First annual NOD AMD audit report published

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THE National Ophthalmology Database (NOD) age-related macular degeneration (AMD) audit report is a significant milestone in benchmarking the delivery of AMD treatment in the UK, using data recorded as part of routine clinical care.

It reflects the desire and willingness of ophthalmologists throughout the UK to quality assure the care they provide for many thousands of patients who have the rapidly progressive ‘wet’ form of AMD. The audit provides understanding of the quality of care and outcomes of treatment for AMD patients, recommendations and next steps for the audit.

AMD is the biggest cause of sight loss in the UK, affecting more than 700,000 people with 39,800 patients developing ‘wet’ AMD each year. At age 60 around one in every 200 people has AMD; however, by the age of 90 it affects one person in five. The number of people with AMD is expected to rise by an alarming 60% by 2035.

As AMD is such a significant public health concern it is essential that the NHS has a thorough understanding of the quality of the care it is providing and how to improve outcomes to maintain patients’ quality of life needs.

The audit found that more than 90% of eyes retained stable vision at the end of the first year of treatment and avoided a ‘significant’ further decrease in vision, while almost 20% of eyes experienced a ‘significant’ improvement in vision and more than 40% had ‘good’ vision – close to driving standard – after the first year of treatment.

‘Good’ visual acuity was retained in most eyes with that level of vision at the start of treatment, but eyes with ‘poor’ vision at the start of treatment rarely achieved ‘good’ vision. That highlights the importance of prompt referral, initial assessment diagnosis and treatment.

Treatment appeared to be safe, with a low number of serious sideeffects: for example, the risk of serious infection after an injection was around one in 6,500.

Mr Martin McKibbin, clinical lead for the NOD AMD Audit, commented: “I am delighted that the first report of the NOD AMD Audit has been published. Clinical staff at all the participating sites want to provide good clinical care and the best outcomes for their patients. The data in the audit will provide the first opportunity to benchmark care processes and acuity outcomes with peers and identify if any improvements are needed.”

The report confirms that regular injections help to stabilise vision in most eyes and early diagnosis and treatment are vital to maintaining good vision after treatment. By identifying best practice and allowing organisations to compare their performance with others, the audit aims to improve the outcomes for all patients having treatment for ‘wet’ AMD. q