title: EFFECTIVENESS OF DIFFERENT MONITORING MODALITIES IN THE DETECTION OF NEOVASCULAR AGE-RELATED MACULAR DEGENERATION: The Home Study, Report Number 3.
abstract: OBJECTIVE
  To determine the effectiveness of different monitoring modalities to detect incident neovascularization associated with age-related macular degeneration (AMD).
  
  
  METHODS
  Secondary analyses compared the rates of detecting incident neovascular AMD in prescheduled office visits versus office visits triggered by monitoring device or by symptom realization in a randomized trial evaluating home telemonitoring device plus standard care (device arm) versus standard care alone.
  
  
  RESULTS
  At prescheduled office visits, neovascular AMD was detected in 14/1927 visits (0.7%, 95% confidence interval [CI]: 0.4%-1.1%) and 14/1949 visits (0.7%, 95% CI: 0.3%-1.1%) in the device and standard care alone arms, respectively. Thirty-seven participants with neovascular AMD were detected in 318 office visits (11.6%, 95% CI: 8.1%-15.2%) triggered by device or symptom realization and 17 neovascular AMD in 65 office visits (26%, 95% CI: 15.5%-36.8%) triggered by symptom realization in the device and standard care alone arms, respectively. The home device strategy had a higher neovascular-AMD detection rate than prescheduled office visits (relative risk = 16.0 [95% CI: 8.8-29.3]). Neovascular AMD detected at triggered visits were associated with less vision loss from baseline in the device arm versus standard care alone arm (-3 letters vs. -11.5 letters, respectively, P = 0.03).
  
  
  CONCLUSIONS
  Telemonitoring may alter the management of patients with AMD and improve vision outcomes.
authors.affiliation: *Clinical Trials Branch, National Eye Institute/National Institutes of Health, Bethesda, Maryland; †The EMMES Corporation, Rockville, Maryland; ‡The Retina Division at the Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland; §Elman Retina Group, Baltimore, Maryland; ¶Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin; **Retina Group of Washington, Washington, D.C.; ††Ophthalmic Consultants of Boston, Boston, Massachusetts; ‡‡Scheie Eye Institute, Philadelphia, Pennsylvania; §§Retina-Vitreous Associates Medical Group, Los Angeles, California.
authors.forename: Emily Y
authors.initials: EY
authors.lastname: Chew
authors.forename: Traci E
authors.initials: TE
authors.lastname: Clemons
authors.forename: Molly
authors.initials: M
authors.lastname: Harrington
authors.forename: Susan B
authors.initials: SB
authors.lastname: Bressler
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Elman
authors.forename: Judy E
authors.initials: JE
authors.lastname: Kim
authors.forename: Richard
authors.initials: R
authors.lastname: Garfinkel
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Heier
authors.forename: Alexander
authors.initials: A
authors.lastname: Brucker
authors.forename: David
authors.initials: D
authors.lastname: Boyer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D020256:Choroidal Neovascularization / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000295:instrumentation*; D009819:Office Visits; D017216:Telemedicine / Q000379:methods*; D014786:Vision Disorders / Q000175:diagnosis* / Q000503:physiopathology; D014792:Visual Acuity / Q000502:physiology; D058609:Visual Field Tests / Q000295:instrumentation; D014794:Visual Fields / Q000502:physiology; D057135:Wet Macular Degeneration / Q000175:diagnosis* / Q000503:physiopathology
chemical_list: D020533:Angiogenesis Inhibitors