Monitoring
The frequency of follow-up depends on the type of AMD and the risk of
progression. Follow-up at regular intervals is recommended for early detection
of asymptomatic and treatable CNV lesions. History documentation and physical
examination are recommended every visit. The recommended monitoring
examinations during follow-up include mononuclear near vision (using Amsler
grid) monitoring, visual acuity assessment at distance with correction, and
stereoscopic biomicroscopic examination of the fundus. Patients treated with
intravitreal anti-VEGF agents or who underwent PDT with Verteporfin or thermal
laser photocoagulation surgery should undergo biomicroscopy of the fundus, OCT,
OCTA, FFA, and fundus photography at regular intervals for earlier detection of
signs of active exudation or disease progression.
Schedule of Follow-up
For non-neovascular early AMD or advanced AMD with bilateral subfoveal
geographic atrophy or disciform scars under observation, follow-up examination
with fundus photography, FFA, OCT or OCTA is done at 6 to 24 months if
asymptomatic. However, immediate follow-up is advised if new symptoms of CNV
occur.
For non-neovascular intermediate or advanced AMD in antioxidant vitamin
and mineral supplements, follow-up is at 6 to 18 months after treatment if
asymptomatic. If there are new symptoms suggestive of CNV, immediate
consultation is advised.
Those with subfoveal neovascular AMD in Aflibercept, Bevacizumab,
Brolicizumab or Ranibizumab therapy, follow-up is at approximately 4 weeks
after treatment. Subsequent follow-up is based on clinical findings.
For those with subfoveal neovascular AMD in Pegaptanib sodium therapy,
follow-up is every 6 weeks with retreatments as indicated. For those with
subfoveal neovascular AMD treated with PDT with Verteporfin, follow-up is at
every 3 months until stable, with retreatments as indicated. Lastly, those with extrafoveal neovascular AMD
after laser photocoagulation therapy, follow-up is at 2 to 4 weeks after
treatment with FFA and then 4 to 6 weeks thereafter based on clinical and
angiographic findings.