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No improvement in injection frequency or in visual outcome over time in two cohorts of patients from the same swedish county treated for wet age-related macular degeneration

Schroeder, Marion LU ; Rung, Lena and Lövestam-Adrian, Monica LU (2017) In Clinical Ophthalmology 11. p.1105-1111
Abstract

Background: Although ranibizumab has been used for the treatment of wet age-related macular degeneration (AMD) since 2007, real-world studies still report undertreatment resulting in a less favorable visual outcome. In this study, two different time cohorts of patients treated with ranibizumab for wet AMD in routine care were analyzed to observe whether there was a change over time regarding visual outcome, injection frequency, and quality of life (QoL). Methods: We compared patients with treatment-naïve wet AMD in two observational follow-up cohorts 2007–2010 (n=50 patients) and 2009–2013 (n=26). After a loading dose of three intravitreal ranibizumab injections, the patients were treated under the pro re nata regimen. Visual acuity... (More)

Background: Although ranibizumab has been used for the treatment of wet age-related macular degeneration (AMD) since 2007, real-world studies still report undertreatment resulting in a less favorable visual outcome. In this study, two different time cohorts of patients treated with ranibizumab for wet AMD in routine care were analyzed to observe whether there was a change over time regarding visual outcome, injection frequency, and quality of life (QoL). Methods: We compared patients with treatment-naïve wet AMD in two observational follow-up cohorts 2007–2010 (n=50 patients) and 2009–2013 (n=26). After a loading dose of three intravitreal ranibizumab injections, the patients were treated under the pro re nata regimen. Visual acuity (VA) was examined by Early Treatment Diabetic Retinopathy Study (ETDRS) charts. The National Eye Institute Visual Functioning Questionnaire 25 was answered by patients at baseline and at 37±7 months (cohort 1) and at 45±4 months (cohort 2). Results: At baseline, the cohorts were homogeneous considering mean age (76±7 vs 75±8 years), mean VA (53±14 vs 52±15 ETDRS letters), and mean self-reported symptom duration (14±11 vs 13±11 weeks). Mean VA decreased in both cohorts over time, from 53±14 to 45±24 letters (P=0.011) and from 52±15 to 46±22 letters (P=0.175), respectively. The patients received a mean of 8±5 and 9±7 injections, respectively. The mean composite score change from baseline to follow-up decreased in cohort 1 from 64±21 to 59±25 scores (P=0.04) but increased in cohort 2 from 64±28 to 67±23 scores (P=0.38). Conclusion: We could not demonstrate any improvement in the number of injections in two different time cohorts of patients treated with ranibizumab for wet AMD in a Swedish county. Visual outcomes decreased after 3 years of follow-up, but QoL scores were divergent.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Anti-VEGF, Clinical care, NEI VFQ-25, Neovascular AMD
in
Clinical Ophthalmology
volume
11
pages
7 pages
publisher
Dove Press
external identifiers
  • scopus:85020487741
  • wos:000402980500002
ISSN
1177-5467
DOI
10.2147/OPTH.S130182
language
English
LU publication?
yes
id
f3b6f546-abd3-46ac-b5da-5082ce85a2a3
date added to LUP
2017-08-11 15:57:17
date last changed
2017-09-18 11:41:35
@article{f3b6f546-abd3-46ac-b5da-5082ce85a2a3,
  abstract     = {<p>Background: Although ranibizumab has been used for the treatment of wet age-related macular degeneration (AMD) since 2007, real-world studies still report undertreatment resulting in a less favorable visual outcome. In this study, two different time cohorts of patients treated with ranibizumab for wet AMD in routine care were analyzed to observe whether there was a change over time regarding visual outcome, injection frequency, and quality of life (QoL). Methods: We compared patients with treatment-naïve wet AMD in two observational follow-up cohorts 2007–2010 (n=50 patients) and 2009–2013 (n=26). After a loading dose of three intravitreal ranibizumab injections, the patients were treated under the pro re nata regimen. Visual acuity (VA) was examined by Early Treatment Diabetic Retinopathy Study (ETDRS) charts. The National Eye Institute Visual Functioning Questionnaire 25 was answered by patients at baseline and at 37±7 months (cohort 1) and at 45±4 months (cohort 2). Results: At baseline, the cohorts were homogeneous considering mean age (76±7 vs 75±8 years), mean VA (53±14 vs 52±15 ETDRS letters), and mean self-reported symptom duration (14±11 vs 13±11 weeks). Mean VA decreased in both cohorts over time, from 53±14 to 45±24 letters (P=0.011) and from 52±15 to 46±22 letters (P=0.175), respectively. The patients received a mean of 8±5 and 9±7 injections, respectively. The mean composite score change from baseline to follow-up decreased in cohort 1 from 64±21 to 59±25 scores (P=0.04) but increased in cohort 2 from 64±28 to 67±23 scores (P=0.38). Conclusion: We could not demonstrate any improvement in the number of injections in two different time cohorts of patients treated with ranibizumab for wet AMD in a Swedish county. Visual outcomes decreased after 3 years of follow-up, but QoL scores were divergent.</p>},
  author       = {Schroeder, Marion and Rung, Lena and Lövestam-Adrian, Monica},
  issn         = {1177-5467},
  keyword      = {Anti-VEGF,Clinical care,NEI VFQ-25,Neovascular AMD},
  language     = {eng},
  month        = {06},
  pages        = {1105--1111},
  publisher    = {Dove Press},
  series       = {Clinical Ophthalmology},
  title        = {No improvement in injection frequency or in visual outcome over time in two cohorts of patients from the same swedish county treated for wet age-related macular degeneration},
  url          = {http://dx.doi.org/10.2147/OPTH.S130182},
  volume       = {11},
  year         = {2017},
}