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Adnan Tufail, AMD National EMR Study Group; United Kingdom Neovascular AMD Database study:outcomes of over 92,000 intravitreal ranibizumab injections. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3825.
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To evaluate the potential use of Electronic Medical Records (EMR) for rapid and high quality data capture. To study ranibizumab therapy for neovascular AMD (nAMD) in terms of baseline demographics, complications and visual outcome in a very large cohort of patients
Participating centres prospectively collected clinical data using a EMR system, with automatic extraction of anonymized data to a database. Up to 5 years of data were collected from each centre. Centres using EMR systems that collected a minimum standard data set for eyes receiving ranibizumab therapy for nAMD including preoperative, visual acuity (ETDRS), operative and postoperative data set, were invited to submit data, which were remotely extracted, anonymised, assessed for conformity and completeness, and analysed
A total of 92,976 ranibizumab treatment episodes from 12952 treated eyes associated with over 300000 clinic visits were collated from treatment naive eyes within a month of starting the study. Mean age at first treatment was 79.1 (SD 8.4) with a female preponderance 1.7:1. Visual acuity changes were as follows For eyes followed for at least 3 years the mean visual change from baseline acuity of 0.58 (LogMAR) visual acuity changes were +4 letters at peak gain timepoint, +2 at 12 months, +1 letter at month 24 and them 0 at month 30. The proportion of eyes that avoided moderate vision loss (15 letters) were 90% by year 1, 84% year 2 and 82% at year 3. The proportion of eyes with visual acuity of 20/40 or better were 16% at baseline ,30% by month year 1, .30% year 2. and 29% year 3. The median number of treatments given were 5 in year one 4 in year 3 and 4 in year 3. . The number of outpatient visit were in year 1 to 3 are 9.2, 8.2, and 8.2 respectively.
EMR has the potential to collate very large volumes of high quality data rapidly. This study provides pooled, anonymized data on the demographics, and visual outcome and treatment and follow up burden of ranibizumab treatment for nAMD. This may enable retina specialist centres to benchmark their outcomes, and facilitate cost-benefit analyses.
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