Abstract
Purpose :
Evaluation of long-term visual acuity (VA) and performance of a monitoring strategy that includes a self-operated artificial intelligence enabled home monitoring system in conjunction with standard care for early detection of neovascular age related macular degeneration (nAMD) (ForeseeHome (FSH), Notal Vision Monitoring Center)
Methods :
A retrospective review was performed of all iAMD patients monitored with FSH from 5 clinics from 8/2010-07/2020. Data included visual acuity (VA) at baseline, VA at conversion to nAMD during the monitoring period, VA at most recent visit, frequency of use, duration of monitoring, modality of CNV diagnosis (system alert vs detection by standard care means), and duration and number of treatments since conversion to most recent visit.
Results :
3334 eyes of 2123 patients were reviewed with a mean (SD) age of 74(8) years, monitored for mean (SD) duration of 3.1(2.4) years, with a total of 1,706,433 tests in 10,474 eye-monitoring years. A Kaplan-Meyer survival analysis predicted a mean (95%CI) 4.5(4.3-4.7) years of monitoring. The mean (SD) weekly FOU per patient was 5.2(3.4) and it was persistent over the usage period. 285 eyes converted while monitored at an annual rate of 2.72% and were treated with mean (SD) 17.3(16.5) injections over mean (SD) 2.7(2.0) years, with 6.4(3.1) injections per year for eye treated for > 1 year. The median VA at baseline and recent visit for eyes that did not convert were 20/27 and 20/34 with a median change of 0.0 letters. The median VA at baseline, conversion and recent visit for eyes that converted during the monitoring period were 20/30, 20/39 and 20/32 with a median change from baseline to conversion, baseline to recent and conversion to recent of -4, -4 and 0 letters, respectively. 52% of the conversions detected had a system alert prior to conversion. 48% of patients were detected by symptoms or routine visit. Patients experienced a non-nAMD alert on average every 4.6 years. At conversion and at recent visit the proportion (95% CI) of eyes that maintained ≥20/40 was 84%(78%-88%) and 82%(76%-86%) respectively.
Conclusions :
Patients in the FSH monitoring program showed excellent long-term visual acuity years after conversion to nAMD, emphasizing the importance of early detection.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.