Teleophthalmology-based evaluations and screenings for patients with diagnosed or suspected diabetic retinopathy (DR) have proven to be largely effective in many studies over the past several years. Patients who might not have been able to travel or access in-person medical care before now have the opportunity to receive critical and preventative medical care through expanding remote telehealth options, which offers convenience to doctors as well. Now thanks to fifth-generation (5G) wireless connectivity, remote laser treatment may also be a safe and effective option for some DR patients.
Six participants in Huzhou, China with severe proliferative DR (five eyes) or nonproliferative DR (four eyes) agreed to undergo real-time telemedicine-mediated laser photocoagulation. Prior to treatment, they also completed in-person visual acuity testing, noncontact intraocular pressure measurements, slit-lamp biomicroscopy, dilated exams, color fundus photography and fluorescein angiography prior to laser treatment. Six eyes underwent panretinal photocoagulation (PRP), one eye underwent focal/grid photocoagulation and two eyes underwent both.
To complete the exams, doctors in the study used a laser system for navigated retinal photocoagulation, a remote computer control platform, video-conference software and 5G networks for high-speed data transmission.
Photocoagulation was successfully completed in every participant with no adverse reactions. There was no signal loss, buffering or pixelation that occurred, and no significant network delay was observed. Researchers detected a mean network latency of just 20 milliseconds, which they believe had no impact on the effectiveness of treatment. The average PRP laser spots per eye in a single session was 913.
As far as patient treatment results, none of them experienced deterioration with respect to DR stage or classification. Some are even continuing remote laser treatment post-study, as virtual appointments are much more accessible in many rural areas of China. However, perhaps especially with the newness of virtual treatments, follow-ups cannot be neglected.
Research shows that “15% of eyes with PDR treated with PRP require vitrectomy within two years, so continued close follow-up after PRP is also important,” the researchers wrote in their paper. “Virtual vision self-checks may be of help in the future.”
Though the above study only included six people, the future looks hopeful with all the possibilities of teleophthalmology. High-speed 5G and the rapid advancement of technology will help you continually expand your practice and improve relationships with patients, even those who are unable to step into the office.
Chen H, Pan X, Yang J, et al. Application of 5g technology to conduct real-time teleretinal laser photocoagulation for the treatment of diabetic retinopathy. JAMA Ophthalmol. July 8, 2021. Epub ahead of print.