Abstract
Purpose :
Neovascular age-related macular degeneration (nAMD) treatments pose heavy burden on patients and the real-world results have lagged behind expected outcomes due to fewer injections compared to clinical trials. We evaluated efficacy in retinal fluid detection of a home optical coherence tomography (OCT) based system that allows self-imaging at home and quantification of essential biomarkers.
Methods :
A prospective cross-sectional study was conducted where patients received commercial OCT imaging, followed by self-imaging using home OCT device in a clinical setting. The study aimed to evaluate the patients' ability to obtain analyzable OCT images using the home OCT device. Both the home OCT and the in-office OCT images were graded by experts for presence as well quantification of intraretinal fluid (IRF) and subretinal fluid (SRF). The retinal fluid measurements were compared as performed by expert graders on in-office OCT images and by an automated deep learning-based algorithm on home OCT.
Results :
Successful images were acquired by 264/290 subjects (91%) with the mean (SD) age of 78.8 (8.8); 153 (58%) were female with median visual acuity (VA) of 20/40 (range: 20/20-20/400). Higher rates of successful imaging were found in eyes with visual acuity ≥ 20/320. Positive percent agreement/negative percent agreement for detecting the presence of subretinal and/ or intraretinal fluid when reviewing for fluid in three repeated volume scans were 97%/95%, respectively, for the home OCT device. A Pearson correlation of 91.6% was obtained between retinal measurements as performed using in-office OCT with expert grader and home OCT with automated deep learning algorithm. The Bland Altman resulted in a mean (95% CI) difference of -2.7 nL, upper limit of agreement (+1.96 SD, 95% CI) of 39.7 nL and lower limit of agreement (-1.96 SD, 95% CI) of -45.2 nL.
Conclusions :
The home OCT device shows a high success rate of self-imaging by nAMD patients up to a visual acuity of 20/320. The automated fluid quantification showed strong correlation with the expert graded fluid quantification performed on in-office OCT. The ability to self-scan and high fidelity automated fluid quantification makes home OCT a promising technology for management of patients with nAMD.
This abstract was presented at the 2023 ARVO Imaging in the Eye Conference, held in New Orleans, LA, April 21-22, 2023.