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Smartphone-based remote monitoring of vision in macular disease enables early detection of worsening pathology and need for intravitreal therapy

BACKGROUND/AIMS: To assess the outcomes of home monitoring of distortion caused by macular diseases using a smartphone-based application (app), and to examine them with hospital-based assessments of visual acuity (VA), optical coherence tomography-derived central macular thickness (CMT) and the requ...

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Autores principales: Islam, Meriam, Sansome, Stafford, Das, Radha, Lukic, Marko, Chong Teo, Kelvin Yi, Tan, Gavin, Balaskas, Konstantinos, Thomas, Peter B M, Bachmann, Lucas M, Schimel, Andrew M, Sim, Dawn A
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8154994/
https://www.ncbi.nlm.nih.gov/pubmed/34035050
http://dx.doi.org/10.1136/bmjhci-2020-100310
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author Islam, Meriam
Sansome, Stafford
Das, Radha
Lukic, Marko
Chong Teo, Kelvin Yi
Tan, Gavin
Balaskas, Konstantinos
Thomas, Peter B M
Bachmann, Lucas M
Schimel, Andrew M
Sim, Dawn A
author_facet Islam, Meriam
Sansome, Stafford
Das, Radha
Lukic, Marko
Chong Teo, Kelvin Yi
Tan, Gavin
Balaskas, Konstantinos
Thomas, Peter B M
Bachmann, Lucas M
Schimel, Andrew M
Sim, Dawn A
author_sort Islam, Meriam
collection PubMed
description BACKGROUND/AIMS: To assess the outcomes of home monitoring of distortion caused by macular diseases using a smartphone-based application (app), and to examine them with hospital-based assessments of visual acuity (VA), optical coherence tomography-derived central macular thickness (CMT) and the requirement of intravitreal injection therapy. DESIGN: Observational study with retrospective analysis of data. METHODS: Participants were trained in the correct use of the app (Alleye, Oculocare, Zurich, Switzerland) in person or by using video and telephone consultations. Automated threshold-based alerts were communicated based on a traffic light system. A ‘threshold alarm’ was defined as three consecutive ‘red’ scores, and turned into a ‘persistent alarm’ if present for greater than a 7-day period. Changes of VA and CMT, and the requirement for intravitreal therapy after an alarm were examined. RESULTS: 245 patients performing a total of 11 592 tests (mean 46.9 tests per user) were included and 85 eyes (164 alarms) examined. Mean drop in VA from baseline was −4.23 letters (95% CI: −6.24 to −2.22; p<0.001) and mean increase in CMT was 29.5 µm (95% CI: −0.08 to 59.13; p=0.051). Sixty-six eyes (78.5%) producing alarms either had a drop in VA, increase in CMT or both and 60.0% received an injection. Eyes with persistent alarms had a greater loss of VA, −4.79 letters (95% CI: −6.73 to −2.85; p<0.001) or greater increase in CMT, +87.8 µm (95% CI: 5.2 to 170.4; p=0.038). CONCLUSION: Smartphone-based self-tests for macular disease may serve as reliable indicators for the worsening of pathology and the need for treatment.
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spelling pubmed-81549942021-06-10 Smartphone-based remote monitoring of vision in macular disease enables early detection of worsening pathology and need for intravitreal therapy Islam, Meriam Sansome, Stafford Das, Radha Lukic, Marko Chong Teo, Kelvin Yi Tan, Gavin Balaskas, Konstantinos Thomas, Peter B M Bachmann, Lucas M Schimel, Andrew M Sim, Dawn A BMJ Health Care Inform Original Research BACKGROUND/AIMS: To assess the outcomes of home monitoring of distortion caused by macular diseases using a smartphone-based application (app), and to examine them with hospital-based assessments of visual acuity (VA), optical coherence tomography-derived central macular thickness (CMT) and the requirement of intravitreal injection therapy. DESIGN: Observational study with retrospective analysis of data. METHODS: Participants were trained in the correct use of the app (Alleye, Oculocare, Zurich, Switzerland) in person or by using video and telephone consultations. Automated threshold-based alerts were communicated based on a traffic light system. A ‘threshold alarm’ was defined as three consecutive ‘red’ scores, and turned into a ‘persistent alarm’ if present for greater than a 7-day period. Changes of VA and CMT, and the requirement for intravitreal therapy after an alarm were examined. RESULTS: 245 patients performing a total of 11 592 tests (mean 46.9 tests per user) were included and 85 eyes (164 alarms) examined. Mean drop in VA from baseline was −4.23 letters (95% CI: −6.24 to −2.22; p<0.001) and mean increase in CMT was 29.5 µm (95% CI: −0.08 to 59.13; p=0.051). Sixty-six eyes (78.5%) producing alarms either had a drop in VA, increase in CMT or both and 60.0% received an injection. Eyes with persistent alarms had a greater loss of VA, −4.79 letters (95% CI: −6.73 to −2.85; p<0.001) or greater increase in CMT, +87.8 µm (95% CI: 5.2 to 170.4; p=0.038). CONCLUSION: Smartphone-based self-tests for macular disease may serve as reliable indicators for the worsening of pathology and the need for treatment. BMJ Publishing Group 2021-05-25 /pmc/articles/PMC8154994/ /pubmed/34035050 http://dx.doi.org/10.1136/bmjhci-2020-100310 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Original Research
Islam, Meriam
Sansome, Stafford
Das, Radha
Lukic, Marko
Chong Teo, Kelvin Yi
Tan, Gavin
Balaskas, Konstantinos
Thomas, Peter B M
Bachmann, Lucas M
Schimel, Andrew M
Sim, Dawn A
Smartphone-based remote monitoring of vision in macular disease enables early detection of worsening pathology and need for intravitreal therapy
title Smartphone-based remote monitoring of vision in macular disease enables early detection of worsening pathology and need for intravitreal therapy
title_full Smartphone-based remote monitoring of vision in macular disease enables early detection of worsening pathology and need for intravitreal therapy
title_fullStr Smartphone-based remote monitoring of vision in macular disease enables early detection of worsening pathology and need for intravitreal therapy
title_full_unstemmed Smartphone-based remote monitoring of vision in macular disease enables early detection of worsening pathology and need for intravitreal therapy
title_short Smartphone-based remote monitoring of vision in macular disease enables early detection of worsening pathology and need for intravitreal therapy
title_sort smartphone-based remote monitoring of vision in macular disease enables early detection of worsening pathology and need for intravitreal therapy
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8154994/
https://www.ncbi.nlm.nih.gov/pubmed/34035050
http://dx.doi.org/10.1136/bmjhci-2020-100310
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