Remote Physiologic Monitoring and Principal Care Management for Chronic Retinal Diseases: Results from over 80,000 Encounters

Abstract Purpose Timely detection of disease activity in chronic retinal diseases improves visual outcomes but is limited by the lack of validated systems for continuous monitoring and care management. We evaluated the real-world performance of an integrated remote physiologic monitoring and principal care management program (RemoniHealth®) using a self-administered multimodal retinal function test (Macustat®) for home monitoring. Methods This single-arm real-world intervention study was conducted across 33 retina practices. A total of 2,216 adults with chronic retinal diseases performed weekly home retinal function testing with integrated care management support. Primary endpoints included the annualized rate of disease progression detection, time to intervention after first flag, true positive rate, and patient adherence. Descriptive statistics and data analyses were analyzed using chi-square tests and Clopper–Pearson confidence intervals. Results Participants contributed 82,644 encounters and 16,805 patient-months of monitoring. The program generated 241 alerts, including 101 Macustat flags and 135 care management prompts. Among 73 adjudicated flags, 56 were true positives and 17 false positives (PPV 76.7%). The annualized detection rate was 4 per 100 patient-years. Of confirmed events, 93% led to intravitreal injection or other major management change. Mean adherence was 72.1%, and patients with ≥80% adherence had higher odds of true positivity. Discussion This RPM–PCM model achieved high engagement and meaningful detection of asymptomatic progression between visits, supporting the value of home monitoring for timely intervention. Translational Relevance These findings support scalable integration of home vision testing and care management into routine retinal practice to enable earlier intervention and improved continuity of care.