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AdaptDx Changed the Way These ODs Detect & Manage AMD

Laurie Sorrenson, OD, FAAO
Tony Jacob, OD
Dannette Lammert, OD

Vision Source optometrists Dr. Laurie Sorrenson, Dr. Tony Jacob, and Dr. Dannette Lammert share their experience with AdaptDx® and how it helps them eliminate preventable blindness caused by age-related macular degeneration.

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Before AdaptDx we were realizing that pathology was being missed. I remember that macular degeneration was just a condition that was very difficult to detect and even once detected difficult to do anything about it. So essentially we were watching patients go blind. Before we got the AdaptDx the only thing we had to go by really was looking at the fundus, looking at the retina, and looking at the OCT and seeing if we saw drusen. But now with the AdaptDx I’m finding patients who have early signs of macular degeneration and normally I wouldn’t have caught them because they look fine still on the OCT so I think it’s wonderful that I’m able to catch those patients before they actually show clinical signs or lose any vision. The way we determine who we’re going to test with the AdaptDx is several different ways: we look at their age and if they’re over 50 we look and see if they’ve had any macular degeneration in their family. And then, honestly, the biggest question is, “Do you have any trouble driving at night or trouble seeing in the dark?” And if they say that then we recommend doing the test.

Dark adaptation testing to help detect subclinical AMD explained

The test is a test of dark adaptation or how fast someone adjusts from day vision to night vision. At the beginning of the test which is done in the dark we show them a camera flash. That flash is about the intensity of your cellphone camera flash and it’s focal located outside the fovea, so it’s non-irritating. The flash is to get everyone’s retinal illumination to a standardized level. After that we present a stimulus to the patient and whenever the patient sees this light, this small flash of light, they press a button. And of course if they press it, it becomes dimmer, if they don’t press it it becomes brighter. What we’re trying to measure is the least amount of light they can see at a given point in a time. After we measure what is called a threshold, they have a rest break. Over time they can see progressively dimmer flashes of light and we can track out what’s called the dark adaptation function.

72% of our 50-year-old and older patients had trouble driving at night

We did a short study for about a week and we found out that 72% of our 50-year-old and older patients had trouble driving at night and when we did that test forty-one percent of those patients who did not pass which was shocking to me just shocking and I was glad for it because now we can do something to prevent those patients from losing vision but I was completely surprised. We were very shocked when we have the data pulled at the end of the week and we had noticed that of the patients that were selected to do the tests that were over fifty 40% had failed AdaptDx. In school they teach us that macular degeneration is generally a disease of the elderly that it is a disease of patients who have lighter set eyes, fair skin, patients over the age of 50, etc. With the AdaptDx it has just completely opened my eyes as far as what we don’t know about this condition. With macular degeneration it’s no longer a disease of the elderly. It is no longer a disease that is only for patients who are lighter set eyes or Caucasian. With AdaptDx I pretty much have diagnosed patients who are below 50. I have also diagnosed two patients now with macular degeneration and they are African-American. One over the age of fifty, one below fifty and so it is just changing entirely what we know about the condition and I’m able to just learn so much more about the condition and be able to treat. It really has changed my whole view because it makes me feel amazing to know that I can actually be a part of this preventing blindness.

The value of subclinical AMD detection

I’m not just doing exams and seeing what’s there right now but I’m actually helping with the future. I think this day and age as we embrace technology early detection is crucial. It’s catching pathology before it becomes permanent and it has life-altering consequences so we’ve noticed that patients are very thankful and grateful and they have also passed on the information to family members and until they’re in you know to their loved ones and so we’ve we find that not only has it helped us as doctors caring for our patients eye care but it’s really made a profound impact in patients quality of life from a long-term perspective. The AdaptDx has really helped me care for my patients. It has helped me find macular degeneration a lot earlier and be able to proactively treat this for my patients. I really believe strongly that if we can catch these patients at this stage and be really proactive with recommending supplements, blue light filters, sunglasses – tell them to watch their BMI, their cholesterol levels – that we can stop or slow down this so much that we can they can maintain the vision the rest of their life and I mean that’s what we’re here for right it’s optometrist that maintain vision and give people the best vision we possibly can so it’s just right along with what we’re supposed to do as optometrists. As far as the AdaptDx in diagnosing and patient stories that we have pretty much I had two sisters who visibly had no signs on their photos, no symptoms, no complaints but because they had a grandmother who went blind from the condition I went ahead and convinced them hey, let’s do a screener. We did the screener and they tested positive for it.

AdaptDx can help eye care professionals be more confident in diagnosing AMD

With that I have created some very loyal patients I am now seeing that entire family and they are completely appreciative that we are catching this at much earlier stages. Needless to say they’re actually in their 40s so being able to prevent any sort of blindness for them is is highly emotional as far as it’s just one of those things that just makes a world of a difference in a patient’s life and it makes me feel so grateful that I can do this for them. AdaptDx has definitely made us feel much more confident in diagnosing AMD. It was the missing link and I feel like it’s just a big piece of the puzzle that we haven’t had in our arsenal for many years. Now that we have the AdaptDx it’s made a world of a difference in diagnosing patients because it just gives us that yes or no information so a lot easier to make that decision now with the AdaptDx. The first thing I say when I walk in the exam room is okay good news bad news. Bad news you didn’t pass the test. Good news is you didn’t pass the test which means we cut it early and we can preserve your vision for the rest of your life. I always print up this little sheet of paper and I sit side by side with the patient so if there’s something in the in the exam chair I pull my stool up right next to them and I put this in front of the the two of us and I go over everything that is important for slowing the progression of macular degeneration. I said you do all these things we’re gonna keep your vision if you do everything I tell you and I’m going to see you back in six months we’re going to see how you’re doing, okay? For me diagnosing macular degeneration before there’s visible signs, it’s a positive thing so when I approached them. I said you did test positive for macular degeneration.

Making proactive lifestyle changes to improve patient outcomes

The amazing news about that now is we know to prevents the care we know we can prevent blindness. We can make these lifestyle changes, we can start you on macular vitamins, and we never have to get to the point where anyone has to see you go blind. I think as the AdaptDx technology becomes more widely implemented and embraced around the globe we’re gonna see AMD being caught much sooner and preserving quality of life and vision. With the AdaptDx we’re gonna uncover just so many more patients that we did not already know about so I think it will aid a lot in being able to catch those patients a lot sooner before they even have to worry about different types of treatment like injections to the eye or any sort of vision loss. Well, I really think that once the AdaptDx gets widely implemented that we’re going to see a significant decrease in vision loss with macular degeneration because we’re going to catch it early and as we find out more and more about how to treat these patients especially these early macular degeneration patients there’s going to be a pill, there’s going to be better supplements, we’re going to know more about how to stop this progression. As we catch more pathology using AdaptDx we are going to notice that not only are we caring for our patients but we’re gonna notice that we are driving more follow-up visits and practice revenue as a by-product will increase with the use of his technology. We found that using AdaptDx in the office has made us better clinicians and has improved the quality of life of our patients. I honestly can’t see myself practicing without it at this point. I love having the AdaptDx in my practice. To have the ability to catch macular degeneration for any true clinical signs occur is huge so I would recommend it for anybody to get in their practice. I would strongly encourage our membership to embrace the AdaptDx technology. We’re all going to catch AMD much sooner.