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Background/Objectives <p>To assess geographically global clinical practice guidelines (CPGs) for neovascular age-related macular degeneration (nAMD) management.</p> Methods <p>A systematic literature review (SLR) of CPGs for nAMD management was conducted using Embase and MEDLINE databases, Guideline Central, Health Technology Assessment bodies, professional ophthalmology associations, and backwards citation tracking. CPGs published between January 2010–October 2023 were included and independently assessed by four reviewers using the Appraisal of Guidelines for Research and Evaluation II (AGREE II). CPGs were qualitatively assessed for anatomical measurements (optical coherence tomography [OCT] and visual acuity [VA]). PROSPERO identification is CRD42023473223.</p> Results <p>Nine of 147 identified global CPGs were included in the SLR for diagnosis, treatment, and disease monitoring for nAMD. Overall AGREE II scores were 62–95 (mean [standard deviation] score 75 [10.6]). Strongest domains were Scope and Purpose (86.6 [11.0]), Clarity of Presentation (84.3 [13.0]), and Editorial Independence (89.1 [15.4]); Stakeholder Involvement (63.4 [16.6]), Applicability (73.0 [12.6]), and Rigor of Development (55.4 [25.9]) were lowest. 4/9 CPGs were “Recommended” by reviewers, and 5/9 were “Recommended with Modifications”. All CPGs recommended OCT for initial diagnosis. 2/9 CPGs did not mention VA. For managing pharmacological interventions, 4/9 CPGs recommended using VA, and three recommended OCT. Eight CPGs recommended using either VA or OCT for disease monitoring while on anti-vascular endothelial growth factor (VEGF) treatment. 6/9 CPGs recommended screening for VA and 7/9 CPGs recommended using OCT to change anti-VEGF intervals.</p> Conclusion <p>CPG methods, recommendations on applicability in resource-constrained systems, and patient advocacy/perspectives will improve CPG trustworthiness and transparency.</p>

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Systematic review of clinical practice guidelines for the management of neovascular age-related macular degeneration

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年5月15日

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  • Jennifer I. Lim,
  • Stella Ko,
  • Mark McAllister,
  • Nancy Faux,
  • Komal Bawa,
  • Elizabeth Mearns,
  • Shriji Patel,
  • Galin Spicer,
  • Amanda Martinez,
  • David Tabano

摘要

Background/Objectives

To assess geographically global clinical practice guidelines (CPGs) for neovascular age-related macular degeneration (nAMD) management.

Methods

A systematic literature review (SLR) of CPGs for nAMD management was conducted using Embase and MEDLINE databases, Guideline Central, Health Technology Assessment bodies, professional ophthalmology associations, and backwards citation tracking. CPGs published between January 2010–October 2023 were included and independently assessed by four reviewers using the Appraisal of Guidelines for Research and Evaluation II (AGREE II). CPGs were qualitatively assessed for anatomical measurements (optical coherence tomography [OCT] and visual acuity [VA]). PROSPERO identification is CRD42023473223.

Results

Nine of 147 identified global CPGs were included in the SLR for diagnosis, treatment, and disease monitoring for nAMD. Overall AGREE II scores were 62–95 (mean [standard deviation] score 75 [10.6]). Strongest domains were Scope and Purpose (86.6 [11.0]), Clarity of Presentation (84.3 [13.0]), and Editorial Independence (89.1 [15.4]); Stakeholder Involvement (63.4 [16.6]), Applicability (73.0 [12.6]), and Rigor of Development (55.4 [25.9]) were lowest. 4/9 CPGs were “Recommended” by reviewers, and 5/9 were “Recommended with Modifications”. All CPGs recommended OCT for initial diagnosis. 2/9 CPGs did not mention VA. For managing pharmacological interventions, 4/9 CPGs recommended using VA, and three recommended OCT. Eight CPGs recommended using either VA or OCT for disease monitoring while on anti-vascular endothelial growth factor (VEGF) treatment. 6/9 CPGs recommended screening for VA and 7/9 CPGs recommended using OCT to change anti-VEGF intervals.

Conclusion

CPG methods, recommendations on applicability in resource-constrained systems, and patient advocacy/perspectives will improve CPG trustworthiness and transparency.