A Smart Mobile Application to Monitor Visual Function in Diabetic Retinopathy and Age-Related Macular Degeneration: The CLEAR Study

Area of Science:

• Ophthalmology
• Digital Health
• Medical Technology

Background:

• Remote patient monitoring is crucial, especially during pandemics.
• Mobile health (mHealth) tools can facilitate virtual monitoring of visual acuity (VA) and Amsler grid findings.
• Assessing visual function remotely requires reliable and user-friendly technology.

Purpose of the Study:

• To evaluate the reliability of the Checkup Vision Assessment System mobile application for remote monitoring of visual acuity (VA) and metamorphopsia.
• To compare remote monitoring results from the Checkup app against standard in-clinic VA reference tests.
• To assess the feasibility and usability of remote vision monitoring using a mobile application.

Main Methods:

• A prospective, multicenter reliability analysis involving 108 patients with retinal conditions or healthy controls.
• Participants underwent testing with the Checkup app, reference VA tests, and Amsler grid tests, with randomized order.
• Patients used the Checkup app for home monitoring at least twice weekly between clinic visits.

Main Results:

• Strong agreement was found between Checkup and reference tests for VA (r=0.86) and Amsler grid (sensitivity: 93%; specificity: 92%).
• Excellent agreement (r=0.96) was observed between home and clinic testing results.
• Patients reported successful home use and rated the app's usability as excellent, with no serious adverse events.

Conclusions:

• The Checkup mobile application demonstrates good agreement with in-clinic tests for VA and Amsler grid assessments.
• The low variance, agreement between home and clinic results, and excellent usability support Checkup's reliability for monitoring retinal pathology.
• Checkup is a viable tool for both clinic-based and home-based remote monitoring of vision.