AAO: Home OCT Device Improves Care for AMD Patients, Reduces Costs and Burden

A newly approved home-based OCT device developed by Notel Vision is allowing patients to monitor their own eye health between appointments, providing physicians with crucial data without requiring in-office visits, according to an AAO news release. A study presented today at AAO 2024 suggests that daily self-imaging using this home OCT device could significantly improve care for patients with wet AMD. Additionally, the study shows that it could reduce both the financial and logistical burdens on patients and the healthcare system.

The study included 15 retina specialists who reviewed treatment decisions for 37 eyes of patients with wet AMD. Initially, these decisions were based solely on in-office OCT scans, which occur at regular intervals. However, when the physicians were given the patients' home OCT scan data, they were asked to reassess their original treatment decisions.

The results were striking:

• In 42% of cases, physicians concluded that treatment could have been delayed based on the home OCT data
• In 35% of cases, they recommended treatment should have been administered at least a week earlier than it was
• In only 23% of cases did physicians agree with the original timing of the treatment, within a margin of one week

"While I expected home OCT data to have some influence on decision-making, the magnitude of the impact was a surprise," Paul Hahn, MD, PhD, a retina specialist and the lead researcher, said in the news release. "But once we consider that physicians now have 30 times more data than before, allowing them to 'fill in the blanks' between visits, it makes sense."

The study revealed that using home OCT devices could lead to significant cost savings. Dr. Hahn’s statistical model estimated a 28% reduction in drug costs due to fewer unnecessary treatments, as well as reduced office visits, leading to savings on in-office procedures and loss of patient productivity. Each office visit represents an estimated loss of $159 for procedures and $117 in patient productivity, according to the study.

Current treatment models for wet AMD typically schedule injections in advance of possible disease reactivation because there has been no way to monitor disease progression between visits. With the availability of home OCT devices, however, physicians can now have a continuous stream of data to help make more informed decisions.

"The presence of home OCT data provides a much-needed safety net," said Dr. Hahn. "This not only limits unnecessary treatments but also provides a mechanism to treat patients promptly when needed, improving overall care."

The home OCT device, developed by Notal Vision, allows patients to perform a self-operated scan in less than one minute per eye. The images are automatically transmitted via a wireless connection to the Notal Health Cloud for analysis. A proprietary AI-based software, the Notal OCT Analyzer, interprets the images and segments the volume of hypo-reflective spaces on the scans, providing key insights into retinal fluid accumulation.

Physicians can review the data through a HIPAA-compliant web portal, set eye-specific notification criteria such as fluid volume thresholds, and receive alerts when certain thresholds are crossed.

Notal Vision has worked to ensure that physicians can be reimbursed for remote OCT monitoring. Three new CPT codes—0604T, 0605T, and 0606T—allow physicians and the monitoring center to bill for services every 30 days. Notal is also collaborating with Medicare Administrative Contractors to establish full coverage and payment for remote OCT services.