NICE has published NICE Guideline (NG) 82 on Age-related macular degeneration.
Age-related macular degeneration (AMD) refers to ageing changes without any other obvious cause in the central area of the retina (the macula). While generally painless it can cause gradual or rapid deterioration in vision. Normal macular ageing changes are a common incidental finding on visits to the optometrist, but can also present with difficulties in performing certain daily tasks like driving, reading, or recognising faces. It can present with formation of new blood vessels (wet AMD) or without (dry AMD), and is broadly categorised into early and late AMD depending on the degree of progression.
It is estimated that around 39,800 people develop neovascular AMD in the UK each year, and there has been an increase in hospital activity in England for episodes with a primary diagnosis of AMD (rising from around 10,000 in 2005/6 to over 75,000 in 2013/14). Two of the main treatments for late wet AMD represent some of the highest expenditure on single NICE-approved medicines in the NHS.
The recommendations offered in NG82 cover the diagnosis and management of AMD in adults, with an aim to improve the speed of diagnosis and prevent unnecessary loss of sight. They include:
- classifying AMD, including a table to differentiate between early and late AMD, and between wet and dry AMD
- information and support
- risk factors
- diagnosis and referral
- pharmacological management of AMD
- non-pharmacological management of AMD
- monitoring AMD.