COMMENTARY

Are Optometrists Qualified to Manage Age-Related Macular Degeneration?

Brianne N. Hobbs, OD

Disclosures

October 06, 2016

Viewpoint

It is not appropriate to conclude that optometrists are equally as skilled as ophthalmologists in classifying stages of neovascular AMD from this trial alone. This trial was very small and relied exclusively on virtual decision-making, so making a definitive judgement from these data is ill-advised. It is important to remember that this study was done in the United Kingdom, where training for optometrists is significantly shorter, a factor that may have contributed to the lack of confidence expressed by the optometrists in this trial.

One of the primary benefits of optometrists participating to a greater degree in the comanagement of patients with neovascular AMD would be the potential savings in healthcare costs. Unfortunately, a cost analysis was not performed in this trial.

Participants in this trial were able to make safe and accurate decisions in a virtual environment, a result that warrants additional investigation into the feasibility of incorporating remote imaging in the management of patients with AMD. The use of teleretinal imaging has not yet been applied to neovascular AMD on a large scale, but this modality holds much promise, as teleretinal imaging has been used successfully in the management of patients with diabetic retinopathy. Improvements in the resolution of OCT imaging have made teleretinal imaging a more realistic possibility for AMD and could help control costs and improve access to care.

Ultimately, expanding the roles of both technology and optometrists in the follow-up of patients with neovascular AMD may be the best way to improve the quality of care for patients with this debilitating condition.

Abstract

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