Thank you for taking our AAO 2020 conference challenge, based on Physician’s Weekly coverage of age-related macular degeneration (AMD)! How did you do?

1) A retrospective study of over 190,000 eyes with AMD that received phacoemulsification achieved substantial gain in visual acuity after cataract surgery in what percentage of patients?

a) 20%
b) 30%
c) 40%
d) 50%

Answer is C.  After cataract surgery, 39.9% of patients with wet AMD had improvements in visual acuity of 0.2 ± 0.4 logMAR when assessed at a 12-week follow-up. However, the authors reported that patients with wet AMD undergoing cataract surgery had higher rates of posterior capsule rupture (2.9% vs 1.1%) and dropped lens fragments (0.6% vs 0.1%). Importantly, 64% of patients with wet AMD resumed treatment with anti-VEGF injections within 3 months after surgery.

Physician’s Weekly Feature: Cataract Surgery in Wet AMD: Assessing Outcomes & Complications

 

2) After patients watched a 2-minute instructional video on how to use a home OTC device, what percent  scanned their own eyes successfully and identified neovascular AMD, according to a recent study?

a) 75%
b) 80%
c) 85%
d) 90%

Answer is D.  Successful scans were completed by 93% of patients; median visual acuity of the other 7% was 20/66, compared with 20/30 for those who completed the imaging. Rates of agreement between the conventional and home OCT devices were 93% for detection of subretinal fluid, 96% for detection of no subretinal fluid, 91% for detection of intraretinal fluid, and 98% for detection of no intraretinal fluid.

Physician’s Weekly Feature: Accurately Identifying Neovascular AMD at Home  

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3) What has hindered the adoption of contrast sensitivity function (CSF) testing in routine clinical practice?

a) Absence of physician education
b) CSF tests are limited to central vision
c) CSF cannot be measured quickly
d) None of the above

Answer is D.  In clinical research, contrast sensitivity function (CSF) has demonstrated the potential to help monitor the progression of eye diseases like AMD. However, the absence of a reliable and clinically applicable test has hindered adoption of CSF testing as a routine practice.

Physician’s Weekly Feature: Assessing a Novel Contrast Sensitivity Function Test in AMD

 

4) Using telemedicine, the accuracy of a new AI platform to identify patients with AMD or intermediate or advanced severity which referral to an ophthalmologist was warranted was nearly what?

a) 99%
b) 89%
c) 79%
d) 69%

Answer is B.  The AI platform also demonstrated sensitivity of 86.3%, specificity of 89.8%, and a kappa score of 0.75. Findings show that early detection of referral level AMD in primary care settings is possible with telemedicine, potentially preventing many cases of vision loss, and also the ensuing downward spiral in overall health, such as depression and the need for nursing home care due to loss of independence, falls, fractures, and death.

Physician’s Weekly Feature: iPredict – A Telemedicine Platform for Screening Patients With Referable AMD