Technology Appraisal Guidance No. 68
Source: National Institute for Health and Care Excellence
- Photodynamic therapy (PDT) is recommended for the treatment of wet age-related macular degeneration for individuals who have a confirmed diagnosis of classic with no occult subfoveal choroidal neovascularisation (CNV) (that is, whose lesions are composed of classic CNV with no evidence of an occult component) and best-corrected visual acuity 6/60 or better. PDT should be carried out only by retinal specialists with expertise in the use of this technology.
- PDT is not recommended for the treatment of people with predominantly classic subfoveal CNV (that is, 50% or more of the entire area of the lesion is classic CNV but some occult CNV is present) associated with wet age-related macular degeneration, except as part of ongoing or new clinical studies that are designed to generate robust and relevant outcome data, including data on optimum treatment regimens, long-term outcomes, quality of life and costs.
- The use of PDT in occult CNV associated with wet age-related macular degeneration was not considered because the photosensitising agent (verteporfin) was not licensed for this indication when this appraisal began. No recommendation is made with regard to the use of this technology in people with this form of the condition.
- Patients currently receiving treatment with PDT could experience loss of well-being if their treatment is discontinued at a time they did not anticipate. Because of this, all NHS patients who have begun a course of treatment with PDT at the date of publication of this guidance should have the option of continuing to receive treatment until their clinical condition indicates that it is appropriate to stop.
The guidance shown above constitutes Section 1 of the full document. A copy of the full document and a summary of the evidence is available on the Internet at http://www.nice.org.uk/guidance/ta68
Copies of the document can also be obtained by contacting 0845 003 7783 or emailing firstname.lastname@example.org and quoting reference number N0303.
This guidance represents the view of the Institute which was arrived at after careful consideration of the available evidence. Health professionals are expected to fully take it into account when exercising their clinical judgement. This guidance does not, however, override the individual responsibility of health professionals to make appropriate decisions in the circumstances of the individual patient, in consultation with the patient and/or guardian or carer.
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Enquiries concerning the guidance should be addressed to: National Institute for Health and Care Excellence, MidCity Place, 71 High Holborn, London WC1V 6NA. email: email@example.com
Guidance on the Use of Photodynamic Therapy for Age-Related Macular Degeneration.
Issue Date: September 2003
Review Date: September 2006