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Key drivers of visual acuity gains in neovascular age-related macular degeneration in real life: findings from the AURA study
BACKGROUND/AIMS: To identify predictive markers for the outcomes of anti-vascular endothelial growth factor therapy for neovascular age-related macular degeneration (nAMD). METHODS: AURA was a retrospective, observational, multicentre study that monitored the 2-year outcomes following intravitreal r...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5256408/ https://www.ncbi.nlm.nih.gov/pubmed/27030279 http://dx.doi.org/10.1136/bjophthalmol-2015-308166 |
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author | Holz, Frank G Tadayoni, Ramin Beatty, Stephen Berger, Alan Cereda, Matteo Giuseppe Hykin, Philip Staurenghi, Giovanni Wittrup-Jensen, Kim Altemark, Andreas Nilsson, Jonas Kim, Kun Sivaprasad, Sobha |
author_facet | Holz, Frank G Tadayoni, Ramin Beatty, Stephen Berger, Alan Cereda, Matteo Giuseppe Hykin, Philip Staurenghi, Giovanni Wittrup-Jensen, Kim Altemark, Andreas Nilsson, Jonas Kim, Kun Sivaprasad, Sobha |
author_sort | Holz, Frank G |
collection | PubMed |
description | BACKGROUND/AIMS: To identify predictive markers for the outcomes of anti-vascular endothelial growth factor therapy for neovascular age-related macular degeneration (nAMD). METHODS: AURA was a retrospective, observational, multicentre study that monitored the 2-year outcomes following intravitreal ranibizumab treatment in patients with nAMD. Using stepwise regression analysis, we evaluated the association between visual acuity outcomes, baseline characteristics and resource utilisation in order to determine which variables are significantly linked to outcomes in AURA. We also examined the relationship between visual acuity outcomes and number of injections received. RESULTS: Analyses were performed using data from year 1 (n=1695) and year 2 completers (n=1184). Logistic analysis showed that baseline visual acuity score, age at start of therapy, number of ophthalmoscopies and optical coherence tomography (OCT) (combined) and number of injections (ranibizumab) were significant (p<0.05) prognostic factors for vision maintenance (loss <15 letters) or vision gain (≥15 letters). Patients who received >7 injections (in 1 year) or >14 injections (over 2 years) gained more letters and demonstrated greater vision maintenance (loss of <15 letters) than patients who received fewer injections. There was a significant (p<0.05) association between number of injections and national reimbursement schemes and OCT. CONCLUSIONS: A number of factors that are predictive of treatment outcomes in a real-life setting were identified. Notably, the decline of treatment benefits may be linked to number of injections and a failure to visit clinicians and receive OCT as required. These findings may be helpful in guiding ophthalmologist treatment decisions under limited time and financial constraints. TRIAL REGISTRATION NUMBER: NCT01447043. |
format | Online Article Text |
id | pubmed-5256408 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-52564082017-01-25 Key drivers of visual acuity gains in neovascular age-related macular degeneration in real life: findings from the AURA study Holz, Frank G Tadayoni, Ramin Beatty, Stephen Berger, Alan Cereda, Matteo Giuseppe Hykin, Philip Staurenghi, Giovanni Wittrup-Jensen, Kim Altemark, Andreas Nilsson, Jonas Kim, Kun Sivaprasad, Sobha Br J Ophthalmol Clinical Science BACKGROUND/AIMS: To identify predictive markers for the outcomes of anti-vascular endothelial growth factor therapy for neovascular age-related macular degeneration (nAMD). METHODS: AURA was a retrospective, observational, multicentre study that monitored the 2-year outcomes following intravitreal ranibizumab treatment in patients with nAMD. Using stepwise regression analysis, we evaluated the association between visual acuity outcomes, baseline characteristics and resource utilisation in order to determine which variables are significantly linked to outcomes in AURA. We also examined the relationship between visual acuity outcomes and number of injections received. RESULTS: Analyses were performed using data from year 1 (n=1695) and year 2 completers (n=1184). Logistic analysis showed that baseline visual acuity score, age at start of therapy, number of ophthalmoscopies and optical coherence tomography (OCT) (combined) and number of injections (ranibizumab) were significant (p<0.05) prognostic factors for vision maintenance (loss <15 letters) or vision gain (≥15 letters). Patients who received >7 injections (in 1 year) or >14 injections (over 2 years) gained more letters and demonstrated greater vision maintenance (loss of <15 letters) than patients who received fewer injections. There was a significant (p<0.05) association between number of injections and national reimbursement schemes and OCT. CONCLUSIONS: A number of factors that are predictive of treatment outcomes in a real-life setting were identified. Notably, the decline of treatment benefits may be linked to number of injections and a failure to visit clinicians and receive OCT as required. These findings may be helpful in guiding ophthalmologist treatment decisions under limited time and financial constraints. TRIAL REGISTRATION NUMBER: NCT01447043. BMJ Publishing Group 2016-12 2016-03-30 /pmc/articles/PMC5256408/ /pubmed/27030279 http://dx.doi.org/10.1136/bjophthalmol-2015-308166 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ |
spellingShingle | Clinical Science Holz, Frank G Tadayoni, Ramin Beatty, Stephen Berger, Alan Cereda, Matteo Giuseppe Hykin, Philip Staurenghi, Giovanni Wittrup-Jensen, Kim Altemark, Andreas Nilsson, Jonas Kim, Kun Sivaprasad, Sobha Key drivers of visual acuity gains in neovascular age-related macular degeneration in real life: findings from the AURA study |
title | Key drivers of visual acuity gains in neovascular age-related macular degeneration in real life: findings from the AURA study |
title_full | Key drivers of visual acuity gains in neovascular age-related macular degeneration in real life: findings from the AURA study |
title_fullStr | Key drivers of visual acuity gains in neovascular age-related macular degeneration in real life: findings from the AURA study |
title_full_unstemmed | Key drivers of visual acuity gains in neovascular age-related macular degeneration in real life: findings from the AURA study |
title_short | Key drivers of visual acuity gains in neovascular age-related macular degeneration in real life: findings from the AURA study |
title_sort | key drivers of visual acuity gains in neovascular age-related macular degeneration in real life: findings from the aura study |
topic | Clinical Science |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5256408/ https://www.ncbi.nlm.nih.gov/pubmed/27030279 http://dx.doi.org/10.1136/bjophthalmol-2015-308166 |
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