Related Experiment Video
Updated: Feb 3, 2026
Author Spotlight: Overcoming Anti-VEGF Resistance Through Advanced Vascular Morphology Assessment in Choroidal Neovascularization
Published on: August 11, 2023
Trainee-led versus specialist-led management of neovascular age-related macular degeneration: a registry-based study
Rohan W Essex1,2, Vuong Nguyen3, Vincent Daien3,4,5
1Academic Unit of Ophthalmology, Australian National University, Acton, Australian Capital Territory, Australia Rohan.Essex@act.gov.au.
Objective:
To compare the outcomes of trainee-led and specialist-led management of neovascular age-related macular degeneration.
Design:
Prospective multicentre registry-based observational study.
Setting:
Ophthalmology training centres in Australia and Europe where both trainee-led and specialist-led models of care coexist.
Participants:
Treatment-naïve eyes with neovascular age-related macular degeneration and at least 12 months follow-up. 726 eyes were included in the study from two centres, 534 receiving trainee-led treatment and 192 specialist-led treatment.
Interventions:
The management and outcomes of patients receiving trainee-led care were compared with those receiving specialist-led care.
Main Outcomes Measures:
The primary outcome was the mean change in visual acuity at 12 months from first injection. Outcomes were also presented at 36 months where available.
Results:
The mean age of participants was 79 years and 65% were female. The adjusted change in acuity at 12 months in trainee-led vs specialist-led eyes was +3.2 letters vs +4.1 letters (difference -0.9 letters, 95% CI -3.4 to 1.5, p=0.473). The mean adjusted change in acuity at 36 months was -0.9 letters in trainees vs +0.2 letters for specialists (difference -1.1 letters, 95% CI -5.1 to 2.9, p=0.596). Eyes treated by trainees received fewer injections on average to 36 months (15.0 vs 19.0, p=0.004), although this trend was observed at one centre only.
Conclusions:
No significant differences in outcome between eyes managed by trainees and eyes managed by specialists were observed. Appropriately structured trainee-led management of neovascular age-related macular degeneration is a reasonable approach where regulatory and practical considerations allow it.
More Related Videos
10:14Author Spotlight: Ex Vivo OCT-Based Multimodal Imaging of Human Donor Eyes for Research into Age-Related Macular Degeneration
Published on: May 26, 2023
10:24Regenerative Therapy by Suprachoroidal Cell Autograft in Dry Age-related Macular Degeneration: Preliminary In Vivo Report
Published on: February 12, 2018
Related Concept Videos
01:29Appendicitis-II: Diagnostic Studies and Management
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
01:26Aging
Cellular Clock Theory
The cellular clock theory posits that the human lifespan is closely tied to the finite capacity of cells to divide, a phenomenon governed by telomeres, which are protective caps at the ends of...
01:19The Effect of Aging on Tissues
01:09Changes in the Appendicular Skeleton with Age
Initially, the limb buds consist of a core of mesenchyme covered by a layer of ectoderm. The ectoderm at the end of the limb bud thickens to form a narrow crest called the apical ectodermal ridge. This ridge stimulates the underlying...
01:26Tonsillitis II: Management