July 2018
Volume 59, Issue 9
Free
ARVO Annual Meeting Abstract  |   July 2018
Home-monitoring by age-related macular degeneration patients using a tablet perimeter.
Author Affiliations & Notes
  • Selwyn Marc Prea
    Optometry and Visions Sciences, The University of Melbourne, Parkville, Victoria, Australia
  • Yu Xiang George Kong
    Centre for Eye Research Australia, East Melbourne, Victoria, Australia
    Royal Victorian Eye & Ear Hospital, East Melbourne, Victoria, Australia
  • Robyn H Guymer
    Centre for Eye Research Australia, East Melbourne, Victoria, Australia
    Royal Victorian Eye & Ear Hospital, East Melbourne, Victoria, Australia
  • Elizabeth Kate Baglin
    Centre for Eye Research Australia, East Melbourne, Victoria, Australia
  • Pyrawy Sivarajah
    Centre for Eye Research Australia, East Melbourne, Victoria, Australia
  • Algis J Vingrys
    Optometry and Visions Sciences, The University of Melbourne, Point Cook, Victoria, Australia
  • Footnotes
    Commercial Relationships   Selwyn Prea, None; Yu Xiang George Kong, Glance Optical Pty Ltd (S); Robyn Guymer, None; Elizabeth Baglin, None; Pyrawy Sivarajah, None; Algis Vingrys, Glance Optical Pty Ltd (S)
  • Footnotes
    Support  Bayer Global Ophthalmology Awards Program 2017, Glance Optical Pty Ltd
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 2386. doi:
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    • Get Citation

      Selwyn Marc Prea, Yu Xiang George Kong, Robyn H Guymer, Elizabeth Kate Baglin, Pyrawy Sivarajah, Algis J Vingrys; Home-monitoring by age-related macular degeneration patients using a tablet perimeter.. Invest. Ophthalmol. Vis. Sci. 2018;59(9):2386.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : The Melbourne Rapid Fields (MRF) iPad app has voice commands to allow home-monitoring of vision to detect early change due to neovascular age-related macular degeneration (AMD). In-clinic the MRF is comparable to the Humphrey Field Analyzer, but it is not clear whether this will translate to home-monitoring assays.

Methods : Twenty-three participants (age 56-84, mean 72 years, 5 males and 18 females) with intermediate AMD have been included in this study. Patients attended an in-office review where high contrast (HC, 130 cd/sq.m) and low luminance (LL, 5 cd/sq.m) visual acuities and central visual field thresholds were established (0-9 degrees) using the MRF-macular test under the supervision of a trained orthoptist. Patients were taught to do these tests with voice over and asked to home-monitor on a weekly basis. Email reminders were sent when 2 consecutive tests were missed. Compliance was established for home-monitoring over the first 12 weeks of testing and outcome accuracy was compared with in-clinic assays. Data are expressed as mean [SD] and analysed using ANOVA or Bland-Altman methods.

Results : All patients have complied with the request for regular home-monitoring over a 12-37 week observation period. Test frequency for the group is 1.1 weeks (8 days) and the average test time for perimetry is 2.1 ±0.5 mins. No significant difference was found between the in-office and at home results for: VA HC (LogMAR home: -0.04 ±0.18 (20/20+2), clinic: -0.02 ±0.15 (20/20+1)), VA LL (home: 0.15 ±0.38 (20/30+2), clinic: 0.10 ±0.24 (20/25)), or the perimetric indices of mean defect (home: -0.46 ±2.38 dB, clinic: -0.28 ±1.50 dB), pattern defect (home: 2.3 ±2.4 dB, clinic: 2.4 ±2.1 dB) or visual capacity (home: 96.7 ±7.8%, clinic: 96.8 ±11.1%). A learning effect (improvement) was apparent for VA LL with performance improving significantly (+1 line) after the first test at home (p=.01). Perimetry shows a gradual improvement from test 1 to test 4 at home but fails to reach statistical significance (MD -0.84 to -0.1 [0.49], p=.055).

Conclusions :
AMD patients are highly motivated and compliant to home-monitoring of vision using the MRF-macular app. Results obtained at home are comparable with in-clinic outcomes. A learning effect was found for VA LL and is suggested in the perimetry data over the first 4 tests. The MRF offers a low-cost alternative to conventional in-office testing.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

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