Abstract
Purpose :
To understand the dynamic fluctuations in visual acuity between hospital visits in patients with diabetic macular oedema (DMO) treated with anti-vascular endothelial growth factor injections (anti-VEGF) and Ozurdex implants through home monitoring of vision via the app “Alleye” to enable personalised treatment timeframes.
Methods :
“Alleye” is a novel free of charge app that is CE marked and FDA cleared for the monitoring of metamorphopsia via a hyperacuity alignment task with a secure web interface for clinicians. Patients with DMO with a visual acuity of ≥ 6/24 with no other concurrent macula pathology were identified in medical retina clinics at Moorfields Eye Hospital, South Division, Croydon from October 2019-December 2019. Patients were approached by a clinician and following verbal consent being gained the app was demonstrated on either their own personal smartphones or an IPod Touch provided with the app pre-installed with a target of performing a visual acuity test daily for three months. Home visual acuity scores were correlated with visual acuity and OCT central retinal thickness (CRT) at follow up hospital visits.
Results :
339 test results have been performed thus far by 20 patients including 14 males and 8 females (age range of 51-89 years). 3 patients are receiving Lucentis, 2 have had an ozurdex implant and 15 are on Eylea therapy. There is a wide variation in the frequency of use between patients. Of the 4 patients that have returned for their first follow up, 3 consistently used the app, and of these patients none had what was deemed as a “significant deterioration” in their visual acuity scores between their visits, and all maintained their vision of 6/6 at follow up. OCT CRT had moderate reductions between visits in those patients with maintained vision, and one patient with an improvement to vision had correlated improvement to Alleye test scores and a 266 micron reduction in CRT. This is an ongoing study with follow up set for a minimum of three months, with a target recruitment of 100 patients.
Conclusions :
We have demonstrated a trend of the feasibility of this app being used frequently by patients, with good correlation thus far of the visual acuity scores at follow up. This offers promise for home monitoring of visual acuity as a potential reliable tool for the future of personalised treatment for diabetic macular oedema within the national health service.
This is a 2020 ARVO Annual Meeting abstract.