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Management of Wet Age-Related Macular Degeneration - Episode 15

Clinical Pearls for the Management of Wet AMD

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A panel of eye care specialists share clinical advice and future directions for the treatment of wet AMD.

John W. Kitchens, MD: In closing, I’d like to get a thought from each of you to our primary care colleagues mainly. Dante, what would be your last parting thoughts to primary care doctors on age-related macular degeneration [AMD]?

Dante J. Pieramici, MD: When I started my career 25 years ago, for the patient with AMD, the going thought was there wasn’t much you could do for them, and the patient was going to lose vision. They were not going to go totally blind but they were going to lose the center vision and probably not be able to drive or read. That’s completely different today. There’s a lot we can do for these patients. We can maintain their vision; we can improve their vision in certain circumstances. We’re doing a whole lot of work with the dry disease itself, too. I would be optimistic to those patients. I hate when I hear the patients come in and say, “Oh, I hear I’m going to go blind,” because many of them aren’t anymore. We’re going to be able to improve their vision and keep them seeing, reading, and driving. I have patients now who have been driving 15 or 20 years. They wouldn’t have been driving before the advent of these agents., So optimism would be my closing point when it comes to AMD.

John W. Kitchens, MD: Roger, what would be your closing thoughts?

Roger A. Goldberg, MD, MBA: Yes. My word was hope, not optimism, but we’ve come so far. I know everybody on this Zoom here tonight is very involved in clinical research. Generation 1.0 of the anti-VEGF agents, our ability to treat wet AMD, diabetic retinopathy and some other diseases, is incredible. The next 30 years are going to be another period of incredible innovation and growth of what we’ll be able to do for our patients. I think we’ll look back on these last 15 years and say, “Oh my gosh, you were injecting patients every month with a single class of medicine.” We’ll look back and say, “That’s barbaric,” because we’re going to have a much broader armamentarium of medicines, and diagnostics, and ways to monitor, and the introduction of artificial intelligence, and stem cells and gene therapy. As someone who’s involved in clinical research in this space, it’s an exciting time. We’ve come far in 15 years, but the next 15 and 30 years are going to be even more impressive.

John W. Kitchens, MD: Lloyd, close us off with your parting thoughts.

Lloyd Clark, MD: Yes. I would go back to basics a bit. The number of senior patients continues to grow dramatically. The baby boomers are coming of age, and there’s a tremendously large group of patients for whom life expectancy is much longer. As you get into your 80s and 90s, the incidence of age-related macular degeneration goes up dramatically. The incidence of diabetes is exploding, and then we have the more common senior causes of vision loss, including cataracts and glaucoma. These patients over the age of 70 need a dilated eye examination by a competent eye care provider every year. There’s a number of things that can trip them up, and their health is so good with better nutrition, better exercise, and better systemic management from you. We don’t want their vision to be their limiting factor, so make sure they get an eye exam, a dilated eye exam, every year because many of these problems if we catch them early will not impact their quality of life.

John W. Kitchens, MD: That’s absolutely a tremendous point. I want to thank Roger, Dante, Lloyd. You guys have been fantastic, covering exudative age-related macular degeneration in such a thoughtful and in-depth way.

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Transcript Edited for Clarity