家庭监测视觉测试以检测活跃的神经血管与年龄相关的黄斑退化
Ruth E Hogg1, Sobha Sivaprasad2, Robin Wickens3
1Center for Public Health, Queen's University Belfast, Belfast, United Kingdom.
JAMA ophthalmology
|April 25, 2024
概括
针对新血管与年龄相关的黄斑变性 (nAMD) 的家庭监测视力测试显示诊断准确性不佳. 这些测试可能会错过活跃的疾病,危及视力丧失,并表明需要改进监测策略.
科学领域:
- 眼科医生 眼科 眼科
- 医学诊断 医学诊断 医学诊断
- 数字健康数字健康
背景情况:
- 神经血管与年龄相关的黄斑变性 (nAMD) 需要长期监测疾病活动.
- 家庭监测策略可以减轻患者/护理人员的负担,并优化诊所资源.
研究的目的:
- 评估三个视力家庭监测测试的诊断准确性,以检测活跃的nAMD.
- 为了比较家庭监测测试的表现与医院内眼科医生诊断.
主要方法:
- 一项诊断准确性研究将KeepSight Journal (KSJ),MyVisionTrack (mVT) 和MultiBit (MBT) 家庭监测测试与眼科医生检查的参考标准进行了比较.
- 297名接受治疗的nAMD患者 (平均年龄为74.9岁) 参加了这项研究,每周或每两个月进行一次测试.
- 分析了2021年5月至9月的数据,重点关注接收器运行特征曲线 (AUROC) 下的区域.
主要成果:
- 所有评估的家庭监测测试显示AUROC低于0.6,表明诊断准确度不令人满意.
- 只有KSJ总结得分显示了与活跃的病变检测具有统计学意义的关联 (OR,3.48;P=.04).
- 家庭监测频率的中位数是每月3-4次.
结论:
- 目前的家庭监测视觉测试缺乏足够的准确性来检测常规治疗后随访中的活跃nAMD.
- 仅依靠这些测试可能会导致错过活跃病变和潜在的视力丧失.
- 进一步开发准确可靠的家庭监控工具对于有效的nAMD管理至关重要.
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