Abstract
Purpose :
Age-related macular degeneration (AMD) requires continuous monitoring of visual acuity (VA), creating an increasing burden for patients and hospitals. Numerical self-tests evaluating VA could remedy this but their interest still remains to be demonstrated especially in near or intermediate vision which are more difficult for AMD patients than distant vision.The main objective of this study was to compare, in patients treated for exudative AMD, AV evolution numerically measured in intermediate vision on computer, or in near vision on electronic tablet, with that measured in distant vision by an orthoptist on ETDRS chart (in current practice).
Methods :
These new tests were simply based on standard numerized ETDRS scales, adapted (sizes, letters intervals) to numerical tools as computer or electronic tablet. In this prospective, monocentric, randomized, double-blind study, each visit was performed under identical conditions of repeatability: 1st standard AV measurement (ETDRS chart at 4 m) by an orthoptist, standard consultation by an ophthalmologist (OCT, intraocular pressure, slit lamp) and 2nd AV measurement (by a dedicated person), either on computer at 80 cm (arm 1), or on electronic tablet at 40 cm (arm 2). Patients were monthly followed for 6 months (Pro Re Nata monitoring).
Results :
From June 2017 to August 2017, 80 patients (25 Men / 55 Women, mean age 81.3 + 7.4 years) monitored and treated for wet AMD by intravitreal injection were included and randomized in the study (40 patients in each arm). During the 6 months of follow-up, there was no significant difference in the evolution of the VA (from one visit to the next one) measured at 4 meters on standard ETDRS scale, and that measured at 80 cm on computer (arm 1; p = 0.9138) or that measured at 40cm on electronic tablet (arm 2; p = 0.9133). (figure)
Conclusions :
Our study confirmed the reliability of these 2 numerical tests in VA monitoring either in intermediate vision (on computer) or in near vision (on electronic tablet) and should continue with the development of a wide "telemedicine" project offering to monitor AV in various pathologies: AMD, diabetic macular edema, and macular edema on retinal vein occlusion (NCT03214484).
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.