Abstract
Purpose :
To determine the severity of age-related macular degeneration (AMD) at first presentation among the Bhutanese patients attending vitreoretinal (VR) clinics and to inform national health policy on the potential benefits of a screening program.
Methods :
A retrospective cross-sectional consecutive case series study was conducted on new AMD cases. If a patient presented with asymmetrical AMD, the eye with more severe AMD was considered. If both the eyes had the same severity one eye was chosen randomly. Collection of demographic data and clinical details including diagnostic testing (fundus photography, OCT and fluorescent angiography) and clinical staging were performed.
Results :
Of 521 new AMD patients aged 71.9 ± 11.3 years, 306 (58.7%) were males (p=0.005). At their first presentation, 234 patients (44.9%) already had late-stage AMD. Importantly, 69 patients (29.5%), that is half of total neovascular AMD (nAMD) patients, had disciform scars (DS) which were beyond treatment, and 7 (3.0%) had geographic atrophy (GA). Fourteen of nineteen polypoidal choroidal vasculopathy (PCV) patients were younger than 50 years.
Conclusions :
Half of total nAMD cases presented as DS not amenable to the treatment. Many potentially treatable patients with nAMD had already lost central vision and were legally blind. Young people with PCV losing vision early in life with longer morbidity-affected life and socio-economic burden was concerning. GA and DS cases need visual rehabilitation to improve their QoL. Incorporating a screening program for AMD with effective health education, and maintaining a national AMD Registry, would potentially lower AMD-related blindness and visual impairment.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.