Effectiveness of Different Monitoring Modalities in the Detection of Neovascular Age-Related Macular Degeneration: The Home Study, Report Number 3

Publication Type
Journal Article
Year of Publication
2016
Authors
Chew, EY; Clemons, TE; Harrington, M; Bressler, SB; Elman, MJ; Kim, JE; Garfinkel, R; Heier, JS; Brucker, A; Boyer, D; AREDS2-HOME Study Research Group
Secondary
Retina
Volume
36
Start Page
1542
Pagination
1542-1547
Date Published
08/2016
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.