This guidance has been re-issued after a change to the patient access scheme in May 2012. Recommendation 1.1 and section 5.3 of the guidance have been updated (May 2012).
Ranibizumab is recommended as a possible treatment for people with wet AMD if all the following apply to their eye:
- The best possible visual acuity after correction with glasses or contact lenses is between 6/12 and 6/96.
- There is no permanent damage to the fovea (the part of the eye that helps people to see things in sharp detail).
- The area affected by AMD is no larger than 12 times the size of the area inside the eye where the optic nerve connects to the retina.
- There are signs that the condition has been getting worse.
- Treatment should be stopped if a person's vision gets worse and there are changes inside the eye which show that treatment isn't working.
Pegaptanib is not recommended for people with wet AMD. Healthcare professionals should not immediately stop prescribing pegaptanib for people who were already taking it when the guidance was issued. These people should be able to carry on taking pegaptanib until they and their healthcare professionals decide that it is the right time to stop treatment.
The recommendations in this guidance represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, health professionals are expected to take this guidance fully into account, alongside the individual needs, preferences and values of their patients. The application of the recommendations in this guidance is at the discretion of health professionals and their individual patients and do not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.
Commissioners and/or providers have a responsibility to provide the funding required to enable the guidance to be applied when individual health professionals and their patients wish to use it, in accordance with the NHS Constitution. They should do so in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.