Die Anti-VEGF-Therapie bei der neovaskulären altersabhängigen Makuladegeneration – therapeutische Strategien

,

doi:10.1007/s00347-014-3222-x

Cited by 23 publications

(5 citation statements)

References 41 publications

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“…All patients in this retrospective, observational cohort study were treated at the Eye Center, University of Freiburg, Germany, according to the treatment recommendations of the German Ophthalmic Society and the German Retina Society (available at http://www.dog.org/?cat=7#9 ). 17 , 18 The study was registered in the German Clinical Trials Register (DRKS) as DRKS00007999. Ethical approval was obtained from the institutional review board of the University of Freiburg, Germany.…”

Section: Methodsmentioning

confidence: 99%

Association of treatment adherence with real-life VA outcomes in AMD, DME, and BRVO patients

Ehlken¹,

Helms²,

Böhringer³

et al. 2017

OPTH

118

128

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PurposeReal-life clinical outcomes of patients treated with anti-VEGF drugs for neovascular age-related macular degeneration (nAMD), diabetic macular edema (DME), or macular edema secondary to branch retinal vein occlusion (BRVO) are often inferior to results from randomized clinical trials. This observational cohort study investigates treatment adherence and real-life clinical outcomes within the first year of treatment.Patients and methodsA total of 708 treatment-naïve patients (466 nAMD, 134 DME, and 108 BRVO) were included. Patients were followed with a PRN treatment protocol with three intravitreal injections (IVIs) and a series of 3 monthly injections in case of persistent or recurrent disease activity, as determined by monthly follow-up exams including optical coherence tomographies. Occurrence of gaps of >56 days between treatments or follow-up (nonadherence [NA]) and the reasons for NA (patient- or center-associated) as well as disease activity within the first 12 months of treatment were analyzed. Visual acuity (VA) as well as numbers and dates of optical coherence tomography and IVI were extracted from medical records.ResultsNA occurred significantly more often in patients with DME (44%) than nAMD (32%) or BRVO (25%, p<0.01 between groups). NA was mainly patient-associated (nAMD: 80.0%, DME: 83.1%, BRVO: 70.4%, p=0.38 between groups). Patients with nAMD and DME and appropriate treatment/follow-up adherence had a better chance of significantly gaining or maintaining VA, respectively (19.9% vs 12.0% with 3-line-gain in nAMD and 1.3% vs 15.3% 3-line loss in DME; each p<0.05). NA did not correlate with VA outcomes in BRVO (3-line gain 30.9% vs 48.1% and 3-line loss 8.6% vs 7.4%; p>0.05).ConclusionNA to treatment and follow-up regimens is a common problem in the management of patients with AMD and DME and limits clinical treatment outcomes under real-life conditions. Patients with DME have the highest risk of patient-associated NA, associated with a higher risk for significant VA loss.

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Section: Methodsmentioning

confidence: 99%

Association of treatment adherence with real-life VA outcomes in AMD, DME, and BRVO patients

Ehlken¹,

Helms²,

Böhringer³

et al. 2017

OPTH

118

128

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“…FA is the gold standard for detection of macular neovascularization (MNV) in neovascular age-related macular degeneration (nAMD) [3]. Because optical coherence tomography (SD-OCT) is a non-invasive examination, it is particularly useful in cases of suspected MNV.…”

Section: Introductionmentioning

confidence: 99%

Morphologic analysis of macular neovascularizations by OCT angiography—Technical limitations in the comparison of 3×3mm and 6×6mm images

et al. 2020

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Background The aim of this study was to ascertain whether there are relevant differences between the vascular morphology of macular neovascularizations (MNV) in 3×3mm and 6×6mm images, produced by optical coherence tomography angiography (OCTA). Methods MNV of 49 patients were automated quantitative analysed, measuring area, flow, the fractal dimension, average vessel length, vascular density, and average vessel caliber. These parameters were compared between the 3×3mm and the 6×6mm images. Results A strong linear association was found between the 3×3mm and the 6×6mm images. While area, flow, and FD of the MNV were very similar, the 3×3mm images showed significantly lower average total vessel length, greater vascular density, and lower average vessel caliber. Conclusion In quantitative analysis of the morphologic parameters of MNV in 3×3mm and 6×6mm images, the structures are not directly equivalent in the two sizes of scan. The images must be evaluated on an individual basis.

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“…In all diseases where regular OCT monitoring is necessary, this comes with high disease burden for the patients. For AMD, most guidelines propose monthly monitoring even when no disease activity has been present for longer periods of time [ 4 , 18 ]. These frequent monitoring visits significantly stress out patients and lead to low therapy adherence [ 10 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

Self-examination low-cost full-field OCT (SELFF-OCT) for patients with various macular diseases

Burchard

Moltmann

Tode

et al. 2020

Graefes Arch Clin Exp Ophthalmol

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Purpose The treatment guidelines for many macular diseases rely on frequent monitoring with optical coherence tomography (OCT). However, the burden of frequent disease control leads to low therapy adherence in real life. OCT home monitoring would address this issue but requires an inexpensive and self-operable device. With self-examination low-cost full-field OCT (SELFF-OCT), our group has introduced a novel technology that may fulfill both requirements. In this pilot study, we report the initial experiences with a clinical prototype. Methods Fifty-one patients with different macular diseases were recruited in a cross-sectional study. The most common diseases were age-related macular degeneration (AMD; 39/51), diabetic macular edema (DME; 6/51), and retinal vein occlusion (RVO; 3/51). Patients received a short training in device usage and then performed multiple self-scans with the SELFF-OCT device. For comparison, scans with a standard clinical spectral domain (SD-)OCT were taken. Results After a brief training, 77% of the patients were able to successfully acquire images that were clinically gradable. No significant influence on success could be found for age (p = 0.08) or BCVA (p = 0.97). Relevant disease biomarkers in the most common retinal diseases could be detected. Conclusions SELFF-OCT was used successfully for retinal self-examination and in the future could be used for retinal home monitoring. Future improvements in technology are expected to improve success rates and image quality. Trial registration The Trial was registered in the German Trial Register under the number DRKS00013755 on 14.03.2018.

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Die Anti-VEGF-Therapie bei der neovaskulären altersabhängigen Makuladegeneration – therapeutische Strategien

Cited by 23 publications

References 41 publications

Association of treatment adherence with real-life VA outcomes in AMD, DME, and BRVO patients

Association of treatment adherence with real-life VA outcomes in AMD, DME, and BRVO patients

Morphologic analysis of macular neovascularizations by OCT angiography—Technical limitations in the comparison of 3×3mm and 6×6mm images

Self-examination low-cost full-field OCT (SELFF-OCT) for patients with various macular diseases

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