Decentralising the monitoring and treatment of retinal disease: Assessing feasibility and capturing specifications

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65% of over 60's suffer with a condition called age-related macular degeneration (AMD). This is a degenerative disease impacting an area at the back of your eye. AMD is the leading cause of blindness in the developed world. As populations age, this patient group will apply substantial pressure to health systems that are already struggling to keep up with the diagnostic and treatment burden of the disease. The clinical gold standard for imaging patients with AMD is a technology called optical coherence tomography (OCT). This sub-surface imaging technique is used to diagnose patients and to monitor for disease changes that require treatment. Rapidly identifying these changes is crucial, as every day that passes without receiving treatment _will_ result in sight loss.Siloton is a start up based in Bristol that is using a new technology called photonic integrated circuits (PICs) to develop a small, robust, and low-cost OCT that can be installed in patient homes. The idea is for patients to use the device themselves and for images to be uploaded to the cloud where algorithms will analyse images and identify patients needing to visit the clinic for treatment. This eliminates the need for monitoring appointments as well as ensuring that patients receive precisely the right amount of medication.Siloton has built a proof of concept of the OCT device, and this project seeks to validate the feasibility of this approach in the UK. The project will assess the regulatory requirements of such a service, perform a health-economic analysis of financial impact to the NHS, and engage with patients via Macular Society-run focus groups in order to perform ergonomic analyses of different device forms and to capture the key psychological factors when implementing such a solution. This information will be used to secure further private investment and further non-dilutive funding such as the NIHR product development awards.