Home OCT Imaging for Newly Diagnosed Neovascular Age-Related Macular Degeneration: A Feasibility Study.
Ophthalmol Retina 2024;
8:376-387. [PMID:
37879537 PMCID:
PMC10997472 DOI:
10.1016/j.oret.2023.10.012]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 10/03/2023] [Accepted: 10/17/2023] [Indexed: 10/27/2023]
Abstract
OBJECTIVE
To assess the feasibility of daily Home OCT imaging among patients with neovascular age-related macular degeneration (nAMD).
DESIGN
Prospective observational study.
PARTICIPANTS
Participants with ≥ 1 eye with previously untreated nAMD and visual acuity 20/20 to 20/320.
METHODS
Participants meeting the ocular eligibility criteria were considered for enrollment; those who provided consent received a Notal Vision Home OCT device. Participants were instructed to scan both eyes daily. Retina specialists managed treatment according to their standard practice, without access to the Home OCT data. The presence of fluid detected by a reading center (RC) from in-office OCT scans was compared with fluid volumes measured by the Notal OCT Analyzer (NOA) on Home OCT images.
MAIN OUTCOME MEASURES
Proportion of participants meeting ocular eligibility criteria who participated in daily scanning, frequency and duration of scanning, proportion of scans eligible for fluid quantification, participant experience with the device, agreement between the RC and NOA fluid determinations, and characteristics of fluid dynamics.
RESULTS
Among 40 participants meeting ocular eligibility criteria, 14 (35%) initiated self-scanning. Planned travel (n = 7, 17.5%) and patient-reported inadequate cell reception for the upload of images (n = 5, 12.5%) were the most frequent reasons for not participating. Considering scans of the study eye only, the mean (standard deviation) was 6.3 (0.6) for weekly scanning frequency and 47 (17) seconds for scan duration per eye. Among 2304 scans, 86.5% were eligible for fluid quantification. All participants agreed that scanning became easier over time, and only 1 did not want to continue daily scanning. For 35 scan pairs judged as having fluid by in-office OCT, the NOA detected fluid on 31 scans (89%). For 14 scan pairs judged as having no fluid on in-office OCT, the NOA did not detect fluid on 10 scans (71%). Daily fluid patterns after treatment initiation varied considerably between patients.
CONCLUSIONS
For patients with nAMD who initiated home scanning, frequency and quality of scanning and accuracy of fluid detection were sufficient to assess the monitoring of fluid at home. Accommodations for travel and Wi-Fi connectivity could improve uptake of the Home OCT device.
FINANCIAL DISCLOSURE(S)
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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