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Guidelines: Test dark adaptation to catch AMD early

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LAS VEGAS – The Maculogix clinical advisory committee released a consensus paper on the importance of visual function in the diagnosis of nonexudative age-related macular degeneration here at Vision Expo West.

The committee members state in the paper, Practice Guidelines for the Treatment of Nonexudative AMD, that while many eye care providers hesitate to diagnose AMD due to the fact that not all drusen are caused by AMD, the dark adaptation test can aid in this differential diagnosis.

Dark adaptation impairment occurs early in the AMD disease process, the committee stated, up to 3 years before the disease can be detected by clinical examination or retinal imaging, according to Owsley and colleagues.

Maculogix President and CEO William McPhee stated at a press conference that the company’s mission is to eliminate blindness due to AMD.

He said that many practicing using the AdaptDx technology are choosing to test all patients 60 years and older and finding that 30% have undiagnosed AMD.

McPhee referred to a study published in JAMA Ophthalmology earlier this year (Neely et al.) that evaluated the prevalence of undiagnosed AMD in primary eye care practices, which included both optometrists and ophthalmologists.

“When we recruited for the clinical trial, we asked referring clinicians to send only patients without AMD,” McPhee said. “It turns out that 25% had AMD, identified with drusen on fundus study.

“The rate of missing the diagnosis was similar in optometrists vs. ophthalmologists,” he continued. “The average primary care provider is not well versed in identifying drusen.”

McPhee continued by saying that 78% of patients that present for their first intravitreal injection have irreversible vision loss.

“AdaptDx can lower this with earlier diagnosis and intervention,” he concluded. – by Nancy Hemphill, ELS, FAAO

References:

Neely DC, et al. JAMA Ophthalmol. 2017;135(6):570-575;doi:10.1001/jamaophthalmol.2017.0830.

Owsley C, et al. Ophthalmology. 2016;123(2):344-351;doi:10.1016/j.ophtha.2015.09/041.