The Retina Institute, St. Louis, Missouri.
DRCR Retina Network, Tampa, Florida.
Ophthalmol Retina. 2024 Apr;8(4):376-387. doi: 10.1016/j.oret.2023.10.012. Epub 2023 Oct 23.
To assess the feasibility of daily Home OCT imaging among patients with neovascular age-related macular degeneration (nAMD).
Prospective observational study.
Participants with ≥ 1 eye with previously untreated nAMD and visual acuity 20/20 to 20/320.
Participants meeting the ocular eligibility criteria were considered for enrollment; those who provided consent received a Notal Vision Home OCT device. Participants were instructed to scan both eyes daily. Retina specialists managed treatment according to their standard practice, without access to the Home OCT data. The presence of fluid detected by a reading center (RC) from in-office OCT scans was compared with fluid volumes measured by the Notal OCT Analyzer (NOA) on Home OCT images.
Proportion of participants meeting ocular eligibility criteria who participated in daily scanning, frequency and duration of scanning, proportion of scans eligible for fluid quantification, participant experience with the device, agreement between the RC and NOA fluid determinations, and characteristics of fluid dynamics.
Among 40 participants meeting ocular eligibility criteria, 14 (35%) initiated self-scanning. Planned travel (n = 7, 17.5%) and patient-reported inadequate cell reception for the upload of images (n = 5, 12.5%) were the most frequent reasons for not participating. Considering scans of the study eye only, the mean (standard deviation) was 6.3 (0.6) for weekly scanning frequency and 47 (17) seconds for scan duration per eye. Among 2304 scans, 86.5% were eligible for fluid quantification. All participants agreed that scanning became easier over time, and only 1 did not want to continue daily scanning. For 35 scan pairs judged as having fluid by in-office OCT, the NOA detected fluid on 31 scans (89%). For 14 scan pairs judged as having no fluid on in-office OCT, the NOA did not detect fluid on 10 scans (71%). Daily fluid patterns after treatment initiation varied considerably between patients.
For patients with nAMD who initiated home scanning, frequency and quality of scanning and accuracy of fluid detection were sufficient to assess the monitoring of fluid at home. Accommodations for travel and Wi-Fi connectivity could improve uptake of the Home OCT device.
FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
评估每日家庭光学相干断层扫描（OCT）在新生血管性年龄相关性黄斑变性（nAMD）患者中的可行性。
前瞻性观察研究。
参与者为患有未经治疗的 nAMD 且视力为 20/20 至 20/320 的至少 1 只眼。
符合眼部纳入标准的参与者被考虑入组；同意入组的参与者会收到 Notal Vision 家庭 OCT 设备。参与者被指导每天扫描双眼。视网膜专家根据他们的标准实践进行治疗，无法获得家庭 OCT 数据。由阅读中心（RC）从办公室 OCT 扫描中检测到的液体与 Notal OCT 分析仪（NOA）在家庭 OCT 图像上测量的液体量进行比较。
符合眼部纳入标准并参与每日扫描的参与者比例、扫描的频率和持续时间、可用于量化液体的扫描比例、参与者对设备的体验、RC 和 NOA 液体测定之间的一致性，以及液体动力学的特征。
在符合眼部纳入标准的 40 名参与者中，有 14 名（35%）开始进行自我扫描。未参与的最常见原因是计划旅行（n=7，17.5%）和患者报告图像上传的细胞接收不足（n=5，12.5%）。仅考虑研究眼的扫描，每周扫描频率的平均值（标准差）为 6.3（0.6），每只眼的扫描持续时间为 47（17）秒。在 2304 次扫描中，86.5%可用于量化液体。所有参与者都认为随着时间的推移扫描变得更容易，只有 1 人不想继续每日扫描。对于 35 对由办公室 OCT 判断为有液体的扫描对，NOA 在 31 次扫描中检测到液体（89%）。对于 14 对由办公室 OCT 判断为无液体的扫描对，NOA 在 10 次扫描中未检测到液体（71%）。治疗开始后，每位患者的每日液体模式差异很大。
对于开始家庭扫描的 nAMD 患者，扫描的频率、质量和液体检测的准确性足以评估家庭中的液体监测。旅行和 Wi-Fi 连接的适应措施可以提高家庭 OCT 设备的采用率。
本文末尾的脚注和披露中可能存在专有或商业披露。
