Innovations in therapy have addressed some of the unmet needs in the treatment of neovascular age-related macular degeneration (nAMD), such as extending the duration between anti-VEGF injections. However, advancements in disease monitoring for nAMD have not kept up, and retina specialists still rely on imaging patients in an office setting. This leads to bottlenecks in clinical workflow, increased burden on patients, and limited data for personalized treatment of this heterogeneous disease. These factors contribute to inferior outcomes for nAMD patients in real-world settings compared to clinical trials. The ForeseeHome AMD Monitoring Program introduced the potential benefits of remote monitoring to retina specialists, and the literature has described the real-world advantages of using the platform to detect the conversion from intermediate AMD to nAMD. The next step in remote monitoring for neovascular AMD is the introduction of AI-powered, home-based optical coherence tomography (OCT) platforms, which could enable more precise and patient-specific medicine. However, some retina specialists have concerns about how incorporating home OCT into patient management will impact reimbursement, workflow, and liability. To gain insights into the adoption of remote monitoring in other medical specialties, I spoke with Ajay V. Srivastava, MD, FACC, an advanced heart failure cardiologist at Scripps Clinic in La Jolla, California. His field has extensive experience with remote monitoring, which can inform how eye care providers envision the future of practice.

We discussed how fears of long-term revenue loss, workflow adjustments, and liability were overcome in cardiology's adoption of remote monitoring. While ophthalmology and cardiology may seem different, there are similarities in the remote monitoring approaches being explored. Both home OCT platforms and remote monitoring platforms used in cardiology share characteristics such as ease of use, quick at-home testing, and the ability to provide vital data to clinicians. Patient education and engagement have played crucial roles in the adoption of remote monitoring technologies in cardiology, and these lessons can be applied to home OCT platforms as well. Concerns about declining revenues in ophthalmology due to fewer patient appointments can be mitigated by the adoption of remote monitoring, as seen in cardiology where practices have realized net positive impacts. Adjusting workflows and creating patient-specific frameworks for remote monitoring are crucial for successful implementation. Liability concerns have been addressed in cardiology, with the understanding that remote monitoring technologies supplement, rather than replace, in-person examinations and are specific to long-term data observation in a single disease state. Ophthalmologists are on the brink of a significant change that can benefit both clinicians and patients. Planning with foresight and intention will ensure the full realization of the potential of remote monitoring in ophthalmology.