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Systematic review of clinical practice guidelines for the management of neovascular age-related macular degeneration.

作者信息

Lim Jennifer I, Ko Stella, McAllister Mark, Faux Nancy, Bawa Komal, Mearns Elizabeth, Patel Shriji, Spicer Galin, Martinez Amanda, Tabano David

机构信息

Department of Ophthalmology and Visual Sciences, University of Illinois Chicago, Chicago, IL, USA.

Genentech, Inc., South San Francisco, CA, USA.

出版信息

Eye (Lond). 2025 May 15. doi: 10.1038/s41433-025-03829-8.


DOI:10.1038/s41433-025-03829-8
PMID:40374931
Abstract

BACKGROUND/OBJECTIVES: To assess geographically global clinical practice guidelines (CPGs) for neovascular age-related macular degeneration (nAMD) management. METHODS: A systematic literature review (SLR) of CPGs for nAMD management was conducted using Embase and MEDLINE databases, Guideline Central, Health Technology Assessment bodies, professional ophthalmology associations, and backwards citation tracking. CPGs published between January 2010-October 2023 were included and independently assessed by four reviewers using the Appraisal of Guidelines for Research and Evaluation II (AGREE II). CPGs were qualitatively assessed for anatomical measurements (optical coherence tomography [OCT] and visual acuity [VA]). PROSPERO identification is CRD42023473223. RESULTS: Nine of 147 identified global CPGs were included in the SLR for diagnosis, treatment, and disease monitoring for nAMD. Overall AGREE II scores were 62-95 (mean [standard deviation] score 75 [10.6]). Strongest domains were Scope and Purpose (86.6 [11.0]), Clarity of Presentation (84.3 [13.0]), and Editorial Independence (89.1 [15.4]); Stakeholder Involvement (63.4 [16.6]), Applicability (73.0 [12.6]), and Rigor of Development (55.4 [25.9]) were lowest. 4/9 CPGs were "Recommended" by reviewers, and 5/9 were "Recommended with Modifications". All CPGs recommended OCT for initial diagnosis. 2/9 CPGs did not mention VA. For managing pharmacological interventions, 4/9 CPGs recommended using VA, and three recommended OCT. Eight CPGs recommended using either VA or OCT for disease monitoring while on anti-vascular endothelial growth factor (VEGF) treatment. 6/9 CPGs recommended screening for VA and 7/9 CPGs recommended using OCT to change anti-VEGF intervals. CONCLUSION: CPG methods, recommendations on applicability in resource-constrained systems, and patient advocacy/perspectives will improve CPG trustworthiness and transparency.

摘要

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Systematic review of clinical practice guidelines for the management of neovascular age-related macular degeneration.

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本文引用的文献

[1]
The Impact of Disease Activity Criteria on Extending Injection Intervals in Real-World Patients with Neovascular Age-Related Macular Degeneration.

Ophthalmol Ther. 2025-4

[2]
Caregiver Experience Survey of Anti-Vascular Endothelial Growth Factor Treatment for Diabetic Macular Edema and Neovascular Age-Related Macular Degeneration.

Ophthalmic Res. 2024

[3]
Impact of treat and extend criteria on proportions that can be extended after loading phase of 2 mg aflibercept therapy for neovascular age related macular degeneration: PRECISE Report 5.

Eye (Lond). 2024-10

[4]
Age-Related Macular Degeneration: An Exponentially Emerging Imminent Threat of Visual Impairment and Irreversible Blindness.

Cureus. 2023-5-29

[5]
IMPACT OF RETINAL FLUID-FREE MONTHS ON OUTCOMES IN NEOVASCULAR AGE-RELATED MACULAR DEGENERATION: A Treatment Agnostic Analysis of the HAWK and HARRIER Studies.

Retina. 2023-4-1

[6]
Barriers and enablers to implementing clinical practice guidelines in primary care: an overview of systematic reviews.

BMJ Open. 2023-1-6

[7]
Optical coherence tomography imaging biomarkers associated with neovascular age-related macular degeneration: a systematic review.

Eye (Lond). 2023-8

[8]
Incidence and Prevalence of Neovascular Age-Related Macular Degeneration in France between 2008 and 2018: The LANDSCAPE Study.

Ophthalmol Sci. 2022-1-22

[9]
Patient Preference and Treatment Satisfaction With a Port Delivery System for Ranibizumab vs Intravitreal Injections in Patients With Neovascular Age-Related Macular Degeneration: A Randomized Clinical Trial.

JAMA Ophthalmol. 2022-8-1

[10]
Modifiable Determinants of Satisfaction with Intravitreal Treatment in Patients with Neovascular Age-Related Macular Degeneration.

Drugs Aging. 2022-5

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