Loewenstein A. Improving adherence and outcomes in AMD therapy: Home monitoring. Presented at: Euretina; Oct. 2-4, 2020 (virtual meeting).
OCT system used at home demonstrates potential for daily monitoring of AMD
The Notal Vision home OCT system performed well in real-world situations in which patients themselves prompted and used the machine in their home environment.
“They had the OCT delivered, had to unpack it, set it up, establish all the connections and use it according to the instructions given in a 2-minute tutorial,” Anat Loewenstein, MD, MHA, said at the virtual Euretina meeting.
Home OCT is a technology that allows cloud-based information generated at home by the patients to be automatically analyzed by a machine-learning algorithm. If retinal fluid is detected, a report is generated and conveyed to the treating physician. Office-based experiments with the technology showed that 90% of patients with age-related macular degeneration (AMD) were able to self-operate the machine, and that the images from this technology compared well with images taken at the same time with a commercial OCT, with both a positive and negative percent agreement of more than 93%.
Five patients were included in this further stage of the study and were followed for 1 month.
“We had amazing results. The technology was able to detect fluid at the level of picoliters. This allowed us to see that one patient who had no fluid at the last visit already had a small increase 4 days later. After another 14 days, there was a big peak. The patient was injected and 4 days after injection the fluid disappeared. You can monitor closely how a patient responds to a certain drug,” Loewenstein said.
Such close monitoring of the disease would allow physicians to treat patients in a precise, timely manner. Accurate as-needed dosing would be tailored to the patient’s needs, making it possible to know exactly how much a treat-and-extend interval can be extended, she said.
“The implications are huge in terms of improving adherence, saving time and optimizing outcomes,” Loewenstein said.