The appraisal of photodynamic therapy (PDT) treatment for wet Age-related Macular Degeneration (AMD) was the second longest in the history of the National Institute for Clinical Excellence (NICE) lasting 120 weeks.
Final Guidance on the use of PDT in the NHS was published on Wednesday 24th September 2003. This recommended that PDT should be made available on the NHS for all 7,500 people a year who have two particular types of wet AMD (with so called classic and predominantly classic lesions).
We campaigned with the Macular Disease Society throughout this appraisal period, lodging a joint appeal against NICE's Final Appraisal Determination, to ensure that PDT treatment was made available to as many people as possible. We also called on the Department of Health to radically improve care pathways for patients and proactively audit the implementation of NICE guidance on PDT two years after the guidance was published as some treatment centres were failing to deliver the service effectively.
PDT is now used very rarely since it has been superseded by more effective anti-VEGF treatments. However, it remains an option for patients who cannot tolerate the injections required for the alternative treatments because they are allergic to their active ingredients or may simply refuse to have injections into their eyes. NICE has recently consulted on a possible review of PDT treatment. However, RNIB, the Macular Disease Society and the Royal College of Ophthalmologists are all taking the view that it would not make much sense to spend resources on such a review and that PDT should simply remain an alternative treatment option that consultants can offer their patients as appropriate.
Read what Prime Minister Tony Blair said when questioned on the delays in implementation at Prime Ministers Question Time.
Further information
NICE have published a booklet 'The use of photodynamic therapy for age-related macular degeneration', which gives an accessible introduction to wet AMD and PDT. Copies can be ordered from the NHS Response Line on 0870 155 5455 (quoting reference N0305). Tape and CD formats of the booklet are available from NICE on 020 7067 5900 or by emailing nice@nice.nhs.uk.