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Miranda Buckle, Rachel Healy, Robert Johnston; Prevalence and incidence of blindness and other degrees of visual impairment in patients with neovascular age-related macular degeneration in a well-defined region of the United Kingdom. Invest. Ophthalmol. Vis. Sci. 2014;55(13):6007.
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The aim of this study was to evaluate the prevalence and incidence of blindness and other degrees of visual impairment in patients receiving anti-vascular endothelial growth factor (VEGF) for neovascular age-related macular degeneration (nAMD) in a well-defined region of the United Kingdom (UK).
Serial visual acuity and injection data were extracted from an electronic medical record (EMR) system, used in the context of a paperless nAMD service, for all treatment-naïve patients receiving their first intravitreal injections of ranibizumab for nAMD in the National Health Service (NHS) ophthalmology department serving Gloucestershire between 2008-10, allowing a minimum of 3 years follow up.
Of the 610 patients meeting the inclusion criteria, 143 patients received their first intravitreal treatment in 2008, 248 patients in 2009, and 219 patients in 2010. The prevalence of blindness (visual acuity in the better-seeing eye 25 ETDRS letters or fewer at two consecutive visits) in all patients at the time of first intravitreal injection was 0.5%, increasing to 2.1% after three years. The prevalence of sight impairment (visual acuity in the better-seeing eye between 26 to 39 ETDRS letters at two consecutive visits) in all patients increased from 3.6% at baseline to 6.2% after three years. The prevalence in all patients of vision sufficient to meet the criteria for holding a UK drivers’ licence (best-corrected visual acuity in the better-seeing eye 70 or more ETDRS letters) reduced from 56.9% at baseline to 49.1% after three years. The incidence rate of blindness from nAMD in Gloucestershire was 1.1 persons per 100 000 population in 2011.
The incidence and prevalence of eligibility for certification of blindness or sight impairment in patients treated for nAMD with ranibizumab is low. Real-world population data, as presented in this paper, are needed to evaluate the benefits of expensive new therapies.
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