Medical practices overview in wAMD in France

Abstract

Purpose: wAMD is a chronic disease mediated by intravitreal injections of the anti-vascular endothelial growth factor (VEGF) that primarily affects an older population (50 y.o and over). If a consensus exists in the induction phase of 3 injections of anti-VEGF, there is a gap for diagnostic and disease management among ophtalmologists to face healthcare organization. The objective of the research was to confirm this hypothesis and better understand practices.

Methods: Ipsos carried out a qualitative survey among 16 retinal specialists and 9 ophthalmologists from September 18th to October 22nd 2013. 15 telephone interviews and 4 face to face duos with 1 retinal specialist and 1 ophthalmologist were carried out. This qualitative survey allowed building a quantitative survey with 200 retinal specialists and ophthalmologists to assess practices in wAMD from screening to follow up. Qualitative survey highlighted practices to be explored in quantitative survey. Our hypothesis was that the different practices were less correlated to patient profiles than ophthalmologists’ profiles in terms of attitudes towards injections and OCT. Those practices were quantified and analysed throughout a national representative survey among ophthalmologists in France.

Results: Physicians’ roles in patient pathway were split between the ophthalmologist who diagnoses the wAMD and the retinal specialist who treats it. At the acute induction stage: treatment schedule was a routine with 3 monthly anti-VEGF injections. Retinal specialists unanimously emphasized the induction phase. Follow up practices were more inhomogeneous. Influencing factors on patients addressing, injection planning and overall organization were key points identified.

Conclusions: Anti-VEGF is the mainstay treatment in wAMD. The initial phase is a 3 monthly injections routine. This suvey aimed to analyse the differences still persisting in management before and after this initial treatment

Keywords: 688 retina • 465 clinical (human) or epidemiologic studies: systems/equipment/techniques