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Application of Mobile and Wearable Technology in Data Collection for Ophthalmology
Published in Ching-Yu Cheng, Tien Yin Wong, Ophthalmic Epidemiology, 2022
Ashwin Venkatesh, Pradeep Ramulu
Metamorphopsia is a perceived distortion of visual space, commonly seen in disorders of macular function. The ForeseeHome device (Notal Vision, Tel Aviv, Israel) uses preferential hyperacuity perimetry to measure visual distortions in age-related macular degeneration and is designed for unsupervised use by patients in their homes. The test involves 500 retinal data points over 14° of the patient’s central visual field, collected in approximately 3 minutes, and allows quantitative monitoring of changes in macular function in metamorphopsia with greater sensitivity than the Amsler grid.14 Results are automatically transmitted to Notal Vision’s Monitoring Center, where they are logged with all previous tests from that patient. Patients who generate an alert on the ForeseeHome test trigger an immediate recall to their ophthalmologist’s office for additional diagnostic testing and examination. The utility of this device is highlighted by the AREDS2-HOME clinical trial, which concluded that the ForeseeHome device enabled earlier detection of choroidal neovascularization in high-risk patients with age-related macular degeneration.15
Clinical Update on Metamorphopsia: Epidemiology, Diagnosis and Imaging
Published in Current Eye Research, 2021
Daren Hanumunthadu, Benedicte Lescrauwaet, Myles Jaffe, Srinivas Sadda, Emily Wiecek, Jean Pierre Hubschman, Praveen J. Patel
Preferential hyperacuity perimetry can be used for monitoring metamorphopsia and has been used to demonstrate distortion in response to many conditions including neovascular AMD.59 Newer home versions (eg. ForseeHome, Notal Vision Ltd, Tel Aviv, Israel) have been shown to have good levels of sensitivity and could be used to help determine development of active forms of neovascular AMD in patients known to have non-neovascular phenotypes.60 During the test, the subject is presented with a dotted line, with some dots misaligned relative to the centre of the line. The subject’s task is to detect the misalignment of the dots. Successive lines are presented across the whole field of vision corresponding to the macula. The preferential hyperacuity perimetry stimulus used for ForeseeHome is available on https://www.foreseehome.com/hcp/how-it-works-technology/.
Perspectives on remote patient monitoring with self-operated OCT for management of neovascular age-related macular degeneration
Published in Expert Review of Ophthalmology, 2021
Anat Loewenstein, Tiarnan D. L. Keenan
All of these challenges can be resolved. The high cost of a portable OCT will decrease in the future, as many technologies did over time. As to the accessibility issue, some studies have already shown that, the portable home OCT device is accessible for the elderly population and most of them can perform self-imaging with good quality. The detection and quantification of important biomarkers performed by home OCT has proven to be accurate and help facilitate treatment course and implement a true individualized regimen. [34,35] User interface, self-alignment and data transmission must be easy to operate by visually impaired patients. On-device video tutorials and visual ques for self-guided operation have to meet special needs. Moreover, capturing meaningful fluid volume trajectories requires good patient compliance with up to daily self-imaging. Physician led monitoring centers that provide not only home use devices and data analytics but also patient compliance monitoring and engagement services play an important role in remote digital technology enabled health-care models. Compliance data from the remote monitoring center supported ForeseeHome AMD Monitoring Program (Notal Vision Inc., Manassas, Virginia) has shown elderly patients testing 5.6-times per week with a preferential hyperacuity perimetry device at home in a real-world cohort of 8,991 prescribed individuals validating the provider model[36].
The Associations among Metamorphopsia, Orientation Discrimination Threshold, and Retinal Layer Thickness in Patients with Idiopathic Epiretinal Membrane
Published in Current Eye Research, 2018
Tianyu Chen, Binbin Su, Zheyi Chen, JianLiang Tong, Harold Bedell, Zongming Song, Bin Zhang
To study the early and subtle functional changes produced by diseases of the outer retina, several new methods have been developed. M-charts19-22 reduce the amount of spatial redundancy in the Amsler grid stimulus with some success. However, these charts do not address the issue of temporal redundancy at all. Preferential hyperacuity perimetry (PHP)23–26 limits temporal redundancy by presenting each stimulus for a duration less than the latency of saccadic eye movement.27,28 However, there is still some spatial redundancy, as the PHP stimulus is made of a series of equally spaced dots that extend over 14° in space. In this study, we chose the orientation discrimination test (OD test)12,29 that minimizes both the influence of “filling-in” and “averaging out” by measuring the orientation discrimination threshold (ODT) with a group of short lines that are displayed only briefly. The first aim of this study was to quantify the changes in ODT in ERM patients. It is of interest to know if the ODT values are elevated in ERM patients when compared to persons with normal vision. It is also of interest to know if patients who report abnormality in the Amsler grid test (Amsler positive) have higher ODTs than those who are Amsler negative.