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Cost, accessibility remain issues for homebased monitoring of AMD
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LISBON, Portugal — Daily home-based monitoring of age-related macular degeneration can have a positive impact on prompt, early treatment and preservation of vision, but access and cost may be issues, speakers said during a debate at the Controversies in Ophthalmology meeting.
Susan B. Bressler, MD, PhD, presented results of the National Eye Institute’s HOME study, a secondary study to AREDS2, in which the ForeseeHome AMD Monitoring Program (Notal Vision) was used. The study was a 3-year phase 3 trial in which 1,520 participants were randomized 1:1 into the device group or the standard care monitoring group.
Susan B. Bressler
In the group in which the device was used, conversion to wet AMD was detected and therefore treated earlier, leading to a significantly lower loss of visual acuity lines in a higher proportion of patients.
“In the standard care arm when patients presented because of symptoms, they had lost 11 letters, whereas in the device arm, there was an average loss of only three letters. The importance of symptoms goes down. It’s the device detecting the changes before symptoms occur,” Bressler said.
Marc De Smet, MD, highlighted some of the problems related to the use of home-monitoring devices. One of them is irregular use by patients, but the main issues, he said, are cost and accessibility.
“House monitoring is important but requires a dedicated device that costs money, and not all patients can have access to it,” he said. “It also requires additional infrastructures, such as a call center and the ability to see the patients quickly and treat them fast. If [one] cannot offer quick and adequate treatment, house monitoring loses its scope.”
Marc De Smet
Disclosures: Bressler received financial support by Notal Vision for the study. De Smet has no relevant financial disclosures.