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Ramiro S Maldonado, Elvira Agron, Traci E Clemons, Emily Y. Chew; Comparison of fluorescein angiography lesion size of choroidal neovascularization associated with age-related macular degeneration in participants and non-participants of the home tele-monitoring study (ForeseeHome Study). Invest. Ophthalmol. Vis. Sci. 2018;59(9):2391.
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Early detection of choroidal neovascularization (CNV) results in better visual acuity (VA) with smaller lesions. The purpose is to evaluate the difference in lesion size of CNV associated with age-related macular degeneration (AMD) in participants and non-participants of the home telemonitoring study. We hypothesize that the CNV lesion size in non-participants would be larger at the time of detection than in participants in a tele-monitoring study which was designed to improve early detection of AMD associated CNV.
Comparison of three groups of participants who developed CNV and enrolled in: 1. Age-related Eye Disease Study 2 (AREDS2), 2. standard care arm (SC) and 3. device arm of the ForeSeeHome Study. At the initial detection of the CNV, fluorescein angiograms were obtained and the CNV size measured by a reading center. Best corrected VA was assessed at this study visit. Wilcoxon test was used to compare medians between groups.
The number of participants who developed CNV were: 288 (AREDS2), 23 (SC) and 49 (device). Median age: 76.9 (53-86), 71.7 (57-90) and 72.9 (53-90); percentage white: 97%, 100%, and 100% and percentage females: 63%, 70%, and 57% respectively. The median CNV size (disc area) was significantly smaller in the device group: 1.4 (0-13.4) for AREDS2, 0.5 (0-5.5) SC and 0 (0-2.7) in the device group (p=0.0003 AREDS2 vs SC; p<0.0001 AREDS2 vs device). Median lesion leakage area was also significantly smaller in the device group: 1.8 (0-16) AREDS2, 0.9 (0-5.9) SC and 0 (0-3.3) device group (p= 0.0028 AREDS2 vs SC; p<0.0001 AREDS2 vs device). Median VA (letter score) was significantly better in the device group compared to AREDS2 group: 72 (0-91) AREDS2, 73 (0-85) SC and 75 (28-94) device group (p=0.96 AREDS2 vs SC; p=0.03 AREDS2 vs device). The median VA letter change compared to baseline was not significantly different across the groups: -6.0 AREDS2; -10.0 SC and -4 .0 device group (p=0.09 AREDS2 vs SC, p=0.5 AREDS2 vs device).
Home telemonitoring device strategy resulted in smaller lesions of CNV than the other two groups. This early detection was associated with better visual acuity and may represent better visual outcomes following therapy for participants in the telemonitoring group.
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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