Glaucoma
Conditions
Keywords
optical coherence tomography, tonometry, glaucoma, screening
Brief summary
The vast majority of glaucoma cases in the United States go undetected and untreated until the late stages of the disease. Open-angle glaucoma is a progressive condition that is asymptomatic in its early to moderate stages and may be amenable to screening through telemedicine-based approaches. This study is a randomized trial to evaluate whether glaucoma screening with established tests (e.g., optical coherence tomography, fundus photography, and tonometry) is more effective for detecting undiagnosed glaucoma cases compared to education alone or delayed intervention.
Detailed description
Specific Aim 1: To determine the effectiveness of a telemedicine-based glaucoma screening program for detecting glaucoma. The investigators hypothesize that a mobile screening intervention incorporating optical coherence tomography (OCT), fundus photography, and tonometry will result in a greater number of new glaucoma diagnoses compared to education alone or delayed treatment. Specific Aim 2: To determine whether a telemedicine-based glaucoma screening program provides benefits beyond glaucoma detection. The investigators hypothesize that (A) individuals randomized to the screening intervention will have higher rates of cataract surgery and distance vision correction one year after screening, and (B) those in the screening intervention will report higher vision-related quality of life one year after screening.
Interventions
OTHERGlaucoma screening with optical coherence tomography (OCT), color fundus photography, and tonometry
Participants will be called and offered a screening appointment. At the appointment, visual acuity, OCT, color fundus photography, tonometry, and visual field testing will be performed. The images will be assessed for abnormalities. Participants meeting referral criteria will be referred for a comprehensive eye examination with an eye care provider.
OTHEREducational Brochure
A brochure about glaucoma screening will be mailed to participants. The brochure will include contact information of a staff member who can schedule an appointment for a comprehensive eye examination.
Sponsors
University of California, San Francisco
Centers for Disease Control and Prevention
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SCREENING
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
50 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Black people aged 50 years or older * Hispanic people aged 65 years or older * People with diabetes aged 50 years or older * Must have been seen at the Federally Qualified Health Center (FQHC) within the past month
Exclusion criteria
* Patients without a valid phone number or mailing address * Patients who have had an optometry appointment within the past year
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Glaucoma Diagnosis or Glaucoma Suspect Requiring Treatment | 3 months from randomization |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Cataract surgery | 12 months | Self-reported cataract surgery |
| Eyeglasses | 12 months | Self-reported purchase of new distance eyeglasses |
| Quality of Life survey | 12 months | Self-reported quality of life on VisQol instrument |
Countries
United States
Contacts
CONTACTAtnasia Mekonnen, MS
CONTACTDionna Wittberg, MPH
PRINCIPAL_INVESTIGATORJeremy D Keenan, MD, MPH
University of California, San Francisco
PRINCIPAL_INVESTIGATORYvonne Ou, MD
University of California, San Francisco
Outcome results
None listed