Home Optical Coherence Tomography and Sustained Delivery Approaches: A Perfect Marriage.

Abstract

To provide a perspective on the management of patients with neovascular age-related macular degeneration (nAMD) using a combination of sustained drug delivery strategies and remote monitoring technology. Evidence-based perspective. Review of the literature and experience of the author. There are currently many ongoing research efforts in the retina field directed at both safe, effective sustained drug delivery and validated remote monitoring. At present, the port delivery system with ranibizumab and the Home OCT are approved by the U.S. Food and Drug Administration and available for use by clinicians. A review of available data and a case example demonstrate the potential for these combined technologies to reduce both the injection burden and the monitoring burden currently experienced by patients with nAMD. Other sustained drug delivery strategies such as tyrosine kinase inhibitor delivery systems and viral vector-mediated anti-vascular endothelial growth factor intraocular biofactory models are not yet approved for clinical use. Early experience with these technologies in clinical trials foretell the potential advantages and possible limitations of remote monitoring with a variety of sustained delivery approaches. The combined use of sustained drug delivery and validated remote monitoring portends a significant change in the current nAMD treatment landscape and has the potential to reduce the injection and monitoring burden faced by patients while optimizing patient outcomes.