11.8.2. Ocular diagnostic and peri-operative preparations and photodynamic treatment
Restrictions:
Restricted to specialist use for indications detailed under Prescribing Notes.
Prescribing Notes:
Formulary indications are:
- Use in adults for the treatment of neovascular (wet) age-related macular degeneration.
- Treatment of visual impairment due to macular oedema secondary to central retinal vein occlusion in accordance with NHSGGC protocol.
- Treatment of visual impairment due to macular oedema secondary to branch retinal vein occlusion (protocol in development)
- Treatment of visual impairment due to diabetic macular oedema (DMO) in adults. It is restricted to specialist use for the treatment of visual impairment due to DMO in adults with best corrected visual acuity (BCVA) 75 Early Treatment Diabetic Retinopathy Study (ETDRS) letters or less at baseline.
- Treatment of visual impairment due to myopic choroidal neovascularisation (myopic CNV) in line with national guidance.
Restrictions:
Restricted to specialist initiation for the diagnosis of Hornor’s syndrome and post-laser surgery.
Prescribing Notes:
For use in the management of glaucoma, see section 11.6.7
Restrictions:
Restricted to specialist use in accordance with local protocol for the following indications:
- treatment of adults with neovascular (wet) age-related macular degeneration (AMD).
- as a second-line agent for the treatment of visual impairment due to diabetic macular oedema in adults with best corrected visual acuity 75 Early Treatment Diabetic Retinopathy Study letters or less at baseline.
Restrictions:
Restricted to specialist use for the treatment of
- visual impairment due to DMO in adults with best corrected visual acuity (BCVA) of 75 Early Treatment Diabetic Retinopathy Study (ETDRS) letters or less at baseline.
- treatment of adult patients with neovascular (wet) age-related macular degeneration (nAMD).
Restrictions:
Restricted to intitiation by or on the advice of a specialist.
Prescribing Notes:
Duration of treatment to be advised by the specialist, but should not exceed three weeks post-operatively
Restrictions:
the reduction of postoperative macular oedema associated with cataract surgery in diabetic patients is restricted to specialist initiation in diabetic patients with retinopathy.
Prescribing Notes:
Initial supply should be obtained from the specialist centre with GP prescribing only necessary where the specialist considers extending the course of treatment to a total duration of 60 days.
For the relevant SMC advice click here
Restrictions:
Restricted to specialist use for reduction in the risk of postoperative macular oedema associated with cataract surgery in diabetic patients.
Prescribing Notes:
Nepafenac 3mg/mL eye drops provide a once daily alternative to nepafenac 1mg/mL eye drops (administered three times daily).
The use of nepafenac 3mg/ml eye drops is not recommended by SMC for use for postoperative pain and inflammation associated with cataract surgery and remains non-formulary.
Restrictions:
Ranibizumab is restricted to specialist use in accordance with local protocols for the following indications:
- The treatment of neovascular (wet) age-related macular degeneration (AMD)
- The treatment of visual impairment due to diabetic macular oedema (DMO)
- The treatment of visual impairment due to macular oedema secondary to retinal vein occlusion (branch RVO or central RVO)
- The treatment for visual impairment due to choroidal neovascularisation secondary to pathologic myopia
NHSGGC Protocols for the Formulary indications can be searched for and accessed here.
Prescribing Notes:
Ranibizumab is not recommended by SMC and is therefore non-Formulary for the following indication:
- Treatment of proliferative diabetic retinopathy in adults (non-Submission to SMC)
Restrictions:
Restricted to specialist use for the treatment of patients with vision loss due to inherited retinal dystrophy caused by confirmed biallelic RPE65 mutations and who have sufficient viable retinal cells.
Prescribing Notes:
- This therapy is available via the Scottish Government Ultra-orphan pathway
- Formulary status will be reconsidered following the reassessment by SMC (expected September 2023).