The major problem with wet macular degeneration is that the “wet” abnormal blood vessels tend to affect the macula. This usually causes decreased vision and distortion. Home monitoring, or self-monitoring, is based on the premise that new distortion may signify presence of neovascularization.
Patients with wet macular degeneration have two major concerns; recurrence in the same eye and wet macular degeneration developing in the other eye. To alleviate their fears, doctors have long been recommending home monitoring as a method to catch the disease as early as possible.
Distortion from “wet” macular degeneration is similar to the “Princess and the Pea,” where the abnormal vessels are trying to sandwich themselves between the layers of the retina. This causes the retinal surface to become uneven which translates into distortion.
Amsler Grid Testing – The Amsler Grid is used on a daily basis, testing each eye separately. In this way, a patient with macular degeneration will become familiar with their own pattern of distortion. Any new waviness should be reported to their doctor. This may be a sign of active “wet” macular degeneration.
An electronic version of the Amsler Grid is available at “MyVisionTest.com.” There is also a link on the left side panel if you ever forget.
The ForSeeHome™ AMD Monitor is the first telemedicine device for the home. According to the company web page, this device offers self-monitoring of patients with known macular degeneration. It is not a diagnostic tool, but monitors changes in distortion. This information can then be transferred to the eye doctor for review. The device has received FDA “510(k)” clearance.
What Does This Mean? The idea of self-monitoring is to catch the “wet” form as early as possible. Early detection of wet macular degeneration usually translates to a better outcome. In my experience patients with wet macular degeneration are pretty motivated to self-test regularly and the Amsler Grid seems to be a very good, cheap, and reliable test. Remember that the macula is very sensitive and any change in distortion is usually pretty obvious.
It seems that a new telemedicine device might be “overdoing” it, at least from what I can tell from the web page and the press release. It does not make a diagnosis and examination by the doctor is still necessary.
I see three scenarios; however, where this might be useful; 1) a patient is unable to tell, himself, if there are changes in his own vision (yes, it happens), 2) a patient’s vision is so poor that subtle changes are unnoticed and 3) the device picks up earlier changes than can be noticed by the average individual, that is, the device is super-sensitive.
“Randy”
Randall V. Wong, M.D.
Ophthalmologist, Retina Specialist
Fairfax, Virginia
