Wealth of information benefits retina specialists worldwide
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The best source of evidence to base one’s clinical decisions on is a well-designed prospective randomized masked controlled clinical trial.
These clinical trials represent level I evidence, and if two or three well-designed prospective clinical trials produce similar evidence, the likelihood that the evidence is accurate is very strong.
In the anterior segment world, the majority of our prospective clinical trials are designed and funded by industry. In the retina world, many high-quality clinical trials are initiated, designed and completed by clinician scientists in collaboration with one another, industry, and either a society, especially the American Society of Retina Specialists, or a research consortium such as the DRCR Retina Network. These collaborations are virtuous and have contributed in a meaningful way to the clinical practice of retina globally.
There are about 20,000 ophthalmologists in the United States. In the U.S., about 10% of ophthalmologists, or 2,000, are fellowship-trained retina specialists. Another 1,000 of our U.S.-based colleagues describe their practice as having a retina emphasis, usually medical retina. The number of retina specialists outside the U.S. is difficult to determine but is likely closer to 5% of about 120,000 global ophthalmologists. The ASRS publishes a Global Trends in Retina consensus each year surveying retina specialists from 40 societies around the world. This year, 722 retina specialists completed the survey, providing useful information, much of which is discussed in the accompanying cover story.
Of interest to me was that only 10% of retina specialists surveyed support genetic testing for age-related macular degeneration, 70% today would choose Eylea (aflibercept, Regeneron) if they or a family member required intravitreal injections, and 50% will tolerate some fluid in the retina on OCT (when visual acuity remains stable) in a patient when utilizing a treat-and-extend anti-VEGF intravitreal injection approach for treating wet AMD. The full 2020 survey and those performed in previous years are available on the ASRS website.
The other amazingly constructive collaboration in the retina field is DRCR.net, which was founded in 2002 and includes the National Eye Institute, the National Institute of Diabetes and Digestive and Kidney Diseases, the Jaeb Center for Health Research, several companies and 350 collaborating retina specialists in both private practice and academia. The more than 30 prospective randomized masked controlled clinical trials completed and published by DRCR.net have shaped the clinical treatment of diabetic eye disease worldwide.
Our retina colleagues have done an admirable job gathering level I evidence upon which to base their treatment plans and have disseminated the information gathered worldwide to the benefit of millions of patients.
Editor’s note: Click here to read “ASRS’ Global Trends survey shows growing homogeneity of retina treatment, part 1” in the Feb. 25, 2021, issue of Ocular Surgery News.
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