Clinical Use of Home OCT Data to Manage Neovascular Age-Related Macular Degeneration.
Jeffrey S Heier, Yingna Liu, Nancy M Holekamp, Mohsin H Ali, Konstantin Astafurov, Kevin J Blinder, Miguel A Busquets, Moises A Chica, Michael J Elman, Jordana G Fein, Paul Hahn, Nikolas London, Thomas Margolis, Yasha S Modi, Aleksandra Rachitskaya, Eric W Schneider, Glenn L Stoller, Jay C Wang, Ankoor R Shah
Author Information
Jeffrey S Heier: Ophthalmic Consultants of Boston, Boston, MA, USA.
Yingna Liu: Ophthalmic Consultants of Boston, Boston, MA, USA.
Nancy M Holekamp: Pepose Vision Institute, St. Louis, MO, USA. ORCID
Mohsin H Ali: Retina Group of Washington, Washington, DC, USA. ORCID
Konstantin Astafurov: Monmouth Retina Consultants, Belleville, NJ, USA.
Kevin J Blinder: The Retina Institute, St. Louis, MO, USA. ORCID
Miguel A Busquets: Retina Associates of Kentucky, Lexington, KY, USA. ORCID
Moises A Chica: Retina Consultants of Texas, San Antonio, TX, USA.
Michael J Elman: Elman Retina Group P.A., Rosedale, MD, USA. ORCID
Jordana G Fein: Retina Group of Washington, Washington, DC, USA. ORCID
Paul Hahn: NJ Retina, Belleville, NJ, USA.
Nikolas London: Retina Consultants San Diego, Poway, CA, USA.
Thomas Margolis: Retinal and Ophthalmic Consultants, Northfield, NJ, USA.
Yasha S Modi: New York University Langone Health, New York, NY, USA.
Aleksandra Rachitskaya: Cleveland Clinic Cole Eye Institute, Cleveland, OH, USA. ORCID
Eric W Schneider: Tennessee Retina, Nashville, TN, USA.
Glenn L Stoller: Ophthalmic Consultants of Long Island, Long Island, NY, USA.
Jay C Wang: Northern California Retina Vitreous Associates, Mountain View, CA, USA.
Ankoor R Shah: Retina Consultants of Texas, Houston, TX, USA.
To investigate how home optical coherence tomography (OCT) influences the clinical decision-making of retina specialists for the management of neovascular age-related macular degeneration (nAMD). In this retrospective imaging review, 15 retina specialists each evaluated 10 home OCT data segments from 29 eyes being treated for nAMD. Based on OCT data, indications were identified for when eyes should be treated, which antivascular endothelial growth factor should be used, and the specific retinal fluid and time thresholds for notification. Withholding treatment was recommended in 64 (42.7%) of 150 data segments (95% CI, 34.7-50.6), whereas 100% of eyes received treatment on the last day of each data segment. Treatment was recommended in 86 cases (57.3%), with treatment occurring 7 or more days before the actual treatment was advised in 52 (60.5%) of 86 data segments. This earlier treatment would have prevented the accumulation of intraretinal fluid (IRF), subretinal fluid (SRF), and total retinal fluid for 69.1 nL, 162.2 nL, and 231.2 nL days. Retina specialists chose a different type of treatment agent in 35 (40%) of 86 cases. The following notification values were set: IRF, mean 9.8��������14.9 nL (median, 5; IQR, 5); SRF, mean 10.2��������16.1 nL (median, 5.5; IQR, 5); total retinal fluid, mean 15.2��������24.0 nL (median, 10; IQR, 5). The time-based notification interval was set at a mean of 34.7��������21.9 days (median, 30; IQR, 2). Home OCT-based decision-making by retina specialists differed substantially from actual clinical care. Home OCT has the potential to facilitate personalized care in nAMD.
