Perspectives on the Home Monitoring of Macular Disease

Miller, James R. C.; Patel, Praveen J; Hanumunthadu, Daren

doi:10.1007/s40123-022-00632-6

Cited by 4 publications

(2 citation statements)

References 20 publications

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“…When making decisions regarding future home monitoring of patients over time, a number of considerations need to be addressed. First, the frequency of administration—the literature on home monitoring of DME is in its infancy, but emergent studies of this condition 58 and other maculopathies 59,60 point towards a daily testing regimen being optimal. Qualitative research on other eye conditions suggests that patients may be highly motivated to undertake frequent home self‐monitoring if it would mean any deterioration in vision could be detected and addressed sooner 61 .…”

Section: Discussionmentioning

confidence: 99%

Tablet‐based tests of everyday visual function in a diabetic macular oedema (DME) clinic waiting area: A feasibility study

Taylor,

Alquiza,

Jones

et al. 2023

Ophthalmic Physiologic Optic

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Purpose(1) To assess the feasibility of conducting tablet‐based vision tests in hospital clinic waiting areas; (2) To test the hypothesis that increasing severity of diabetic macular oedema (DME) is associated with the performance of tablet‐based surrogates of everyday tasks and self‐reported visual function.MethodsSixty‐one people with mild (n = 28), moderate (n = 24) or severe (n = 9) DME performed two tablet‐based tests of ‘real‐world’ visual function (visual search and face recognition) while waiting for appointments in a hospital outpatient clinic. Participants also completed a tablet‐based version of a seven‐item, visual‐functioning (VF‐7) patient‐reported outcome measure. Test performance was compared to previously published 99% normative limits for normally sighted individuals.ResultsThirty‐four participants (56%; 95% confidence interval [CI] 43%–68%) exceeded normative limits for visual search, while eight (13%; 95% CI 65%–24%) exceeded normative limits for face discrimination. Search duration was significantly longer for people with severe DME than those with mild and moderate DME (p = 0.01). Face discrimination performance was not significantly associated with DME severity. VF‐7 scores were statistically similar across DME severity groups. Median time to complete all elements (eligibility screening, both tablet‐based tasks and the VF‐7) was 22 (quartiles 19, 25) min. Further, 98% and 87% of participants, respectively, reported the search task and face discrimination task to be enjoyable, while 25% and 97%, respectively, reported finding the two tasks to be difficult.ConclusionsPortable tablet‐based tests are quick, acceptable to patients and feasible to be performed in a clinic waiting area with minimal supervision. They have the potential to be piloted in patients' homes for self‐monitoring.

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Section: Discussionmentioning

confidence: 99%

Tablet‐based tests of everyday visual function in a diabetic macular oedema (DME) clinic waiting area: A feasibility study

Taylor,

Alquiza,

Jones

et al. 2023

Ophthalmic Physiologic Optic

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“…A variety of approaches have been considered including visual function tests implemented on tablets or smartphones and home OCTs. 1 – 4 …”

Section: Introductionmentioning

confidence: 99%

Inequalities in Uptake and Use of Digital Applications for Home-Monitoring of Neovascular Age-Related Macular Degeneration in an Elderly Visually Impaired Population: The MONARCH Study

Hogg,

Wickens,

O'Connor

et al. 2024

Trans. Vis. Sci. Tech.

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Purpose To describe inequalities in the Monitoring for Neovascular Age-related Macular Degeneration Reactivation at Home (MONARCH) diagnostic test accuracy study for: recruitment; participants’ ability to self-test; and adherence to testing using digital applications during follow-up. Methods Home-monitoring vision tests included two tests implemented as software applications (apps: MyVisionTrack and MultiBit) on an iPod Touch device. Patients were provided with all hardware required to participate (iPod and MIFI device) and trained to use the apps. Regression models estimated associations of age, sex, Index of Multiple Deprivation, strata of time since first diagnosis, and baseline visual acuity at study entry on outcomes of willingness to participate, ability to perform tests, and adherence to weekly testing. Results A minority of patients who were approached were willing-in-principle to participate. Increasing age was associated with being unwilling-in-principle to participate. Patients from the most deprived areas had a 47% decrease in odds of being willing compared to those from the middle quintile deprived areas (odds ratio, 0.53; 95% confidence interval = 0.32, 0.88). Increasing age and worse deprivation were not consistently associated either with ability to self-monitor with the index tests, or adherence to weekly testing. Conclusions Associations of increasing age and worse deprivation index were associated with unwillingness-in-principle to participate despite the provision of hardware’ highlighting the potential for inequality with interventions of the kind evaluated. Translational Relevance The clear evidence of inequalities in participation should prompt future research on ways to encourage adoption of mobile health technologies by underserved populations.

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