Outcome of treatment for neovascular age-related macular degeneration by practice-based ophthalmologists compared with a macula clinic

Kaya, Cagdas; Pfister, Isabel B.; Gerhardt, Christin; Garweg, Justus G.

doi:10.1007/s00417-020-04667-y

Cited by 1 publication

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References 26 publications

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“…These points may at least partially explain the less favourable outcomes in this real-world setting compared to clinical trials. In comparison, the lower adherence to treatment in the second period in our institution reflects an increasing trend to seek anti-VEGF treatment and follow-up by the patients’ family ophthalmologists, rather than a treatment interruption (Table 1 ) [ 26 ]. A more restricted use of triamcinolone and focal and pan-retinal laser photocoagulation and their inherent side effects on visual performance may have added to reduce the treatment burden and patient fears, and thus, have added to the treatment adherence in real-world settings.…”

Section: Discussionmentioning

confidence: 99%

Long-term outcomes of intravitreal therapy for symptomatic diabetic macular oedema in a real-world setting in Switzerland

Zirpel

Pfister

Gerhardt

et al. 2021

Graefes Arch Clin Exp Ophthalmol

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Objective To assess the long-term visual outcomes in eyes with symptomatic diabetic macular oedema (DME) under intravitreal treatment (IVT) in a clinical routine setting. Methods Patients with newly diagnosed DME were included in this retrospective study if they had received at least three IVTs and a follow-up period ≥ 2 years. Due to altered treatment patterns since the approval of ranibizumab for DME in 2012, patients were subdivided according to their first IVT before 2013 (group 1) or thereafter (group 2). The primary outcome measure was the evolution of best-corrected visual acuity (BCVA) over time. Results Of 217 eyes (191 patients) with DME, 151 eyes (117 patients) fulfilled the inclusion criteria (63 eyes in the first period, 88 in the second period). Mean follow-up time was 7.9 ± 3.1 (group 1) and 4.1 ± 1.4 years (group 2; p < 0.001). Visual gains were similar in the first year (group 1: + 5.3 ± 15.5, group 2: + 7.3 ± 12.2 Early Treatment Diabetic Retinopathy Study (ETDRS) letters; p = 0.44), but not thereafter (after 2 years in group 1: + 4.4 ± 15.0, group 2: + 8.3 ± 13.0 ETDRS letters; p = 0.038). During the first year, group 1 patients received less clinical examinations (group 1: 6.6 ± 3.3, group 2: 7.5 ± 2.1; p = 0.007) and less injections (group 1: 3.6 ± 2.7, group 2: 6.1 ± 2.7; p < 0.001). Conclusion A greater visual gain, in response to more intensive treatment during the first year, was maintained for at least 5 years in group 2 subjects. Our data confirm that in a real-world setting, early intensive treatment results in satisfying long-term visual outcomes.

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Section: Discussionmentioning

confidence: 99%