title: Improving accessibility to intravitreal anti-vascular endothelial growth factor treatment for ophthalmic patients in a peripheral centre.
abstract: OBJECTIVE
  An exponential rise in patients requiring intravitreal anti-vascular endothelial growth factor (anti-VEGF) treatment has occurred over recent years. We addressed this in Palmerston North by establishing a senior nurse-led macular review clinic. We aimed to determine the current intravitreal service accessibility and compared it to results from 2012.
  
  
  METHODS
  Chart analysis.
  
  
  RESULTS
  Planned follow-up was aimed for 42 days, near the end of the anti-VEGF therapeutic effect. It occurred on average at 45.05 (12 to 127) days after initial treatment induction and 40.7 (14 to 77) days for subsequent follow-ups. Treatment was started on average 29.8 (0 to 139) days after the decision was made. Further injections occurred on average 25.7 (0 to 104) days after the retreatment decision. These findings were similar to 2012 where initial follow-up occurred on average 42 (29 to 89) days following treatment, initial treatment 30 (0 to 78) days after treatment decision and retreatment at 34 (6 to 89) days.
  
  
  CONCLUSIONS
  Instituting the senior nurse-led macular review clinic has enabled timely review of patients despite significant increases in those requiring treatment and surveillance. The average follow-up appointment delay is within the four week guideline set by NICE.
authors.affiliation: Department of Ophthalmology, Auckland District Health Board, Auckland.
authors.forename: Verona E
authors.initials: VE
authors.lastname: Botha
authors.affiliation: Department of Ophthalmology, Midcentral District Health Board, Palmerston North.
authors.forename: John J
authors.initials: JJ
authors.lastname: Ah-Chan
authors.affiliation: Department of Ophthalmology, Midcentral District Health Board, Palmerston North.
authors.forename: Nishan
authors.initials: N
authors.lastname: Ramachandran
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D058449:Intravitreal Injections; D008269:Macular Edema / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009936:Organizational Innovation; D011785:Quality Assurance, Health Care; D058996:Quality Improvement; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*; D014792:Visual Acuity / Q000502:physiology*
chemical_list: D020533:Angiogenesis Inhibitors; D042461:Vascular Endothelial Growth Factor A