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Home Monitoring for Age-Related Macular Degeneration

  • Voraporn Chaikitmongkol
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Abstract

In the anti-vascular endothelial growth factor (anti-VEGF) era, visual outcomes of choroidal neovascularization (CNV) associated with age-related macular degeneration (AMD) have been dramatically improved. Good baseline vision and smaller size of CNV at the time of treatment initiation are the main predictors for favorable outcomes. Patients at high risk of developing neovascular AMD are those with intermediate-staged AMD who typically been scheduled for evaluations 1–2 times/year. Home-monitoring devices, therefore, become a potential tool to first detect changes in the visual functions of these patients before their clinic visits. Prompt evaluations following an alert from the device, with timely anti-VEGF treatments would increase the patients’ opportunities to achieve excellent outcomes.

The Amsler grid was the first home-monitoring device for AMD and had been widely used since the 1940s. In the past decade, many home-monitoring devices have been developed, but only two have been approved by the United States Food and Drug Administration, i.e., ForeseeHome device (preferential hyperacuity perimeter) and MyVisionTrack (handheld shape discrimination hyperacuity test). The ForeseeHome device has been the only home-monitoring device evaluated and proven in a large clinical trial, the Home Monitoring of the Eye (HOME) study. Results suggested that participants in the device arm had a lesser degree of vision loss from baseline vision at the time of CNV detection. Despite its proven efficacy, the ForeseeHome device is currently available only in the United States. Several other home-monitoring technologies on personal electronic devices have been introduced, but strong evidence to support the validity of these technologies in detecting CNV is still limited.

Keywords

Age-related macular degeneration Choroidal neovascularization Early detection Home monitoring Preferential hyperacuity perimeter Shape discrimination hyperacuity Self-monitoring 

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Copyright information

© Springer Nature Singapore Pte Ltd. 2020

Authors and Affiliations

  • Voraporn Chaikitmongkol
    • 1
  1. 1.Retina Division, Department of OphthalmologyChiang Mai UniversityChiang MaiThailand

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