McKibbin, M, Baker, L, Baxter, P et al. (2 more authors) (2015) The accuracy of home monitoring to detect disease activity during maintenance therapy for neovascular ARMD. Graefe's Archive for Clinical and Experimental Ophthalmology, 253 (9). 1479 - 1483. ISSN 0721-832X
Abstract
Purpose: To report the reproducibility, sensitivity, specificity, and predictive value of home monitoring for disease activity in neovascular age-related macular degeneration (ARMD). Methods: Participants were trained to complete three separate home monitoring tasks, designed to identify subtle changes in visual function that may indicate increasing neovascular ARMD disease activity. These included measurement of near acuity and assessments of environmental distortion and overall visual function. The need for repeat intra-vitreal injection, as predicted by home monitoring, was compared to standard clinical assessment involving ETDRS distance acuity, slit lamp examination, and spectral domain ocular coherence tomography. Results: Although all participants were able to complete the home monitoring tasks, the reproducibility of each of the three tasks was modest. Cohen’s kappa was 0.118 (p = 0.54) for the comparison of the outcome of the home monitoring exercise with the gold standard of hospital assessment to determine disease activity. The sensitivity of the home monitoring exercise was 33.3 % (95 % CI 15.2–51.4) and the specificity was 77.8 % (95 % CI 61.8–93.8). Conclusions: This study suggests that current tests of visual function, which are readily completed at home, cannot replace traditional clinic-based assessments for neovascular ARMD disease activity. Instead, such tests are likely to remain complementary to standard assessment in clinic.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | (c) Springer-Verlag Berlin Heidelberg 2014. This is an author produced version of a paper published in Graefe's Archive for Clinical and Experimental Ophthalmology. Uploaded in accordance with the publisher's self-archiving policy. The final publication is available at Springer via http://dx.doi.org/10.1007/s00417-014-2839-4 |
Keywords: | Age-related macular degeneration; Self-monitoring; Sensitivity |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Genetics, Health and Therapeutics (LIGHT) > Division of Epidemiology & Biostatistics (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 08 Oct 2015 15:08 |
Last Modified: | 08 Nov 2015 08:44 |
Published Version: | http://dx.doi.org/10.1007/s00417-014-2839-4 |
Status: | Published |
Publisher: | Springer Verlag |
Identification Number: | 10.1007/s00417-014-2839-4 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:89618 |