Delay between medical indication to anti-VEGF treatment in age-related macular degeneration can result in a loss of visual acuity
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Philipp Sebastian Muether & Manuel M. Hermann & Konrad Koch & Sascha Fauser
- چاپ و سال / کشور: 2010
Description
Background Complicated approval procedures and limited short-term surgical capacities can result in time delays between the definition of a medical indication for ranibizumab treatment in active neovascular age-related macular degeneration (AMD) and the starting of treatment. This study aimed to evaluate changes in visual acuity and central retinal thickness over time, and their consequences for the patients concerned. Methods Sixty-nine patients indicated for first-time ranibizumab treatment and 21 patients with necessary retreatment were included in the study. Visual acuity and spectral domain optical coherence tomography (SD-OCT) central retinal thickness at the time of the indication examination were compared to values at the first-time treatment and during recurrent ranibizumab treatment. Results For first-time treatment, the delay between indication and treatment was significantly higher for patients with vision loss compared to those without vision loss (31.6 ± 20.5 vs. 24.0 ± 8.3 days, p=0.012). The increase in OCT central retinal thickness was 50.4 ± 92.8 ىm for patients with vision loss compared to 5.1 ± 63.4 ىm for those without vision loss, p=0.029. A 1.1 logMAR line difference in vision loss was significant at p=0.01 for patients with a delay in treatment of less than or equal to 28 days (48/69 patients, 69.7%) compared to those with a delay of more than 28 days (21/69 patients, 30.3%). Conclusions Even though average visual decay was slow at about one logMAR line over 110 days, individual patients (8.7%) experienced rapid loss of one or more lines within 21 days. Administrative procedures should therefore be expedited so that delays do not exceed 2 weeks for the sake of vision preservation in individual patients.
Graefes Arch Clin Exp Ophthalmol (2011) 249:633–637 DOI 10.1007/s00417-010-1520-9 Received: 10 May 2010 / Revised: 2 August 2010 / Accepted: 5 September 2010 / Published online: 24 September 2010
