June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Social and clinical characteristics associated with low visual acuity at presentation of AMD
Author Affiliations & Notes
  • Vuong Nguyen
    Save Sight Institute, Sydney, New South Wales, Australia
  • Vincent Daien
    Save Sight Institute, Sydney, New South Wales, Australia
    Inserm, Montpellier, Macao
  • Robyn Guymer
    Centre for Eye Research Australia, Melbourne, Victoria, Australia
  • Ian McAllister
    Lions Eye Institute, Perth, Western Australia, Australia
  • Nigel Morlet
    Department of Population Health, University of Western Australia, Perth, Western Australia, Australia
  • Daniel Barthelmes
    University Hospital Zurich, Zurich, Switzerland
  • Mark C Gillies
    Save Sight Institute, Sydney, New South Wales, Australia
  • Footnotes
    Commercial Relationships   Vuong Nguyen, None; Vincent Daien, Alcon (F), Bayer (F), Novartis (R); Robyn Guymer, Bayer (F), Bayer (S), Novartis (F), Novartis (S); Ian McAllister, Bayer (S), Novartis (S); Nigel Morlet, None; Daniel Barthelmes, Bayer (F), Bayer (R), Novartis (F), Novartis (R); Mark Gillies, Allergan (F), Bayer (F), Bayer (S), Novartis (F), Novartis (S), Opthea (F)
  • Footnotes
    Support  Royal Australian NZ College of Ophthalmologists Eye Foundation (2007-2009); National Health and Medical Research Council, Australia (NHMRC 2010-2012)
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 1524. doi:
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      Vuong Nguyen, Vincent Daien, Robyn Guymer, Ian McAllister, Nigel Morlet, Daniel Barthelmes, Mark C Gillies; Social and clinical characteristics associated with low visual acuity at presentation of AMD. Invest. Ophthalmol. Vis. Sci. 2017;58(8):1524.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To assess the social and clinical characteristics associated with low visual acuity at presentation among a cohort of patients with neovascular age-related macular degeneration (nAMD) that had been treated with vascular endothelial growth factor (VEGF) inhibitors.

Methods : This was a cross-sectional analysis of Australian patients from a prospectively designed observational study. Participants included treatment-naïve patients with nAMD tracked by the Fight Retinal Blindness! outcome registry that commenced anti-VEGF therapy between 1st Jan 2006 to 1st Sept 2016. Demographic and clinical characteristics were recorded at baseline including age, gender, ethnicity, visual acuity, angiolesion size and type. Socio-economic status (SES) was assessed using the Australian Bureau of Statistics socio-economic indexes for areas. The primary outcome was the association between poor VA and social and clinical characteristics.

Results : We identified 3242 treatment-naïve patients from 54 practices being treated for nAMD. Mean (SD) age at first presentation remained constant over time (79.6 [8.6] years; P = 0.608). The mean (SD) VA increased from 2009 onwards, from 50.7 (19.3) to 60.3 (17.4) letters in 2016. Poorer VA at presentation of nAMD was associated with older age (P < 0.001), predominantly classic lesions (P < 0.001), greater lesion size (P < 0.001) and treatment at a public practice (P < 0.001) after multivariable adjustment. Gender, ethnicity and SES were not independently associated with VA at presentation (P = 0.339, P = 0.293 and P = 0.726, respectively).

Conclusions : Poor VA at presentation was associated with older age, predominantly classic lesions, greater lesion size and treatment at a public practice but not gender, ethnicity or SES. Clinical audits into public practices are warranted to determine why patients are presenting with worse visual acuity than private counterparts. Improvements in presenting VA over the past several years provide encouraging signs that patients are better informed. Identifying barriers in accessing treatment for nAMD is a public health issue and epidemiological trends of patient’s characteristics at presentation of nAMD from large observational cohorts are particularly important for driving public health policies.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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