One of the questions we occasionally hear from ForeseeHome patients is:” Why can’t I establish a baseline?” So, let’s begin with what a baseline is: a starting point. When you start testing, you need to first establish your baseline, which is determined by assessing your visual distortion and comparing it to the patient population threshold.
ForeseeHome works by detecting visual distortion in age-related macular degeneration (AMD). It has been FDA cleared for monitoring intermediate dry AMD to help with early detection of conversion to advanced wet AMD. Visual distortion is usually the first abnormality that develops in AMD and often occurs before you lose vision. Your doctor has prescribed ForeseeHome to help him or her to detect wet AMD before you lose vision. To monitor your eye, ForeseeHome must have a starting point, known as a baseline, from which to monitor; ideally when there is no or minimal visual distortion.
To test on ForeseeHome there are a couple of requirements. One is that your vision must be good enough to see the lines presented in the device viewer. Another is that you do not have so much distortion in your central vision that ForeseeHome cannot obtain a starting point or detect if or when your visual distortion is getting worse.
While you may not be aware of any distortion, ForeseeHome has highly developed ways to measure what distortion, if any, you do have. In monitoring your eye, ForeseeHome has a sophisticated computer program and uses artificial intelligence (AI) to keep track of your visual distortion and compare it with the distortion you have had in the past, starting with the baseline period, to try to predict if you have developed wet disease. If through your test results it predicts that you have converted to wet AMD, an alert is generated and reviewed by our Notal Vision Monitoring Center team then shared with your eye doctor.
A small percentage of patients could not establish a baseline or participate in the HOME study, which was the initial study by the National Eye Institute which demonstrated the benefit of Foreseehome when added to standard care in helping to detect conversion to wet AMD while patients still had good vision. This study led to FDA clearance and Medicare coverage of ForeseeHome. Not establishing a baseline just means that the device is not compatible with your eye(s). In some cases, your eye is unable to obtain a starting point if the distortion in your central vision is too great, or because of a high rate of unreliable responses, or because there are blind spots or visual dimness in the central areas of your visual field not allowing you to see the presented lines well. In other cases, we are not completely sure why an eye cannot establish a baseline but suspect it may have to do with other nonrelated conditions of your eye or visual attentiveness. Unfortunately, we will not be able to monitor for visual changes without a reliable baseline starting point.
