June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Comparison of Near and Distance Visual Acuity Measured via ETDRS Charts in neovascular Age-related Macular Degeneration and Diabetic Macular Edema Study Participants Managed with Anti-VEGF Therapy
Author Affiliations & Notes
  • Kira Lin
    Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States
    Albert Einstein College of Medicine, Bronx, New York, United States
  • Onnisa Nanegrungsunk
    Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States
    Ophthalmology, Chiang Mai University, Suthep, Chiang Mai, Thailand
  • Guillaume Normand
    Novartis Pharmaceuticals Corp, East Hanover, New Jersey, United States
  • Susan B Bressler
    Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States
  • Daniele Dolis
    Novartis Pharma AG, Basel, Basel-Stadt, Switzerland
  • Lieve Convents
    Novartis Pharma NV/SA, Vilvoorde, Belgium
  • John Seaman
    Novartis Pharmaceuticals Corp, East Hanover, New Jersey, United States
  • Kang Yan
    Novartis Pharmaceuticals (China), Shanghai, China
  • Georges Weissgerber
    Novartis Pharma AG, Basel, Basel-Stadt, Switzerland
  • Guy Simpson
    Novartis Pharmaceuticals Corp, East Hanover, New Jersey, United States
  • Michael J Elman
    Elman Retina Group, Maryland, United States
  • Hani Salehi-Had
    Retina Associates of Southern California, Huntington Beach, California, United States
  • Andres Emanuelli
    Emanuelli Research and Development Center, Puerto Rico
  • Zhuolin Li
    Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States
  • Neil M Bressler
    Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States
  • Footnotes
    Commercial Relationships   Kira Lin None; Onnisa Nanegrungsunk None; Guillaume Normand Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA, Code E (Employment); Susan Bressler Novartis, Code F (Financial Support); Daniele Dolis Novartis Pharma AG, Basel, Switzerland, Code E (Employment); Lieve Convents Novartis Pharma NV, Vilvoorde, Belgium, Code E (Employment); John Seaman Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA, Code E (Employment); Kang Yan Shanghai Novartis Trading Ltd., Shangai, China, Code E (Employment); Georges Weissgerber Novartis Pharma AG, Basel, Switzerland, Code E (Employment); Guy Simpson Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA, Code E (Employment); Michael Elman Grants from Allergan Pharmaceutical, Alimera Sciences, Apellis Pharmaceutical, Clover Therapeutics, Genentech Inc/F. Hoffmann La Roche, Graybug Vision, JAEB Center, Lowy Medical Research Institute, National Institutes of Health, Neurotech Pharmaceuticals, Inc., NGM Biopharmaceuticals Corporation, Notal Vision, Novartis Pharmaceuticals Corporation, Optos, The EMMES Company, YD Global Life Science, Code F (Financial Support); Hani Salehi-Had None; Andres Emanuelli Research grant by Novartis, Novartis Institute of Biomedical Research, Regeneron Pharmaceuticals, Roche/Genentech, Adverum Biotechnologies, Kodiak Sciences, Ophthea, and NanoscopeTherapeutics, Code F (Financial Support); Zhuolin Li None; Neil Bressler received grants to Johns Hopkins University from Bayer, Biogen, Genentech (Roche), Novartis, Regeneron, Samsung Bioepis; contract with AMA as Editor in Chief of JAMA Ophthalmology; contract with Emmes LLC as Chair, NEI Data and Safety Monitoring Committee for intramural trials, Code F (Financial Support)
  • Footnotes
    Support  Johns Hopkins University School of Medicine
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 1397 – A0093. doi:
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      Kira Lin, Onnisa Nanegrungsunk, Guillaume Normand, Susan B Bressler, Daniele Dolis, Lieve Convents, John Seaman, Kang Yan, Georges Weissgerber, Guy Simpson, Michael J Elman, Hani Salehi-Had, Andres Emanuelli, Zhuolin Li, Neil M Bressler; Comparison of Near and Distance Visual Acuity Measured via ETDRS Charts in neovascular Age-related Macular Degeneration and Diabetic Macular Edema Study Participants Managed with Anti-VEGF Therapy. Invest. Ophthalmol. Vis. Sci. 2022;63(7):1397 – A0093.

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

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Abstract

Purpose : To minimize the number and reliance on in-person clinical care and trial visits, many mobile apps for visual acuity (VA) self-assessment have been introduced recently. However, few publications, to our knowledge, have compared near VA with distance VA, routinely tested in clinical practice, using standardized charts. The purpose of this paper is to evaluate the level of agreement between near and distance VA obtained with Early Treatment Diabetic Retinopathy Study (ETDRS) charts in the clinic.

Methods : This study is a multi-site study for 90 participants with neovascular age-related macular degeneration (nAMD) or diabetic macular edema (DME). Patients with nAMD or DME in one eye, aged ≥18 years, VA better than 20/200 were eligible. Each participant had the study eye assessed two times with each chart at both the Baseline (V2) and end of study (V3) visits, using habitual correction for distance VA at 4 m and near VA at 40 cm. Bland-Altman plots with repeated measurements per participant were produced. The 95% limits of agreement (LoA) for the difference between near and distance VA assessment methods are presented, along with 95% confidence intervals (CIs) around the LoAs calculated using the method of variance estimates recovery.

Results : From the preliminary results, 39 participants had completed the V2 visit, of which 34 (87%) had nAMD, mean (±SD) distance VA in the study eye was 0.27 logMAR (0.214), mean (±SD) age was 73.0 (8.4) years and 20 (51%) were female. A total of 35 participants with data at both V2 and V3 visits from the Johns Hopkins University clinical site were included in this analysis. Agreement between BCNVA obtained with the near ETDRS chart in the clinic and BCDVA obtained with the distance ETDRS chart in the clinic observed a mean difference of 0.04 with an upper LoA of -0.22 logMAR (95% CI: -0.29, -0.18) and a lower LoA 0.29 logMAR (95% CI: 0.25, 0.36).

Conclusions : Our results suggest that the LoAs CIs when comparing the VA obtained with the near and distance charts were close to being within a 0.3 logMAR threshold, beyond which typically is considered a clinically relevant change for these diseases. Differences might come from some participants being less optimally corrected with their habitual near correction.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

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