May 31, 2019 Conference


Prevention and home monitoring of AMD

Dr. Chirag Shah, Ophthalmic Consultants of Boston (Presenter)

AREDS and AREDS 2 vitamins still remain the standard of care in decreasing the risk of intermediate dry AMD from progressing to wet AMD1. There are still no proven treatments to halt, slow, or prevent progression to atrophic AMD.  Studies are evaluating several pathways to slow progression of atrophic AMD, mostly focused on the complement pathway.  Parallel phase III studies evaluating lampalizumab, Chroma and Spectri, found no benefit2.  A recent study evaluating subthreshold laser for prevention of dry AMD progression found no benefit.  A post hoc analysis found dry AMD progression slowed by 20% in eyes without reticular pseudodrusen; this finding warrants further study3.  For wet AMD, the PROCON study tested the hypothesis that quarterly aflibercept injections in eyes with high risk drusen might prevent (or treat subclinically) conversion to wet AMD.  This study found no benefit of preventative aflibercept4. The CATT study found that earlier detection and treatment of wet AMD resulted in better visual acuity outcomes5.  Notal Vision developed the Foresee Home device to detect conversion to wet AMD earlier than would be detected with Amsler grid testing.  They found that 87% of eyes converting to wet AMD were detected at 20/40 or better with the device, compared to 62% of eyes monitored by Amsler grid6.  SightSentry is a home OCT device to monitor anatomy, rather than symptoms.