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Claudio Azzolini, Giuseppe De Crecchio, Simone Donati, Alfredo Pece, Italian-based reality wet AMD project; Wet AMD Project: from Clinical Trials to Clinical Practice. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1407.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the management of wet AMD patients on a usual care, compared to a teleconsultation network care (iRetina).
A usual care survey was organized and a board of 10 expert retinologists managed a series of meetings in different Italian regions involving 66 general or specialized retina ophthalmologists. 72% of the clinicians were based on a public hospital, 93% works on a day hospital structure for the treatment of macular pathologies. The first questionnaire investigated the times for diagnosis and access to treatment, the second the therapeutical approach and the third one the follow up management, in order to evaluate the personal approach of each clinician on his settings.<br /> Results were compared to the iRetina project (presented in part at the ARVO 2012 meeting) where 11 groups of 20 expert retinologists involved 74 general ophthalmologists in different Italian cities, where patients were referred to the retina center via the network.
In the usual care survey, we found different results in various Italian regional realities. Generally, we found that more than 90% patients waited from 15 to 30 days to the definite diagnosis and in 70% of cases they underwent to the treatment within 20 days. More than 70% of the ophthalmologists considered as best approach the pro re nata therapy after the loading phase. More than 90% of the ophthalmologists considered that a non responder patient must be recognized not only on functional but also on morphological parameters and in this cases 80% believed important to re-evaluate a correct diagnosis. At last more than 74% of the ophthalmologists considered important an intensive care on the first period followed by an extension in time of the control visits. A correct follow up appeared to allow the diagnosis of an early recurrence (according to 27% ophthalmologists) and to stabilize the result (10%).<br /> In the iRetina project, the time delay before therapy was significantly shorter (mean 5.5 days) compared with the usual care survey (mean 28 days), as well as the improvement of visual acuity after treatment.
The usual care survey demonstrated different wet AMD management and treatment timing in different Italian regional realities. The iRetina project using telemedicine network allows to send patients to the retinal center quicker and easier when required, accelerating the treatment process and improving the final outcome.<br />
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