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Presenter: Keep dry AMD patients in your practice
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LAS VEGAS – A presenter here at a Vision Expo West continuing education session said optometrists are over-referring patients with age-related macular degeneration.
“Only 20% of AMD patients will convert to wet AMD,” Kirk Smick, OD, chairman of the conference advisory board, told attendees. “There’s no reason to refer a patient with dry AMD as long as you can do ocular coherence tomography on them,” he said.
“Retinal specialists are overworked,” Smick continued. “We have ODs who refer patients to our office to have an OCT performed. We don’t see the patient; we just run the test and bill a technical component for it.”
Jack L. Schaeffer, OD, of Birmingham, Ala., another member of this “what’s new” session panel, recommended finding several other optometrists in your area to share the cost of purchasing an Optovue OCT and a table. The portable instrument could travel among the offices, he said.
“You can all share it, and you can pay off your portion in several months,” Schaeffer said. “Eventually you can get to the point where you can purchase one for yourself.”
Smick also discussed genetic testing for AMD in the optometrist’s office.
“The Macula Risk cheek swab [by ArcticDx] identifies AMD patients who will progress to vision loss,” Smick said. “Medicare pays for this; we don’t collect any money from the patient; we don’t make any money on it other than the office visit.”
Smick said a report is provided in 2 weeks and scores the patient from MR1 to MR5. “MR1 and MR2 are considered normal,” Smick said. “If it’s MR3 or MR4, we have them come back for additional testing and counseling. If the score is M3, M4 or M5 we change the frequency of visits depending on clinical signs and their score.”
Smick added that environmental factors are also involved in progression of AMD, “and the #1 cause for a patient progressing to wet AMD is smoking,” he said. “In fact, your likelihood for progressing is increased by 12 times if you’re a smoker.”
In addition to smoking, excessive weight and lack of physical activity also contribute, Smick said.
- Disclosures: Schaeffer has a financial interest in Optovue. Smick is a member of the Macula Risk Advisory Panel.