ArticleBMJ open2017
Investigation of time to first presentation and extrahospital factors in the treatment of neovascular age-related macular degeneration: a retrospective cross-sectional study.
Article in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Systematic review: non-adherence and non-persistence in intravitreal treatment.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2020Pooled it
- Optimising the patient pathway for macular conditions requiring intravitreal injections.BMJ open ophthalmology · 2026Review
- The role of general practice in the identification of age-related vision impairment and chronic eye diseases: a systematic review.BJGP open · 2025Article
- Patients' awareness and presenting symptoms at the onset of neovascular age-related macular degeneration in two distinct European cohorts.International ophthalmology · 2025Article
- Prevalence of Age-Related Macular Degeneration in the United States: A Medicare-Based Analysis from 2014 to 2021.Ophthalmic research · 2025Article
- Anatomical and Functional Outcomes with Prompt versus Delayed Initiation of Anti-VEGF in Exudative Age-Related Macular Degeneration.Journal of clinical medicine · 2023Article
- Associations with baseline visual acuity in 12,414 eyes starting treatment for neovascular AMD.Eye (London, England) · 2023Article
- Development of Knowledge, Attitude and Practice Questionnaire for age-related macular degeneration patients.International journal of ophthalmology · 2023Article
- Tele-ophthalmology for age-related macular degeneration during the COVID-19 pandemic and beyond.Journal of telemedicine and telecare · 2022Article
- A model to quantify the influence of treatment patterns and optimize outcomes in nAMD.Scientific reports · 2022Article
- Moorfields AMD database report 2: fellow eye involvement with neovascular age-related macular degeneration.The British journal of ophthalmology · 2020Article
- Action on neovascular age-related macular degeneration (nAMD): recommendations for management and service provision in the UK hospital eye service.Eye (London, England) · 2019Article
- Patient-reported reasons for delay in diagnosis of age-related macular degeneration: a national survey.BMJ open ophthalmology · 2019Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
objectivesTo assess the time from symptom onset to treatment for neovascular age-related macular degeneration (nvAMD) and to measure the awareness of AMD in Southeast Scotland.
designRetrospective cross-sectional study.
settingSecondary care, Southeast of Scotland.
methodsPatients treated with intravitreal therapy (IVT) for nvAMD in Southeast Scotland between 2013 and 2015 were identified using a treatment register. Notes were retrospectively reviewed. We measured time from: (A) symptom onset to first presentation at primary care, (B) referral to ophthalmic clinic appointment and (C) ophthalmic clinic appointment to first IVT treatment. To investigate AMD awareness, we performed a cluster random sample survey of patients visiting non-AMD ophthalmic clinics using a previously validated 12-item questionnaire.
results195 patients (mean age 78 years) were included in the study. The mean delays between the different stages-A, B and C-were 54.2 (95% CI ±13), 28.2 (95% CI ±4.0) and 31.5 (95% CI ±3.6) days, respectively. There was an additional mean delay of 7.5 (95% CI ±1.6) days when patients were indirectly referred by optometrists via general practitioners (P<0.05). 140 patients (mean age 78) participated in the awareness survey; 62.1% reported being 'aware' of AMD but only 37.3% described AMD symptoms correctly.
conclusionsThere was a significant delay at every step of the nvAMD care pathway. The causes for this were multifactorial and included delays in first presentation to a healthcare provider, referral from primary care and initiation of secondary care treatment. Our data are likely to underestimate prehospital delays as a large number of cases are likely to have undefined symptoms and onset. We also identified suboptimal awareness of AMD which could account for a substantial delay in presentation from symptom onset. These findings highlight the need to address AMD awareness and the need for urgent treatment to prevent avoidable vision loss resulting from nvAMD.
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