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Outcome of anti-vascular endothelial growth factor therapy for neovascular age-related macular degeneration in real-life setting
  1. Maria Kataja1,2,
  2. Pekko Hujanen1,
  3. Heini Huhtala3,
  4. Kai Kaarniranta4,5,
  5. Anja Tuulonen1,
  6. Hannele Uusitalo-Jarvinen1,2
  1. 1 Tays Eye Centre, Tampere University Hospital, Tampere, Finland
  2. 2 Department of Ophthalmology, University of Tampere, Tampere, Finland
  3. 3 School of Health Sciences, University of Tampere, Tampere, Finland
  4. 4 Department of Ophthalmology, University of Eastern Finland, Kuopio, Finland
  5. 5 Department of Ophthalmology, Kuopio University Hospital, Kuopio, Finland
  1. Correspondence to Dr Hannele Uusitalo-Jarvinen, Tays Eye Centre, Tampere University Hospital Tampere, 33521 Tampere, Finland; llhauus{at}uta.fi

Abstract

Aims To evaluate outcome of anti-vascular endothelial growth factor (VEGF) therapy for the treatment of neovascular age-related macular degeneration (nAMD) in the real-life setting and to compare incidence of ocular serious adverse events (SAE) after injections administered by nurses and physicians.

Methods Retrospective, single-centre study. Medical records of patients receiving anti-VEGF treatment for nAMD between 2008 and 2013 with three-loading-dose regimen were evaluated. Outcome measures were baseline visual acuity (VA), change in VA, number of intravitreal injections, incidence of ocular SAE and patients’ baseline characteristics affecting VA change. In addition, the number of injections per 1000 citizens living in the serving area and per individuals over 65 years old were estimated.

Results 1349 eyes in 1117 patients received a total of 11 562 intravitreal anti-VEGF injections. Twenty-one per cent of patients received treatment for both eyes. The mean baseline Snellen VA was 0.32. The mean change of VA from baseline was +2, +2 and ±0 Early Treatment Diabetic Retinopathy Study letters and the mean numbers of injections were 5.7, 4.7 and 4.9 at years 1, 2 and 3, respectively. There was a negative correlation between baseline VA and change of VA. Incidence of endophthalmitis was 0.086%. No difference in the incidence of ocular SAE was identified between injections given by nurses or by physicians. The number of intravitreal injections per all citizens was 9 per 1000 inhabitants and 45 per 1000 inhabitants over 65 years.

Conclusion The VA was maintained at the baseline level (±0 letters) with the mean of 15.3 anti-VEGF injections in real-world clinical practice during 3-year follow-up.

  • degeneration
  • macula
  • neovascularisation
  • treatment medical
  • retina

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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Footnotes

  • Contributors HUJ and AT designed the research. MK and PH performed the data collection. MK, PH, HH, HUJ and KK analysed the data. MK, KK, AT and HUJ wrote the manuscript. MK made the figures. MK, PH, HH, KK, AT and HUJ reviewed the paper.

  • Funding The study was supported by the Competitive Research Funding of the Pirkanmaa Hospital District.

  • Competing interests HUJ: Advisory Board/Consultant (Allergan, Bayer, Novartis); Speaker’s Bureau (Santen).

  • Patient consent Detail has been removed from this case description/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.

  • Ethics approval Pirkanmaa Hospital District Ethical Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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