Remote Monitoring of Visual Function in Patients with Maculopathy: The Aphelion Study

Anthony Joseph, Mark Bullimore, Faye Drawnel, Marco Miranda, Zoe Morgan, Yi Zhong Wang

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: Remote monitoring of vision, using tools such as the shape discrimination hyperacuity (SDH) test, can detect disease activity in patients with maculopathy. We determined the in-clinic accuracy and repeatability of three myVisionTrack expanded version (mVTx) tests for self-testing of visual acuity (VA) and contrast sensitivity. Methods: Aphelion, a single-arm, prospective study conducted at two sites in the USA, included adults with any maculopathy and a baseline VA of 0.7 log of minimum angle of resolution (logMAR) (Snellen 20/100) or better. Participants completed the mVTx tests (tumbling E, Landolt C, contrast sensitivity, and SDH) and standard clinical tests (near and distance Early Treatment Diabetic Retinopathy Study [ETDRS] charts and the Pelli–Robson contrast sensitivity chart). Test–retest repeatability and agreement between the mVTx tests and the corresponding clinical test were assessed by Bland–Altman analyses. Participants also completed a usability survey. Results: The mean age of the 122 participants was 67 years. The most common diagnosis was age-related macular degeneration (42% of patients). The tumbling E test had a test–retest 95% limit of agreement (LoA) of ± 0.18 logMAR; the Landolt C test, ± 0.23 logMAR; the SDH test, ± 0.24 logMAR; and the contrast sensitivity test, ± 0.32 log contrast threshold (logCT). Compared with the distance ETDRS chart, the LoA was ± 0.35 logMAR for the tumbling E test (mean difference, − 0.07 logMAR) and ± 0.39 logMAR for the Landolt C test (mean difference, 0.03 logMAR). For the contrast sensitivity test, the LoA compared with the Pelli–Robson chart was ± 0.30 logCT (mean difference, − 0.25 logCT). Most participants (85%) reported that they learned the tests quickly. The tumbling E test scored the highest on ease of use. Conclusion: The mVTx tests of VA are accurate and repeatable, supporting their potential use alongside the SDH test to detect disease progression remotely between clinic visits.

Original languageEnglish (US)
Pages (from-to)409-422
Number of pages14
JournalOphthalmology and Therapy
Volume13
Issue number1
DOIs
StatePublished - Jan 2024
Externally publishedYes

Keywords

  • Contrast sensitivity
  • Hyperacuity
  • Maculopathy
  • Remote monitoring
  • Smartphone application
  • Visual acuity

ASJC Scopus subject areas

  • Ophthalmology

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