Checkup Mobile App to Monitor Visual Function in Diabetic Retinopathy and Age-related Macular Degeneration: The CLEAR Study

Abstract

Purpose : To determine if a mobile application, Checkup (Verana Health, CA) can reliably monitor visual acuity (VA) and metamorphopsia in the home vs 2 standard VA reference tests (Lebehnson near card for VA and Amsler grid for metamorphopsia) in the clinic.

Methods : CLEAR (NCT02871817) was a 2-month, prospective, multicenter, observational study that assessed the agreement between Checkup and Lebehnson near card for VA and Amsler grid for metamorphopsia, and assessed test-retest repeatability in the clinic and home settings. 108 participants were enrolled at 13 sites from August 30, 2017 – January 12, 2018. Patients were evaluated at baseline and two monthly visits. At Visit 0, patients were randomized for the duration of the study to testing with either Checkup or Ref first. Patients took each test twice per visit with rest in between. Patients wore corrective lenses if applicable. Between office visits, patients used Checkup for VA and Amsler testing at least twice per week at home. At the final visit, a patient usability survey was conducted.

Results : Agreement was strong between Checkup and reference tests for VA (r=0.86) and Amsler (sensitivity 93%, specificity 92%). Home vs clinic testing showed excellent agreement (r=0.96). Patients reported successful home use. There were no serious adverse events or discontinuations.

Conclusions : CLEAR results show good agreement between Checkup and Ref in clinic for both VA and Amsler grid tests. Checkup demonstrated good reproducibility and consistent testing in clinic and home settings. The patient survey demonstrated that Checkup was easy to use and that patients would recommend it to others. Our findings suggest that Checkup is a reliable method to monitor patients with retinal pathology in clinical and home settings.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.