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Study finds high prevalence of undiagnosed AMD in primary eye care
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A study found a high rate of undiagnosed age-related macular degeneration in primary eye care practices and advocated the need for improved detection strategies.
Participants were recruited from primary eye care practices in Birmingham, Alabama, and consisted of 1,288 eyes of 644 adults aged 60 years or older who had previously received a comprehensive dilated eye examination and did not have a diagnosis of AMD. Digital color fundus photographs of both eyes were captured, evaluated and graded according to the Clinical Age-Related Maculopathy Staging system.
Approximately 25% of the eyes with no diagnosis of AMD in the medical records were found to have AMD. About 30% of these eyes had large drusen and would have benefited from AREDS supplementation. The largest percentage of undiagnosed patients was older adults, which was “puzzling,” according to the authors, because “one would surmise that a patient’s advanced age would lead primary eye care physicians to more closely scrutinize the fundus for signs of AMD.”
The number of undiagnosed cases was not different for primary care ophthalmologists and optometrists.
The authors suggested that more specific training in identifying AMD during fundus examination and higher quality retinal imaging modalities should be implemented in primary eye care to allow correct identification of AMD and treatment in the earliest phases, thus preventing avoidable loss of vision. – by Michela Cimberle
Disclosure: The authors report no relevant financial disclosures.
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Neely DC, et al. JAMA Ophthalmol. 2017;doi:10.1001/jamaophthalmol.2017.0830.
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