January 22, 2015
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Home monitoring enables early detection of CNV in AMD patients

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WAILEA, Hawaii – A home monitoring device increased the chances of identifying choroidal neovascularization early and preserving vision in patients with age-related macular degeneration, according to a study presented here.

Neil M.
Bressler

Neil M. Bressler, MD, discussed results of the AREDS2 Home Study at Retina 2015. Bressler substituted for Susan B. Bressler, MD, who was unable to attend.

“[The device] will help you pick up cases at a better level of visual acuity at a time when they’re less likely to lose 15 letters or more, and it increases the likelihood that we can maximize the visual acuity once we begin treatment,” Bressler said.

The AREDS2 Home Study, a randomized trial, included 1,970 patients with at least one large drusen (at least 125 μm), visual acuity of 20/60 or better and no signs of advanced AMD. Ultimately, 1,520 patients (77%) met study inclusion criteria.

A home monitoring arm included 763 patients and a control arm of 757 patients underwent standard monitoring.

Investigators used the ForeseeHome home monitoring device (Notal Vision). ForseeHome is a hyperacuity visual field test in which signals are presented within the central visual field and patients report perceived image distortion. Data are recorded and indicate the presence of choroidal neovascularization (CNV).

Mean patient age was 72 years and mean baseline visual acuity was 20/25.

Bressler focused on study results in an intent-to-treat cohort.

Study results showed 51 CNV events in the device arm and 31 CNV events in the control arm.

The mean change in visual acuity from baseline to CNV detection was a loss of four letters in the device arm and nine letters in the control arm; the difference was statistically significant (P = .021).

Significantly more eyes in the device arm (87% to 94%) maintained visual acuity of 20/40 or better at CNV detection than in the control arm (62%).

Significantly more eyes in the control arm lost more than 15 letters than in the device arm, Bressler said.

The false positive rate was 24%. – by Matt Hasson and Patricia Nale

Disclosure: Susan B. Bressler, MD, has received grant support from Genentech, Notal Vision, Novartis, Regeneron, Research to Prevent Blindness, EMMES Corporation and GlaxoSmithKline. Notal Vision and the National Eye Institute sponsored the study.