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Merina Thomas, Yulia Wolfson, Voraporn Chaikitmongkol, Susan B Bressler, Neil M Bressler; Qualifying to Use a Preferential Hyperacuity Perimetry Home Device Prior to Monitoring for Neovascular Age-related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2014;55(13):1645. doi: https://doi.org/.
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To determine the ability of study participants with the intermediate stage of age-related macular degeneration (AMD) to qualify and establish a baseline to use the ForeseeHome™ (Notal Vision, Tel Aviv) preferential hyperacuity perimetry (PHP) for home monitoring within a clinic setting.
Following approval by the Johns Hopkins University School of Medicine’s Institutional Review Board, all eligible participants had the following criteria: age 55 or older, at high risk for neovascular AMD, ability to use a standard computer mouse correctly without assistance, and visual acuity with habitual correction of 20/63 or better in the study eye(s). Consented participants completed an initial PHP test on the study eye to determine if the participant was likely to qualify to use the device at home successfully using the algorithm provided during the study period. Among qualified participants, 5 stable test scores at home were required to determine if a baseline could be established to permit monitoring for development of neovascular AMD.
Between October 2010 and May 2011, of the 131 patients with the intermediate stage of AMD in at least 1 eye who were enrolled, 129 (98%, 95% confidence interval: 94% to 99.9%) had a reliable test while 91 (69%, 95% confidence interval: 61% to 77%) had a test score suggesting that it was likely they would use the device at home successfully. All 91 were able to set up the device, 86 began testing (4 withdrew before starting first test; 95% CI: 87% to 98%), and 82 of 86 (95%, 95% CI: 88% to 99%) were able to establish a baseline after 5 at-home tests. In a retrospective review of the 38 who did not qualify, 2 developed CNV, both almost one year after failing to qualify. Of the 4 who qualified but were not able to establish a baseline, 2 developed CNV, both within one year of being unable to establish baseline.
These data suggest that most patients who have the intermediate stage of AMD should produce a reliable test when first using a home device PHP and between 61% to 77% likely will pass a qualification test to initiate at home monitoring, among whom 88% to 99% likely will establish a baseline after 5 at-home tests to permit monitoring for progression to neovascular AMD.
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