The Effectiveness of Community versus Hospital Eye Service follow-up for patients with neovascular age-related macular degeneration with quiescent disease: a virtual trial

Wet, or neovascular, age-related macular degeneration (nAMD) is a condition which causes severe sight loss and is the most common cause of blindness in older people in the UK.  nAMD develops when abnormal blood vessels form in the part of the eye responsible for central vision (the field of vision when looking straight ahead).  The current treatment for patients with nAMD is monthly observation and administration of a drug which is designed to block one of the chemicals responsible for the growth of new blood vessels.  The drug is injected into the eye when the disease is active and stopped when the disease process is controlled.

Hospital eye doctors (ophthalmologists) continue to see patients monthly, even when no injections are needed, because there is a very high risk of needing to restart treatment at some point in the future.  This is burdensome for patients and for busy hospital clinics, particularly since the need for monthly treatment diminishes over time.

NIHR Award Information


The Echoes study aimed to determine whether follow up by optometrists in optician practices in the community is as good as follow-up by opthalmologists.  Rather than carrying out a new trial, eye images (colour fundus and ocular coherence tomography images) collected during a large UK based multicentre clinical trial (the IVAN trial) were used to determine whether optometrists can detect disease activity and make the same decisions about re-treatment as opthalmologists.  full paper.