Self‐reported optometric practise patterns in age‐related macular degeneration

Abstract

Background

The use of advanced imaging in clinical practice is emerging and the use of this technology by optometrists in assessing patients with age‐related macular degeneration is of interest. Therefore, this study explored contemporary, self‐reported patterns of practice regarding age‐related macular degeneration diagnosis and management using a cross‐sectional survey of optometrists in Australia and New Zealand.

Methods

Practising optometrists were surveyed on four key areas, namely, demographics, clinical skills and experience, assessment and management of age‐related macular degeneration. Questions pertaining to self‐rated competency, knowledge and attitudes used a five‐point Likert scale.

Results

Completed responses were received from 127 and 87 practising optometrists in Australia and New Zealand, respectively. Advanced imaging showed greater variation in service delivery than traditional techniques (such as slitlamp funduscopy) and trended toward optical coherence tomography, which was routinely performed in age‐related macular degeneration by 49 per cent of respondents. Optical coherence tomography was also associated with higher self‐rated competency, knowledge and perceived relevance to practice than other modalities. Most respondents (93 per cent) indicated that they regularly applied patient symptoms, case history, visual function results and signs from traditional testing, when queried about their management of patients with age‐related macular degeneration. Over half (63 per cent) also considered advanced imaging, while 31 per cent additionally considered all of these as well as the disease stage and clinical guidelines. Contrary to the evidence base, 68 and 34 per cent rated nutritional supplements as highly relevant or relevant in early age‐related macular degeneration and normal aging changes, respectively.

Conclusions

These results highlight the emergence of multimodal and advanced imaging (especially optical coherence tomography) in the assessment of age‐related macular degeneration by optometrists. Clinically significant variations in self‐rated test competency and the understanding regarding nutritional supplements for different stages of age‐related macular degeneration suggest that further work to up‐skill optometrists may be required.

Key words:

• age‐related macular degeneration
• diagnosis
• optometrist
• patterns of practice

ACKNOWLEDGEMENTS

This work was supported, in part, by grants and awards from the University of New South Wales (Early Career Research Grant 2016 #P535430, an Australian Postgraduate Award) and a National Health and Medical Research Council (NHMRC) grant (#1033224). Guide Dogs NSW/ACT is a partner in the NHMRC grant and also provided a supplementary PhD scholarship for Angelica Ly and support for Lisa Nivison‐Smith.

SUPPORTING INFORMATION

Additional supporting information may be found in the online version of this article at the publisher’s website:

Appendix S1. Practise patterns in AMD survey to Australian optometrists. Copy of the survey that was electronically distributed to participants.

Additional information

Funding

University of New South Wales (Early Career Research)

National Health and Medical Research Council (NHMRC)