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I. Chowers, R.A. Cervantes–Castañeda, I. Hemo, M. Shpigel, E. Averbukh, E. Banin; The Benefit of Early Awareness to Age–Related Macular Degeneration . Invest. Ophthalmol. Vis. Sci. 2006;47(13):2131.
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© ARVO (1962-2015); The Authors (2016-present)
To assess whether awareness to age related macular degeneration (AMD) prior to the development of choroidal neovascularization (CNV) confers better outcome in patients who are treated with photodynamic therapy.
Observational study on 122 eyes of 122 consecutive patients who underwent photodynamic therapy for neovascular AMD (NVAMD) was performed. Patients were classified into those who were unaware (Group 1), or aware (Group 2), to the fact that they had AMD prior to diagnosis of CNV in the study eye. Medical and ocular histories were obtained, a full ophthalmic examination was performed, and charts and fluorescein angiograms were reviewed.
Among 122 patients, 95 patients (78%) were unaware (Group 1) and 27 patients (22%) were aware (Group 2), of the fact that they had AMD prior to the development of CNV in the study eye. Group 1 patients were more likely to have a positive history for smoking (51% vs. 27% in Group 2, p = 0.042). Median follow –up time was 10 months in Group 1 (range 2 – 60 months), and nine months in Group 2 (range 2 – 46 months). Mean initial lesion size (SD) was 3000µm ± 1200 and 3450µm ± 1350 in Groups 1 and 2, respectively (p = 0.5). Mean initial study eye visual acuity in Group 1 and Group 2 was 0.92 ± 0.71 logarithm of the minimum angle of resolution (logMAR), and 1.01 ± 0.83 logMAR, respectively (about 6/48 and 6/60, respectively, p = 0.9). Lesion composition, final lesion size and final visual acuity were also similar in both groups.
These data suggest that current screening methods fail to identify the majority of patients with AMD prior to the development of CNV. The findings also demonstrate that in the routine clinical setting, prior diagnosis of intermediate AMD and monocular advanced AMD does not lead to early detection of CNV. Therefore, current practice guidelines for such patients should be evaluated in order to maximize the benefit from early awareness to the disease.
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