Prospective, Longitudinal Pilot Study
Purpose: To evaluate longitudinally the performance of the Notal Vision Home OCT (NVHO), comprising a spectral-domain OCT device for patient self-imaging at home, telemedicine infrastructure for automated data upload, and deep learning algorithm for automated OCT evaluation. The aims were to study t...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-06-01
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| Series: | Ophthalmology Science |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666914521000324 |
| _version_ | 1818885947033387008 |
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| author | Tiarnan D.L. Keenan, BM BCh, PhD Michaella Goldstein, MD Dafna Goldenberg, MD Dinah Zur, MD Shiri Shulman, MD Anat Loewenstein, MD |
| author_facet | Tiarnan D.L. Keenan, BM BCh, PhD Michaella Goldstein, MD Dafna Goldenberg, MD Dinah Zur, MD Shiri Shulman, MD Anat Loewenstein, MD |
| author_sort | Tiarnan D.L. Keenan, BM BCh, PhD |
| collection | DOAJ |
| description | Purpose: To evaluate longitudinally the performance of the Notal Vision Home OCT (NVHO), comprising a spectral-domain OCT device for patient self-imaging at home, telemedicine infrastructure for automated data upload, and deep learning algorithm for automated OCT evaluation. The aims were to study the system’s performance in daily image acquisition and automated analysis and to characterize the dynamics of retinal fluid exudation in neovascular age-related macular degeneration (nAMD). Design: Pilot prospective, observational longitudinal study. Participants: Four individuals (mean age, 73.8 years) with nAMD (one or both eyes) undergoing anti–vascular endothelial growth factor therapy in routine clinical practice. Methods: The participants performed daily self-imaging at home with the NVHO for 1 month. The macular cube scans were uploaded automatically to the Notal Health Cloud. They underwent evaluation separately by the Notal OCT Analyzer (NOA) and human expert graders for fluid presence, segmentation, and volume. Main Outcome Measures: Daily self-imaging completion, image quality, acquisition time, agreement between automated and human grading of retinal fluid, and temporal dynamics of fluid volume. Results: Of 240 self-imaging attempts initiated, the number successfully completed was 211 (87.9%). Of these, 97.6% had satisfactory quality. For fluid presence, the NOA agreed with human grading in 94.7% of cases. From a subset of 24 scans with fluid, for agreement between NOA and human fluid volume measurements, the correlation coefficient was 0.996 and mean absolute difference was 1.5 nl (vs. 0.995 and 1.2 nl, respectively, for interhuman agreement). Graphic plots of fluid volume revealed wide variation in the dynamics of fluid exudation and treatment response. Conclusions: The participants could perform daily self-imaging at home and generate macular cube scans of satisfactory quality. Automated quantitative OCT analysis achieved high agreement with human grading. Daily self-imaging with automated OCT analysis permitted detailed characterization of the dynamics of fluid exudation and revealed wide variation between eyes. Metrics describing these dynamics may become important disease biomarkers. Home OCT telemedicine systems represent an alternative paradigm of disease monitoring; they may allow highly personalized retreatment decisions, with fewer unnecessary injections and clinic visits. |
| first_indexed | 2024-12-19T16:13:32Z |
| format | Article |
| id | doaj.art-4f8bf14f1a7548b4af34e9ef64527ec9 |
| institution | Directory Open Access Journal |
| issn | 2666-9145 |
| language | English |
| last_indexed | 2024-12-19T16:13:32Z |
| publishDate | 2021-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Ophthalmology Science |
| spelling | doaj.art-4f8bf14f1a7548b4af34e9ef64527ec92022-12-21T20:14:41ZengElsevierOphthalmology Science2666-91452021-06-0112100034Prospective, Longitudinal Pilot StudyTiarnan D.L. Keenan, BM BCh, PhD0Michaella Goldstein, MD1Dafna Goldenberg, MD2Dinah Zur, MD3Shiri Shulman, MD4Anat Loewenstein, MD5Division of Epidemiology and Clinical Applications, National Eye Institute, National Institutes of Health, Bethesda, Maryland; Correspondence: Tiarnan D. L. Keenan, BM BCh, PhD, National Institutes of Health, Building 10, CRC, Room 10D45, 10 Center Drive, MSC 1204, Bethesda, MD 20892-1204.Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, IsraelDivision of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Division of Ophthalmology, Assuta Medical Center, Tel Aviv, IsraelDivision of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, IsraelDivision of Ophthalmology, Assuta Medical Center, Tel Aviv, IsraelDivision of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, IsraelPurpose: To evaluate longitudinally the performance of the Notal Vision Home OCT (NVHO), comprising a spectral-domain OCT device for patient self-imaging at home, telemedicine infrastructure for automated data upload, and deep learning algorithm for automated OCT evaluation. The aims were to study the system’s performance in daily image acquisition and automated analysis and to characterize the dynamics of retinal fluid exudation in neovascular age-related macular degeneration (nAMD). Design: Pilot prospective, observational longitudinal study. Participants: Four individuals (mean age, 73.8 years) with nAMD (one or both eyes) undergoing anti–vascular endothelial growth factor therapy in routine clinical practice. Methods: The participants performed daily self-imaging at home with the NVHO for 1 month. The macular cube scans were uploaded automatically to the Notal Health Cloud. They underwent evaluation separately by the Notal OCT Analyzer (NOA) and human expert graders for fluid presence, segmentation, and volume. Main Outcome Measures: Daily self-imaging completion, image quality, acquisition time, agreement between automated and human grading of retinal fluid, and temporal dynamics of fluid volume. Results: Of 240 self-imaging attempts initiated, the number successfully completed was 211 (87.9%). Of these, 97.6% had satisfactory quality. For fluid presence, the NOA agreed with human grading in 94.7% of cases. From a subset of 24 scans with fluid, for agreement between NOA and human fluid volume measurements, the correlation coefficient was 0.996 and mean absolute difference was 1.5 nl (vs. 0.995 and 1.2 nl, respectively, for interhuman agreement). Graphic plots of fluid volume revealed wide variation in the dynamics of fluid exudation and treatment response. Conclusions: The participants could perform daily self-imaging at home and generate macular cube scans of satisfactory quality. Automated quantitative OCT analysis achieved high agreement with human grading. Daily self-imaging with automated OCT analysis permitted detailed characterization of the dynamics of fluid exudation and revealed wide variation between eyes. Metrics describing these dynamics may become important disease biomarkers. Home OCT telemedicine systems represent an alternative paradigm of disease monitoring; they may allow highly personalized retreatment decisions, with fewer unnecessary injections and clinic visits.http://www.sciencedirect.com/science/article/pii/S2666914521000324AgreementArtificial intelligenceAutomatedDeep learningHome OCTMacular exudation |
| spellingShingle | Tiarnan D.L. Keenan, BM BCh, PhD Michaella Goldstein, MD Dafna Goldenberg, MD Dinah Zur, MD Shiri Shulman, MD Anat Loewenstein, MD Prospective, Longitudinal Pilot Study Ophthalmology Science Agreement Artificial intelligence Automated Deep learning Home OCT Macular exudation |
| title | Prospective, Longitudinal Pilot Study |
| title_full | Prospective, Longitudinal Pilot Study |
| title_fullStr | Prospective, Longitudinal Pilot Study |
| title_full_unstemmed | Prospective, Longitudinal Pilot Study |
| title_short | Prospective, Longitudinal Pilot Study |
| title_sort | prospective longitudinal pilot study |
| topic | Agreement Artificial intelligence Automated Deep learning Home OCT Macular exudation |
| url | http://www.sciencedirect.com/science/article/pii/S2666914521000324 |
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