Can Home Perimetry Make Glaucoma Trials Faster?

Studies found that portable perimetry was less precise but that more frequent testing might facilitate earlier disease detection.

Andrew Pouw, MD

Glaucoma Today

Key Takeaways Recent studies evaluated whether portable perimetry could facilitate the earlier detection of glaucomatous progression. The lower precision of home perimetry might be offset with more frequent testing and might identify a greater proportion of the eyes experiencing slow disease progression. Real-world implementation of the home technologies requires further analysis. On the Feasibility of Accelerating Glaucoma Clinical Trials Using Portable Perimetry Tan JCK, Montesano G, Crowston J, Bell K, Crabb DP, Jones PR1 Industry support for this study: None ABSTRACT SUMMARY This cross-sectional study sought to determine whether more frequent portable (ie, home) perimetry could detect glaucomatous progression more quickly than traditional perimetry in a clinical trial setting. STUDY IN BRIEF A cross-sectional study compared test-retest variability with home perimetry using smartglasses (Eyecatcher 3.0, Irida Health) versus the Swedish Interactive Threshold Algorithm Fast (Humphrey Field Analyzer, Carl Zeiss Meditec). The results were then used to model the impact of different frequencies of portable perimetry on clinical trial duration and required sample sizes for detecting the effect of glaucoma treatment on disease progression. Although home visual field assessments were less reliable than standard clinic-based testing, the increased frequency was projected to allow faster or greater detection of glaucomatous progression. WHY IT MATTERS The earlier detection of glaucomatous progression could allow earlier treatment escalation and better prevent irreversible vision loss. Portable perimeters make home visual field testing feasible, which might reduce the logistical and economic burden of glaucoma monitoring while improving patients’ access to care. Increased testing frequency through home perimetry might also facilitate clinical trials that rely on visual field progression endpoints.

Three Major Acquisitions Announced in Ophthalmology

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Tarsus Pharmaceuticals enters into a definitive agreement to acquire Alkeus Pharmaceuticals; Harrow acquires dry eye disease nasal spray Tyrvaya from Viatris; and Italy-based Alfasigma enters into a share purchase agreement with Sever Life Sciences to acquire 100% of Nordic Pharma and its subsidiaries. Learn more about your ad choices. Visit megaphone.fm/adchoices

Using Data to Catch Problems Early

How operational safety nets can turn practice data into early warnings for workflow and reimbursement issues.

Bill James, MHA, COE

Retina Today

Key Takeaways Leadership at Talley Eye Institute used structured query language (SQL) programming to develop operational “scrubbers” to identify potential workflow, coding, and billing issues. The SQL-based program reported an unexpected change in the allowable reimbursement for aflibercept 8 mg (Eylea HD, Regeneron), allowing the practice to identify the issue before significant additional underpayments occurred. Proactive data reporting can help practices identify workflow gaps and reimbursement trends early, so that staff can intervene before small issues become larger operational or financial problems. As retina practices adjust to growing patient volumes, reduced reimbursement, employee turnover, and the introduction of new therapies (including biosimilars), the opportunity for operational mistakes is ever-present. At the same time, insurance companies are becoming increasingly aggressive in denying or underpaying claims for rendered services and intravitreal injections. In retina care, small operational misses can quickly become significant clinical or financial problems. While practice data is often used to monitor overall financial and operational performance, a deeper analytical approach can help identify workflow gaps, catch errors before they escalate, and monitor reimbursement at a granular level. IDENTIFYING THE PROBLEMS At Talley Eye Institute, we recognized that despite the best efforts of our staff, errors in appointment scheduling, coding, and billing can still occur. For example, patients may be added to the schedule after the day’s prior authorizations for injections or surgeries had been completed, creating gaps that are easy to miss in real time. To help ensure that intravitreal injections were reimbursed accurately, we identified areas where rare scheduling exceptions could create operational or financial consequences if left undetected.