The evaluation of a novel tool to remotely assess visual acuity in chronic uveitis patients during the COVID-19 pandemic

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Abstract

Background

Restrictions due to the recent COVID-19 pandemic catalysed the deployment of telehealth solutions. A novel web‐based visual acuity test, validated in a healthy population, may be of great value in the follow‐up of uveitis patients.

Objective

To determine the measurement accuracy of the unsupervised remote Easee web‐based visual acuity test in uveitis patients, when compared to a conventional in‐hospital assessment.

Methods

Cross‐sectional diagnostic accuracy study. Between April 2020 and September 2020, consecutive adult uveitis patients were invited for the web‐based visual acuity test (index test) within two weeks prior to their conventional in‐hospital assessment (reference test).

Results

A total of 269 patients were invited by mail, of whom 84 visited the website (31%). Ultimately 98 eyes met the criteria for statistical analysis. The mean difference between the two tests was low and non‐significant: 0.02 logMAR (SD 0.12, P = 0.085). The 95% limits of agreement ranged from ‐0.21 to 0.26 logMAR. No relevant differences were identified in clinical characteristics between subgroups with a good performance (i.e. difference between the tests 0.15 logMAR) or underperformance (i.e. difference >0.15 logMAR) on the web‐based test.

Conclusion

The web‐based visual acuity test is a promising tool to remotely assess visual acuity in the majority of uveitis patients, especially relevant when access to ophthalmic care is limited. No association between patient‐ or uveitis‐related variables and (under)performance of the test were identified. These outcomes underline the potential of remote vision testing in other common ophthalmic conditions. A proper implementation of this web‐based tool in health care could be of great value for revolutionizing teleconsultations.

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