title: Estimated cases of blindness and visual impairment from neovascular age-related macular degeneration avoided in Australia by ranibizumab treatment.
abstract: Intravitreal injections of anti-vascular endothelial growth factor agents, such as ranibizumab, have significantly improved the management of neovascular age-related macular degeneration. This study used patient-level simulation modelling to estimate the number of individuals in Australia who would have been likely to avoid legal blindness or visual impairment due to neovascular age-related macular degeneration over a 2-year period as a result of intravitreal ranibizumab injections. The modelling approach used existing data for the incidence of neovascular age-related macular degeneration in Australia and outcomes from ranibizumab trials. Blindness and visual impairment were defined as visual acuity in the better-seeing eye of worse than 6/60 or 6/12, respectively. In 2010, 14,634 individuals in Australia were estimated to develop neovascular age-related macular degeneration who would be eligible for ranibizumab therapy. Without treatment, 2246 individuals would become legally blind over 2 years. Monthly 0.5 mg intravitreal ranibizumab would reduce incident blindness by 72% (95% simulation interval, 70-74%). Ranibizumab given as needed would reduce incident blindness by 68% (64-71%). Without treatment, 4846 individuals would become visually impaired over 2 years; this proportion would be reduced by 37% (34-39%) with monthly intravitreal ranibizumab, and by 28% (23-33%) with ranibizumab given as needed. These data suggest that intravitreal injections of ranibizumab, given either monthly or as needed, can substantially lower the number of cases of blindness and visual impairment over 2 years after the diagnosis of neovascular age-related macular degeneration.
authors: Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Westmead, New South Wales, Australia.
authors: Paul
authors: P
authors: Mitchell
authors: Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States of America.
authors: Neil
authors: N
authors: Bressler
authors: Outcomes Insights, Inc., Westlake Village, California, United States of America.
authors: Quan V
authors: QV
authors: Doan
authors: CMD Consulting, Inc., Sandy, Utah, United States of America.
authors: Chantal
authors: C
authors: Dolan
authors: Novartis, Basel, Switzerland.
authors: Alberto
authors: A
authors: Ferreira
authors: Novartis, Basel, Switzerland.
authors: Aaron
authors: A
authors: Osborne
authors: Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Westmead, New South Wales, Australia.
authors: Elena
authors: E
authors: Rochtchina
authors: Outcomes Insights, Inc., Westlake Village, California, United States of America.
authors: Mark
authors: M
authors: Danese
authors: Genentech, Inc., South San Francisco, California, United States of America.
authors: Shoshana
authors: S
authors: Colman
authors: Singapore Eye Research Institute, National University of Singapore, Singapore, Singapore; Centre for Eye Research Australia, University of Melbourne, Parkville, Victoria, Australia.
authors: Tien Y
authors: TY
authors: Wong
mesh_terms: D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D001315:Australia / Q000453:epidemiology; D001766:Blindness / Q000188:drug therapy* / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D005260:Female; D006801:Humans; D015994:Incidence; D008268:Macular Degeneration / Q000150:complications* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D000069579:Ranibizumab; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000069579:Ranibizumab