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Importance of Anatomical Efficacy for Disease Control in Neovascular AMD: An Expert Opinion

Balaskas, Konstantinos; Amoaku, Winfried M; Cudrnak, Tomas; Downey, Louise M; Groppe, Markus; Mahmood, Sajjad; Mehta, Hemal; ... Yang, Yit C; + view all (2021) Importance of Anatomical Efficacy for Disease Control in Neovascular AMD: An Expert Opinion. Ophthalmology and Therapy , 10 (2) pp. 231-243. 10.1007/s40123-021-00342-5. Green open access

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Abstract

BACKGROUND: Neovascular age-related macular degeneration (nAMD) presents a significant treatment burden for patients, carers and medical retina services. However, significant debate remains regarding how best to manage nAMD when assessing disease activity by optical coherence tomography (OCT), and particularly the significance of different types of fluid and how the understanding of anatomical efficacy can influence treatment strategies. This article provides opinion on the practical implications of anatomical efficacy and significance of fluid in the management of nAMD and proposes recommendations for healthcare professionals (HCPs) to improve understanding and promote best practice to achieve disease control. METHODS: An evidence-based review was performed and an expert panel debate from the Retina Outcomes Group (ROG), a forum of retinal specialists, provided insights and recommendations on the definition, role and practical implications of anatomical efficacy and the significance of fluid at the macula in the management of nAMD. RESULTS: The ROG has developed recommendations for achieving disease control through a zero-tolerance approach to the presence of fluid in nAMD as patients who avoid fluctuations in fluid at the macula have better visual outcomes. Recommendations cover five key areas: service protocol, training, regimen, multidisciplinary teams and engagement. This approach facilitates more standardised protocol-based treatment strategies. CONCLUSIONS: Targeting a fluid-free macula and aiming for disease control are essential to improve outcomes. As new therapies and technologies become available, drying the macula and maintaining disease control will become even more achievable. The outlined recommendations aim to promote best practice among HCPs and medical retina services to improve patient outcomes.

Type: Article
Title: Importance of Anatomical Efficacy for Disease Control in Neovascular AMD: An Expert Opinion
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1007/s40123-021-00342-5
Publisher version: https://doi.org/10.1007/s40123-021-00342-5
Language: English
Additional information: © 2023 Springer Nature Switzerland AG. This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/).
Keywords: Anatomical efficacy, Disease control fluid, OCT, Stability
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Institute of Ophthalmology
URI: https://discovery.ucl.ac.uk/id/eprint/10165119
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