We have received a request to move the parent of 312899005 |Fibrovascular macular scar (disorder)| which is currently 267718000 |Age-related macular degeneration (disorder)| to 414173003 |Exudative age-related macular degeneration (disorder)|.
I am unsure if this is always and necessarily true or wet AMD is only one of the possible causes. I would appreciate your opinion.
References from requester.
https://amdbook.org/content/disciform-scars-0#:~:text=Disciform%20scars%20form%20the%20stage,hyperplasic%20elements%20of%20the%20RPE
"Fibrotic disciform scars represent the end-stage of wet age-related macular degeneration (AMD)" https://bmcophthalmol.biomedcentral.com/articles/10.1186/1471-2415-14-82
https://www.med.upenn.edu/cpob/assets/user-content/documents/10_RiskofscarintheComparisonofAge-relatedMacularDegernationTreatmentsTrialsCATT.pdf
https://eyewiki.aao.org/Age-Related_Macular_Degeneration#cite_ref-green1_21-3
7 Comments
Anthony Khawaja
Again, I am not a retinal specialist. To me, if a fibrovascular scar is caused by AMD, it is always exudative (i.e. wet not dry). But, I think there are other non-AMD causes, e.g. myopia.
Sally Baxter
Agree that fibrovascular scar reflects exudative/wet AMD. Adding Cindy Cai in case she has any other thoughts given that she is a retinal specialist.
Eric Brown
I agree that a retina doc would be the authority on this, but I'd suspect that a fibrovascular scar can also be caused by myopia, trauma, retinal tears, ROP, and diabetic retinopathy, in addition to AMD. Unless there is a more "correct" term for those pathologies. So, should it instead be a sibling of 267718000 (child of Degenerative disorder of macula (disorder), SCTID: 422338006)?
Cindy Cai
Disciform scar (in that way most retina folks use it) is in the context of end-stage wet AMD. CNV can happen in myopia and trauma, but we don't typically call them disciform scars.
Elaine Wooler
Thank you.
Cindy Cai is it perhaps the concept descriptions are not truly synonymous and we need to separate them out in to distinct concepts?
Cindy Cai
That's a good point, Elaine. I think it's a combination of the concept descriptions not being truly synonymous and how people use the terminology. I might suggest putting Kuhnt-Junuis degeneration (https://journals.sagepub.com/doi/full/10.4137/OED.S40523?rfr_dat=cr_pub++0pubmed&url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org), disciform macular degeneration, and disciform senile macular retinal degeneration in one category (under wet AMD). And then grouping fibrovascular macular scar in another category (since, as Eric points out, it can occur in myopia, etc. https://iovs.arvojournals.org/article.aspx?articleid=2124454). Disciform macular degeneration should also be linked to fibrovascular macular scar.
Elaine Wooler
Thanks Cindy Cai good solution to the problem. Thank you all for the input.