The Need for Treatment of Neovascular Age-Related Macular Degeneration: A Study Based on the Polish National Registry

Teper, Sławomir; Nowińska, Anna; Figurska, Małgorzata; Rękas, Marek; Wylęgała, Edward

doi:10.1007/s40123-022-00545-4

Cited by 3 publications

(2 citation statements)

References 15 publications

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“…However, the first monocentric database was the UK Moorfields AMD database, which collected the EMR from October 2008. It was implemented in September 2012, and then the data were merged into a centralized repository, the data warehouse [35]. Recently, the Berlin Macula Registry was used to present the outcomes of switching to bevacizumab in patients with wAMD [36,37].…”

Section: Tablementioning

confidence: 99%

Comparative Study on Anti-VEGF in Wet Age-Related Macular Degeneration in the Setting Based on Lean Methodology from the Bari Intravitreal Injection Registry (BIVIR)

Grassi,

Viggiano,

Borrelli

et al. 2024

Ophthalmol Ther

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Introduction: Optimizing treatment protocols for wet age-related macular degeneration (wAMD) is an ongoing challenge, as it involves a delicate balance between achieving therapeutic efficacy and minimizing invasive procedures' frequency. This study aimed to apply the Lean methodology and evaluate the effectiveness of this new setting on intravitreal therapy for wAMD, employing different anti-vascular endothelial growth factors (VEGF) drugs (bevacizumab, brolucizumab, aflibercept, ranibizumab), drawing data from the Bari Intravitreal Injections Registry (BIVIR).Methods: This was a retrospective, monocentric, nonrandomized, comparative study. Lean methodology was employed to design the new setting and the BIVIR collected information from electronic medical records. Clinical data of four groups, stratified based on the first-line anti-VEGF agents used, were compared. Bestcorrected visual acuity (BCVA) and central retinal thickness (CRT) changes were compared between the four groups at 3 and 12 months. Results: Out of 4990 eyes and 41,323 intravitreal injections (IVs) recorded in BIVIR, 1421 eyes of 1182 patients were included. The mean number of IVs in first year was 6.1 ± 2.5, with no significant differences among the four subgroups. The mean change in BCVA was ? 6.2 letters [95% confidence interval (CI) 5.6-6.8] after two IVs, and ? 5.9 (95% CI 5.1-6.8) letters after three IVs; at three months, brolucizumab was associated with a greater mean increase in BCVA than bevacizumab (p = 0.050); aflibercept (p = 0.044) and ranibizumab p = 0.047). At the 1-year follow-up, the mean change was ? 6.3 letters (95% CI 5.4-7.2), brolucizumab and ranibizumab were associated with a superior improvement in BCVA compared to aflibercept (p = 0.033). Regarding the CRT, a significant reduction was observed in the subgroup treated with brolucizumab at the 3-month follow-up, compared to bevacizumab (p = 0.003), aflibercept (p = 0.015), and ranibizumab (p \ 0.001); Aflibercept exhibited a superior effect than

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Section: Tablementioning

confidence: 99%

Comparative Study on Anti-VEGF in Wet Age-Related Macular Degeneration in the Setting Based on Lean Methodology from the Bari Intravitreal Injection Registry (BIVIR)

Grassi,

Viggiano,

Borrelli

et al. 2024

Ophthalmol Ther

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“…A 2016 report by the Institute of Healthcare suggested that in Poland, the number of AMD patients in 2016 may have reached 2.7 million people, including 273,000 with wAMD. Furthermore, projections indicate that this number could increase to as many as 3.6 million by 2060 [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Ranibizumab Modifies the Expression of Metalloproteinases and Their Tissue Inhibitors in Peripheral Blood Mononuclear Cells in Patients with Exudative Age-Related Macular Degeneration

Strzalka-Mrozik,

Paprzycka,

Gruszka

et al. 2024

JCM

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Background: Age-related macular degeneration (AMD) is the leading cause of vision loss in people over 60 years of age. Despite research, the causes of AMD remain unclear. Matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) are known to be involved in AMD development, and anti-vascular endothelial growth factor therapy has revolutionized its treatment. This study aims to analyze the changes in gene expression in MMPs and TIMPS in patients with neovascular AMD before and after three doses of ranibizumab. Methods: The study involved 29 patients with neovascular AMD treated with ranibizumab. Peripheral blood mononuclear cells were collected before treatment and 24 h after the third dose of ranibizumab. We assessed MMP and TIMP gene expression profiles through oligonucleotide microarrays and validated selected differential genes using RT-qPCR. Results: A statistically significant change in the expression of six MMP- and TIMP-related genes was observed using oligonucleotide microarray. The mRNA levels of the two genes with the most significant fold changes, MMP15 and TIMP2, were then quantified using RT-qPCR. The results confirmed a statistically significant increase in MMP15 expression and a decrease in TIMP2 levels, although this change was not statistically significant in the group before and after the third dose of ranibizumab. Conclusion: Ranibizumab affects the systemic expression of MMP and TIMP-related genes in patients with neovascular AMD. Results from our exploratory study suggest that MMP15, in particular, may play a role in the treatment response, but further research is necessary.

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A deep learning approach to explore the association of age‐related macular degeneration polygenic risk score with retinal optical coherence tomography: A preliminary study

Sendecki,

Ledwoń,

Nycz

et al. 2024

Acta Ophthalmologica

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PurposeAge‐related macular degeneration (AMD) is a complex eye disorder affecting millions worldwide. This article uses deep learning techniques to investigate the relationship between AMD, genetics and optical coherence tomography (OCT) scans.MethodsThe cohort consisted of 332 patients, of which 235 were diagnosed with AMD and 97 were controls with no signs of AMD. The genome‐wide association studies summary statistics utilized to establish the polygenic risk score (PRS) in relation to AMD were derived from the GERA European study. A PRS estimation based on OCT volumes for both eyes was performed using a proprietary convolutional neural network (CNN) model supported by machine learning models. The method's performance was assessed using numerical evaluation metrics, and the Grad‐CAM technique was used to evaluate the results by visualizing the features learned by the model.ResultsThe best results were obtained with the CNN and the Extra Tree regressor (MAE = 0.55, MSE = 0.49, RMSE = 0.70, R2 = 0.34). Extending the feature vector with additional information on AMD diagnosis, age and smoking history improved the results slightly, with mainly AMD diagnosis used by the model (MAE = 0.54, MSE = 0.44, RMSE = 0.66, R2 = 0.42). Grad‐CAM heatmap evaluation showed that the model decisions rely on retinal morphology factors relevant to AMD diagnosis.ConclusionThe developed method allows an efficient PRS estimation from OCT images. A new technique for analysing the association of OCT images with PRS of AMD, using a deep learning approach, may provide an opportunity to discover new associations between genotype‐based AMD risk and retinal morphology.

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The Need for Treatment of Neovascular Age-Related Macular Degeneration: A Study Based on the Polish National Registry

Cited by 3 publications

References 15 publications

Comparative Study on Anti-VEGF in Wet Age-Related Macular Degeneration in the Setting Based on Lean Methodology from the Bari Intravitreal Injection Registry (BIVIR)

Comparative Study on Anti-VEGF in Wet Age-Related Macular Degeneration in the Setting Based on Lean Methodology from the Bari Intravitreal Injection Registry (BIVIR)

Ranibizumab Modifies the Expression of Metalloproteinases and Their Tissue Inhibitors in Peripheral Blood Mononuclear Cells in Patients with Exudative Age-Related Macular Degeneration

A deep learning approach to explore the association of age‐related macular degeneration polygenic risk score with retinal optical coherence tomography: A preliminary study

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