The National Institute for Clinical Excellence (NICE) has recommended that certain patients with age related macular degeneration should have photodynamic therapy and that other patients should be given the treatment as part of a national study to provide more evidence on outcomes in clinical practice.
NICE has recommended that all patients with one type of “wet” age related macular degeneration—with a confirmed diagnosis of classic subfoveal choroidal neovascularisation but with no sign that this is occult and with at least 6/60 vision—should be considered for photodynamic therapy.
Photodynamic therapy uses a low power laser to activate a previously administered light sensitive substance to seal the leaky new blood vessels in the area under the retina associated with the condition.
The guidance states: “The evidence showed that for people within this group, PDT [photodynamic therapy] had a reasonable chance of halting or slowing the progression of the disease.”
However, the guidance found that the evidence for benefit of photodynamic therapy was inconclusive for a second group of people with a different type of wet, age related macular degeneration with some occult subfoveal choroidal neovascularisation.
The independent advisory committee advising NICE recommended that these people should have access to photodynamic therapy through clinical studies. For the first time as part of a NICE evaluation procedure, the Department of Health agreed to fund a nationwide clinical study to implement this recommendation. The results of this study will be taken into account when the guidance is reviewed in 2006.
David Barnett, chairman of the NICE appraisal committee and professor of clinical pharmacology at the University of Leicester, said, “Evaluation of use of treatment in practice will benefit future appraisals.”
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NICE's guidance can be found at www.nice.org.uk