Reviewed by Lexie CornerOct 21 2024
According to a study presented at the 128th annual meeting of the American Academy of Ophthalmology (AAO) 2024, daily self-imaging can improve care while reducing financial strain on patients and the healthcare system.
Ophthalmologists use optical coherence tomography (OCT) to assess whether a patient with age-related macular degeneration (AMD) requires treatment at their scheduled appointment or can wait a few more weeks. A newly approved home-based OCT device now allows patients to monitor their response to treatment between visits.
Fifteen retina specialists reviewed the treatment histories of 37 wet AMD patients, where standard care decisions were based on in-office OCT scans. After receiving the patients’ home OCT scans, the doctors re-evaluated their initial treatment choices.
They found that treatment could have been postponed in nearly 42 % of cases, with 35 % of patients receiving treatment at least one week later than originally recommended. Only 23 % of physicians agreed with the initial timing of the treatment, which was within a week.
While I expected home OCT data to have some influence on decision-making, the magnitude was certainly a surprise. However, once we consider that physicians now have 30 times more data than before and can now "fill in the blanks" between visits, this impact makes sense.
Paul Hahn, MD, Ph.D., Study Lead Researcher and Retina Specialist, NJRetina
Reduced office visits resulted in proportional savings on in-office procedures and productivity loss, estimated at $159 and $117 per visit. Additionally, the reduced treatment recommended in this study would have led to a 28 % decrease in drug costs, according to Dr. Hahn's statistical model.
Dr. Hahn added, “Our current paradigms for treatment of retinal diseases, in particular wet AMD, require injections well in advance of disease reactivation because of the acuteness of the disease and lack of a monitoring safety net between treatment visits. The presence of home OCT data provides this much-needed safety net, which not only limits unnecessary treatments but also provides a mechanism to promptly treat patients when needed.”
According to Notal Vision, the manufacturer of the home OCT device, physicians can now receive reimbursement for remote OCT. The monitoring center and physicians can bill for services every 30 days using three specific CPT codes: 0604T, 0605T, and 0606T. Additionally, Notal is working with Medicare Administrative Contractors to establish coverage and payment for these remote OCT billing codes.
The patient-operated scan typically takes less than a minute per eye, and images are automatically sent to the Notal Health Cloud via an integrated wireless connection for analysis. The Notal OCT Analyzer, a proprietary AI tool, calculates the volume of hypo-reflective areas on the OCT images. Physicians can review the data through a HIPAA-compliant web portal, set eye-specific notification criteria such as volume thresholds, and receive alerts when necessary.