Category: Research

Month: 01 Jan 2019

Issue: not yet available

A majority of office-based ophthalmologists do not claim with a familiarity of AMD genetics

A report of a survey among private practice ophthalmologists and hospital-based ophthalmologists suggest that clinicians may have insufficient knowledge of genetics in AMD.  Both office and hospital-based ophthalmologists do not consider to have practical genetic skills relevant to patient care.  To remedy such concerns, several genetics educational programmes may need to tailor revised courses, or CME activities, to focus on any relevant AMD genetics support.  One representative respondent reflects a similar issue among several ophthalmologists, such as: “…to be honest, genetics is certainly an issue that I’m not well informed about”.

 

The survey had indicated that knowledge of a strong genetic background on AMD can be challenging for daily practice and that guidelines may not offer specific recommendations to support AMD patients.  As commented by a researcher, “ophthalmologists are left alone with emerging facts, and it is unclear what conclusions they draw without guidance on communication strategies”.  A majority of office-based ophthalmologists claim that clinicians do not have sufficient genetics expertise and that there may be relative complexity to understand AMD support.  In contrast, some hospital-affiliated ophthalmologists may feel relatively-informed with genetics knowledge, and perhaps may have some genetics support within a hospital environment.  Ophthalmologists appear to believe that genetics do not have practical relevance to everyday patient care.  The research paper on this survey (PLoS ONE https://doi.org/10.1371/journal.pone.0209328) have commented that “addressing relatives of AMD patients as persons with a higher genetic risk of AMD was dismissed by the majority of both office-based and hospital-affiliated ophthalmologists, mainly for ethical reasons (avoiding unnecessary burden as well as allocation and privacy problems). The doctors would even be reserved when directly asked by relatives about their risks. None of the interviewees has ever discussed (results of) genetic testing with their patients yet, the majority (but not all) would advise against it if directly consulted on this”.

 

In conclusion, genetics knowledge appears not have had any impact on clinical ophthalmologic practice, neither on private practitioners or on ophthalmologists in hospitals.  In addition, doctors may withhold information from patients and their relatives because of the uncertainty of predicting AMD and for fear of unsettling those individuals.  Preventive efforts for late AMD based on genetic information are seen as irrelevant.  These findings highlight a need for genetic educational programs for routine care situations of ophthalmologists. The current survey only reported a cross-sectional qualitative study with 30 clinical respondents in Germany however, a far broader analysis covering several EU jurisdictions may be extremely helpful.

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