Effectiveness of different monitoring modalities in the detection of neovascular agerelated macular degeneration: The home study, report number 3

Emily Y. Chew, Traci E. Clemons, Molly Harrington, Susan B. Bressler, Michael J. Elman, Judy E. Kim, Richard Garfinkel, Jeffrey S. Heier, Alexander Brucker, David Boyer

Research output: Contribution to journalArticle

Abstract

Purpose: To determine the effectiveness of different monitoring modalities to detect incident neovascularization associated with age-related macular degeneration (AMD). Methods: Secondary analyses compared the rates of detecting incident neovascular AMD in prescheduled office visits versus office visits triggered by monitoring device or by symptom realization in a randomized trial evaluating home telemonitoring device plus standard care (device arm) versus standard care alone. Results: At prescheduled office visits, neovascular AMD was detected in 14/1927 visits (0.7%, 95% confidence interval [CI]: 0.4%-1.1%) and 14/1949 visits (0.7%, 95% CI: 0.3%- 1.1%) in the device and standard care alone arms, respectively. Thirty-seven participants with neovascular AMD were detected in 318 office visits (11.6%, 95% CI: 8.1%-15.2%) triggered by device or symptom realization and 17 neovascular AMD in 65 office visits (26%, 95% CI: 15.5%-36.8%) triggered by symptom realization in the device and standard care alone arms, respectively. The home device strategy had a higher neovascular-AMD detection rate than prescheduled office visits (relative risk = 16.0 [95% CI: 8.8-29.3]). Neovascular AMD detected at triggered visits were associated with less vision loss from baseline in the device arm versus standard care alone arm (-3 letters vs. -11.5 letters, respectively, P = 0.03). Conclusion: Telemonitoring may alter the management of patients with AMD and improve vision outcomes.

Original languageEnglish (US)
Pages (from-to)1542-1547
Number of pages6
JournalRetina
Volume36
Issue number8
DOIs
StatePublished - Jul 26 2016

Keywords

  • Age-related macular degeneration
  • Incident choroidal neovascularization
  • Telemonitoring

ASJC Scopus subject areas

  • Ophthalmology

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    Chew, E. Y., Clemons, T. E., Harrington, M., Bressler, S. B., Elman, M. J., Kim, J. E., Garfinkel, R., Heier, J. S., Brucker, A., & Boyer, D. (2016). Effectiveness of different monitoring modalities in the detection of neovascular agerelated macular degeneration: The home study, report number 3. Retina, 36(8), 1542-1547. https://doi.org/10.1097/IAE.0000000000000940