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Purpose: To retrospectively analyze clinical outcomes of patients with "treatment‐resistant" neovascular age‐related macular degeneration or diabetic macular edema who were switched to intravitreal faricimab injections (IFIs) using a "real‐world" treat‐and‐extend (TAE) protocol. Methods: Seventy‐one eyes from 62 patients receiving antivascular endothelial growth factor injections were evaluated before and after switching to IFI. Demographic and clinical data were collected. Primary endpoints were treatment interval extension and presence of intraretinal or subretinal fluid on spectral‐domain optical coherence tomography (OCT) after switching to IFI. Secondary endpoints included best‐corrected visual acuity, average OCT central subfield thickness, and presence of a pigment epithelium detachment and pigment epithelium detachment height. Results: The average treatment interval after switching to IFI significantly increased from 37.6 ± 10.8 days to 45.2 ± 16.6 days (p = 0.0016). At the last follow‐up, 35% of eyes were able to achieve a fluid‐free status post‐IFI. A chi‐square test of independence validated this finding by showing a significant difference in the OCT findings trending towards less or no fluid on follow‐up (X2 [3, N = 71] = 13.0705; p = 0.0003). The average central subfield thickness decreased from 327.2 ± 89.1 μm to 294.8 ± 86.5 μm (p = 0.0294). Best‐corrected visual acuity, intraocular pressure, pigment epithelium detachment presence, and height had no significant difference after switching to IFI. Conclusions: In "treatment‐resistant" patients receiving anti‐VEGF therapy for neovascular age‐related macular degeneration or diabetic macular edema, switching to IFI in a "real‐world" TAE protocol led to statistically significant improvements in treatment interval and retinal fluid on spectral domain OCT. [ABSTRACT FROM AUTHOR]

Despite growing interest in remote patient monitoring, limited evidence exists to substantiate claims of its ability to improve outcomes. Our aim was to evaluate randomized controlled trials (RCTs) that assess the effects of using wearable biosensors (e.g. activity trackers) for remote patient monitoring on clinical outcomes. We expanded upon prior reviews by assessing effectiveness across indications and presenting quantitative summary data. We searched for articles from January 2000 to October 2016 in PubMed, reviewed 4,348 titles, selected 777 for abstract review, and 64 for full text review. A total of 27 RCTs from 13 different countries focused on a range of clinical outcomes and were retained for final analysis; of these, we identified 16 high-quality studies. We estimated a difference-in-differences random effects meta-analysis on select outcomes. We weighted the studies by sample size and used 95% confidence intervals (CI) around point estimates. Difference-in-difference point estimation revealed no statistically significant impact of remote patient monitoring on any of six reported clinical outcomes, including body mass index (-0.73; 95% CI: -1.84, 0.38), weight (-1.29; -3.06, 0.48), waist circumference (-2.41; -5.16, 0.34), body fat percentage (0.11; -1.56, 1.34), systolic blood pressure (-2.62; -5.31, 0.06), and diastolic blood pressure (-0.99; -2.73, 0.74). Studies were highly heterogeneous in their design, device type, and outcomes. Interventions based on health behavior models and personalized coaching were most successful. We found substantial gaps in the evidence base that should be considered before implementation of remote patient monitoring in the clinical setting.

To present a semi-automated method of image alignment to aid in monitoring the progression of inherited retinal degenerations (IRDs). A 22-year-old woman presented with nyctalopia and a family history of retinitis pigmentosa (RP), but with no prior genetic testing. Fundus examination showed a sectoral retinal degeneration involving the inferior and nasal retina with rare, pigmented deposits. Goldmann kinetic perimetry demonstrated corresponding superotemporal visual field defects. The best-corrected visual acuity was 20/20 in both eyes. Multimodal imaging delineated geographically restricted peripheral retinal degeneration extending to the inferior edge of the macula. Central visual function remained intact with normal multifocal electroretinography findings. Optical coherence tomography (OCT) through the leading edge of the retinal degeneration confirmed loss of the photoreceptor layer and associated retinal pigment epithelium. In the region of retinal degeneration, loss of vascular flow density was noted on optical coherence tomography angiography (OCTA). Genetic testing identified a pathologic sequence variant in RHO (c.68C>A, p.Pro23His), confirming autosomal dominant sector retinitis pigmentosa (SRP). Image alignment allowed for precise measurement of the progression of SRP over a period of 18 months. SRP is a rare subtype of RP characterized by focal, typically inferior and nasal, retinal degeneration of the peripheral retina. Although the onset and extent of peripheral retinal degeneration varies, compared with RP, SRP typically progresses more slowly to involve the macula. In this report, we highlight the utility of image registration and alignment to aid in monitoring disease progression in IRDs by means of multimodal imaging. [ABSTRACT FROM AUTHOR]