Q&A: State of diagnosis, screening in AMD
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Earlier diagnosis of certain types of age-related macular degeneration is integral to preserve vision for patients.
In an email interview, Arshad M. Khanani, MD, MA, FASRS, director of clinical research at Sierra Eye Associates and clinical associate professor at the University of Nevada, Reno School of Medicine, discussed how AMD is currently diagnosed and how the process has evolved over time.
Healio: What are the challenges of diagnosing AMD?
Khanani: We need a complete eye exam and multimodal imaging to diagnose AMD. There are several masqueraders of AMD, and we can rule them out with a proper exam and imaging.
Healio: How important is early diagnosis of AMD, and how can earlier treatment affect the course of the disease?
Khanani: We currently do not have any treatments for dry AMD, so early diagnosis may not be important. However, we will hopefully have treatments in the near future, and if we intervene early, we may be able to preserve functional vision for a long time.
As far as wet AMD is concerned, earlier diagnosis and treatment are crucial to avoid vision loss due to subretinal hemorrhage and fibrosis.
Healio: How have diagnostic and screening methods changed during the last 10 years?
Khanani: We have made significant improvements in imaging technology over the last decade. Spectral domain OCT with fast acquisition time, the advent of OCT angiography (OCTA) and widefield color photos, as well as fluorescein angiography, have revolutionized how we screen patients for AMD.
Healio: What disparities exist in diagnosing AMD?
Khanani: If there is no access to multimodal imaging equipment, it may limit the ability to diagnose and treat AMD.
Healio: What role does dark adaptation play in diagnosing AMD?
Khanani: Dark adaptation can be impaired in patients with AMD, but we do not use dark adaptation in our clinic to diagnose AMD.
Healio: How is the diagnostic process different for wet and dry types of AMD?
Khanani: We perform OCT in all patients with wet and dry AMD, but if there is a concern for wet AMD, we utilize OCTA and fluorescein angiography to evaluate for macular neovascularization.
Healio: What do you see on the horizon for diagnosing and screening for AMD?
Khanani: I foresee improvement in OCTA technology, resulting in faster and more detailed scans.
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Healio interview.
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