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The reordering is complete and verified. Here is your reordered presentation:

ARMD Reordered

Presentation · PPTX

Here is how the 78 slides were reorganized into the standard ARMD clinical presentation flow:

#	Section	Slides
1	Title & Contents	Title, Contents
2	Definition	Definition & Overview
3	Anatomy & Normal Aging	Macula anatomy, Retinal layers, RPE functions & visual cycle
4	Epidemiology	Prevalence & statistics
5	Risk Factors & Genetics	Risk factors table, Genetic basis (CFH, ARMS2)
6	Pathogenesis	Overview, Flowchart, Complement cascade, Lipofuscin/A2E toxicity, VEGF signalling
7	Classification & Drusen	Drusen types, AREDS classification, MNV types, SDD, PCV, Pachychoroid, Staging systems
8	Clinical Features	Dry AMD features, Wet AMD features, Subretinal haemorrhage, RPE tear, Disciform scar
9	Investigations	Imaging modalities, SD-OCT biomarkers, FAF patterns, Dark adaptation, Microperimetry, Multimodal algorithm
10	Differential Diagnosis	DDx table
11	Management - Dry AMD	AREDS supplements, AREDS risk stratification
12	Management - Wet AMD	Anti-VEGF therapy, Agent comparisons, Historical treatments, Dosing strategies, Real-world outcomes, Treatment flowchart, Complications, Treatment landscape summary, Tachyphylaxis, Combination therapies, Systemic safety
13	Clinical Trials	AREDS & AREDS2 data, Major nAMD trials, CATT, VIEW 1&2, GA trials, Updated 2022-2024 data
14	Emerging Therapies	Faricimab, Port delivery system, GA treatments, Complement therapies, Gene therapy, Investigational agents, Biosimilars, Ang-Tie pathway, AI/digital health, Recent advances 2020-2025, Eylea HD 8mg, Extended-interval agents, Photobiomodulation, Stem cell therapies
15	Prognosis & Prevention	Natural history, Prevention/public health, Low vision rehab, Patient self-monitoring
16	Summary & Case	Clinical vignette, Clinical approach summary, Key take-home points
17	References	Key references, Additional references

Key fixes from the original: moved AREDS trials (originally scattered at slide 22) together with all clinical trials; moved dosing strategies and treatment flowchart into the wet AMD management block; moved the AREDS risk stratification table next to dry AMD management; and grouped all extended anatomy/pathology slides with their parent sections.

If I add the images to that chat, will you add to the slide?

Yes, absolutely! Just share the images in the chat and tell me:

Which slide(s) each image should go on (by slide number or title)
Where on the slide - e.g. replace existing content, add alongside text, full-bleed background, bottom right corner, etc.

Once you upload them, I'll add them to the reordered presentation and give you a new file to download.

How to memorise the clinical trials? So difficult

Clinical trials for AMD are actually very pattern-friendly once you group them by what question they were answering. Here's a system that works:

The "Story Arc" Method

Think of trials as chapters in a story:

Chapter 1: "Does anti-VEGF work?" (Proof of concept)

Trial	Drug	Hook
MARINA	Ranibizumab vs sham	Marina = the sea = first wave of anti-VEGF
ANCHOR	Ranibizumab vs PDT	Anchored the era — beat the old standard (PDT)

Mnemonic: "Drop ANCHOR in the MARINA" - both proved ranibizumab works

Chapter 2: "Which drug/dose?" (Head-to-head)

Trial	Question	Hook
CATT	Ranibizumab vs Bevacizumab	CATT = Cat fight between the two drugs
IVAN	Same question (UK version)	IVAN is a Russian name = European CATT
VIEW 1 & 2	Aflibercept vs Ranibizumab	VIEW = you're viewing a new drug enter

Mnemonic: "CATT and IVAN had a VIEW of the competition"

Chapter 3: "How often to inject?" (Dosing)

Trial	Strategy	Hook
PIER	Quarterly fixed dosing	PIER = rigid structure, fixed schedule
PRONTO	PRN dosing	PRONTO = Spanish for "quickly/as needed"
SUSTAIN	PRN after loading	Self-explanatory - sustain with less
CATT	Also compared PRN vs monthly

Chapter 4: "Can we extend intervals?" (Treat & Extend)

Trial	Drug	Hook
HAWK	Brolucizumab q12w	HAWK = sharp eyes, watches from far away (extended interval)
HARRIER	Brolucizumab q16w	Harrier = even faster/longer ranging bird
TENAYA / LUCERNE	Faricimab	Mountains = high durability, reaching new heights

Mnemonic: "HAWK and HARRIER fly far between visits" (extended dosing)

Chapter 5: "What about dry AMD/GA?" (Prevention)

Trial	Drug	Hook
AREDS	Antioxidants + zinc	AREDS = A RED Supplement
AREDS2	Replaced beta-carotene with lutein/zeaxanthin	Version 2 = upgrade
OAKS / DERBY	Pegcetacoplan (complement C3)	OAK trees are strong, DERBY = race to slow GA
GATHER 1 & 2	Avacincaptad pegol (C5)	GATHER your complement, stop it assembling

The One-Line Rule

For each trial, remember just 3 things:

Drug | vs what | Key result (one number)

Example:

CATT: Bevacizumab vs Ranibizumab | non-inferior at 1 year (+8 vs +8.5 letters)
VIEW: Aflibercept 2mg q8w | non-inferior to monthly ranibizumab
HAWK/HARRIER: Brolucizumab | non-inferior at q12w, some IOI risk

Quick Recall Trick

Write out this table from memory daily for 1 week:

MARINA / ANCHOR  → Ranibizumab proof
CATT / IVAN      → Bev = Ran (cheaper = same)
VIEW             → Aflibercept enters
HAWK/HARRIER     → Brolucizumab (q12w)
TENAYA/LUCERNE   → Faricimab (bispecific)
OAKS/DERBY       → GA: pegcetacoplan
GATHER           → GA: avacincaptad
AREDS/AREDS2     → Dry AMD supplements

That's the entire landscape in 8 rows. Once the story makes sense, the names stick naturally. Would you like me to make a flashcard deck or a one-page cheat sheet from your slides?

Make a one-page clinical trials summary cheat sheet

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Here's your cheat sheet:

AMD Clinical Trials CheatSheet

PDF Document · PDF

The one-pager is organised into 4 sections:

1. nAMD Pivotal Trials (13 trials) - teal table covering MARINA through PULSAR, in chronological story order: proof-of-concept → head-to-head → extended interval

2. Dry AMD / GA Trials (8 trials) - red table covering AREDS, AREDS2, FILLY, OAKS, DERBY, GATHER 1&2, and CHROMA/SPECTRI (the failed one)

3. Memory Mnemonics bar - 7 colour-coded boxes with the story-arc hooks ("Drop ANCHOR in the MARINA", "HAWK & HARRIER fly far", etc.)

4. Dosing Strategies + Approved Drugs Quick Ref - side-by-side tables with dosing strategy comparisons and all 7 drugs with doses, intervals, and targets

Print it A4 and keep it in your notes - everything fits on one page at readable font size.

i have added pictures to the slide in animation, look at it, is anything missing? i think BalmD or something is missing. the clinical trials looks overexplained. is it?

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BALMD clinical trial AMD macular degeneration

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Good - I have a clear picture now. Here's my full assessment:

What's in the presentation - looks good ✓

71 slides, well structured, images added to key slides (anatomy, drusen, clinical features, haemorrhage, RPE tear, disciform scar, FAF, etc.)
Logical flow from definition → pathology → classification → clinical → investigations → management → trials → emerging → summary

What's missing

1. HARBOR trial - this is almost certainly what you mean by "BalmD" or similar

It's a significant ranibizumab trial that's completely absent from the presentation:

HARBOR (2012): n=1097, compared ranibizumab 0.5mg vs 2mg (monthly vs PRN) - found high-dose (2mg) offered no benefit over 0.5mg; PRN slightly inferior to monthly. It's the definitive dose-comparison trial for ranibizumab and belongs on slide 48 alongside MARINA/ANCHOR/CATT.

2. IVAN trial - missing

UK equivalent of CATT (ranibizumab vs bevacizumab, n=610), confirms CATT findings. Standard to include alongside CATT.

3. CATT trial has its own dedicated slide missing from this version

In the original ARMD_Complete_Final.pptx there was a separate CATT deep-dive slide - it's gone from this 71-slide version.

4. Pachychoroid Spectrum slide - dropped

Was in the original (slide 58), not in this version.

5. RPE Functions slide - dropped

Was slide 51 in the original.

On the clinical trials being overexplained - YES, you're right

Slides 47-51 are 5 separate slides covering trials. The problem:

Slide 48 ends at CATT (2011) and slide 49 continues the same table (VIEW, HAWK, LUCERNE) - this is a broken split across two slides that's confusing
Slide 51 (Updated 2022-2024 data) includes PHOTON (DME trial - not relevant to AMD), and GATHER2 is duplicated (also on slide 50)
The CATT deep-dive slide adds granular detail (OR values, GA risk) that's better as a note than a standalone slide for revision

Suggestion: Merge slides 48+49 into one combined trial table, remove PHOTON (DME) from slide 51, and cut the standalone CATT deep-dive. That gets you from 5 trial slides down to 3 tighter ones.

Short answer: Yes, HARBOR is the missing trial. And yes, the trials section is over-split - slides 48 and 49 are one broken table across two slides, and GATHER2 + PHOTON are duplicated/irrelevant content. Want me to fix those slides directly in the file?

i want to remove some of the clinical trials, what can be removed?

Here's a clear breakdown of what's safe to cut vs must keep, based on clinical exam relevance:

KEEP — Core trials every ophthalmologist must know

Trial	Why keep
MARINA	Proof ranibizumab works; foundational
ANCHOR	Ranibizumab beat PDT; ended PDT era
CATT	Bevacizumab = Ranibizumab; cost landmark
VIEW 1&2	Aflibercept approved; q8w standard of care
HAWK/HARRIER	Brolucizumab; extended interval concept
YOSEMITE/LUCERNE	Faricimab; bispecific; q16w
AREDS / AREDS2	Dry AMD supplements; everyone asks this
OAKS/DERBY	GA treatment approved (pegcetacoplan)
GATHER 1	GA treatment approved (avacincaptad)

CUT — Safe to remove

Trial	Why cut
PIER	Historically interesting but only showed quarterly dosing is inferior — not actionable today
PRONTO	Small (n=40), pilot study only, superseded by larger PRN trials
FILLY (Ph2)	Phase 2 only — OAKS/DERBY are the Phase 3 that got approval; FILLY is redundant
GATHER2	Duplicated — it's already summarised in GATHER1 context; lower dose, smaller effect
CHROMA/SPECTRI	Failed trial (lampalizumab); interesting but not exam-relevant
BRIMO DDS	Failed trial; very niche
PHOTON	DME trial — not AMD at all, shouldn't be in this deck
OPT-302 SHORE	Failed trial (2024), discontinued — not established knowledge
ARCHWAY (PDS)	PDS is a device, covered in its own slide already — trial detail is redundant
PULSAR	Aflibercept 8mg is covered in its own dedicated slide (slide 62); PULSAR data duplicated there

MAYBE — Depends on your exam level

Trial	Keep if...
CATT deep-dive slide	Postgrad/fellowship level; cut for undergrad
LUCERNE/YOSEMITE 2yr update (slide 51)	Keep the 2yr data point but merge into the main YOSEMITE/LUCERNE row
Updated 2022-2024 slide (slide 51)	Trim to just PULSAR + YOSEMITE 2yr; remove the rest

Recommended end result

Cut slides 48+49 down to one merged table with just: MARINA → ANCHOR → CATT → VIEW → HAWK/HARRIER → YOSEMITE/LUCERNE

Slide 50 (GA trials): Keep OAKS/DERBY + GATHER1 only. Cut FILLY, GATHER2, CHROMA, BRIMO.

Slide 51 (Updated data): Cut entirely, or keep as 2 rows max (PULSAR + YOSEMITE 2yr).

That takes you from 5 trial slides → 3 clean slides.

Want me to make those edits directly to the file?

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