title: Multi-country real-life experience of anti-vascular endothelial growth factor therapy for wet age-related macular degeneration.
abstract: OBJECTIVE
  Real-life anti-vascular endothelial growth factor (VEGF) therapy use in patients with wet age-related macular degeneration (wAMD) was assessed in a retrospective, observational study in Canada, France, Germany, Ireland, Italy, the Netherlands, UK and Venezuela.
  
  
  METHODS
  Medical records of patients with wAMD, who started ranibizumab treatment between 1 January 2009 and 31 August 2009, were evaluated. Data were collected until the end of treatment and/or monitoring or until 31 August 2011.
  
  
  RESULTS
  2227 patients who received ≥1 anti-VEGF injection with a baseline visual acuity assessment and ≥1 postbaseline visual acuity assessment for the treated eye were evaluated. Visual acuity improved until about day 120; thereafter, visual acuity gains were not maintained. Mean change in visual acuity score from baseline to years 1 and 2 was +2.4 and +0.6 letters, respectively. Patients received a mean of 5.0 and 2.2 injections in the first and second year, respectively. There were substantial differences in visual outcomes and injection frequency between countries. More frequent visits and injections were associated with greater improvements in visual acuity.
  
  
  CONCLUSIONS
  In clinical practice, fewer injections are administered than in clinical trials. Anti-VEGF treatment resulted in an initial improvement in visual acuity; however, this was not maintained over time.
  
  
  BACKGROUND
  NCT01447043.
authors.affiliation: Department of Ophthalmology, University of Bonn, Bonn, Germany.
authors.forename: Frank G
authors.initials: FG
authors.lastname: Holz
authors.affiliation: Department of Ophthalmology, Hôpital Lariboisière, AP-HP, Université Paris 7-Sorbonne Paris Cité, France.
authors.forename: Ramin
authors.initials: R
authors.lastname: Tadayoni
authors.affiliation: Department of Ophthalmology, Institute of Eye Surgery, Waterford, Ireland.
authors.forename: Stephen
authors.initials: S
authors.lastname: Beatty
authors.affiliation: Department of Ophthalmology and Vision Sciences, University of Toronto, and St Michael's Hospital, Toronto, Canada.
authors.forename: Alan
authors.initials: A
authors.lastname: Berger
authors.affiliation: Department of Biomedical and Clinical Science Luigi Sacco, Luigi Sacco Hospital, University of Milan, Milan, Italy.
authors.forename: Matteo G
authors.initials: MG
authors.lastname: Cereda
authors.affiliation: Centro de Cirugia Oftalmologica, Caracas, Venezuela.
authors.forename: Rafael
authors.initials: R
authors.lastname: Cortez
authors.affiliation: Department of Ophthalmology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
authors.forename: Carel B
authors.initials: CB
authors.lastname: Hoyng
authors.affiliation: NIHR Biomedical Centre for Research in Ophthalmology, Moorfields Eye Hospital, London, UK.
authors.forename: Philip
authors.initials: P
authors.lastname: Hykin
authors.affiliation: Department of Biomedical and Clinical Science Luigi Sacco, Luigi Sacco Hospital, University of Milan, Milan, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Staurenghi
authors.affiliation: Bayer HealthCare Pharmaceuticals, Berlin, Germany.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Heldner
authors.affiliation: Bayer HealthCare Pharmaceuticals, Montville, New Jersey, USA.
authors.forename: Timon
authors.initials: T
authors.lastname: Bogumil
authors.affiliation: Bayer HealthCare Pharmaceuticals, Montville, New Jersey, USA.
authors.forename: Theresa
authors.initials: T
authors.lastname: Heah
authors.affiliation: NIHR Biomedical Centre for Research in Ophthalmology, Moorfields Eye Hospital, London, UK King's College Hospital, London, UK.
authors.forename: Sobha
authors.initials: S
authors.lastname: Sivaprasad
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D002170:Canada; D005060:Europe; D005260:Female; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D000069579:Ranibizumab; D019233:Retreatment; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014687:Venezuela; D014792:Visual Acuity / Q000502:physiology; D057135:Wet Macular Degeneration / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000069579:Ranibizumab
keywords: Degeneration; Macula; Treatment Medical