Can Digital Instruments Like the Macula-App Support AMD Therapy? / Können digitale Instrumente wie die Makula-App die AMD-Therapie unterstützen?

BACKGROUND: A long lasting and continuous anti VEGF-therapy represents a gold standard in nAMD treatment to maintain and stabilize vision in the individual patient. Disease Management represents a daily life challenge for patients and relatives and "Real-life" clinical outcomes of patients treated with IVOM therapy are often inferior to results from randomized clinical trials. After their diagnosis, AMD-patients undergo individualized long-term therapeutic approaches. An important success factor is, that this care is patient centered and provided continuously. This study aimed at evaluating, whether digital tools, such as Makula-App 1.0 developed by the AMD-Netz can support AMD patients. PATIENTS AND METHODS: The results of a user survey integrated in the Makula-App 1.0 (n = 110) as well as the results of an additional survey on the topic of "Digital appointment management in IVOM therapy" by ophthalmologists (n = 54) and patients (n = 60) were analysed with respect to use and acceptance of the Makula-App. RESULTS: The survey revealed: 79% of Makula-App user rely on the information presented, 71% perceive the device helpful for their daily life and 80% would recommend the device. 52% of ophthalmologists and 65% of patients regard clear benefits of future digital tools for patient adherence. A digital appointment management function is rated as important by 82% of ophthalmologists. CONCLUSIONS: User perceived Makula-App 1.0 as well as its future development options as beneficial especially for the management of appointment arrangements but also as information tool. Ophthalmologists confirm the importance and usefulness of devices such as Makula-App 1.0 with respect to an optimized management of appointments and an improved patient adherence. These promising results support the future development of a Makula-App 2.0 platform, providing interfaces for an information exchange between patient and treating ophthalmologist.

A new surgical triple procedure in pseudoexfoliation glaucoma using cataract surgery, Trabectome, and trabecular aspiration.

BACKGROUND: To evaluate the potential of lowering intraocular pressure in pseudoexfoliation glaucoma with combined phacoemulsification, Trabectome, and trabecular aspiration (triple procedure) compared to phacoemulsification and trabecular aspiration alone. METHODS: Using a case-matched retrospective study design, 30 patients were included into each group. The main outcome measures were the reduction of intraocular pressure and medication score at the end of follow-up. Clinical data were collected from the patients' medical records. RESULTS: Mean follow-up was 15 months in both groups. Intraocular pressure decreased from 25.3 ± 6.3 mmHg to 14.4 ± 3.7 mmHg (p < 0.0001) in the triple procedure group and from 25.3 ± 4.2 mmHg to 18.1 ± 4.2 mmHg (p < 0.0001) in the control group. The medication score was lowered from 3.4 ± 1.7 to 2.1 ± 1.2 (p = 0.0017) in the triple procedure group and from 3.8 ± 1.8 to 2.3 ± 1.5 (p < 0.008) in the control group. The reduction of intraocular pressure was higher (p < 0.004) in the triple procedure group (38.4 ± 17.3 %) compared to the control group (26.8 ± 19.6 %) The reduction of the medication score did not differ significantly. CONCLUSIONS: The triple procedure is more effective in lowering intraocular pressure compared to phacoemulsification and trabecular aspiration alone in pseudoexfoliation glaucoma.