Time between Symptom Onset and Assessment in Age-Related Macular Degeneration with Subfoveal Choroidal Neovascularization

Abstract

Background: Therapy delay in neovascular age-related macular degeneration (NV-AMD) is associated with risk of visual deterioration. Methods: Retrospective cross section analysis including patients with NV-AMD who received fluorescein angiography (FA). The time elapsed from symptom onset to assessment was analysed in relation to different factors. Inclusion criteria were: age >50 years, symptom onset within 6 months before assessment, no previous AMD therapy, indication for vascular endothelial growth factor inhibitor treatment. Results: Mean duration of symptoms was 2.272 ± 1.683 months (n = 220); percentiles 25, 50, 75 and 90 corresponded to 1, 2, 3 and 5.383 months. A significant increase (p = 0.033) in mean symptom duration was found between age groups 65–74, 75–84 and over 84 years. Privately insured persons (assessment 1.242 ± 1.060 months after symptom onset; n = 14) received FA 1.083 months earlier (p = 0.0089) than patients with a statutory health insurance (assessment 2.325 ± 1.661 months after symptom onset; n = 194). Conclusion: In order to avoid progressive visual deterioration in patients with NV-AMD earlier assessment of these individuals should be aimed for.

Treatment patterns, visual acuity and quality-of-life outcomes of the WAVE study - A noninterventional study of ranibizumab treatment for neovascular age-related macular degeneration in Germany

“…2011). There are several reasons for this, amongst which a worse visual acuity and higher age at baseline as well as a considerable delay to treatment in routine clinical settings seem to be the most important (Schalnus et al. 2010; Mariani et al.…”

“…Clinician-determined retreatment after an upload phase appears to be less effective in improving BCVA compared with randomized controlled trials (Kumar et al 2011). There are several reasons for this, amongst which a worse visual acuity and higher age at baseline as well as a considerable delay to treatment in routine clinical settings seem to be the most important (Schalnus et al 2010; Mariani et al 2011). Available evidence points towards baseline BCVA predicting treatment outcomes with poor baseline visual acuity determining poor treatment outcomes (Shona et al 2011).…”

Visual function quality of life measure changes upon conversion to neovascular age-related macular degeneration in second eyes

“…Deferral of therapy after onset of CNV has a negative effect on visual acuity outcome [12–14] because untreated CNV continues to grow at a mean growth rate of 10–18 μm per day [15,16]. One study showed that a delay in treatment of more than 28 days compared with 28 days or less resulted in a statistically significant greater percent of patients with at least 1 line loss of vision (p = 0.01) [17].…”

Delay to Treatment and Visual Outcomes in Patients Treated With Anti-Vascular Endothelial Growth Factor for Age-Related Macular Degeneration

“…Despite this, a number of attempts have been made to document this period retrospectively. 11,12 Retrospective evaluation can be difficult, however, since the onset of symptoms often cannot readily be determined without detailed specific questioning of the patient by a trained clinician. Additionally, the timing of symptom awareness is likely to differ, depending on the visual acuity in the other eye.…”