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Observational Study
. 2024 Apr;8(4):376-387.
doi: 10.1016/j.oret.2023.10.012. Epub 2023 Oct 23.

Home OCT Imaging for Newly Diagnosed Neovascular Age-Related Macular Degeneration: A Feasibility Study

Kevin J Blinder  1 , Claire Calhoun  2 , Maureen G Maguire  2 , Adam R Glassman  3 , Calvin E Mein  4 , Darrell E Baskin  4 , Gabriela Vieyra  2 , Lee M Jampol  5 , Moises A Chica  4 , Jennifer K Sun  6 , Daniel F Martin  7 ; DRCR Retina Network
Collaborators, Affiliations
Observational Study

Home OCT Imaging for Newly Diagnosed Neovascular Age-Related Macular Degeneration: A Feasibility Study

Kevin J Blinder et al. Ophthalmol Retina. 2024 Apr.

Abstract

Objective: To assess the feasibility of daily Home OCT imaging among patients with neovascular age-related macular degeneration (nAMD).

Design: Prospective observational study.

Participants: Participants with ≥ 1 eye with previously untreated nAMD and visual acuity 20/20 to 20/320.

Methods: 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.

Main outcome measures: 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.

Results: 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.

Conclusions: 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.

Keywords: Home OCT; Neovascular age-related macular degeneration; OCT.

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Figures

Figure 1.
Figure 1.. Participant flow diagram.
Sites asked potential participants about cell reception, upcoming travel, and interest in participating in a research study prior to formal screening. Potential participants were not formally screened before obtaining informed consent. Ocular eligibility criteria was confirmed after obtaining informed consent. OCT, optical coherence tomography; nAMD, neovascular age-related macular degeneration
Figure 2:
Figure 2:. Average number of scans per week.
Average number of scans per week across the follow-up period.
Figure 3.
Figure 3.. Average manufacturer signal index per week.
This figure displays the average manufacturer signal index (MSI) across the follow-up period. An MSI ≥2 is considered a good quality scan.
Figure 4.
Figure 4.. Fluid curves over time.
This figure displays the total retinal fluid volume during the study for each participant.
Figure 5.
Figure 5.. Case examples of fluid volume trajectories.
This figure displays fluid volume trajectories generated by the Notal OCT Analyzer (NOA) over a 3-month period during the 6-month study.
Figure 5.
Figure 5.. Case examples of fluid volume trajectories.
This figure displays fluid volume trajectories generated by the Notal OCT Analyzer (NOA) over a 3-month period during the 6-month study.
Figure 5.
Figure 5.. Case examples of fluid volume trajectories.
This figure displays fluid volume trajectories generated by the Notal OCT Analyzer (NOA) over a 3-month period during the 6-month study.
See this image and copyright information in PMC

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