clinic. In the first analysis, 12 (4.8%; 95% CI 2.5% to 8.2%) GMS patients scored outside the 90% expected values based on the reference database. In the second analysis, 1.9% (95% CI 0.4% to 5.4%) GMS patients had VF changes outside of the expected 90% limits.

Conclusions Using ‘big data’ collected in the standard glaucoma care service, we found that patients attending a GMS have equivalent outcomes on the VF test. Our findings provide support for the implementation of virtual healthcare delivery in the hospital eye service.

  • glaucoma

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  • Contributors LJ: data analysis, data interpretation and manuscript preparation. SRB: data analysis, data interpretation and manuscript critique. MAM: data analysis and manuscript critique. DPC and AK: study design, data interpretation and manuscript critique.

  • Competing interests None declared.

  • Ethics approval Caldicott Guardian and Information Governance Lead at Moorfields Eye Hospital NHS Foundation Trust.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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