‘Regular injections essential in maintaining vision’

Early diagnosis, prompt initial treatment, and regular injections help stabilise vision in most eyes with wet age-related macular degeneration (AMD), according to a new report published by the Royal College of Ophthalmologists

The second annual report of the National Ophthalmology Database (NOD) AMD Audit analysed data from 66 healthcare organisations offering NHS-funded treatment for wet AMD. Covering nearly 26,000 eyes initiating treatment between April 2021 and March 2022, the report aims to standardise care and improve visual outcomes between different organisations and locations.

According to the findings, timely treatment played a pivotal role in preserving vision. Without intervention, most eyes affected by wet AMD faced a gradual decline in vision. However, with NHS-funded treatment, over 90% of eyes maintained stable vision after the first year of regular injections, preventing further significant deterioration.

Almost 20% of eyes experienced a significant improvement in vision and more than 40% had good vision after the first year of treatment. Timing of treatment was also crucial, as around one in every three people started injections within a month of referral. Within 10 weeks, two-thirds of people had completed their initial phase of treatment of three injections at monthly intervals.

The report also highlighted how treatment appeared to be very safe, with a low number of serious side effects. For example, the risk of serious infection after an injection was around one in 6,600.

Additionally, it was observed that the majority of injections were administered by non-medical staff, primarily trained nurses or optometrists. This not only eases the workload for ophthalmologists but also streamlines the treatment process for patients, potentially reducing waiting times.

Commenting on the report, Martin McKibbin, clinical lead for the NOD AMD Audit, said: “We’re really pleased to see the continued progress with the AMD Audit.

“Clinical staff across most sites continue to deliver exemplary care and optimal outcomes for patients. With this data, we can aim to ensure everyone with AMD receives the best care and outcomes for their vision, no matter where they are treated.”

Variation was found to exist in the care of patients, and the level of vision after treatment varied between providers of NHS treatment. By identifying the best practice and allowing centres to compare local performance with their peers, national averages, and standards, the audit hopes to improve outcomes for all patients having NHS treatment for wet AMD.