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Hassiba Oubraham Mebroukine, Salomon Cohen, Gerard Mimoun, Eric Souied, Stéphane Quéré, Véronique Schneider, TWIN study group; TWIN : Evolution of visual acuity in patients with wet AMD diagnosed since 2010 and treated with ranibizumab, in current practice - Comparison with LUMIERE study. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3821.
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A previous retrospective study (LUMIERE ) performed with 551 patients diagnosed and treated between 2007 and 2009 has suggested infrequent monitoring explaining why the visual function results were lower. The TWIN study was performed in the same centers to describe the evolution of visual acuity (VA) in patients with wet age-related macular degeneration (wAMD) diagnosed and treated since 2010.
Retrospective observational study sponsored by Novartis. 21 sites (included 13 of the 16 involved in LUMIERE) included 906 eyes of consecutive patients with wAMD diagnosed and treated since 2010 (from 01-2010 to 11-2011).
In the TWIN study at baseline, most patients were female (67.7%), their mean age was 79.3 ± 7.8 years and their VA 56.8 ± 18.0 letters. The lesion was mostly occult (61.3%). The time from diagnosis to treatment improved from 12.6 ± 26.4 days to 7.7 ± 10.9 days. More patients received an induction phase with the first 3 injections every 4-5 weeks (56.6% vs 39.6% ). No patient had a strict monthly monitoring over 12 months (visits every 30 days +/- 7 days) but about the same proportion of patients underwent "regular" monitoring visits every 37 days +/- 14 days (6.5% vs 4.4%). The average visits number was lower (7.4 ± 2.0 vs 8.6 ± 2.0 ) for a greater average of injections (5.6 ± 2.3 vs 5.1 ± 2.1 injections ). At 12 months, the VA gain was similar (4.3 ± 15.4 vs. 3.2 ± 14.8 letters), but a greater proportion of patients presented a gain greater than 5 letters (43.7% vs 37.0% ) or between 0 and 15 letters (40.2 % vs 33.4% ).
The results suggest that compared to 2007-2009 (LUMIERE), physicians in the TWIN study achieve more VA gainers by waiting less before first treatment and by complying more to the loading doses while monitoring less but giving more injections.
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