Home-Monitoring Vision Tests to Detect Active Neovascular Age-Related Macular Degeneration
Ruth E Hogg1, Sobha Sivaprasad2, Robin Wickens3
1Center for Public Health, Queen's University Belfast, Belfast, United Kingdom.
JAMA Ophthalmology
|April 25, 2024
Summary
Home-monitoring vision tests for neovascular age-related macular degeneration (nAMD) showed poor diagnostic accuracy. These tests may miss active disease, risking sight loss and indicating a need for improved monitoring strategies.
Area of Science:
- Ophthalmology
- Medical Diagnostics
- Digital Health
Background:
- Neovascular age-related macular degeneration (nAMD) requires long-term monitoring for disease activity.
- Home-monitoring strategies could alleviate patient/caregiver burden and optimize clinic resources.
Purpose of the Study:
- To assess the diagnostic accuracy of three vision home-monitoring tests for detecting active nAMD.
- To compare home-monitoring test performance against in-hospital ophthalmologist diagnosis.
Main Methods:
- A diagnostic accuracy study compared KeepSight Journal (KSJ), MyVisionTrack (mVT), and MultiBit (MBT) home-monitoring tests against a reference standard of ophthalmologist examination.
- 297 patients (mean age 74.9 years) with treated nAMD participated, testing weekly or bi-monthly.
- Data were analyzed from May to September 2021, focusing on area under the receiver operating characteristic curve (AUROC).
Main Results:
- All evaluated home-monitoring tests demonstrated an AUROC below 0.6, indicating unsatisfactory diagnostic accuracy.
- Only the KSJ summary score showed a statistically significant association with active lesion detection (OR, 3.48; P=.04).
- Median home-monitoring frequency was 3-4 times per month.
Conclusions:
- Current home-monitoring vision tests lack sufficient accuracy for detecting active nAMD in routine after-treatment follow-up.
- Relying solely on these tests could lead to missed active lesions and potential vision loss.
- Further development of accurate and reliable home-monitoring tools is crucial for effective nAMD management.
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