RESUMO
Fundamento. Relacionar la ganancia de agudeza visual (AV) con el coste asistencial y de tratamiento con terapia anti-factor de cre-cimiento endotelial vascular (antiVEGF) en pacientes diagnostica-dos de degeneración macular asociada a la edad exudativa (DMAE exudativa).Pacientes y métodos. Estudio observacional, longitudinal, retros-pectivo, de pacientes ≥50 años diagnosticados de DMAE exudativa, con AV logMAR entre 0,6 y 0,06, en seguimiento y tratamiento en nuestro hospital de tercer nivel entre el 01/01/2014 y el 31/12/2018.Resultados. Se incluyeron 778 pacientes, 62,2% mujeres y media de edad 79,83±7,94 años, con 957 ojos con DMAE exudativa. La AV final global (0,65±0,45) aumentó un 3,2% respecto de la inicial. El 60,3% de los ojos recibieron antiVEGF con ranibizumab, el 10,2% con aflibercept y el 29,5% con ambos (mixto). El grupo mixto in-crementó significativamente la AV respecto de la inicial, sin dife-rencias entre grupos. Aunque el seguimiento/tratamiento fue más largo para el grupo mixto, este recibió menos inyecciones antiVE-GF y tomografías de coherencia óptica (OCT). El gasto total por año y ojo tratado fue de 1.972,7 ±824,5; los costes fueron mayores para visita, OCT y tratamiento en el grupo de aflibercept, y menores para angiografías con fluoresceína, tratamiento antiVEGF y costes totales en el grupo mixto. La ganancia decimal de AV tuvo un coste de 872 ±1.077,7 sin diferencias significativas entre grupos.Conclusiones. Los tratamientos antiVEGF con ranibizumab, afli-bercept y ambos mantuvieron la AV en pacientes con DMAE exu-dativa. En general, los costes asistenciales y de tratamiento fueron menores en el grupo que recibió ambos fármacos (AU)
Background. We examined the relationship between visual acuity changes (VA) and the cost of care and treatment with anti-vascular endothelial growth factors (antiVEGF) in patients diagnosed with age-related exudative macular degeneration(exudative AMD).Methods. Observational, longitudinal, retrospective study of pa-tients ≥50 years of age diagnosed with exudative AMD, with a log-MAR VA between 0.6 and 0.06. and 0.06. Follow-up and treatment were done in our tertiary hospital between January 1, 2014 and December 31, 2018.Results. The study included 778 patients; 62.2% female and mean age 79.83±7.94 years; 957 eyes had exudative AMD. Mean of final VA (0.65±0.45) increasing 3.2% compared to initial values. Ranibi-zumab was administered to 60.3% of the eyes, aflibercept to 10.2% and ranibizumab + aflibercept (mixed group) to 29.5%. Significant increase in VA was seen in the group with the mixed treatment, with no inter-group differences. Although follow-up/treatment was longer for the mixed group, they received fewer anti-VEGF injections and optical coherence tomography (OCT). The total expenditure per year and treated eye was 1,972.7±824.5; costs were higher for visit, OCT, and treatment in the aflibercept group, and lower for fluorescein angiography, antiVEGF treatment, and total costs in the mixed group. Decimal VA gain had a cost of 872±1,077.7 with no significant inter-group differences.Conclusion. AntiVEGF treatments (ranibizumab, aflibercept, or both) maintained VA in patients with exudative AMD. Overall, care and treatment costs were lower in the group that received both drugs (AU)
Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Degeneração Macular/economia , Degeneração Macular/terapia , Fatores de Crescimento do Endotélio Vascular/administração & dosagem , Acuidade Visual , Estudos Longitudinais , Estudos RetrospectivosRESUMO
BACKGROUND: We examined the relationship between visual acuity changes (VA) and the cost of care and treatment with anti-vascular endothelial growth factors (antiVEGF) in patients diagnosed with age-related exudative macular degeneration (exudative AMD). METHODS: Observational, longitudinal, retrospective study of patients ≥50 years of age diagnosed with exudative AMD, with a log-MAR VA between 0.6 and 0.06. and 0.06. Follow-up and treatment were done in our tertiary hospital between January 1, 2014 and December 31, 2018. RESULTS: The study included 778 patients; 62.2% female and mean age 79.83±7.94 years; 957 eyes had exudative AMD. Mean of final VA (0.65±0.45) increasing 3.2% compared to initial values. Ranibizumab was administered to 60.3% of the eyes, aflibercept to 10.2% and ranibizumab + aflibercept (mixed group) to 29.5%. Significant increase in VA was seen in the group with the mixed treatment, with no inter-group differences. Although follow-up/treatment was longer for the mixed group, they received fewer anti-VEGF injections and optical coherence tomography (OCT). The total expenditure per year and treated eye was 1,972.7±824.5; costs were higher for visit, OCT, and treatment in the aflibercept group, and lower for fluorescein angiography, antiVEGF treatment, and total costs in the mixed group. Decimal VA gain had a cost of 872±1,077.7 with no significant inter-group differences. CONCLUSIONS: AntiVEGF treatments (ranibizumab, aflibercept, or both) maintained VA in patients with exudative AMD. Overall, care and treatment costs were lower in the group that received both drugs.
