Clinical and social characteristics associated with reduced visual acuity at presentation in Australian patients with neovascular age‐related macular degeneration: a prospective study from a long‐term observational data set. The Fight Retinal Blindness! Project

Nguyen, Vuong; Daïen, Vincent; Guymer, Robyn H.; McAllister, Ian L.; Morlet, Nigel; Barthelmes, Daniel; Gillies, Mark C

doi:10.1111/ceo.13038

Cited by 5 publications

(7 citation statements)

References 31 publications

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“…Additional factors include socio-economic status and resource allocation with deprivation being related to worse ocular health outcomes. 62 , 63…”

Section: Discussionmentioning

confidence: 99%

“…Additional factors include socioeconomic status and resource allocation with deprivation being related to worse ocular health outcomes. 62,63 Choosing the right parameters to judge the quality of a good service is an important consideration. Looking just at mean VA gain could penalize services that have good referral mechanisms in place and start with better baseline VA.…”

Section: Inter-centre and Intra-centre Variation In Visual Outcomesmentioning

confidence: 99%

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<p>Trends in Real-World Neovascular AMD Treatment Outcomes in the UK</p>

Mehta¹,

Kim²,

Mathis³

et al. 2020

OPTH

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Purpose: To report trends in real-world outcomes of anti-vascular endothelial growth factor (anti-VEGF) therapy for neovascular age-related macular degeneration (nAMD) in the United Kingdom (UK) over the last decade. Design: Systematic review. Methods: Medline, PubMed, and Embase databases were searched from 9 April 2010 to 8 April 2020 for publications that met the inclusion criteria: treatment-naïve eyes, UK-only data and ≥1 year of follow-up. ICHOM (International Consortium for Health Outcome Measures) outcomes and study quality were assessed. Visual acuity (VA) trends were assessed in studies with ≥100 eyes at baseline. Results: Twenty-six studies (n=25,761 eyes) were included, meeting 14-17 out of 20 Institute of Health Economics Quality Appraisal of Case Series checklist domains. Only ranibizumab and aflibercept outcome data were available. The mean injection number in the first year of treatment was 5.9 in publications from 2010 to 2015 and 7.1 from 2015 to 2020. Average baseline VA and mean one-year, two-year and three-year VA gains gradually improved over the last decade. Longer-term studies reported that the visual gains achieved in the first year of treatment were rarely maintained, with under-treatment a likely contributing factor. Conclusion: UK real-world outcomes have improved over the last decade with improved service delivery and the adoption of more proactive treatment regimens but are still not always as impressive as registration clinical trial results. Access to longer-acting anti-VEGF therapies would reduce the treatment burden for patients, carers, and the healthcare system, potentially making replication of clinical trial results possible in the NHS.

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“…Additional factors include socio-economic status and resource allocation with deprivation being related to worse ocular health outcomes. 62 , 63…”

Section: Discussionmentioning

confidence: 99%

Section: Inter-centre and Intra-centre Variation In Visual Outcomesmentioning

confidence: 99%

<p>Trends in Real-World Neovascular AMD Treatment Outcomes in the UK</p>

Mehta¹,

Kim²,

Mathis³

et al. 2020

OPTH

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“…Unlike the findings of this study, Acharya et al 4 did not found an association between the SES and baseline VA of the first eye as a binary or continuous variable in 240 patients with nvAMD from the United Kingdom. Similarly, Nguyen et al 12 did not found connection between SES and VA at presentation in Australia. On the other hand, More et al 13 found similar results to the ones described in this study with patients from lower SES having lower VA at presentation.…”

Section: Discussionmentioning

confidence: 88%

“…The analysis was done by considering SES cluster as a continuous variable and also by grouping SES into four categories (category 1 ¼ cluster 1-5, category 2 ¼ cluster 6-10, category 3 ¼ cluster 11-15, category 4 ¼ cluster 16-20). As detailed in the "Results" section, for some of the clinical parameters, analysis was done comparing between the lower cluster (1)(2)(3)(4)(5) and the rest (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20), and by dividing the scale into two parts (1-10 and 11-20).…”

Section: Methodsmentioning

confidence: 99%

Socioeconomic status and visual outcome in patients with neovascular age-related macular degeneration

Levinger

Beykin

Grunin

et al. 2020

European Journal of Ophthalmology

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Purpose Visual outcome in patients with neovascular age-related macular degeneration is variable. We aimed to evaluate for association between socioeconomic status visual acuity in neovascular age-related macular degeneration. Methods A retrospective single-center study of a consecutive group of neovascular age-related macular degeneration patients was performed. Socioeconomic status was determined for each patient based on the 2008 Israeli census. Medical information was extracted from medical records and included visual acuity and optical coherence tomography parameters. Associations between socioeconomic status and clinical outcomes were analyzed. Results A total of 233 patients were included in the analysis. A correlation was found between low baseline visual acuity of the first eye diagnosed with neovascular age-related macular degeneration and low socioeconomic status (r = −0.13, p = 0.049; n = 233). The difference between the visual acuity of the lowest and the highest socioeconomic status categories at baseline was approximately 3 ETDRS lines (p = 0.048). Socioeconomic status and baseline visual acuity of the second eye of the same individual with neovascular age-related macular degeneration were not correlated (r = −0.05, p = 0.95). Socioeconomic status was not associated with the number of anti-vascular endothelial growth factor injections of the first or second eye, or the visual acuity outcome of the first or second eye after 1 year of therapy (p = 0.421, p = 0.9, respectively). Central subfield thickness of the first eye at presentation as measured by spectral-domain optical coherence tomography was associated with socioeconomic status (r = −0.31 p = 0.001). Conclusion Individuals of lower socioeconomic status presented at more advanced stage of the disease when developing neovascular age-related macular degeneration in the first eye but not in the second eye. The research underscores the importance of improving referral patterns and awareness for the lowest socioeconomic status classes.

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“…[1314] Australian studies have shown AMD to be a significant contributor to blindness and visual impairment in Australian population. [15] This in turn demands increased proficiency in retinal diagnosis and treatment. [16] The high prevalence of diabetes in India can translate into a large number of people with DR.…”

Section: Discussionmentioning

confidence: 99%

Ophthalmology residency training in India: Comparing feedback about how the training equips ophthalmologists to combat retinal diseases. READS report #6

Gogate

Biswas²,

Das

et al. 2019

Indian J Ophthalmol

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Purpose:To document whether the residency training in management of retinal diseases has improved in 2000s to meet the increasing demand of retina care in India.Methods:A survey, using a prevalidated questionnaire, was conducted by Academic and Research Committee (ARC) of the All India Ophthalmological Society (AIOS) in 2014–2016 among ophthalmologists to document teaching of retina-related clinical and surgical skills in the postgraduate residency program.Results:The 144-item questionnaire was mailed to 4512 practicing ophthalmologists with residency training in two different periods, between 1967 and 2000 (group 1; 20th-century trained) and between 2003 and 2012 (group 2; 21st-century trained). Response was received from 320 (19.1%) of group 1 ophthalmologists and 531 (18.7%) of group 2 ophthalmologists. The average age was 49.2 ± 8.7 and 32.6 ± 4 years, respectively. Group 2 residents had received superior training in indirect ophthalmoscopy, slit lamp biomicroscopy using + 78 and + 90D lens, optical coherence tomography, fundus photography, and fluorescein angiography (all P < 0.001), but there was large variation between the training institutions. The residents were not taught vitreous and retinal detachment surgeries in either period of training.Conclusion:Teaching of retina-related clinical skills have improved in Indian residency program, but there are variations across programs. This information might help redesign the ophthalmology residency programs to meet the demands of comprehensive eye care and universal health coverage of increasing retinal diseases in India.

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Clinical and social characteristics associated with reduced visual acuity at presentation in Australian patients with neovascular age‐related macular degeneration: a prospective study from a long‐term observational data set. The Fight Retinal Blindness! Project

Cited by 5 publications

References 31 publications

<p>Trends in Real-World Neovascular AMD Treatment Outcomes in the UK</p>

<p>Trends in Real-World Neovascular AMD Treatment Outcomes in the UK</p>

Socioeconomic status and visual outcome in patients with neovascular age-related macular degeneration

Ophthalmology residency training in India: Comparing feedback about how the training equips ophthalmologists to combat retinal diseases. READS report #6

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