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Yi-Sheng Chang; Comparison of initially on-scheduled versus delayed versus missed ranibizumab treatment in neovascular age-related macular degeneration. Invest. Ophthalmol. Vis. Sci. 2018;59(9):830.
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This study investigated a 30-month outcome of “real-world” use of ranibizumab for neovascular age-related macular degeneration (nAMD) under the Taiwan National Health Insurance (TNHI) coverage.
We reviewed medical records at National Cheng Kung University Hospital, Taiwan, during 2012–2014 for the patients with nAMD, who were pre-approved for ranibizumab treatment covered by TNHI.
A total of 194 eyes (73.5%) in 179 patients (65.5% men; mean ± standard deviation age 69.0 ± 10.5 years) were pre-approved. Among these, Group 1 comprised of 147 eyes (75.8%) with three loading injections completed as scheduled. Group 2 comprised of 27 eyes (13.9%) with initially delayed injections. Group 3 comprised of 20 eyes (10.3%) with missed injections. The main reasons of initially delayed or missed treatment were systemic illness (11 eyes, 23.4%), a stable condition as judged by the clinician (8 eyes, 17.0%), happy with a stable vision (6 eyes, 12.8%), and visiting another hospital (5 eyes, 10.6%). The mean ± SD number of injections over 30 months were 6.3 ± 3.2 in Group 1, 5.4 ± 2.5 in Group 2, and 1.4 ± 1.6 in Group 3. The mean ± SD number of clinics visits over 30 months were 19.4 ± 10.2 in Group 1, 24.0 ± 9.9 in Group 2, and 7.6 ± 5.4 in Group 3. Visual outcome at the 30th month was significantly better in Group 1 and Group 2, compared with Group 3. One patient in Group 3 died of acute myocardial infarction, and three patients (one in each group) suffered from stroke; all were not related to the use of ranibizumab.
In conclusion, ranibizumab is effective and safe for nAMD and maintained the vision. Missed treatment poses poor visual outcome.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
Mean visual acuity (in Landolt C equivalent converted from Log MAR) in 194 eyes (179 patients) over 30 months divided into three groups of initially on-scheduled, initially delayed, and missed treatment.
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