title: Reduced occurrence of severe visual impairment after introduction of anti-Vascular Endothelial Growth Factor in wet age-related macular degeneration - a population- and register-based study from northern Sweden.
abstract: OBJECTIVE
  To study the occurrence of severe visual impairment (SVI) and treatment outcome at 12 months in patients treated for wet age-related macular degeneration (AMD) by use of data from the Swedish Macula Register (SMR) and referrals to the regional low vision clinics in five northern counties.
  
  
  METHODS
  Referrals to low vision clinics during 2005, 2009 and 2013 and treatment outcome at 12 months from the SMR database from 2008 until 2013 in patients >65 years of age in five northern counties were included in the survey.
  
  
  RESULTS
  The rate of referral due to AMD was significantly reduced during the time period (-48%; p < 0.001). At 12 months, a significant slight mean improvement in logMAR visual acuity (VA) was observed (-0.01, SD 0.37; p < 0.001) after a mean of 5.0 ± 2.3 anti-vascular endothelial growth factor (VEGF)-injections were administered. Age and low baseline VA was associated with less favourable visual outcome (p < 0.001).
  
  
  CONCLUSIONS
  Referral rate to low vision clinic is a valuable tool for estimating occurrence of SVI and fell between the years 2005 until 2013. Data from the SMR showed improvement in visual acuity on the whole, but also identified patients at high risk for developing SVI during anti-VEGF-treatment.
authors.affiliation: Center for Clinical Research, Uppsala University/County Council of Västmanland, Västerås, Sweden. elisabet.granstam@ltv.se.
authors.forename: Elisabet
authors.initials: E
authors.lastname: Granstam
authors.affiliation: Department of Clinical Science/Ophthalmology, Umeå University, Umeå, Sweden.
authors.forename: Inger
authors.initials: I
authors.lastname: Westborg
authors.affiliation: Department of Ophthalmology, Östersund County Hospital, Östersund, Sweden.
authors.forename: Anna
authors.initials: A
authors.lastname: Barkander
authors.affiliation: Department of Ophthalmology, Skellefteå County Hospital, Skellefteå, Sweden.
authors.forename: Malin
authors.initials: M
authors.lastname: Börjesson
authors.affiliation: Department of Ophthalmology, Umeå University Hospital, Umeå, Sweden.
authors.forename: Sara
authors.initials: S
authors.lastname: Lindahl
authors.affiliation: Department of Ophthalmology, Gävleborg County Hospital/Gävle, Gävle, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Meszaros
authors.affiliation: Department of Ophthalmology, Sunderby County Hospital, Sunderbyn, Sweden.
authors.forename: Anna
authors.initials: A
authors.lastname: Wojciechowska-Zajac
authors.affiliation: Center for Clinical Research, Uppsala University/County Council of Västmanland, Västerås, Sweden.
authors.forename: Philippe
authors.initials: P
authors.lastname: Wagner
authors.affiliation: Swedish Macula Register, RC Syd, Karlskrona, Sweden.
authors.forename: Susanne
authors.initials: S
authors.lastname: Albrecht
authors.affiliation: Swedish Macula Register, RC Syd, Karlskrona, Sweden.
authors.forename: Niklas
authors.initials: N
authors.lastname: Karlsson
authors.affiliation: Swedish Macula Register, RC Syd, Karlskrona, Sweden.
authors.forename: Gunilla
authors.initials: G
authors.lastname: Bjärnhall
authors.affiliation: IKVL Institution of Clinical Science, Ophthalmology, Lund University, Lund, Sweden.
authors.forename: Monica
authors.initials: M
authors.lastname: Lövestam-Adrian
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D058449:Intravitreal Injections; D008297:Male; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012042:Registries; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*; D015354:Vision, Low / Q000453:epidemiology* / Q000503:physiopathology; D014792:Visual Acuity / Q000502:physiology; D019987:Persons with Visual Disabilities / Q000706:statistics & numerical data*; D057135:Wet Macular Degeneration / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D020533:Angiogenesis Inhibitors; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A
keywords: Swedish Macula Register; anti-vascular endothelial growth factor; low vision clinics; wet AMD