Optometry Australia’s chairside reference suggests limiting the use of terms such as “age-related maculopathy,” “wet,” and “dry” AMD, and instead use the Beckman classification
OD assessments equal to ophthalmologists’
A recent U.K. study found optometrists were as effective at identifying developments in AMD as ophthalmologists, and that “shared care with optometrist monitoring quiescent wet AMD lesions has the potential to reduce workload in hospitals.”4
The study found 84.5% of optometrists (n = 48) and 85.4% of ophthalmologists (n=48) classified lesions correctly. One finding of the study of potential interest, however, is that optometrists were more cautious and more likely to reclassify a lesion as re-activated.
These results clashed with an earlier study, however, that found optometrists were less able to recognize macular edema and drusen, although they “perform satisfactorily” in identifying the symptoms.5
At the time, it was suggested additional training may improve diagnostic outcomes. That may have been borne out by a study6 published last year. In that, it was suggested that optical coherence tomography (OCT) improves optometrists’ diagnostic performance compared to fundus observation alone. These initial results suggest that OCT provides valuable additional data that could augment case‐finding for glaucoma and retinal disease.
1. Hart KM, Abbott C, Ly A, et al. Optometry Australia’s chairside reference for the diagnosis and management of age-related macular degeneration. Clin Exper Optom 2019. DOI:10.1111/cxo.12964
2. Ferris FL, Wilkinson CP, Bird A, et al. Clinical classification of age‐related macular degeneration. Ophthalmology 2013; 120: 844–851
3. Ferris FL, Davis MD, Clemons TE, et al. A simplified severity scale for age‐related macular degeneration: AREDS Report No. 18. Arch Ophthalmol 2005; 123: 1570–1574.
4. Reeves BC, Scott LJ, Taylor J, et al. Effectiveness of community versus hospital eye service follow-up for patients with neovascular age-related macular degeneration with quiescent disease (ECHoES): a virtual non-inferiority trial. BMJ Open 2016;6:e010685. doi:10.1136/bmjopen-2015-010685
5. Muen WJ, Hewick SA. Quality of optometry referrals to neovascular age-related macular degeneration clinic: a prospective study. JRSM Short Rep. 2011;2(8):64. doi:10.1258/shorts.2011.011042
6. Jindal A, Ctori I, Fidalgo B, Dabasia P, Balaskas K, Lawrenson JG. Impact of optical coherence tomography on diagnostic decision-making by UK community optometrists: a clinical vignette study. Ophthalmic Physiol Opt. 2019;39(3):205–215. doi:10.1111/opo.12613
7. Jalbert I, Rahardjo D, Yashadhana A, Liew G, Gopinath B (2020) A qualitative exploration of Australian eyecare professional perspectives on Age-Related Macular Degeneration (AMD) care. PLoS ONE 15(2): e0228858. https://doi.org/ 10.1371/journal.pone.0228858