UK AMD EMR USERS GROUP REPORT V: benefits of initiating ranibizumab therapy for neovascular AMD in eyes with vision better than 6/12
UK AMD EMR USERS GROUP REPORT V: benefits of initiating ranibizumab therapy for neovascular AMD in eyes with vision better than 6/12
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DOI：
10.1136/bjophthalmol-2014-306229
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发表时间：
2015-08-01
影响因子：
4.1
通讯作者：
Tufail, Adnan
中科院分区：
文献类型：
--
作者：
Lee, Aaron Y.;Lee, Cecilia S.;Tufail, Adnan
背景/目的 研究在英国国家卫生服务中心开始用雷珠单抗治疗新生血管性年龄相关性黄斑变性 (nAMD) 时，视力 (VA) 良好（优于 6/12 或 >70 早期治疗糖尿病视网膜病变研究字母）的眼睛的有效性和临床相关性。目前，VA 优于 (>) 6/12 的眼睛不会常规资助治疗。方法 对分析前 3-5 年接受治疗的患者进行多中心国家 nAMD 数据库研究。匿名结构化数据是从 14 个中心收集的。主要结果是第 1 年、第 2 年和第 3 年的平均 VA。次要指标包括就诊次数和注射次数。结果 该研究包括 11 135 名接受 92 976 次雷珠单抗治疗的患者的 12 951 只未接受治疗的眼睛。共有 754 名患者的基线 VA 优于 6/12，并且进行了至少 1 年的随访。第 1、2、3 年基线 VA>6/12 的首次治疗眼的平均 VA 分别为 6/10、6/12、6/15，基线 VA 6/12 至 >6/24 的眼睛分别为 6/15、6/17、6/20（比较 6/12 和 6/12-6/24 组之间的差异，p 值 < 0.001）。对于基线 VA>6/12 的第二只眼睛，第 1、2、3 年的平均 VA 分别为 6/9、6/9、6/10，基线 VA 6/12 至 >6/24 的眼睛分别为 6/15、6/15、6/27（p 值 < 0.001-0.005）。 VA 优于 6/12 和较差的患者之间的平均就诊或注射次数没有显着差异。结论 基线 VA > 6/12 的所有眼睛在所有时间点都比基线 VA 6/12 至 > 6/24 的眼睛保持更好的平均 VA 至少 2 年。接受良好基线 VA 治疗的患者视力结果明显改善，这对未来有关 nAMD 患者资助治疗标准的政策具有影响。
Background/aims To study the effectiveness and clinical relevance of eyes treated with good (better than 6/12 or >70 Early Treatment Diabetic Retinopathy Study letters) visual acuity (VA) when initiating treatment with ranibizumab for neovascular age-related macular degeneration (nAMD) in the UK National Health Service. Currently eyes with VA better than (>) 6/12 are not routinely funded for therapy.Methods Multicentre national nAMD database study on patients treated 3-5 years prior to the analysis. Anonymised structured data were collected from 14 centres. The primary outcome was the mean VA at year 1, 2 and 3. Secondary measures included the number of clinic visits and injections.Results The study included 12 951 treatment-naive eyes of 11 135 patients receiving 92 976 ranibizumab treatment episodes. A total of 754 patients had baseline VA better than 6/12 and at least 1-year of follow up. Mean VA of first treated eyes with baseline VA>6/12 at year 1, 2, 3 were 6/10, 6/12, 6/15, respectively and those with baseline VA 6/12 to >6/24 were 6/15, 6/17, 6/20, respectively (p values < 0.001 for comparing differences between 6/12 and 6/12-6/24 groups). For the second eyes with baseline VA>6/12, mean VA at year 1, 2, 3 were 6/9, 6/9, 6/10 and those with baseline VA 6/12 to >6/24 were 6/15, 6/15, 6/27, respectively (p values < 0.001-0.005). There was no significant difference in the average number of clinic visits or injections between those with VA better and worse than 6/12.Conclusions All eyes with baseline VA>6/12 maintained better mean VA than the eyes with baseline VA 6/12 to >6/24 at all time points for at least 2 years. The significantly better visual outcome in patients who were treated with good baseline VA has implications on future policy regarding the treatment criteria for nAMD patients' funding.