Efficacy of a Disease Management Program of a Tertiary Center and Ophthalmologic Practitioners for the Treatment of Neovascular Age-Related Macular Degeneration

Purpose: The aim of the study was to examine real-world data of patients with neovascular age-related macular degeneration (nAMD) within a disease management program (DMP) treated with anti-VEGF. Methods: A monocentric, retrospective chart review of 379 eyes of a local DMP was conducted at the Department of Ophthalmology, Kepler University Clinic Linz. Eyes were treated either with bevacizumab or aflibercept using a pro re nata scheme, consisting of 3 injections every 4 weeks in case of presence of disease activity. The observational period was up to 24 months. Disease activity was monitored by visual acuity (VA), clinical examination, and optical coherence tomography (OCT). For (re-)treatments, ophthalmologic practitioners referred patients directly to the intravitreal injection, avoiding redundant examinations. Results: VA improved significantly for all patients after 2 months (logMAR 0.47 +/- 0.36; p = 0.000) compared to baseline (0.55 +/- 0.37), and for the aflibercept group for up to 6 months (0.36 +/- 0.27; p = 0.018). After 12 months, VA remained stable without further significant improvement and decreased by 24 months compared to baseline. The median number of injections was 6 over the first 12 months and 4 in the second year. Conclusion: Data revealed the efficacy of a DMP for nAMD involving both ophthalmologic practitioners and a tertiary center. Avoiding redundant examinations increased the efficacy of a clinical setting. (C) 2021 S. Karger AG, Basel