{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T02:32:39Z","timestamp":1793413959776,"version":"4.5.0"},"reference-count":36,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T00:00:00Z","timestamp":1782432000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Despite recent advancement, neovascular age-related macular degeneration (nAMD) remains a leading cause of irreversible vision loss. Undertreatment, fewer anti-VEGF injections and longer intervals than in clinical trials have been associated with sub-optimal visual outcomes. Visit-based regimens (Treat-and-Extend, PRN) may permit intervals of unrecognized retinal fluid between office visits. A home OCT system with near-daily self-imaging provides frequent structural retinal information between office visits that can support early detection of persistent or recurring fluid. The objective was to evaluate the duration and magnitude of fluid exposure between standard care visits and estimate the potential to shorten that exposure. Materials andMethods: Ad hoc analysis of three cohorts of treatment na\u00efve and experienced nAMD eyes managed by standard care while participating in observational studies of the home OCT system, with treating physicians masked to home OCT data. AI-based analysis of fluid volume, rate of change and time of fluid onset was performed. Results: Data from 209 participants, mean age 76.4 years, 53% female, who performed 10,110 scans (6.0 scans\/week) were analyzed. An amount of 119 eligible eyes provided data from 185 standard care intervals. Persistent or recurring fluid was identified in 121 (65%) intervals, on average 32 days prior to the next office visit. Of these, 84 (69%) had potential visit advancement within labeled minimal treatment intervals of 19 days. Mean fluid volume at the earliest possible notification was 26 nL and recurrence rate averaged 4.4 nL\/day. Conclusions: A substantial proportion of patients experience unrecognized disease activity between visits. Home OCT monitoring provides adjunctive information to support early detection of fluid and may facilitate timely clinical evaluation. In this context, such monitoring may be considered reasonable and necessary to inform management of nAMD within established standards of care, while not replacing clinician-directed diagnosis or treatment decisions.<\/jats:p>","DOI":"10.3390\/medicina62071241","type":"journal-article","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T00:54:42Z","timestamp":1782694482000},"page":"1241","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Home OCT Monitoring as a Safety Net for Early Detection of Recurrent Disease Activity in Neovascular Age-Related Macular Degeneration Under Standard Care"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-2627-5203","authenticated-orcid":false,"given":"Deepak","family":"Sambhara","sequence":"first","affiliation":[{"name":"Eye Clinic of Wisconsin, Wausau, WI 54403, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashkan M.","family":"Abbey","sequence":"additional","affiliation":[{"name":"Texas Retina Associates, Dallas, TX 75231, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0654-0668","authenticated-orcid":false,"given":"David A.","family":"Eichenbaum","sequence":"additional","affiliation":[{"name":"Retina Vitreous Associated of Florida, St. Petersburg, FL 33711, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e106","DOI":"10.1016\/S2214-109X(13)70145-1","article-title":"Global prevalence of age-related macular degeneration and disease burden projection for 2020 and 2040: A systematic review and meta-analysis","volume":"2","author":"Wong","year":"2014","journal-title":"Lancet Glob. Health"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1202","DOI":"10.1001\/jamaophthalmol.2022.4401","article-title":"Prevalence of Age-Related Macular Degeneration in the US in 2019","volume":"140","author":"Rein","year":"2022","journal-title":"JAMA Ophthalmol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1038\/s41572-021-00265-2","article-title":"Age-related macular degeneration","volume":"7","author":"Fleckenstein","year":"2021","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1419","DOI":"10.1056\/NEJMoa054481","article-title":"Ranibizumab for Neovascular Age-Related Macular Degeneration","volume":"355","author":"Rosenfeld","year":"2006","journal-title":"N. Engl. J. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1432","DOI":"10.1056\/NEJMoa062655","article-title":"Ranibizumab versus Verteporfin for Neovascular Age-Related Macular Degeneration","volume":"355","author":"Brown","year":"2006","journal-title":"N. Engl. J. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2537","DOI":"10.1016\/j.ophtha.2012.09.006","article-title":"Intravitreal Aflibercept (VEGF Trap-Eye) in Wet Age-related Macular Degeneration","volume":"119","author":"Heier","year":"2012","journal-title":"Ophthalmology"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1038\/eye.2015.217","article-title":"Ranibizumab for the treatment of wet AMD: A summary of real-world studies","volume":"30","author":"Chong","year":"2016","journal-title":"Eye"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1136\/bjophthalmol-2014-305327","article-title":"Multi-country real-life experience of anti-vascular endothelial growth factor therapy for wet age-related macular degeneration","volume":"99","author":"Holz","year":"2015","journal-title":"Br. J. Ophthalmol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2292","DOI":"10.1016\/j.ophtha.2013.03.046","article-title":"SEVEN-UP Study Group. Seven-Year Outcomes in Ranibizumab-Treated Patients in ANCHOR, MARINA, and HORIZON","volume":"120","author":"Rofagha","year":"2013","journal-title":"Ophthalmology"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"100421","DOI":"10.1016\/j.xops.2023.100421","article-title":"Impact of Anti-VEGF Treatment and Patient Characteristics on Vision Outcomes in Neovascular Age-related Macular Degeneration","volume":"4","author":"Wykoff","year":"2024","journal-title":"Ophthalmol. Sci."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1111\/ceo.14559","article-title":"Real-World 10-Year Outcomes of Anti-VEGF Therapy for Neovascular Age-Related Macular Degeneration: A Meta-Analysis","volume":"53","author":"Spooner","year":"2025","journal-title":"Clin. Exp. Ophthalmol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.oret.2019.05.017","article-title":"Visual Acuity Outcomes and Anti\u2013Vascular Endothelial Growth Factor Therapy Intensity in Neovascular Age-Related Macular Degeneration Patients","volume":"4","author":"Ciulla","year":"2020","journal-title":"Ophthalmol. Retin."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"OCTi","DOI":"10.1167\/iovs.16-20269","article-title":"Foreword: 25 Years of Optical Coherence Tomography","volume":"57","author":"Fujimoto","year":"2016","journal-title":"Investig. Opthalmol. Vis. Sci."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2223","DOI":"10.1038\/s41433-025-03829-8","article-title":"Systematic review of clinical practice guidelines for the management of neovascular age-related macular degeneration","volume":"39","author":"Lim","year":"2025","journal-title":"Eye"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2119","DOI":"10.1038\/s41433-021-01487-0","article-title":"Fluid as a critical biomarker in neovascular age-related macular degeneration management: Literature review and consensus recommendations","volume":"35","author":"Kodjikian","year":"2021","journal-title":"Eye"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/j.ophtha.2017.07.014","article-title":"Treat-and-Extend versus Monthly Regimen in Neovascular Age-Related Macular Degeneration","volume":"125","author":"Silva","year":"2018","journal-title":"Ophthalmology"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1038\/s41433-022-02020-7","article-title":"Efficacy, safety, and treatment burden of treat-and-extend versus alternative anti-VEGF regimens for nAMD: A systematic review and meta-analysis","volume":"37","author":"Rosenberg","year":"2023","journal-title":"Eye"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1016\/j.oret.2016.12.004","article-title":"Randomized Trial of Treat-and-Extend versus Monthly Dosing for Neovascular Age-Related Macular Degeneration","volume":"1","author":"Wykoff","year":"2017","journal-title":"Ophthalmol. Retin."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"14166","DOI":"10.1038\/s41598-022-18158-z","article-title":"A real-world study assessing the impact of retinal fluid on visual acuity outcomes in patients with neovascular age-related macular degeneration in Korea","volume":"12","author":"Kim","year":"2022","journal-title":"Sci. Rep."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2983","DOI":"10.1038\/s41433-020-01354-4","article-title":"Impact of macular fluid volume fluctuations on visual acuity during anti-VEGF therapy in eyes with nAMD","volume":"35","author":"Chakravarthy","year":"2021","journal-title":"Eye"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1001\/jamaophthalmol.2020.3001","article-title":"Associations of Variation in Retinal Thickness with Visual Acuity and Anatomic Outcomes in Eyes with Neovascular Age-Related Macular Degeneration Lesions Treated with Anti\u2013Vascular Endothelial Growth Factor Agents","volume":"138","author":"Evans","year":"2020","journal-title":"JAMA Ophthalmol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1097\/IAE.0000000000003349","article-title":"Effect of retinal thickness variability on visual outcomes and fluid persistence in neovascular age-related macular degeneration","volume":"42","author":"Dugel","year":"2022","journal-title":"Retina"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"100034","DOI":"10.1016\/j.xops.2021.100034","article-title":"Prospective, Longitudinal Pilot Study: Daily Self-Imaging with Patient-Operated Home OCT in Neovascular Age-Related Macular Degeneration","volume":"1","author":"Keenan","year":"2021","journal-title":"Ophthalmol. Sci."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1016\/j.oret.2022.02.011","article-title":"Prospective, Longitudinal Study: Daily Self-Imaging with Home OCT for Neovascular Age-Related Macular Degeneration","volume":"6","author":"Liu","year":"2022","journal-title":"Ophthalmol. Retin."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Kim, J.E., Tomkins-Netzer, O., Elman, M.J., Lally, D.R., Goldstein, M., Goldenberg, D., Shulman, S., Benyamini, G., and Loewenstein, A. (2022). Evaluation of a self-imaging SD-OCT system designed for remote home monitoring. BMC Ophthalmol., 22.","DOI":"10.1186\/s12886-022-02458-z"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1016\/j.oret.2023.10.012","article-title":"Home OCT Imaging for Newly Diagnosed Neovascular Age-Related Macular Degeneration: A Feasibility Study","volume":"8","author":"Blinder","year":"2024","journal-title":"Ophthalmol. Retin."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1177\/24741264241302858","article-title":"Clinical Use of Home OCT Data to Manage Neovascular Age-Related Macular Degeneration","volume":"9","author":"Heier","year":"2025","journal-title":"J. Vitreoretin. Dis."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"100772","DOI":"10.1016\/j.xops.2025.100772","article-title":"Pivotal Trial Validating Usability and Visualization Performance of Home OCT in Neovascular Age-Related Macular Degeneration: Report 1","volume":"5","author":"Heier","year":"2025","journal-title":"Ophthalmol. Sci."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"100662","DOI":"10.1016\/j.xops.2024.100662","article-title":"Pivotal Trial towards Effectiveness of Self-Administered OCT in Neovascular Age-related Macular Degeneration. Report Number 2\u2014Artificial Intelligence Analytics","volume":"5","author":"Schneider","year":"2025","journal-title":"Ophthalmol. Sci."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"100907","DOI":"10.1016\/j.xops.2025.100907","article-title":"Longitudinal Validation of the Artificial Intelligence Algorithm in Home OCT for Age-Related Macular Degeneration. Report 3","volume":"6","author":"Leng","year":"2025","journal-title":"Ophthalmol. Sci."},{"key":"ref_31","unstructured":"(2026, June 01). EYLEA HD\u00ae (Aflibercept) Injection, for Intravitreal Use, Available online: https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2024\/761355s006lbl.pdf."},{"key":"ref_32","unstructured":"(2026, June 01). VABYSMO\u00ae (Faricimab-Svoa) Injection, for Intravitreal Use, Available online: https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2024\/761235s005lbl.pdf."},{"key":"ref_33","unstructured":"Jaeb Center for Health Research (2024, June 05). Home OCT-Guided Treatment Versus Treat and Extend for the Management of Neovascular AMD (DRCR Protocol AO CT.gov NCT05904028). Available online: https:\/\/public.jaeb.org\/drcrnet\/stdy\/597."},{"key":"ref_34","unstructured":"London, N.J.S., and Lazzarini, T. (Retina Specialist, 2026). Why I treat wet AMD patients until dry, Retina Specialist."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"3781","DOI":"10.1007\/s00417-022-05716-4","article-title":"Relationship between retinal fluid characteristics and vision in neovascular age-related macular degeneration: HARBOR post hoc analysis","volume":"260","author":"Sadda","year":"2022","journal-title":"Graefe\u2019s Arch. Clin. Exp. Ophthalmol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1016\/j.ajo.2024.10.031","article-title":"Home OCT and Sustained Delivery Approaches, a Perfect Marriage","volume":"277","author":"Holekamp","year":"2024","journal-title":"Am. J. Ophthalmol."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/7\/1241\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T01:51:09Z","timestamp":1782697869000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/7\/1241"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,26]]},"references-count":36,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7]]}},"alternative-id":["medicina62071241"],"URL":"https:\/\/doi.org\/10.3390\/medicina62071241","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,26]]}}}