A Delphi study on the clinical management of age-related macular degeneration
- PMID: 35149923
- DOI: 10.1007/s10792-021-02177-2
A Delphi study on the clinical management of age-related macular degeneration
Abstract
Purpose: Age-related macular degeneration (AMD) is one of the main causes of blindness and visual impairment worldwide. As achieving a dry macula is one of the main objectives in AMD management, the purpose of this work was to reach a consensus on the relevance of retinal fluid in function, disease activity control and treatment patterns.
Methods: Forty-seven Portuguese ophthalmologists specialized in AMD participated in a DELPHI panel. Two rounds of presential meetings were conducted and a cut-off of 80% or more of votes was defined to consider answers consensual.
Results: Consensus was reached for 11 out of 18 questions. These questions focused on the impact of anatomical results on visual acuity, standards exams and parameters to assess disease activity, frequency and factors which influence disease activity assessment, criteria to use non-fixed treatment regimens, usefulness of individualized regimens and conditions for treatment interruption. No consensus was obtained for relevance of the different fluid types in AMD prognosis, frequency of fluid presence assessment, factors commonly associated with progression to geographic atrophy, ideal conditions for a fixed treatment regimen, date of first disease activity assessment and parameters to monitor disease activity.
Conclusions: Consensus was achieved for over half of the questions assessed through this Delphi study. The questions for which no consensus was reached concerned either subjects that need further investigation or monitoring times which are influenced by resource availability. Raising awareness for these issues will allow the improvement of AMD management and treatment.
Keywords: Age-related macular degeneration; Consensus; Disease activity; Disease management; Retinal fluid; Treatment regimen.
© 2022. The Author(s), under exclusive licence to Springer Nature B.V.
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References
-
- Schmidt-Erfurth U, Chong V, Loewenstein A, Larsen M, Souied E, Schlingemann R, Eldem B, Mones J, Richard G, Bandello F, European Society of Retina S (2014) Guidelines for the management of neovascular age-related macular degeneration by the European Society of Retina Specialists (EURETINA). Br J Ophthalmol 98:1144–1167. https://doi.org/10.1136/bjophthalmol-2014-305702 - DOI - PubMed
-
- Holz FG, Dugel PU, Weissgerber G, Hamilton R, Silva R, Bandello F, Larsen M, Weichselberger A, Wenzel A, Schmidt A, Escher D, Sararols L, Souied E (2016) Single-chain antibody fragment VEGF inhibitor RTH258 for neovascular age-related macular degeneration: a randomized controlled Study. Ophthalmology 123:1080–1089. https://doi.org/10.1016/j.ophtha.2015.12.030 - DOI - PubMed
-
- van Lookeren CM, LeCouter J, Yaspan BL, Ye W (2014) Mechanisms of age-related macular degeneration and therapeutic opportunities. J Pathol 232:151–164. https://doi.org/10.1002/path.4266 - DOI
-
- Chopdar A, Chakravarthy U, Verma D (2003) Age related macular degeneration. BMJ 326:485–488. https://doi.org/10.1136/bmj.326.7387.485 - DOI - PubMed - PMC
-
- Schmidt-Erfurth U, Vogl WD, Jampol LM, Bogunovic H (2020) Application of automated quantification of fluid volumes to anti-VEGF therapy of neovascular age-related macular degeneration. Ophthalmology 127:1211–1219. https://doi.org/10.1016/j.ophtha.2020.03.010 - DOI - PubMed
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