Dallas, Texas – (July 2010) – The popularity of the iPhone and iPad “app” has sparked the interest of our researchers to create visual testing technology that is ready for the New Age. With consumers downloading 6.3 million applications onto their iPhones daily, the Retina Foundation of the Southwest is in the process of developing a very simple and unique way for patients with age-related macular degeneration and diabetic retinopathy to test their vision at home using iPhone technology.

A start-up medical device company is collaborating with Dr. Yi-Zhong Wang, the Director of the Macular Function Laboratory, to develop an at-home device for monitoring retinal disease in patients. The availability of new smart phones and hand held devices such as the iPhone, iPad, and iPod Touch made it possible for the developers to create a program that could easily administer an at-home version of the shape-discrimination test, a vision test developed by Dr. Wang to detect early signs of age-related macular degeneration (AMD).

Dr. Wang developed the shape-discrimination test because there were very few tests available that were sensitive enough to detect vision loss in patients with early AMD and most were ineffective in monitoring the progression of the disease in its early stages.

“Other available vision tests are not very sensitive in detecting early signs of change of the disease,” said Dr. Wang. “The shape-discrimination test has a lot of advantages. It is a very easy test for patients to take at home for monitoring their vision.”

In the shape-discrimination test, the patient is presented with a group of three circles. In each group, only one of the circles is distorted while the others are perfectly symmetrical. The distorted circle becomes more difficult for the patient to identify as the test goes along. The test continues until the patient is unable to tell the difference between the three circles. Studies have shown that it is difficult for patients with AMD to detect subtle distortions of the circular shapes even when visual acuity is good.

The iPhone vision test application randomizes the series of circles presented to the patient for each test. It also adapts to the patient's vision, becoming easier or more difficult depending on the patient’s ability to detect the distortion. Currently, research is underway to test the effectiveness of this application for remotely monitoring the progression of retinal disease in patients.

“The shape discrimination test itself has actually been in development for ten to twelve years. We have gradually developed it into a handheld device because of the availability of the technology,” said Dr. Wang.

An at-home device has been needed in the field of ophthalmology for many years. Patients who are at high risk for developing advanced AMD typically visit their eye doctor two times a year. For patients who could develop the wet form of AMD, it is critical for the doctor to be alerted of changes in the patient’s vision as soon as possible because there are now effective treatments for the wet form of the disease.

Wet AMD occurs when abnormal blood vessels behind the retina start to grow under the macula. The blood eventually leaks onto the macula, causing damage to photoreceptor cells and destroying sight. If the change from high risk early AMD to wet AMD can be detected early, severe vision loss may be prevented. Therefore, it is important to monitor the progression of the disease in order to provide treatment to the patient at the onset of the advanced stage.

“If the onset of the wet AMD is between the patient’s doctor visits, their treatment could be delayed. The patient could experience a considerable loss of vision during that time,” said Dr. Wang. “But if there is a device that the patient can use at-home to detect the early onset of the advanced stage, the treatment can be given immediately before the patient suffers significant vision loss. It is preventive.”

This use of the device could literally save sight for many patients with wet AMD. Studies have shown that early treatment of wet AMD recovers vision dramatically for these patients.

“It will help save vision for a lot of patients, if this product is successful,” said Dr. Wang. “It will basically change lives.”

The iPhone application of the shape-discrimination test is still under development and is only being used in research studies at the Retina Foundation.