Nuno Gomes1, Angelina Meireles2, Ângela Carneiro3, Rufino Silva4,5,6, António Campos7,8, Lilianne Duarte9, Rita Flores10, Carlos Marques-Neves11. 1. Departamento de Retina Do Hospital de Braga, Rua das Comunidades Lusíadas 133, Braga, Portugal. nunolgomes@gmail.com. 2. Department of Ophthalmology, Hospital de Santo António, Centro Hospitalar Universitário Do Porto, Porto, Portugal. 3. Department of Ophthalmology, Centro Hospitalar Universitário de São João, Porto, Portugal. 4. Department of Ophthalmology, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal. 5. Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal. 6. Association for Innovation and Biomedical Research On Light and Image (AIBILI), Coimbra, Portugal. 7. Department of Ophthalmology, Centro Hospitalar de Leiria, Leiria, Portugal. 8. Coimbra Institute for Clinical and Biomedical Research (iCBR), Coimbra, Portugal. 9. Department of Ophthalmology, Centro Hospitalar de Entre O Douro E Vouga, Santa Maria da Feira, Portugal. 10. Department of Ophthalmology, Centro Hospitalar Lisboa Central, Lisboa, Portugal. 11. Faculdade de Medicina da Universidade de Lisboa, University Ophthalmology Clinic, Lisboa, Portugal.
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.
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.
Authors: Frank G Holz; Pravin U Dugel; Georges Weissgerber; Robin Hamilton; Rufino Silva; Francesco Bandello; Michael Larsen; Andreas Weichselberger; Andreas Wenzel; Anne Schmidt; Dominik Escher; Laura Sararols; Eric Souied Journal: Ophthalmology Date: 2016-02-20 Impact factor: 12.079
Authors: Jennifer J Arnold; Anna Campain; Daniel Barthelmes; Judy M Simpson; Robyn H Guymer; Alex P Hunyor; Ian L McAllister; Rohan W Essex; Nigel Morlet; Mark C Gillies Journal: Ophthalmology Date: 2015-04-04 Impact factor: 12.079
Authors: Alessandro Arrigo; Emanuela Aragona; Carlo Di Nunzio; Francesco Bandello; Maurizio Battaglia Parodi Journal: Transl Vis Sci Technol Date: 2020-08-31 Impact factor: 3.283