Outcome of treatment for neovascular age-related macular degeneration by practice-based ophthalmologists compared with a macula clinic.
Graefes Arch Clin Exp Ophthalmol
; 258(7): 1405-1410, 2020 Jul.
Article
em En
| MEDLINE
| ID: mdl-32266472
ABSTRACT
PURPOSE:
The aim of this study was to compare neovascular age-related macular degeneration (nAMD) treatment outcomes between ophthalmological practices and a specialized macula clinic.METHODS:
In this case series, we included 347 treatment-naïve eyes with nAMD (332 patients). All patients received intravitreal anti-VEGF treatment using ranibizumab or aflibercept at the discretion of the treating physician using a treat-and-extend protocol either by one of 28 practice-based ophthalmologists (group 1; n = 215 eyes) or at a macula clinic (group 2; n = 132 eyes) over 24 months.RESULTS:
Baseline characteristics of the patients in the two groups, including age, initial BCVA (group 1 58.2 ± 18.5, group 2 60.8 ± 16.1 ETDRS letters; p = 0.32), and baseline CRT, were comparable. By end of the observation period, both groups presented similar BCVA (group 1 67.4 ± 19.3, group 2 66.8 ± 17.2 letters; p = 0.51), visual gains (group 1 7.8 ± 16.9, group 2 5.8 ± 14.4 letters; p = 0.11), CRT values (group 1 259.6 ± 80.5, group 2 277.4 ± 87.1 µm; p = 0.10), and number of injections (group 1 13.0 ± 4.5, group 2 11.6 ± 4.1 injections; p = 0.09), as well as portion of eyes with stable disease (absence of any intraretinal fluid and absence or stability of subretinal fluid and pigment epithelial detachment group 1 78% (n = 128), group 2 75% (n = 95); p = 0.63). However, there was a significant difference regarding the number of examinations (group 1 12.8 ± 5.0, group 2 9.7 ± 3.1 visits; p = 0.0005).CONCLUSIONS:
nAMD treatment delivered by practice-based ophthalmologists is reasonable regarding functional outcomes and reduces the indirect treatment burden, which is partially outweighed by significantly more clinical examinations in ophthalmological practices.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Proteínas Recombinantes de Fusão
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Receptores de Fatores de Crescimento do Endotélio Vascular
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Degeneração Macular Exsudativa
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Ranibizumab
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Oftalmologistas
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Macula Lutea
Tipo de estudo:
Diagnostic_studies
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Guideline
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Observational_studies
/
Prognostic_studies
Limite:
Aged80
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Female
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Humans
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Male
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article