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.

[Analysis of the "Portal" Care Model - Examination of the Outcome Quality of IVOM Therapy with Regard to Latency Periods in Exudative AMD]. / Analyse des Versorgungsmodells "Portal" ­ Untersuchung der Ergebnisqualität der IVOM-Therapie im Hinblick auf Latenzzeiten bei exsudativer AMD.

BACKGROUND: For many maculopathies, the management of intravitreal injection (IVOM) presents a logistical challenge. To ensure contemporary and timely treatment, patients have to organise their rides to the surgery, and the clinic has to provide enough short term resources. The objective of this study is an evaluation of the IVOM therapy for patients with exudative AMD according to four quality indicators a) latency time within the treatment and monitoring cycle, b) the treatment and monitoring frequency, c) the adherence and d) the medical outcome. MATERIALS AND METHODS: For more than seven years, patients with exudative AMD have been treated by many ophthalmologists using a networked portal system. Therefore, conservative doctors and surgical eye centres exchange treatment-relevant data. In total there are documented 2283 eyes of 1850 patients. We evaluate these electronic medical records retrospectively according to the mentioned quality indicators. RESULTS: This evaluation results in a latency time from OCT monitoring and the start of a new IVOM series of 8.1 working days. Within the first two treatment years, we achieve 10.5 injections and 8.2 monitoring visits in average. After two years, 72.9% of the cases were still in treatment or monitoring. We observed stabilisation of mean visual accuracy of about 0.05 logMAR. CONCLUSIONS: To improve the visual acuity, it is essential to achieve consistent therapy over a long period of time, especially in the case of treatment-relevant exudative AMD. The evaluation of our treatment system demonstrated that the PRN-scheme can be implemented by a cooperatively organised IVOM therapy. It is possible to achieve rapid retreatment and good adherence over many treatment years. For treatment-relevant exudative AMD it is essential for the improvement of the visual accuracy to implement consistent therapy over a long period of time. The evaluation of our treatment system demonstrates that the PRN scheme can be implemented in a cooperatively organised IVOM therapy. It is possible to achieve rapid retreatment and good patients' adherence over many treatment years.