Abstract
Purpose :
To evaluate the usability of the NVHO in a cross-sectional study and quantify retinal fluid with an AI-based algorithm in eyes with DME
Methods :
93 eyes of 56 patients performed 2 to 5 (mean of 3.7) consecutive NVHO self-imaging sessions in a clinic setting resulting in a total of 288 volume scans. Retinal fluid was quantified using the Notal OCT Analyzer (NOA). Usability of the NVHO was assessed with median (IQR) of self-imaging duration and precent of successful attempts. Image quality was evaluated by the mean (SD) of manufacturer signal quality index (MSI – scale 1-7) as well as eligibility rate for retinal fluid volume quantification. Mean (SD) retinal fluid volume quantified by NOA as well as the fluid type, subretinal (SRF) or intraretinal (IRF) fluid (figure 1). In addition, the analysis included findings of hyperreflective foci (HF), diffuse retinal thickening (DRT) and hard exudates (HE). Automatic segmentation of these findings is being developed, and results will be shared by the authors during ARVO.
Results :
The median (IQR) of self-imaging duration was 42 (36-60) seconds, the percent of successful attempts was 94% and the mean (SD) MSI was 4.1 (1.4), 85% of the volume-scans were eligible for retinal fluid quantification. Of the 74% eyes with fluid, 65% had a clinically meaningful amounts of fluid (>3 nL) with a mean (SD) of 95 (155) nanoliters. 4% of eyes had SRF, 33% had IRF and 63% had both SRF and IRF. HF, DRT and HE were identified on 63%, 9% and 42% of the eyes respectively.
Conclusions :
The satisfactory self-imaging performance of patients with nv-AMD on the NVHO was previously reported. The current study reports similar results for DME patients. The range of fluid volume found is significantly larger than the volumes reported for nv-AMD eyes during the maintenance phase in the HARBOR study with mean SRF and IRF volumes of 39 and 24 nanoliters respectively. The frequency of clinic visits is expected to be reduced with the development of slow release and higher dosage drugs. However, to ensure improved clinical outcomes and protection of the fellow eye, a clear need for remote patient monitoring emerges. Self-imaging on the NVHO is speedy and together with automatic analysis NOA, may allow remote care with minimal burden on both the patient and the retina specialist.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.