Abstract

DO.18.09

Bonn Ophthalmology Online Network (BOON): a pilot study

Nicole Eter für die BOON Studiengruppe
Universitäts-Augenklinik Bonn

Objective: According to the label monthly follow-up visits are requested following initial upload with 3 injections of Lucentis™ (Ranibizumab) in patients with choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD). Re-treatment is recommended in case of vision loss of more than 5 ETDRS letters (equivalent to 1 line Snellen acuity). According to the latest surveys these monthly follow-up visits are often not performed due to logistic reasons. Patients are rather seen every 3 months. These intervals, however, are too long to preserve an initial gain in visual acuity (VA), which has been demonstrated recently comparing the PRONTO (monthly control intervals) and PIER (3-monthly control intervals) study results.
Methods: A pilot study has been started by the University Eye Hospital Bonn in collaboration with 10 referring ophthalmologists setting up an online platform for concerted AMD patient care. Patients’ master file data as well as diagnosis, injection data, VA, macular thickness, and morphologic criteria are recorded, and fundus photographs, angiography files, and OCT pictures can be uploaded. In case of missing control visits or VA loss of more than 5 letters during follow-up safety mechanisms are automatically activated alerting the hospital and the referring ophthalmologist and thus guarantying prompt patient contact. Furthermore, thorough documentation enables the evaluation of quality parameters for cross-sector AMD treatment.
Results: Both the University Eye Hospital and the referring ophthalmologists agreed upon common standards for diagnosis and treatment of AMD. Entry masks have already been programmed and uploaded on an independent server. Mutual access to the platform has been established, and first patients are recorded at this time.
Conclusions: The conjoint online network leads to a better supervision of injections and follow-up visits, and actively counteracts prolonged control intervals. Concerted access to the follow-up parameters of each patient improves patient care and prompt re-treatment in case of disease progression.

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