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

• Published in: Acta Ophthalmologica
• Main Authors: Granstam, Elisabet, Westborg, Inger, Barkander, Anna, Börjesson, Malin, Lindahl, Sara, Meszaros, Eva, Wojciechowska-Zajac, Anna, Wagner, Philippe, Albrecht, Susanne, Karlsson, Niklas, Bjärnhall, Gunilla, Lövestam, Adrian Monica
• Format: Article in Journal/Newspaper
• Language: English
• Published: Wiley-Blackwell 2016
• Subjects: Ophthalmology; anti-vascular endothelial growth factor; low vision clinics; Swedish Macula Register; wet AMD; Northern Sweden
• Online Access: https://lup.lub.lu.se/record/83c13585-1756-44ff-9740-3f2e198ff472; https://doi.org/10.1111/aos.13187

Purpose: 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). Conclusion: 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.