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

Islam, M; Sansome, S; Das, R; Lukic, M; Chong Teo, KY; Tan, G; Balaskas, K; ... Sim, DA; + view all (2021) Smartphone-based remote monitoring of vision in macular disease enables early detection of worsening pathology and need for intravitreal therapy. BMJ Health and Care Informatics , 28 (1) , Article e100310. 10.1136/bmjhci-2020-100310. Green open access

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Abstract

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.

Type: Article
Title: Smartphone-based remote monitoring of vision in macular disease enables early detection of worsening pathology and need for intravitreal therapy
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/bmjhci-2020-100310
Publisher version: http://dx.doi.org/10.1136/bmjhci-2020-100310
Language: English
Additional information: © 2022 BMJ Publishing Group Ltd & BCS, the Chartered Institute for IT. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license (http://creativecommons.org/licenses/by-nc/4.0/).
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Institute of Ophthalmology
URI: https://discovery.ucl.ac.uk/id/eprint/10165117
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