García-Layana Alfredo, Garhöfer Gerhard, Aslam Tariq M, Silva Rufino, Delcourt Cécile, Klaver Caroline C W, Seddon Johanna M, Minnella Angelo M
Clínica Universidad de Navarra, IdiSNA (Instituto de Investigación Sanitaria de Navarra), 31009 Pamplona, Spain.
Department of Clinical Pharmacology, Medical University of Vienna, 1090 Wien, Austria.
J Clin Med. 2021 Nov 20;10(22):5432. doi: 10.3390/jcm10225432.
Early identification of AMD can lead to prompt and more effective treatment, better outcomes, and better final visual acuity; several risk scores have been devised to determine the individual level of risk for developing AMD. Herein, the Delphi method was used to provide recommendations for daily practice regarding preventive measures and follow-up required for subjects at low, moderate, and high risk of AMD evaluated with the Simplified Test AMD Risk-assessment Scale (STARS) questionnaire.
A steering committee of three experts drafted and refined 25 statements on the approach to be recommended in different clinical situations [general recommendations ( = 2), use of evaluation tools ( = 4), general lifestyle advice ( = 3), and AREDS-based nutritional supplementation ( = 5)] with the help of a group of international experts, all co-authors of this paper. Thirty retinal specialists from Europe and the US were chosen based on relevant publications, clinical expertise, and experience in AMD, who then provided their level of agreement with the statements. Statements for which consensus was not reached were modified and voted upon again.
In the first round of voting, consensus was reached for 24 statements. After modification, consensus was then reached for the remaining statement.
An interprofessional guideline to support preventive measures in patients at risk of AMD based on STARS scoring has been developed to aid clinicians in daily practice, which will help to optimize preventive care of patients at risk of AMD.
早期识别年龄相关性黄斑变性（AMD）可带来及时且更有效的治疗、更好的治疗效果以及更佳的最终视力；已设计出多种风险评分来确定个体患AMD的风险水平。在此，采用德尔菲法就使用简化AMD风险评估量表（STARS）问卷评估为低、中、高风险的AMD患者的预防措施和随访提供日常实践建议。
一个由三名专家组成的指导委员会在一组国际专家（均为本论文的共同作者）的帮助下，起草并完善了25条关于在不同临床情况中应推荐的方法的陈述[一般建议（=2条）、评估工具的使用（=4条）、一般生活方式建议（=3条）以及基于年龄相关性眼病研究组（AREDS）的营养补充（=5条）]。根据相关出版物、临床专业知识以及在AMD方面的经验，从欧洲和美国挑选了30名视网膜专家，他们随后对这些陈述表示了同意程度。未达成共识的陈述经过修改后再次进行投票。
在第一轮投票中，24条陈述达成了共识。经过修改后，其余陈述也达成了共识。
已制定出一项基于STARS评分的跨专业指南，以支持对有AMD风险的患者采取预防措施，帮助临床医生进行日常实践，这将有助于优化对有AMD风险患者的预防护理。
