- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT06076785
Impact of ODYSight in the Management of patientS With imparairEd Visual acuitY (ODYSSEY)
Impact of ODYSight in the Management of patientS With imparairEd Visual acuitY (ODYSSEY).
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Near or distance vision impairment is affecting more and more patients each year and the prevalence is about 2.2 billion people around the world. It has been estimated that in almost half of the cases, the vision impairment has not yet been addressed or could have been prevented. The most important causes of vision impairment are:
- Age-related macular degeneration (AMD),
- Cataract,
- Diabetic retinopathy,
- Glaucoma,
- Uncorrected refracted errors. Among the strategies setup to address vision impairment, preventive care and follow-up treatment and recurrent vision monitoring are the most performant. Standard clinical care requiring patient to physically attend can be a burden for an effective care.
Remote monitoring of visual acuity and follow-up of patients suffering from visual impairment using home-based solutions have known a great outbreak in the las few years. The use of smartphones and tablets supporting applications developed to monitor and evaluate patient's vision has considerably evolved. Moreover, the recent COVID-19 pandemic underlined the need to develop qualified remote care systems to enhance healthcare access.
In the last decade, several tools were developed in the field of ophthalmology for visual function self assessment. The Visual Acuity (VA) testing is the most performed ophthalmologic examination to evaluate patient's potential visual impairment and can be tested either classically with letters optotype charts and projection systems or more recently with the help of digital tools. These tools allow patients to evaluate their VA using applications designed for smartphones, tablets, or computers.
In the standard clinical practice, the VA testing is mostly performed using a Snellen chart (black letters and optotypes of different sizes printed on a white chart), developed in 1862. This tool has been progressively improved, notably with the development of ETDRS charts, considered more accurate and that are thus used in research. These tools required the patient to physically attend the clinical examination, which is sometimes difficult to achieve considering patient mobility issues (age, disability, lack of transportation…), the lack of clinical practices in some areas, or other reasons.
Digital VA testing tools are an interesting alternative to the standard tests performed in clinic.
Nevertheless, their development implies a clinical validation research and certification, to be used for patient ophthalmic care.
Several studies have proved the reliability of digital systems for VA measurement, in remotely operated systems. In 2012, the equivalence of VA measurement using a computer-based logarithmic (logMAR) chart with the standard examination in the physical presence of an optometrist was shown. There was no statistically significant difference between the median VA measurement assessed by the two methods (physical optometrist or remote computer-based system).
The feasibility and the accuracy of a smartphone-based method for VA testing has been addressed in 2014, in the context of Early Treatment for Diabetic Retinopathy Study (ETDRS) testing, using the SightBookTM application. The results of the study evidenced test-retest high reliability and concordance with EDTRS distance VA testing and standard near vision testing.
More recently, VA testing methods have been compared using standard ETDRS chart, near chart and a smartphone-based eye chart application. The study concludes in favour of an equivalent efficiency of the three methods, suggesting a potential interest for remote VA-testing especially when standard clinical examination is not possible or difficult.
Another study, evaluating a smartphone-based VA testing (logMAR) reliability for test-retest compared to standard care showed promising results for remote healthcare and accessibility.
Interestingly, remote VA testing has been shown to be efficient in both adults and children.
The COVID-19 pandemic challenged standard ophthalmologic practice and revealed an acute need of remote healthcare access that emphasizes the development of more efficient tools for VA monitoring and clinical visit scheduling when required.
OdySight® is a medical application intended for patients 18 years of age and older for self-evaluation of visual parameters: near visual acuity and symptoms such as metamorphopsia and scotoma. The test results are sent to the doctor.
OdySight® does not provide any interpretation of the test results and is not intended to provide a diagnosis. OdySight® helps patients to determine whether they need to consult a doctor for diagnosis and treatment.
Three clinical studies have been conducted to evaluate the Odysight® application efficiency compared to standard ophthalmologic care.
In 2019, a prospective, open-labelled, single-arm, single-site study has been performed to compare the results of gold standard VA testing (Sloan ETDRS letter chart for near and distance vision testing), contrast sensitivity (Pelli-Robson chart), and metamorphopsia/scotoma (Amster Grid). The analysis showed a concordance between the results obtained with the OdySight® VA module and the Sloan ETDRS (near and distance). No significant difference has been shown between the OdySight® Amsler Grid module and standard metamorphopsia/scotoma testing. On the other hand, a broader disagreement has been pointed out for the evaluation of contrast sensitivity between the standard Pelli-Robson test and the OdySight® module, which would require more investigation.
The overall results are in favour of using the OdySight® application for remote monitoring of vision between clinic visits and potential assistance for follow-up scheduling.
In 2021, the implementation and clinical efficacy of the OdySight® application was evaluated in a study involving patients (n=60) with oedematous maculopathies receiving standard care. Patients were offered to use OdySight® to self-evaluate changes in their VA. The use of the application and the processing of notifications for VA decrease by the clinical team was analysed for one year to assess the feasibility and the reliability of the system. In all, about 60% of the patients completed at least one test following the prescription and almost 25% of the patients were still using the application after one month. During this trial, 19 notifications for VA decrease were processed by the clinical team in an average of less than 6 days. The decrease in VA was detected with a sensitivity of 92% and a specificity of 99%.
An observational, retrospective, multicentric study, published in 2022, was conducted to evaluate the additional value of using the OdySight® application in addition to a standard follow-up for the detection of exudatives recurrences in patients suffering from macular oedema. In all, 123 patients (149 eyes) were included in the study. The sensitivity of the alerts for the detection of recurrences was around 30%, and the specificity reached 84%. In total, 12 alerts on 39 detected a recurrence and 8 of them resulted in rescheduling or advancement of intravitreal injection. Although the sensitivity and the specificity appear to be a bit low, exudatives recurrences not being necessarily associated to a decrease in VA, the results of the study confirm that OdySight® use can be of interest in the detection of recurrence in advance and allow an anticipated readjustment of the treatment in addition with a standard care follow-up.
Study Type
Enrollment (Estimated)
Contacts and Locations
Study Locations
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Auvergne Rhône Alpes
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Chambéry, Auvergne Rhône Alpes, France, 73000
- Centre Ophtalmologique Oculus
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Normandie
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Rouen, Normandie, France, 76000
- Clinique Mathilde
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Évreux, Normandie, France, 27000
- SELARL Dr Boulet
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Occitanie
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Montauban, Occitanie, France, 82000
- Clinique Honore Cave
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Pays De La Loire
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Nantes, Pays De La Loire, France, 44300
- Institut Ophtalmologique de l'Ouest Jules Verne
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Saint-Herblain, Pays De La Loire, France, 44800
- Institut ophtalmologique Sourdille Atlantique
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Rhône Alpes
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Lyon, Rhône Alpes, France, 69002
- Centre Ophtalmologique Rabelais
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Île De France
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Paris, Île De France, France, 75012
- Hôpital des XV-XX
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
- OdySight® user (between 07/21/2021 and 11/14/2022),
- Performed at least 3 tests on the same eye (minimum number of tests to trigger an alert).
Exclusion Criteria:
- Opposition to personal data collection and processing,
- Patient's death is documented.
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
OdySight users
OdySight users between 07/21/2021 and 11/14/2022 who performed Visual Acuity testing through OdySight and according to standard practice.
|
At home measurements of visual acuity through a mobile app.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Impact of OdySight® in the management of patients suffering from impaired visual acuity.
Time Frame: At least 3 months of follow-up.
|
Number of patients concerned by one or more OdySight® notification(s) for visual acuity decrease followed by a visit where at least one of the following situations is noticed:
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At least 3 months of follow-up.
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Performances of OdySight® in tracking visual acuity decrease and/or anatomic change.
Time Frame: At least 3 months of follow-up.
|
Sensitivity, specificity, Positive Predicted Value and Negative Predicted Value of OdySight® in tracking visual acuity decrease and/or anatomic change with subgroups analysis.
|
At least 3 months of follow-up.
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Bénédicte BROUSSEAU, MD, Centre Ophtalmologique Ophtalliance
- Principal Investigator: Maddalena QUARANTA, MD, Centre Ophtalmologique Rabelais
- Principal Investigator: Vincent GUALINO, MD, Clinique Honore Cave
- Principal Investigator: Jean-François GIRMENS, MD, Hôpital des XV-XX
- Principal Investigator: Isabelle FOURNIER, MD, Institut ophtalmologique Sourdille Atlantique
- Principal Investigator: Marie-Noëlle GUILLEMOT, MD, Institut ophtalmologique Sourdille Atlantique
- Principal Investigator: Jean-François BOULET, MD, Cabinet d'ophtalmologie
- Principal Investigator: Pierre-Olivier LAFONTAINE, MD, Centre Ophtalmologique Oculus
- Principal Investigator: Joël UZZAN, MD, Clinique Mathilde
- Principal Investigator: Viviane VINH, MD, Centre d'Ophtalmologie du Dauphiné
Publications and helpful links
General Publications
- GBD 2019 Blindness and Vision Impairment Collaborators; Vision Loss Expert Group of the Global Burden of Disease Study. Causes of blindness and vision impairment in 2020 and trends over 30 years, and prevalence of avoidable blindness in relation to VISION 2020: the Right to Sight: an analysis for the Global Burden of Disease Study. Lancet Glob Health. 2021 Feb;9(2):e144-e160. doi: 10.1016/S2214-109X(20)30489-7. Epub 2020 Dec 1. Erratum In: Lancet Glob Health. 2021 Apr;9(4):e408.
- Claessens JLJ, Geuvers JR, Imhof SM, Wisse RPL. Digital Tools for the Self-Assessment of Visual Acuity: A Systematic Review. Ophthalmol Ther. 2021 Dec;10(4):715-730. doi: 10.1007/s40123-021-00360-3. Epub 2021 Jun 25. Erratum In: Ophthalmol Ther. 2021 Dec;10(4):731-732.
- Srinivasan K, Ramesh SV, Babu N, Sanker N, Ray A, Karuna SM. Efficacy of a remote based computerised visual acuity measurement. Br J Ophthalmol. 2012 Jul;96(7):987-90. doi: 10.1136/bjophthalmol-2012-301751. Epub 2012 Apr 26.
- Yeung WK, Dawes P, Pye A, Neil M, Aslam T, Dickinson C, Leroi I. eHealth tools for the self-testing of visual acuity: a scoping review. NPJ Digit Med. 2019 Aug 22;2:82. doi: 10.1038/s41746-019-0154-5. eCollection 2019. Erratum In: NPJ Digit Med. 2019 Nov 26;2:117.
- Williams AM, Kalra G, Commiskey PW, Bowers EMR, Rudolph BR, Pitcher MD, Dansingani KK, Jhanji V, Nischal KK, Sahel JA, Waxman EL, Fu R. Ophthalmology Practice During the Coronavirus Disease 2019 Pandemic: The University of Pittsburgh Experience in Promoting Clinic Safety and Embracing Video Visits. Ophthalmol Ther. 2020 Sep;9(3):1-9. doi: 10.1007/s40123-020-00255-9. Epub 2020 May 6.
- Tiraset N, Poonyathalang A, Padungkiatsagul T, Deeyai M, Vichitkunakorn P, Vanikieti K. Comparison of Visual Acuity Measurement Using Three Methods: Standard ETDRS Chart, Near Chart and a Smartphone-Based Eye Chart Application. Clin Ophthalmol. 2021 Feb 26;15:859-869. doi: 10.2147/OPTH.S304272. eCollection 2021.
- Miller JM, Jang HS, Ramesh D, Gonzalez Marshall MS, Yescas S, Harvey EM. Telemedicine distance and near visual acuity tests for adults and children. J AAPOS. 2020 Aug;24(4):235-236. doi: 10.1016/j.jaapos.2020.06.003. Epub 2020 Jul 30.
- Iskander M, Hu G, Sood S, Heilenbach N, Sanchez V, Ogunsola T, Chen D, Elgin C, Patel V, Wronka A, Al-Aswad LA. Validation of the New York University Langone Eye Test Application, a Smartphone-Based Visual Acuity Test. Ophthalmol Sci. 2022 Jun 15;2(3):100182. doi: 10.1016/j.xops.2022.100182. eCollection 2022 Sep.
- Kielwasser G, Kodjikian L, Dot C, Burillon C, Denis P, Mathis T. Real-Life Value of the Odysight(R) Application in At-Home Screening for Exudative Recurrence of Macular Edema. J Clin Med. 2022 Aug 26;11(17):5010. doi: 10.3390/jcm11175010.
- Guigou S, Michel T, Merite PY, Coupier L, Meyer F. Home vision monitoring in patients with maculopathy: Real-life study of the OdySight application. J Fr Ophtalmol. 2021 Jun;44(6):873-881. doi: 10.1016/j.jfo.2020.09.034. Epub 2021 May 20.
- Brucker J, Bhatia V, Sahel JA, Girmens JF, Mohand-Said S. Odysight: A Mobile Medical Application Designed for Remote Monitoring-A Prospective Study Comparison with Standard Clinical Eye Tests. Ophthalmol Ther. 2019 Sep;8(3):461-476. doi: 10.1007/s40123-019-0203-9. Epub 2019 Jul 25.
- Allen L, Thirunavukarasu AJ, Podgorski S, Mullinger D. Novel web application for self-assessment of distance visual acuity to support remote consultation: a real-world validation study in children. BMJ Open Ophthalmol. 2021 Sep 30;6(1):e000801. doi: 10.1136/bmjophth-2021-000801. eCollection 2021.
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
- TIL-003
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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