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    Macular Thickness Maps for Monitoring Wet AMD

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    To preserve vision in patients receiving anti-VEGF therapy for exudative age-related macular degeneration (eAMD), clinicians rely on in-office OCT scans to detect new onset or recurrent exudation over time. Because interruptions in monitoring can have devastating effects on vision in eAMD patients, Bascom Palmer Eye Institute researchers wanted to explore the effectiveness of and potential for remote monitoring using macular thickness maps (MTMs)—a technique shown in previous research to effectively determine the presence of macular fluid in eyes with eAMD. They report that MTMs are an effective way to monitor disease progression remotely and may help identify patients who need treatment in clinic while minimizing unnecessary visits for stable patients.1

    “Our findings suggest that MTMs provide sufficient information to accurately identify new or recurrent fluid in patients with eAMD,” said lead study author Omer Trivizki, MD, MBA, at Tel Aviv Medical Center, and a senior researcher at Bascom Palmer Eye Center. “By enabling timely detection and treatment, remote monitoring with MTMs could preserve vision for AMD patients,” he said.

    An up-close view of a white OCT scanner against a lime green background.

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    Approach. The researchers performed a retrospective analysis using data from 53 eyes—including a total of 45 patients being treated in at least one eye for eAMD with anti-VEGF therapy. They compared different imaging strategies, including MTMs alone, selective OCT B-scans alone, and the entire OCT data set. “Although the cohort size was relatively small, our analysis included data from over 1,380 imaging sessions acquired over 12 years, which allowed us to confidently draw conclusions,” said Dr. Trivizki.

    MTMs. While performing full OCT scans to identify fluid changes can be complex and time consuming, MTMs are generated using a macular thickness algorithm available on the OCT scanner. The macular thickness analysis is calculated using the distance between the inner limiting membrane and the retinal pigment epithelium.

    Results. Five retinal specialists evaluated the imaging results. The majority consensus based on full OCT data was used as “the ground truth.” On average, the evaluations by the graders of the MTM images agreed with their full OCT assessments in 90% of cases across graders. This was higher than the agreement rate for central B-scans (88%). The results suggest MTMs simplify monitoring and may allow for remote patient self-assessment to identify early fluid changes needing treatment, but more research is required.

    —Christos Evangelou, PhD

     ___________________________

    1 Trivizki O et al. Am J Ophthalmol. 2023;256:1-8.

    ___________________________

    Relevant financial disclosures: Dr. Trivizki—None.

    For full disclosures and the disclosure key, see below.

    Full Financial Disclosures

    Dr. Kastner None.

    Dr. Grant None.

    Dr. Busik Ceramedix: C.

    Dr. Sheheitli  None

    Dr. Trivizki Carl Zeiss Meditec, Perceive Bio: S; AbbVie, Roche, Bayer: L; Truemed: C.

    Disclosure Category

    Code

    Description
    Consultant/Advisor C Consultant fee, paid advisory boards, or fees for attending a meeting.
    Employee E Hired to work for compensation or received a W2 from a company.
    Employee, executive role EE Hired to work in an executive role for compensation or received a W2 from a company.
    Owner of company EO Ownership or controlling interest in a company, other than stock.
    Independent contractor I Contracted work, including contracted research.
    Lecture fees/Speakers bureau L Lecture fees or honoraria, travel fees or reimbursements when speaking at the invitation of a commercial company.
    Patents/Royalty P Beneficiary of patents and/or royalties for intellectual property.
    Equity/Stock/Stock options holder, private corporation PS Equity ownership, stock and/or stock options in privately owned firms, excluding mutual funds.
    Grant support S Grant support or other financial support from all sources, including research support from government agencies (e.g., NIH), foundations, device manufacturers, and\or pharmaceutical companies. Research funding should be disclosed by the principal or named investigator even if your institution receives the grant and manages the funds.
    Stock options, public or private corporation SO Stock options in a public or private company.
    Equity/Stock holder, public corporation US Equity ownership or stock in publicly traded firms, excluding mutual funds (listed on the stock exchange).

     

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