Home Monitoring of Age-Related Macular Degeneration Progress

A new device helps monitor age-related macular degeneration (AMD) for signs of an oncoming choroidal neovascularization (CNV) at the patient's home.

The ForeseeHome device is a telemedicine system that characterizes and follows changes in the extent of central and paracentral metamorphopsia (visual distortion) in intermediate AMD patients. The device--which is installed at the patient's home and is connected on-line to a central data monitoring center--runs a psychophysical test based on preferential hyperacuity perimetry (PHP), a design specifically developed for unsupervised usage by the elderly. At the end of each test, results are automatically transmitted to the monitoring center; then, through a secure web site, eye care professionals have immediate access to test results of their corresponding patients, assisting in correct diagnosis.

Among the features of the ForeseeHome device are field tested ergonomics and human factors driven design; a simple plug and play operation; automatic eye detection; and a closed hood and head sensors to control for ambient light and distance from display. The three-minute test is conducted via an integrated, interactive self-tutorial designed for elderly patients, and is specific to PHP technology. A call center offers assistance with initial installation, as well as active intervention when compliance falls below requested minimum. On-line access to the patient's information is granted according to role such as the eye care professional, the data-monitoring center, administrators, and the patient himself. A web report is generated for users that include daily test results, trend analysis, spatial maps of interest, and frequency of usage. The ForeseeHome device is a product of Notal Vision (Tel Aviv, Israel), and has received approval both in Europe (CE Marking), and from the U.S. Food ad Drug Administration (FDA).

"The Foresee Home test distinguishes between intermediate AMD and CNV eyes with high specificity and sensitivity,” said Anat Loewenstein, M.D., of the Tel Aviv Medical Center (Israel), who presented the results of a study of 109 patients at risk for developing wet AMD who used the ForeseeHome device at the Association for Research in Vision and Ophthalmology annual meeting, held during May 2009 in Fort Lauderdale (FL, USA).

AMD usually affects older adults and results in a loss of vision in the center of the visual field (the macula) because of damage to the retina; it occurs in "dry” and "wet” forms. In the dry (nonexudative) form, cellular debris called "drusen” accumulates between the retina and the choroid, and the retina can become detached. In the wet (exudative) more severe form, blood vessels grow up from the choroid behind the retina, and the retina can become detached. It can be treated with laser coagulation, and with medication that stops and sometimes reverses the growth of blood vessels.

Related Links:
Notal Vision
Tel Aviv Medical Center