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Merina Thomas, Shiri Zayit-Soudry, Peggy R. Orr, Susan B. Bressler, Neil M. Bressler; Preferential Hyperacuity Perimetry Home Monitoring in Patients at High Risk or Following Treatment for Neovascular Age-related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2011;52(14):125.
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To determine the ability of study participants at high risk or following treatment (but not needing treatment at current visit) for neovascular age-related macular degeneration (AMD) to qualify to use the ForeseeHomeTM (Notal Vision, Tel Aviv) preferential hyperacuity perimetry (PHP) for home monitoring, and to determine the relationship between the qualification score on the PHP home device and the participant’s demographic and baseline ocular features.
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 or following treatment 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). Demographics and baseline ocular features were recorded from the chart. Before entry to the study, participants completed an initial PHP test on the study eye (or better-seeing eye if both eyes were eligible). Participants with an unreliable test (i.e., test with a pre-determined insufficient percentage of correct responses or excess of non-responded stimuli) did not qualify to use the PHP for home monitoring and were exited from the study. High risk patients also required a test score relative to a previously determined cut-off value that distinguishes between intermediate AMD and newly diagnosed CNV patients (sensitivity and specificity: 85% each) to remain in the study.
Among the 43 study participants who attempted the qualification test, 34 participants were at high risk and 9 participants were following treatment. 27 (79%, 95% confidence interval [CI] 63% to 90%) of 34 eyes at high risk and 8 eyes (89%, 95% CI 54% to >99 %) of 9 eyes following treatment produced reliable qualifying tests.
These findings suggest that a majority of patients from a clinical practice setting at high risk or following treatment (but not needing treatment at a current visit) for neovascular AMD qualify to use the ForeseeHomeTM PHP for home monitoring of changes suggestive of new fluorescein angiographic leakage of choroidal neovascularization. Longitudinal studies are underway to correlate PHP changes to clinical changes.
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