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D. Barthelmes, M. Menghini, F. K. P. Sutter, M. M. Kurz-Levin, J. C. Fleischhauer, M. C. Gillies; Ranibizumab for Exudative Age Related Macular Degeneration - A Comparison of Treatment Results in Centres from Australia and Switzerland. Invest. Ophthalmol. Vis. Sci. 2010;51(13):98.
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To report and compare visual acuity (VA) results of the use of ranibizumab treatment for exudative age-related macular degeneration (exAMD) over 24 months in two tertiary centers in Australia (AU) and Switzerland (CH), where the health care systems differ in such respects as refunding for treatment and access to retinal specialists.
Retrospective analysis of all patients matching the MARINA and ANCHOR criteria regarding age and VA treated for exAMD for 24 months. Comparison of demographic baseline data included VA at baseline and during follow-up, number of injections, number of visits as well as outcomes in the highest (HQ) vs lowest (LQ) quartiles with respect to VA. No fixed treatment regimen was applied, the decision on the administration of ranibizumab as well as the follow-up regimen was up to the treating physician.
132 (AU) and 382 (CH) eyes were included. Female to male ratio was approximately 2:1 in both countries. Age was 79.3±8.6 and 79.9±7.3 (mean±SD) in AU and CH, repsectively. VA at baseline was 53.9±13.8 (AU) and 52.9±12.8 (CH) letters. In all eyes, changes compared to baseline after 12 months were 3.0±11.3 (AU) and 2.4±13.3 (CH) letters; after 24 months 3.3±11.3 (AU) and 0±15.8 (CH) letters. Eyes in the HQ in AU gained 15.4±7.5 and 12.5±6.9 letters at 12 and 24 months while eyes in CH gained 17.0±6.8 and 13.8±10.0 letters after 12 and 24 months, respectively. Compared to baseline, eyes in LQ in AU changed -11.3±5.4 and -7.0±6.9 after 12 and 24 months, while treated eyes in CH changed by -15.8±11.1 and -16.1±10.6 letters. Eyes in the LQ group from CH did significantly worse than those from AU (P = 0.008). Otherwise, no statistically significant differences regarding baseline data, follow up VA, treatment frequency were found.
Although AU and CH have different health care systems, treatment results are surprisingly similar and physicians seem to take similar decisions with respect to treatment and follow-up schemes. The worse outcome in LQ eyes from CH warrants further evaluation.
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