RESUMEN
BACKGROUND: Resource utilisation and direct costs associated with glaucoma progression in Europe are unknown. As population progressively ages, the economic impact of the disease will increase. METHODS: From a total of 1655 consecutive cases, the records of 194 patients were selected and stratified by disease severity. Record selection was based on diagnoses of primary open angle glaucoma, glaucoma suspect, ocular hypertension, or normal tension glaucoma; 5 years minimum follow up were required. Glaucoma severity was assessed using a six stage glaucoma staging system based on static threshold visual field parameters. Resource utilisation data were abstracted from the charts and unit costs were applied to estimate direct costs to the payer. Resource utilisation and estimated direct cost of treatment, per person year, were calculated. RESULTS: A statistically significant increasing linear trend (p = 0.018) in direct cost as disease severity worsened was demonstrated. The direct cost of treatment increased by an estimated 86 for each incremental step ranging from 455 euro per person year for stage 0 to 969 euro per person year for stage 4 disease. Medication costs ranged from 42% to 56% of total direct cost for all stages of disease. CONCLUSIONS: These results demonstrate for the first time in Europe that resource utilisation and direct medical costs of glaucoma management increase with worsening disease severity. Based on these findings, managing glaucoma and effectively delaying disease progression would be expected to significantly reduce the economic burden of this disease. These data are relevant to general practitioners and healthcare administrators who have a direct influence on the distribution of resources.
Asunto(s)
Glaucoma/economía , Costos de la Atención en Salud/estadística & datos numéricos , Recursos en Salud/estadística & datos numéricos , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Costos de los Medicamentos/estadística & datos numéricos , Europa (Continente) , Femenino , Estudios de Seguimiento , Glaucoma/fisiopatología , Glaucoma/terapia , Humanos , Masculino , Persona de Mediana Edad , Visita a Consultorio Médico/economía , Índice de Severidad de la Enfermedad , Distribución por Sexo , Campos VisualesRESUMEN
Macular edema is an abnormal thickening of the macula associated with the accumulation of excess fluid in the extracellular space of the neurosensory retina. The following chapter looks at the basic pathomechanisms of macular edema as well as major pathologic conditions leading to it: special focus is on diabetic retinopathy, retinal venous occlusions and a number of inflammatory disorders. Currently available data on up-to-date pharmacologic treatment options such as steroids and anti-VEGF compounds is presented and discussed.