Presentation delay in patients affected with exudative age-related macular degeneration

Abstract.

Background: Presentation delay (i.e. duration of visual symptoms before initial presentation) is an established critical parameter for visual prognosis in patients with exudative age-related macular degeneration (ARMD) considering the natural history of the disease and the limitations of current treatments. The purpose of this study was to determine the duration of presentation delay and its evolution in two periods 4 years apart. Methods: Presentation delay in 1598 patients affected with exudative ARMD was retrospectively reviewed during two similar 8-month periods in 1994 and 1998 in a tertiary referral center. Results: The proportions of patients examined either within 1 month, between 1 and 3 months, and between 3 and 6 months after onset of symptoms, respectively, increased between 1994 and 1998 from 23% to 33%, from 27% to 32.5%, and from 14% to 18.5%. The proportions of patients examined between 6 and 12 months and after 12 months decreased from 16% to 12% and from 20% to 4%, respectively. Furthermore, the proportion of patients presenting with a first eye involvement during the first month following the onset of symptoms rose from 42% in 1994 to 52% in 1998. All these differences were statistically significant. Conclusion: This first specific review of presentation delay in exudative ARMD showed a significant decrease in this parameter between 1994 and 1998 that should be taken into account when assessing the overall evolution of visual outcome. Further studies are warranted to ascertain that these findings reflect a global improvement in the management of macular diseases.