title: [Neovascular form of age-related macular degeneration --current management in Poland and in Europe].
abstract: Currently in Poland neovascular form of age-related macular degeneration (AMD) is treated with vascular endothelial growth factor (VEGF) inhibitors--ranibizumab, aflibercept and bevacizumab. Photodynamic therapy is still refunded, although it is very rarely used. It can be estimated that only small minority (about 5-10%) of cases are properly treated due to mainly refunding restrictions in Poland. In countries with wider access to treatment 50% reduction in AMD-related blindness incidence was noted. Low-cost off-label anti-VEGF agent bevacizumab is almost inaccessible in Polish public health system because of law regulations. In order to increase availability of anti-VEGF injections vials of all mentioned drugs are divided which raises safety concerns. Despite new potent drug in the market aflibercept, cost of treatment remains very high. The optimal treatment regimen includes three monthly injections, after which is usually used pro re nata therapy based primarily on the outcome of macular optical coherence tomography. Routinely recommended antibiotic prophylaxis of injection-related endophthalmitis probably has no meaning apart from the generation of resistance.
authors.forename: Sławomir
authors.initials: S
authors.lastname: Teper
authors.forename: Anna
authors.initials: A
authors.lastname: Nowińska
authors.forename: Anita
authors.initials: A
authors.lastname: Lyssek-Boroń
authors.forename: Edward
authors.initials: E
authors.lastname: Wylegała
mesh_terms: D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage / Q000191:economics; D000068258:Bevacizumab; D004334:Drug Administration Schedule; D006801:Humans; D008268:Macular Degeneration / Q000188:drug therapy*; D009389:Neovascularization, Pathologic / Q000188:drug therapy* / Q000209:etiology; D010778:Photochemotherapy / Q000191:economics; D011044:Poland; D000069579:Ranibizumab; D040262:Receptors, Vascular Endothelial Growth Factor / Q000008:administration & dosage / Q000191:economics / Q000600:supply & distribution; D011993:Recombinant Fusion Proteins / Q000008:administration & dosage / Q000191:economics / Q000600:supply & distribution; D012052:Reimbursement, Incentive; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D011993:Recombinant Fusion Proteins; D042461:Vascular Endothelial Growth Factor A; C533178:aflibercept; D000068258:Bevacizumab; D040262:Receptors, Vascular Endothelial Growth Factor; D000069579:Ranibizumab