June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Seven years treatment outcome of neovascular age-related macula degeneration. Data from the Swedish Macula Register.
Author Affiliations & Notes
  • Inger Westborg
    Clinical Science/ Ophthalmology, Umeå University, Boden, Sweden
  • Elisabet Granstam
    Center for Clinical Research, Uppsala University, Uppsala, Sweden
  • Susanne Albrecht
    Register Center South , Karlskrona, Sweden
  • Aldana Rosso
    Department of Radiology, Institution of Translational Medicine, Lund University, Lund, Sweden
  • Niklas Karlsson
    Ophthalmology, Örebro University Hospital, Örebro, Sweden
  • Monica Lövestam-Adrian
    Department of Ophthalmology, Lund University, Lund, Sweden
  • Footnotes
    Commercial Relationships   Inger Westborg, None; Elisabet Granstam, Allergan (R), Bayer (C), Novartis (R); Susanne Albrecht, Bayer (R); Aldana Rosso, None; Niklas Karlsson, Norvartis (R); Monica Lövestam-Adrian, Allergan (R), Bayer (C), Novartis (R)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 1527. doi:
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      Inger Westborg, Elisabet Granstam, Susanne Albrecht, Aldana Rosso, Niklas Karlsson, Monica Lövestam-Adrian; Seven years treatment outcome of neovascular age-related macula degeneration. Data from the Swedish Macula Register.. Invest. Ophthalmol. Vis. Sci. 2017;58(8):1527.

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

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Abstract

Purpose : Real world data from the Swedish Macula Register regarding treatment of neovascular AMD in clinical practice from 2008 -2014.

Methods : Retrospective register-based study. Baseline demographics, visual outcome and the number of injections during this period were evaluated.

Results : Mean age at diagnosis was 79± SD=8 years, 65% women. The proportion of patients with less than 2 months’ duration of symptoms increased from 26% in 2008 to 40% in 2014 (p < 0.001).
Mean visual acuity (VA) at baseline increased from 54.4 ± 15.1 letters in 2008 to 57.9 ±15.8 letters in 2014 (p<0.001).
Mean VA after one year of treatment was 57.8±17.7 ETDRS letters for patients who started the treatment in 2008 and 62.8 ±16.4 ETDRS letters in patients starting treatment in 2014 (p<0.001). The proportion of patients with an improvement in VA between 5 and 15 letters was around 30% whereas 14% had VA improvement of more than 15 letters for all separate years. The mean number of injections during the first treatment year increased from 4.3 ±1.9 in 2008 to 5.9 ±2.9 injections in 2014 (p<0.001 ).
Seven years follow up of 346 patients showed a mean change of -1 letters from baseline with a mean number of 20 injections.

Conclusions : The present study is a summary of how patients with neovascular AMD were treated in Sweden during 2008-2014, including results for patients followed regularly for seven years. The number of patients who seek care with short-term duration of symptoms increased, and that VA at baseline and also after 1 year of treatment improved over the years, while the mean VA improvement the first year remained stable over the years.
Furthermore, the number of registered injections also increased. However, there is still a large difference between the amount of injections given in standard health care and the treatment recommended by the pivotal trials with ranibizumab and aflibercept. Long-term follow-up demonstrated stable VA. Therefore, further studies about the optimal treatment frequency in clinical practice are needed. Additional analyses are ongoing from the SMR regarding long-term outcomes of anti-VEGF-treatment for wet AMD in clinical practice in Sweden.

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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