Daily Self-Imaging with Home OCT Viable Among Patients with nAMD

Jeffrey Heier, MD

New findings suggest daily home optical coherence tomography (OCT) imaging has feasibility among patients with neovascular age-related macular degeneration (nAMD).

The home OCT additionally allowed for detailed graphical and mathematical analyses of retinal fluid volume trajectories, including novel parameters in order to inform clinical decision making.

“It demonstrated good agreement with human expert grading for retinal fluid identification and excellent agreement with the in-clinic OCT scans,” wrote study author Jeffrey Heier, MD, Ophthalmic Consultants of Boston.

The prospective, observational study aimed to validate the performance of a home OCT system (Notal Vision Home OCT) for daily self-imaging at home and characterize the retinal fluid dynamics of patients with nAMD.

A total of 15 participants who had at least 1 eye with nAMD and underwent anti-VEGF treatments were included in the study. The participants were required to perform daily self-maging at home using the home OCT system for 3 months.

Scans were then uploaded to the cloud, analyzed using an OCT analyzer, and evaluated by human experts for fluid presence. They were then compared with in-office OCT scans.

The main outcome measures were considered weekly self-scan rate, image quality, scan duration, agreement between the home OCT analyzer and human expert grading for fluid presence, and agreement between the home OCT system and in-office OCT sans for fluid presence.

As well, the measures include central subfield thickness (CST), retinal fluid volume, and the characteristics of fluid dynamics during the study and in response to treatments.

Data show the mean weekly scan frequency was 5.7 ± 0.9 scans per week and 93% of the included scans were eligible for analyses. The median scan time was 42 seconds.

Investigators reported the OCT analyzer and human experts agreed on the fluid status in 83% of the scans, with discrepancies limited to trace amounts of fluid. Moreover, the NVHO scans analyzed and the in-office OCT scans graded by human experts agreed on the fluid status in 96% of the cases.

Based on home OCT and in-office OCT scans, CST and retinal fluid volume measurements demonstrate a Pearson correlation coefficient of r = .90 and r = .92, respectively. Over time, novel parameters, including retinal fluid volume and area under the curve (AUC) of retinal fluid volume, demonstrated wide variations in fluid exudation and load among the patients.

“Parameters such as the rate of reduction in fluid volume in the first week after treatment and AUC between treatments captured the speed and duration of the response to anti-VEGF agents,” Heier added.

The study, “Prospective, Longitudinal Study: Daily Self-Imaging with Home OCT for Neovascular Age-Related Macular Degeneration,” was published in Ophthalmology Retina.