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

Marion Schroeder,1 Lena Rung,2 Monica Lövestam-Adrian1 1Division of Ophthalmology, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, 2Department of Ophthalmology, Helsingborg Hospital, Helsingborg, Sweden Background: Although ranibizumab has...

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Autores principales:	Schroeder M, Rung L, Lövestam-Adrian M
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2017
Materias:	neovascular AMD anti-VEGF NEI VFQ-25 clinical care Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/fea7eba8d90a4f9680dda563a3d8c9d3
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spelling	oai:doaj.org-article:fea7eba8d90a4f9680dda563a3d8c9d32021-12-02T08:42:10ZNo 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 degeneration1177-5483https://doaj.org/article/fea7eba8d90a4f9680dda563a3d8c9d32017-06-01T00:00:00Zhttps://www.dovepress.com/no-improvement-in-injection-frequency-or-in-visual-outcome-over-time-i-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Marion Schroeder,1 Lena Rung,2 Monica Lövestam-Adrian1 1Division of Ophthalmology, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, 2Department of Ophthalmology, Helsingborg Hospital, Helsingborg, Sweden 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. Keywords: neovascular AMD, anti-VEGF, NEI VFQ-25, clinical careSchroeder MRung LLövestam-Adrian MDove Medical Pressarticleneovascular AMDanti-VEGFNEI VFQ-25clinical careOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 11, Pp 1105-1111 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	neovascular AMD anti-VEGF NEI VFQ-25 clinical care Ophthalmology RE1-994
spellingShingle	neovascular AMD anti-VEGF NEI VFQ-25 clinical care Ophthalmology RE1-994 Schroeder M Rung L Lövestam-Adrian M 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
description	Marion Schroeder,1 Lena Rung,2 Monica Lövestam-Adrian1 1Division of Ophthalmology, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, 2Department of Ophthalmology, Helsingborg Hospital, Helsingborg, Sweden 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. Keywords: neovascular AMD, anti-VEGF, NEI VFQ-25, clinical care
format	article
author	Schroeder M Rung L Lövestam-Adrian M
author_facet	Schroeder M Rung L Lövestam-Adrian M
author_sort	Schroeder M
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
title_short	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
title_full	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
title_fullStr	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
title_full_unstemmed	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
title_sort	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
publisher	Dove Medical Press
publishDate	2017
url	https://doaj.org/article/fea7eba8d90a4f9680dda563a3d8c9d3
work_keys_str_mv	AT schroederm noimprovementininjectionfrequencyorinvisualoutcomeovertimeintwocohortsofpatientsfromthesameswedishcountytreatedforwetagerelatedmaculardegeneration AT rungl noimprovementininjectionfrequencyorinvisualoutcomeovertimeintwocohortsofpatientsfromthesameswedishcountytreatedforwetagerelatedmaculardegeneration AT lovestamadrianm noimprovementininjectionfrequencyorinvisualoutcomeovertimeintwocohortsofpatientsfromthesameswedishcountytreatedforwetagerelatedmaculardegeneration
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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

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