Understanding the Impact of a New wAMD Diagnosis

Welcome back to another Ophthalmology Times Peer Exchange series. In this episode titled "Understanding the Impact of a New wAMD Diagnosis," moderator Dilsher Dhoot, MD, FASRS is joined by Esther Kim, MD, FASRS, John Kitchens, MD, and Michael Javaheri, MD, MSc, FASRS to open the series on wet age-related macular degeneration.A diagnosis of wet age-related macular degeneration (wAMD) may feel routine to retina specialists, but for patients it is often a frightening, life-altering moment that reshapes how they view their future. Dr. Kim notes that newly diagnosed patients frequently fear blindness and begin questioning whether they can keep driving and living independently, so she pairs the diagnosis with a clear message of hope.

Dr. Javaheri explains that the conversation depends on how the patient arrives. Patients already monitored for dry disease can be reassured that conversion was caught early, whereas those presenting with sudden vision loss face a far greater shock and need time to absorb what a chronic, potentially lifelong condition will demand of them.Turning to treatment goals, Dr. Kitchens distinguishes between what physicians and patients prioritize. His own target remains a completely dry retina, because he believes consistent disease control translates into better long-term vision, while patients first need visible proof, sometimes shown on optical coherence tomography (OCT), that injections are working so they and their families commit to care.

Dr. Kim adds nuance, explaining that fluid location dictates how strict she is. She tolerates no intraretinal fluid but has come to accept stable subretinal fluid when vision holds steady, suspecting that a bone-dry retina may coincide with the onset of atrophy in some patients. Dr. Dhoot observes that recent trials of more durable agents likewise tolerated some subretinal fluid while patients still achieved reasonable outcomes.Together, the panel frames the first visits as the moment to set realistic expectations and build the trust that sustains long-term treatment.

In the next episode, "Selecting Initial Therapy in Newly Diagnosed Wet AMD," panelists will continue their discussion on wAMD and highlight the clinical features and patient priorities that drive their first-line anti-VEGF choices.