-
Články
Top novinky
Reklama- Vzdělávání
- Časopisy
Top články
Nové číslo
- Témata
Top novinky
Reklama- Kongresy
- Videa
- Podcasty
Nové podcasty
Reklama- Kariérní portál
Doporučené pozice
Reklama- Praxe
Top novinky
ReklamaBest Practices for Age-Related Macular Degeneration (AMD) Therapy
Authors: Pavel Němec 1,2; Daniela Vysloužilová 3; Libor Hejsek 4; Jan Němčanský 5,6; Jan Studnička 4,7
Authors place of work: Lexum – eye clinics, Czech Republic 1; 1st Faculty of Medicine, Charles University in Prague, Czech Republic 2; Department of Ophthalmology, University Hospital Brno Bohunice and, Faculty of Medicine, Masaryk University, Czech Republic 3; Department of Ophthalmology, University Hospital Hradec Králové and Faculty of Medicine in Hradec Králové, Charles University, Czech Republic 4; Department of Ophthalmology, University Hospital Ostrava, Czech Republic 5; Department of Craniofacial Sciences, Faculty of Medicine, University of Ostrava, Czech Republic 6; VISUS, spol. s. r. o., Czech Republic 7
Published in the journal: Čes. a slov. Oftal., 82, 2026, No. 3, p. 123-131
Category: Ostatní články
doi: https://doi.org/10.31348/2026/2Summary
Age-related macular degeneration is one of the leading causes of severe loss of sight in developed countries. Diagnostic procedures have developed dramatically in recent years, and modern imaging methods have contributed to improved options for population screening, targeted diagnostics, and monitoring of the treatment process. At the same time, new treatment options have also been developing rapidly. The recommended procedures summarize the current knowledge with the aim of unifying procedures for the diagnosis, classification, and treatment of age-related macular degeneration (AMD).
Keywords:
choroidal neovascular membrane – treatment – diagnostics – age-related macular degeneration – recommended procedures – anti-vascular endothelial growth factor – macular neovascularization
Zdroje
1. Klein R, Klein BE, Linton KL. Prevalence of age-related maculopathy. The Beaver Dam Eye Study. Ophthalmology. 1992;99(6):933-943.
2. Kahn HA, Leibowitz HM, Ganley JP, et al. The Framingham Eye Study. I. Outline and major prevalence findings. Am J Epidemiol. 1977;106(1):17-32.
3. Sommer A, Tielsch JM, Katz J, et al. Racial differences in the cause - -specific prevalence of blindness in east Baltimore. N Engl J Med. 1991;325(20):1412-1417.
4. Friedman DS, O’Colmain BJ, Munoz B, et al. Prevalence of age-related macular degeneration in the United States. Arch Ophthalmol. 2004;122(4):564-572.
5. Congdon N, O’Colmain B, Klaver CC, et al. Causes and prevalence of visual impairment among adults in the United States. Arch Ophthalmol. 2004;122(4):477-485.
6. Wong WL, Su X, Li X, et al. Global prevalence of age-related macular degeneration and disease burden projection for 2020 and 2040: a systematic review and meta-analysis. Lancet Glob Health. 2014;2(2):e106-116.
7. Solomon SD, Lindsley K, Vedula SS, Krzystolik MG, Hawkins BS. Anti-vascular endothelial growth factor for neovascular age - -related macular degeneration. Cochrane Database Syst Rev. 2019;3:CD005139. 8. Guidelines od American Academy of Ophthalmology (AAO). Available from: https://www.aao.org/preferred-practice-pattern/age - -related-macular-degeneration-ppp-2020
9. Guidelines od National Institute for Health and Care Excellence (NICE). Available from: https://www.nice.org.uk/guidance/ ng82
10. Guidelines od Royal College of Ophthalmologists (RCOphth). Available from: https://www.rcophth.ac.uk/wp-content/uploads/ 2019/09/AMD-Guidelines-Sept-2018-FINAL-1.pdf
11. Tomany SC, Wang JJ, Van Leeuwen R, et al. Risk factors for incident age-related macular degeneration: pooled findings from 3 continents. Ophthalmology. 2004;111(7):1280-1287.
12. Thornton J, Edwards R, Mitchell P, Harrison RA, Buchan I, Kelly SP. Smoking and age-related macular degeneration: a review of association. Eye. 2005;19 : 935-944.
13. Khan JC, Thurlby DA, Shahid H, et al. Smoking and age related macular degeneration: the number of pack years of cigarette smoking is a major determinant of risk for both geographic atrophy and choroidal neovascularisation. Br J Ophthalmol. 2006;90(1):75-80.
14. Delcourt C, Michel F, Colvez A, Lacroux A, Delage M, Vernet MH. Associations of cardiovascular disease and its risk factors with age - -related macular degeneration: the POLA Study. Ophthalmic Epidemiol. 2001;8(4):237-249.
15. Fernandez AB, Wong TY, Klein R, et al. Age-related macular degeneration and incident cardiovascular disease: the Multi-Ethnic Study of Atherosclerosis. Ophthalmology. 2012;119(4):765-770.
16. Hyman L, Schachat AP, He Q, Leske MC. Age-Related Macular Degeneration Risk Factors Study Group. Hypertension, cardiovascular disease, and age-related macular degeneration. Arch Ophthalmol. 2000;118(3):351-358.
17. van Leeuwen R, Boekhoorn S, Vingerling JR, et al. Dietary intake of antioxidants and risk of age-related macular degeneration. JAMA. 2005;294(24):3101-3107.
18. Fritsche LG, Igl W, Bailey JN, et al. A large genome-wide association study of age-related macular degeneration highlights contributions of rare and common variants. Nat Genet. 2016;48(2):134-143.
19. Francis PJ, Klein ML. Update on the role of genetics in the onset of age-related macular degeneration. Clin Ophthalmol. 2011;5 : 1127 - 1133.
20. Ferris FL, III, Wilkinson CP, Bird A, et al. Clinical classification of age-related macular degeneration. Ophthalmology. 2013;120(4):844-851.
21. Gass JDM. Stereoscopic Atlas of Macular Diseases: Diagnosis and Treatment. 4th ed. St. Louis, MO: CV Mosby; 1997.
22. Ryan SJ, Hinton DR, Schachat AP, Wilkinson CP, eds. Retina. 4th ed. St. Louis, MO: CV Mosby; 2005.
23. Chew EY, Clemons TE, Agron E, et al. Age-Related Eye Disease Study Research Group. Ten-year follow-up of age-related macular degeneration in the age-related eye disease study: AREDS report number 36. JAMA Ophthalmol. 2014;132(3):272-277.
24. Ferris FL, Davis MD, Clemons TE, et al. Age-Related Eye Disease Study (AREDS) Research Group. A simplified severity scale for age - -related macular degeneration: AREDS report number 18. Arch Ophthalmol. 2005;123(11):1570-1574.
25. Klein ML, Francis PJ, Ferris FL, III, Hamon SC, Clemons TE. Risk assessment model for development of advanced age-related macular degeneration. Arch Ophthalmol. 2011;129(12):1543-1550.
26. Klein R, Klein BE, Jensen SC, Meuer SM. The five-year incidence and progression of age-related maculopathy: the Beaver Dam Eye Study. Ophthalmology. 1997;104(1):7-21.
27. Solomon SD, Jefferys JL, Hawkins BS, Bressler NM, Bressler SB. Submacular Surgery Trials Research Group. Risk factors for second eye progression to advanced age-related macular degeneration: SST report number 21. Retina. 2009;29(8):1080-1090.
28. Sunness JS, Rubin GS, Applegate CA, et al. Visual function abnormalities and prognosis in eyes with age-related geographic atrophy of the macula and good visual acuity. Ophthalmology. 1997;104(10):1677-1691.
29. Holz FG, Sadda SR, Staurenghi G, et al; CAM Group. Imaging protocols in clinical studies in advanced age-related macular degeneration: recommendations from Classification of Atrophy Consensus Meetings. Ophthalmology 2017; 124(4):464-478.
30. Holz FG, Strauss EC, Schmitz-Valckenberg S, van Lookeren Campagne M. Geographic atrophy: clinical features and potential therapeutic approaches. Ophthalmology 2014; 121(5):1079-1091.
31. Sunness JS, Margalit E, Srikumaran D, et al. The long-term natural history of geographic atrophy from age-related macular degeneration: enlargement of atrophy and implications for interventional clinical trials. Ophthalmology 2007; 114(2):271-277.
32. Pfau M, Lindner M, Goerdt L, Thiele S, et al; Fundus Autofluorescence in Age-Related Macular Degeneration Study Group. Prognostic value of shape-descriptive factors for the progression of geographic atrophy secondary to age-related macular degeneration. Retina. Epub ahead of print 2018 May 16.
33. Macular Photocoagulation Study Group. Argon laser photocoagulation for neovascular maculopathy: five-year results from randomized clinical trials. Arch Ophthalmol. 1991;109(8):1109-1114.
34. Yannuzzi LA, Sorenson J, Spaide RF, Lipson B. Idiopathic polypoidal choroidal vasculopathy (IPCV). Retina. 1990;10(1):1-8.
35. Yannuzzi LA, Negrao S, Iida T, et al. Retinal angiomatous proliferation in age-related macular degeneration. Retina. 2001;21(5):416 - 434.
36. Němec P, Kousal B, Löfflerová V. Optická koherenční tomografie, 2. Přepracované vydání, Praha, Mladá fronta a.s., 2017, ISBN – 978 - 80-204-4414-1.
37. Forte R, Coscas F, Serra R, Cabral D, Colantuono D, Souied EH. Long-term follow-up of quiescent choroidal neovascularisation associated with age-related macular degeneration or pachychoroid disease. Br J Ophthalmol. 2020 Aug;104(8):1057-1063.
38. Vavvas DG, Small KW, Awh CC, Zanke BW, Tibshirani RJ, Kustra R. CFH and ARMS2 genetic risk determines progression to neovascular age-related macular degeneration after antioxidant and zinc supplementation. Proc Natl Acad Sci U S A. 2018;115(4):E696 -E704.
39. Evans JR, Lawrenson JG. Antioxidant vitamin and mineral supplements for preventing age-related macular degeneration. Cochrane Database Syst Rev. 2012(6):CD000253.
40. Davis MD, Gangnon RE, Lee LY, et al. Age-Related Eye Disease Study Group. The Age-Related Eye Disease Study severity scale for age-related macular degeneration: AREDS report number 17. Arch Ophthalmol. 2005;123(11):1484-1498.
41. Age-Related Eye Disease Study 2 Research Group. Lutein + zeaxanthin and omega-3 fatty acids for age-related macular degeneration: the Age-Related Eye Disease Study 2 (AREDS2) randomized clinical trial. JAMA. 2013;309(19):2005-2015.
42. Langrová H, Rencová E, Bláha M, et al. Rheopheresis in the treatment of age-related macular degeneration. Cesk Slov Oftalmol. 2022 Winter;79(1):8-24.
43. ASFA Guidelines, Special Issue-Clinical Applications of Therapeutic Apheresis-An Evidence Based Approach. 7th Edition_JClinApher. 2016 Jun_31(3):169-170.
44. Rencová E, Bláha M, Studnička J, et al. Reduction in the drusenoid retinal pigment epithelium detachment area in the dry form of age-related macular degeneration 2.5 years after rheohemapheresis. Acta Ophthalmol 2013;91 : 406-408.
45. Holz FG, Sadda SR, Busbee B, et al. Efficacy and Safety of Lampalizumab for Geographic Atrophy Due to Age-Related Macular Degeneration: Chroma and Spectri Phase 3 Randomized Clinical Trials. JAMA Ophthalmol. 2018;136(6):666-677.
46. Heier JS, Lad EM, Holz FG, et al. OAKS and DERBY study investigators. Pegcetacoplan for the treatment of geographic atrophy secondary to age-related macular degeneration (OAKS and DERBY): two multicentre, randomised, double-masked, sham-controlled, phase 3 trials. Lancet. 2023 Oct 21;402(10411):1434-1448.
47. Khanani AM, Patel SS, Staurenghi G, et al. GATHER2 trial investigators. Efficacy and safety of avacincaptad pegol in patients with geographic atrophy (GATHER2): 12-month results from a randomised, double-masked, phase 3 trial. Lancet. 2023 Oct 21;402(10411):1449-1458.
48. Solomon SD, Lindsley K, Vedula SS, Krzystolik MG, Hawkins BS. Anti-vascular endothelial growth factor for neovascular age-related macular degeneration. Cochrane Database Syst Rev. 2019 Mar 4;3(3):CD005139.
49. Oncel D, Oncel D, Mishra K, Oncel M, Arevalo JF. Current Management of Subretinal Hemorrhage in Neovascular Age-Related Macular Degeneration. Ophthalmologica. 2023;246(5-6):295-305.
50. Cruess AF, Zlateva G, Pleil AM, Wirostko B. Photodynamic therapy with verteporfin in age-related macular degeneration: a systematic review of efficacy, safety, treatment modifications and pharmacoeconomic properties. Acta Ophthalmol. 2009 Mar;87(2):118 - 132.
51. Virgili G, Bini A. Laser photocoagulation for neovascular age-related macular degeneration. Cochrane Database Syst Rev. 2007 Jul 18;(3):CD004763.
52. Amoaku WM, Chakravarthy U, Gale R, et al. Defining response to anti-VEGF therapies in neovascular AMD. Eye (Lond). 2015 Jun;29(6):721-731.
53. Heier JS, Brown DM, Chong V, et al. VIEW 1 and VIEW 2 Study Groups. Intravitreal aflibercept (VEGF trap-eye) in wet age-related macular degeneration. Ophthalmology. 2012 Dec;119(12):2537 - 2548.
54. Lanzetta P, Korobelnik JF, Heier JS, et al. PULSAR Investigators. Intravitreal aflibercept 8 mg in neovascular age-related macular degeneration (PULSAR): 48-week results from a randomised, double-masked, non-inferiority, phase 3 trial. Lancet. 2024 Mar 23;403(10432):1141-1152.
55. Dugel PU, Koh A, Ogura Y, et al. HAWK and HARRIER Study Investigators. HAWK and HARRIER: Phase 3, Multicenter, Randomized, Double-Masked Trials of Brolucizumab for Neovascular Age-Related Macular Degeneration. Ophthalmology. 2020 Jan;127(1):72 - 84.
56. Khanani AM, Kotecha A, Chang A, et al. TENAYA and LUCERNE Investigators. TENAYA and LUCERNE: Two-Year Results from the Phase 3 Neovascular Age-Related Macular Degeneration Trials of Faricimab with Treat-and-Extend Dosing in Year 2. Ophthalmology. 2024 Feb 19:S0161-6420(24)00134-9.
57. Rosenfeld PJ, Brown DM, Heier JS, et al. MARINA Study Group. Ranibizumab for neovascular age-related macular degeneration. N Engl J Med. 2006 Oct 5;355(14):1419-1431.
58. Brown DM, Michels M, Kaiser PK, Heier JS, Sy JP, Ianchulev T; ANCHOR Study Group. Ranibizumab versus verteporfin photodynamic therapy for neovascular age-related macular degeneration: Two-year results of the ANCHOR study. Ophthalmology. 2009 Jan;116(1):57-65.e5.
59. Rayess N, Rahimy E, Storey P, et al. Postinjection endophthalmitis rates and characteristics following intravitreal bevacizumab, ranibizumab and aflibercept. Am J Ophthalmol. 2016; 165 : 88-93.
60. Pilli S, Kotsolisn A, Spaide RF, et al. Endophthalmitis associated with intravitreal anti-vascular endothelial growth factor therapy injections in an office setting. Am J Ophthalmol. 2008; 145 : 879-882.
61. Freiberg FJ, Brynskov T, Munk MR, et al. Low endophthalmitis rates after intravitreal antivascular endothelial growth factor injections in an operation room: a retrospective multicenter study. Retina. 2017; 37 : 2341-2346.
62. Brynskov T, Kemp H, Sorensen TL. No cases of endophthalmitis after 20,293 intravitreal injections in an operating room setting. Retina 2014; 34 : 951-957.
63. Schwartz SG, Flynn HW, Grzybowski A. Controversies in topical antibiotics use with intravitreal injections. Curr Pharm Des. 2015;21 : 4703-4706.
64. Schwartz SG, Grzybowski A, Flynn HW Jr. Antibiotic prophylaxis: different practice patterns within and outside the United States. Clin Ophthalmol. 2016;10 : 251-256.
65. Benoist d’Azy C, Pereira B, Naughton G, Chiambaretta F, Dutheil F. Antibioprophylaxis in prevention of endophthalmitis in intravitreal injection: a systematic review and meta-analysis. PLoS One. 2016;11:e0156431.
66. Aiello LP, Brucker AJ, Chang S, et al. Evolving guidelines for intravitreous injections. Retina 2004;24:S3–S19.
67. Ali T, Jung K, Montan PG. Eyelid skin disinfecting and conjunctival bacteria in cataract surgery. Acta Ophthalmol. 2013;91 : 114-117.
68. Wen JC, McCannel CA, Mochon AB, Garner OB. Bacterial dispersal associated with speech in the setting of intravitreous injections. Arch Ophthalmol. 2011;129 : 1551-1554.
69. Berkelman RL, Holland BW, Anderson RL. Increased bactericidal activity of dilute preparations of povidone-iodine solutions. J Clin Microbiol. 1982;15 : 635-639.
70. Wykoff CC, Flynn HW Jr, Rosenfeld PJ. Prophylaxis for endophthalmitis following intravitreal injection: antisepsis and antibiotics. Am J Ophthalmol. 2011;152 : 717-719.e712.
71. Fineman MS, Hsu J, Spirn MJ, Kaiser RS. Bimanual assisted eyelid retraction technique for intravitreal injections. Retina. 2013;33 : 1968 - 1970.
72. Rahimy E, Fineman MS, Regillo CD, et al. Speculum versus bimanual lid retraction during intravitreal injection. Ophthalmology. 2015;122 : 1729-1730.
73. Shrier EM. Cotton-tip applicator lid retraction technique for controlled intravitreal injection. Retina 2014;34 : 1244-1246.
74. Eaton AM, Gordon GM, Wafapoor H, Sgarlata A, Avery RL. Assessment of novel guarded needle to increase patient comfort and decrease injection time during intravit real injection. Ophthalmic Surg Lasers Imaging Retina. 2013;44 : 561-568.
75. Mayer CH, Fung A, Saxena S, Holz FG. Steps for a safe intravitreal injection technique. Retinal Physician. 2009. http://www.retinalphysician.com/articleviewer.aspx?articleid = 103195
76. Berkelman RL, Holland BW, Anderson RL. Increased bactericidal activity of dilute preparations of povidone-iodine solutions. J Clin Microbiol. 1982;15 : 635-639.
77. Avery RL, Bakri SJ, Blumenkranz MS, et al. Intravitreal injection technique and monitoring: updated guidelines of an expert panel. Retina. 2014;34:S1-S18.
78. McCannel CA. Meta-analysis of endophthalmitis after intravitreal injection of anti-vascular endothelial groty factor agents: causative organisms and possible prevention strategies. Retina. 2011;31 : 654-661.
79. Green-Simms AE, Ekdawi NS, Bakri SJ. Survey of intravitreal injection techniques among retinal specialists in the United States. Am J Ophthalmol. 2011;151 : 329-332.
80. Yanagi Y, Tsujimura J, Ohno S, et al. Cost-effectiveness analysis of bispecific antibody faricimab for treatment of neovascular age-related macular degeneration and diabetic macular edema in Japan. J Med Econ. 2025 Dec;28(1):448-459. doi: 10.1080/13696998.2025.2478755
81. Quist SW, Nab H, Postma M. et al. A cost-minimization analysis of anti-VEGFs for the treatment of neovascular age-related macular degeneration in the Netherlands. Graefes Arch Clin Exp Ophthalmol. 2025;263,327-345. https://doi.org/10.1007/s00417-024-06588-6
82. El-Dahiyat F, Eljilany I. Cost-Minimization Analysis of Ranibizumab Versus Aflibercept for Treating Saudi Patients With Visual Impairment Owing to Age-Related Macular Degeneration or Diabetic Macular Edema. Value Health Reg Issues. 2020 Sep;22 : 23-26. doi: 10.1016/j.vhri.2019.09.007
83. Bührer C, Paling T, Gale R, et al. Cost-Effectiveness of Faricimab in the Treatment of Diabetic Macular Oedema (DMO): A UK Analysis. PharmacoEconomics Open. 2024;8 : 445-457. https://doi. org/10.1007/s41669-023-00465-4
84. Diles D, Wong D, Gizicki R, Icente C, Bührer C. Cost-Effectiveness of Faricimab in Canada for the Treatment of Patients With Macular Edema Secondary to Retinal Vein Occlusion. Value in Health. 2024;27(12): S197.
85. Casselholm de Salles M, Amrén U, Kvanta A, Epstein DL. Injection frequency of aflibercept versus ranibizumab in a treat-and-extend regimen for central retinal vein occlusion: A Randomized Clinical Trial. Retina. 2019;39(7):1370-1376. 86. Hykin P, Prevost AT, Vasconcelos JC, et al. Clinical Effectiveness of Intravitreal Therapy With Ranibizumab vs Aflibercept vs Bevacizumab for Macular Edema Secondary to Central Retinal Vein Occlusion: A Randomized Clinical Trial. JAMA Ophthalmol. 2019;137(11):1256-1264.
Štítky
Oftalmologie
Článek vyšel v časopiseČeská a slovenská oftalmologie
Nejčtenější tento týden
2026 Číslo 3- Aktuální poznatky o významu vitaminu B12 v terapii diabetické retinopatie
- Selektivní laserová trabekuloplastika nesnižuje nitroční tlak více než argonová laserová trabekuloplastika
- Progresi glaukomu je třeba hodnotit strukturálními i funkčními parametry
- Ztráta centrálního vidění po filtrujících operacích glaukomu
- Od PGF-2 alfa-isopropyl esteru k latanoprostu: přehled vývoje Xalatanu
-
Všechny články tohoto čísla
- Doporučené postupy pro terapii věkem podmíněné makulární degenerace (VPMD)
- Prevalence Fuchsovy dystrofie rohovkového endotelu u kataraktových pacientů v české populaci
- Výsledky reoperací perzistující primární makulární díry
- Subjektívne zmeny vo videní u pacientov s diabetickým makulárnym edémom liečených ranibizumabom
- Dlouhodobé výsledky externí dakryocystorinostomie s lalokem ve tvaru U a nazolakrimální intubací u dospělých pacientů s malým slzným vakem a primární obstrukcí nazolakrimálního kanálu
- Subhyaloid Hemorrhage after Bungee Jumping Experience. A Case Report
- Česká a slovenská oftalmologie
- Archiv čísel
- Aktuální číslo
- Informace o časopisu
Nejčtenější v tomto čísle- Doporučené postupy pro terapii věkem podmíněné makulární degenerace (VPMD)
- Subjektívne zmeny vo videní u pacientov s diabetickým makulárnym edémom liečených ranibizumabom
- Subhyaloid Hemorrhage after Bungee Jumping Experience. A Case Report
- Prevalence Fuchsovy dystrofie rohovkového endotelu u kataraktových pacientů v české populaci
Kurzy
Zvyšte si kvalifikaci online z pohodlí domova
Revma Focus: Spondyloartritidy
nový kurz
Autoři: prof. MUDr. Vladimír Palička, CSc., Dr.h.c., doc. MUDr. Václav Vyskočil, Ph.D., MUDr. Petr Kasalický, CSc., MUDr. Jan Rosa, Ing. Pavel Havlík, Ing. Jan Adam, Hana Hejnová, DiS., Jana Křenková
Autoři: MDDr. Eleonóra Ivančová, PhD., MHA
Autoři: prof. MUDr. Eva Kubala Havrdová, DrSc.
Všechny kurzyPřihlášení#ADS_BOTTOM_SCRIPTS#Zapomenuté hesloZadejte e-mailovou adresu, se kterou jste vytvářel(a) účet, budou Vám na ni zaslány informace k nastavení nového hesla.
- Vzdělávání