Original articleDelay to Treatment and Visual Outcomes in Patients Treated With Anti-Vascular Endothelial Growth Factor for Age-Related Macular Degeneration
Section snippets
Study Design and Eligibility
Study patients were recruited consecutively between August 1, 2007 and December 31, 2008 from the Medical Retina Clinic at the Royal Victorian Eye and Ear Hospital and the private rooms of the Vision Retinal Institute Eastern, in Melbourne. All patients were over the age of 50 years and were diagnosed with subfoveal CNV (subfoveal lesions included those juxtafoveal lesions that could not be safely treated with either thermal laser or photodynamic therapy, without involvement of the center of
Population Characteristics
A total of 198 eyes from 192 patients were recruited into the study. Seven eyes of 7 patients failed to complete the follow-up period and were excluded. Of the 6 patients that had bilateral treatment, only the worse-seeing eye at 6 months was analyzed as we were particularly interested in determinants of poor outcomes. A total study population of 185 eyes of 185 patients was therefore analyzed for this study. Of these treated eyes, 75 had either bevacizumab or ranibizumab during the course of
Discussion
This study analyzed the influences upon clinic-based treatment outcomes of patients receiving either bevacizumab or ranibizumab for neovascular AMD. Our analyses found that better baseline vision was more likely to be associated with adverse visual outcomes. This has been documented previously9, 10 and is likely explained by the “ceiling” effect, where it is hard to improve vision where the vision is already good at baseline. We also demonstrated that longer treatment delay from first symptoms
Jonathan Lim, MBBS/BMedSci, is currently a Hospital Medical Officer at The Alfred Hospital, Melbourne, Australia. He received his medical degree from the University of Melbourne, during which he conducted ophthalmological research at the Centre for Eye Research Australia and undertook his medical elective at Moorfields Eye Hospital, London. He has presented research findings at the Royal Australian and New Zealand College of Ophthalmologists Annual Scientific Congress and at the Association for
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2022, Progress in Retinal and Eye ResearchCitation Excerpt :The cost of these invasive therapies is significant with each injection costing up to £1000 in the UK and some patients requiring monthly injections (Raftery et al., 2007). With the healthcare costs of managing patients with neovascular AMD increasing significantly, early diagnosis AMD is crucial in addition to developing robust methods to identify its progression early (Keenan et al., 2020; J. H. Lim et al., 2012). Neovascular AMD is characterised by the presence of intraretinal fluid, subretinal fluid and choroidal neovascularisation.
Jonathan Lim, MBBS/BMedSci, is currently a Hospital Medical Officer at The Alfred Hospital, Melbourne, Australia. He received his medical degree from the University of Melbourne, during which he conducted ophthalmological research at the Centre for Eye Research Australia and undertook his medical elective at Moorfields Eye Hospital, London. He has presented research findings at the Royal Australian and New Zealand College of Ophthalmologists Annual Scientific Congress and at the Association for Research in Vision and Ophthalmology Annual Meeting.
Sanj Wickremasinghe is a consultant in the Medical Retina Unit at the Royal Victorian Eye and Ear Hospital, Melbourne, Australia. He holds a research fellowship at the Macular Research Unit, within the Centre for Eye Research Australia. He completed specialist ophthalmic training at Moorfield's Eye Hospital, London and has fellowship experience both at Moorfields Eye Hospital and the Royal Victorian Eye and Ear Hospital. He is currently involved in research into the predictors of outcome in patients with neovascular AMD following intravitreal anti-VEGF treatment.