Outcome of anti-vascular endothelial growth factor therapy for neovascular age-related macular degeneration in real-life setting

Abstract

AimsTo evaluate outcome of anti-vascular endothelial growth factor (VEGF) therapy for the treatment of neovascular age-related macular degeneration (nAMD) in the real-life setting and to compare incidence of ocular serious adverse events (SAE) after injections administered by nurses and physicians.MethodsRetrospective, single-centre study. Medical records of patients receiving anti-VEGF treatment for nAMD between 2008 and 2013 with three-loading-dose regimen were evaluated. Outcome measures were baseline visual acuity (VA), change in VA, number of intravitreal injections, incidence of ocular SAE and patients’ baseline characteristics affecting VA change. In addition, the number of injections per 1000 citizens living in the serving area and per individuals over 65 years old were estimated.Results1349 eyes in 1117 patients received a total of 11 562 intravitreal anti-VEGF injections. Twenty-one per cent of patients received treatment for both eyes. The mean baseline Snellen VA was 0.32. The mean change of VA from baseline was +2, +2 and ±0 Early Treatment Diabetic Retinopathy Study letters and the mean numbers of injections were 5.7, 4.7 and 4.9 at years 1, 2 and 3, respectively. There was a negative correlation between baseline VA and change of VA. Incidence of endophthalmitis was 0.086%. No difference in the incidence of ocular SAE was identified between injections given by nurses or by physicians. The number of intravitreal injections per all citizens was 9 per 1000 inhabitants and 45 per 1000 inhabitants over 65 years.ConclusionThe VA was maintained at the baseline level (±0 letters) with the mean of 15.3 anti-VEGF injections in real-world clinical practice during 3-year follow-up.

Expression of VEGFA‐regulating miRNAs and mortality in wet AMD

“…Real‐world data (RWD) were monitored for up to 12 years. Finnish national guidelines for modified PRN ( pro re nata ) were applied in the follow‐up and treatments of wet AMD patients …”

“…Finnish national guidelines for modified PRN (pro re nata) were applied in the followup and treatments of wet AMD patients. [19][20][21][22] Ethics Committee of the Kuopio University Hospital has approved the study, and the tenets of the Declaration of Helsinki are followed. All participants have been asked to sign an informed consent form.…”

Psychological and Psychosocial Interventions for Depression and Anxiety in Patients With Age-Related Macular Degeneration: A Systematic Review

“…Additionally, in some AMD patients, particularly in patients with wet AMD, their mental health needs might not be exclusively linked to visual impairment, as these patients can have their vision preserved by medical treatments (e.g. anti-VEGF) (46). In two studies examining anxiety related to receiving regular anti-VEGF treatment for wet AMD (9,47), patients reported being distressed by anticipatory anxiety of going blind in the future due to disease progression, and fear of going blind because of the intravitreal injections they regularly receive (anti-VEGF treatment).…”

One and Two Year Visual Outcomes from the Moorfields AMD Database - an Open Science Resource for the Study of Neovascular Age-related Macular Degeneration

“…The advent of electronic medical records (EMR) has facilitated the collection of large amounts of data in routine clinical practice and thus has the potential to make retrospective study populations more representative of real life. (13)(14)(15)(16)(17)(18) were merged into the current centralised repository, the data warehouse. We have created a dataset from this which represents, to our knowledge, the largest single-center cohort of patients receiving treatment for neovascular AMD in the world.…”

“…The advent of electronic medical records (EMR) has facilitated the collection of large amounts of data in routine clinical practice and thus has the potential to make retrospective study populations more representative of real life. (13)(14)(15)(16)(17)(18) This is very much dependent, however, on the quality of data entry and the reliable follow-up of patients, and so these issues can remain problematic. The amount of data available from EMR systems also challenges the traditional methods of validation, analytics and reporting, and there is a struggle to implement the existing clinical research guidelines.…”