Article
Factors influencing persistence in intensive real life ranibizumab treatment in exudative age-related macular degeneration
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Published: | May 30, 2012 |
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Purpose: To identify problems, burdens, and factors influencing persistence in patients undergoing anti-VEGF therapy under real life conditions.
Methods: Cross sectional study of 96 patients receiving ranibizumab on pro re nata regimen on a tertiary health care clinic. For each visit a detailed examination was performed, included best corrected visual acuity (BCVA) using modified early treatment for diabetic retinopathy study (ETDRS) protocol, slit lamp examination, and spectral-domain optical coherence tomography (SD-OCT). A self administered questionnaire was developed and analyzed.
Results: Fourty two men and 54 women were included. Mean follow up time under anti-VEGF therapy was 604 (63–1008) days. Mean number of follow up visits was 19 (3–30) and of intravitreal injection was 10 (3–23). Nineteen of 96 patients did not attend the final follow up visit. Among these nineteen patients; two of them died, three patients were seriously ill and could not attend the visits, and five patients went to another doctor because of the distance to our hospital. In two cases no further anti-VEGF was given due to fibrosis. Seven patients saw no benefit from the treatments and did not continue the follow-up visits. Overall, there was a high persistence rate with 77 patients out of 96, which was independent from visual acuity course.
Conclusion: In spite of several factors limiting the persistence of patients with anti-VEGF therapy in AMD under intensive real life clinical treatment conditions, for example high visit frequency, distance to hospital, few subjective benefit, there was a high persistence rate.