Macular thickness maps alone are sufficient to guide the management of recurrent exudation in patients with exudative age-related macular degeneration (eAMD) and may enable remote monitoring in these individuals, according to research published in the American Journal of Ophthalmology.
Researchers included 45 patients (eyes, 53; age range, 71-96 years; 62.2% women) in a retrospective, comparative diagnostic analysis to determine whether macular thickness maps can enable eAMD management. Study participants underwent optical coherence tomography (OCT) imaging using a macula centered 6×6 mm scan pattern, and a total of 5 graders viewed 2 consecutive scans using 1 of 3 imaging strategies: macular thickness maps alone, foveal-centered B scans alone, or 5 macular B scans, which included the foveal-centered B scan.
After performing imaging assessments using each method, the graders determined whether their findings warranted a full clinical assessment. The investigators also established the consensus ground truth using a photo fundus imaging review station to evaluate the entire OCT scan.
The intragrader agreement (Fleiss kappa) was highest when the graders were given macular thickness maps alone compared with the ground truth, with graders giving the same clinical recommendation for 88.79% of the cases. Comparing the averages of all 5 graders with the ground truth, the macular thickness maps alone demonstrated the highest level of agreement (90.05%), followed by the central B-scans (87.87%), and the method using 5 B scans (86.512%).
“[T]he use of [macular thickness maps] offers convenience and accessibility, particularly in situations such as the current pandemic, where in-person visits may be limited,” according to the study authors. “This strategy not only enhances patient satisfaction but also contributes to improved healthcare resource allocation by reducing unnecessary clinic visits and associated burdens.”
Limitations of the study included the retrospective design and data collection in the clinic without the use of a prototype home OCT instrument.
Disclosure: This research was supported by Carl Zeiss Meditec, Inc. Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.
Trivizki O, Varcheie M, Bello S, et al. Assessing change in exudative AMD with macular thickness maps as a surrogate strategy for remote patient monitoring. Am J Ophthalmol. Published online July 25, 2023. doi:10.1016/j.ajo.2023.07.014