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Real World Data: Home Monitoring Detects Conversion to nAMD

We know that early diagnosis and treatment of wet (or neovascular) age-related macular degeneration (nAMD) is crucial to preserving vision. However, in order to catch nAMD before it progresses, patients need to be monitored — which is becoming an increasingly difficult proposition during the COVID-19 pandemic. 

Fortunately, home or remote monitoring diagnostics have experienced an uptick in use — with impressive results. The ForeseeHome® AMD Monitoring Program (Notal Vision, Virginia, USA) is one such innovation — also with impressive (real world) results. This data — which showed that the use of ForeseeHome provides a significant benefit to patients by detecting nAMD earlier — was presented at the American Society of Retina Specialists 38th Annual Scientific Meeting (ASRS 2020).

We’re a naturally curious bunch at PIE magazine. So to learn more, PIE magazine CEO Matt Young spoke with Allen Ho, MD, the study’s principal author and director of retina research at Wills Eye Hospital and professor of ophthalmology at the Kimmel School of Medicine at Thomas Jefferson University (Philadelphia, Pennsylvania, USA), about ForeseeHome and how it can help detect nAMD earlier and thus, improve long-term visual outcomes.

Real world experience shows… home monitoring works!

“ForeseeHome is a home monitoring device for patients with age-related macular degeneration who are at risk of conversion from the intermediate dry form of the disease to the more advanced wet form,” explained Dr. Ho. 

It’s important to monitor vision in these cases because earlier detection generally means better vision at start of anti-VEGF treatment, which translates to better outcomes: “We know that most patients in the real-world present with a certain level of vision decline,” explained Dr. Ho. 

To illustrate this point, he shared data from a retrospective analysis of medical records from the Notal Vision Diagnostic Clinic including 306 eyes that converted to wet AMD. What they found was encouraging: ForeseeHome identified 69% of the conversions, which confirms the findings of the AREDS 2 randomized controlled HOME study, where 64% of the detections were triggered by ForeseeHome alerts in a comparable group. 

This stands out for a few reasons: One is that there’s usually a disconnect between the real world and clinical data, said Prof. Ho. “These were patients, post-FDA clearance, commercial use, who had detection of CNV based on ForeseeHome,” he shared. 

Further, the study found that functional vision (≥20/40) at conversion was maintained in 83% of patients in the real world ForeseeHome cohort, compared to only 34% in the standard of care IRIS registry. This real world data resembles the results of the HOME study, where 94% of patients maintained functional vision at conversion using the same system.

Dr. Ho said, “This confirms that the use of ForeseeHome provides a significant benefit to patients as a means of increasing the early detection of wet AMD.”

Various factors — technology, remote home monitoring, testing, the ability to produce the system and transmit data to the cloud, having patients comfortable with using technology, etc. — are the driving force behind this innovation, explained Dr. Ho. “As patients increasingly engage with telehealth tools, ForeseeHome can be a useful strategy to monitor at-risk intermediate AMD and help protect vision.”

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