Evaluating the Treatment of Diabetic Macular Edema with Aflibercept Based on a Regional Network of Ophthalmologic Care Givers

Purpose. In Austria, anti-VEGF therapies are reimbursed only in clinical settings. This study aimed to describe the outcome of a treat and extend regimen (TER) with aflibercept for diabetic macular edema (DME) in a network of practitioners. Methods. In a prospective study over 36 months, patients wi...

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Main Authors: Haidar Khalil, Siegfried Mariacher, Rupert Strauss, Dominika Podkowinski, Klemens Waser, Matthias Bolz
Format: Article
Language:English
Published: Wiley 2023-01-01
Series:Journal of Ophthalmology
Online Access:http://dx.doi.org/10.1155/2023/3165965
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author Haidar Khalil
Siegfried Mariacher
Rupert Strauss
Dominika Podkowinski
Klemens Waser
Matthias Bolz
author_facet Haidar Khalil
Siegfried Mariacher
Rupert Strauss
Dominika Podkowinski
Klemens Waser
Matthias Bolz
author_sort Haidar Khalil
collection DOAJ
description Purpose. In Austria, anti-VEGF therapies are reimbursed only in clinical settings. This study aimed to describe the outcome of a treat and extend regimen (TER) with aflibercept for diabetic macular edema (DME) in a network of practitioners. Methods. In a prospective study over 36 months, patients with DME were treated with a loading dose of aflibercept and further on with adjusted treatment intervals based on optical coherence tomography (OCT) findings. All patients were monitored in an outpatient setting by regional ophthalmologists, and the treatment was administered in the clinic. Main outcome parameters were best-corrected visual acuity (BCVA) from baseline to the last regular visit. Number of visits at the practitioner’s office as well as the number of injections were secondary outcome parameters. Results. Thirty-three patients completed the study at their final visit. BCVA improved significantly by 5.8 letters between baseline and the final visit from 70.4 letters at baseline (p=0.004). Patients visited the practitioner’s office 12.8 times in the observation period of 36 months. 3.7, 5.1, and 3.9 visits were performed, respectively, in the first, second, and third years, and 25.5 ± 7.9 injections were performed. The mean interval of injections over the observation period was 6.2 ± 2.2 in weeks. Conclusion. The treat and extend regimen was valuable for treating patients with DME in this specific setting. The functional results of this study were comparable to those of other real-world evaluations. Adherence to the same treating institution seems to be important to avoid differences in therapeutic decision making and may also increase patient’s compliance.
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spelling doaj-art-7e2660d791c74d66bac7ba55439530332025-02-03T06:04:50ZengWileyJournal of Ophthalmology2090-00582023-01-01202310.1155/2023/3165965Evaluating the Treatment of Diabetic Macular Edema with Aflibercept Based on a Regional Network of Ophthalmologic Care GiversHaidar Khalil0Siegfried Mariacher1Rupert Strauss2Dominika Podkowinski3Klemens Waser4Matthias Bolz5Department of Ophthalmology and OptometryDepartment of Ophthalmology and OptometryDepartment of Ophthalmology and OptometryDepartment of Ophthalmology and OptometryDepartment of Ophthalmology and OptometryDepartment of Ophthalmology and OptometryPurpose. In Austria, anti-VEGF therapies are reimbursed only in clinical settings. This study aimed to describe the outcome of a treat and extend regimen (TER) with aflibercept for diabetic macular edema (DME) in a network of practitioners. Methods. In a prospective study over 36 months, patients with DME were treated with a loading dose of aflibercept and further on with adjusted treatment intervals based on optical coherence tomography (OCT) findings. All patients were monitored in an outpatient setting by regional ophthalmologists, and the treatment was administered in the clinic. Main outcome parameters were best-corrected visual acuity (BCVA) from baseline to the last regular visit. Number of visits at the practitioner’s office as well as the number of injections were secondary outcome parameters. Results. Thirty-three patients completed the study at their final visit. BCVA improved significantly by 5.8 letters between baseline and the final visit from 70.4 letters at baseline (p=0.004). Patients visited the practitioner’s office 12.8 times in the observation period of 36 months. 3.7, 5.1, and 3.9 visits were performed, respectively, in the first, second, and third years, and 25.5 ± 7.9 injections were performed. The mean interval of injections over the observation period was 6.2 ± 2.2 in weeks. Conclusion. The treat and extend regimen was valuable for treating patients with DME in this specific setting. The functional results of this study were comparable to those of other real-world evaluations. Adherence to the same treating institution seems to be important to avoid differences in therapeutic decision making and may also increase patient’s compliance.http://dx.doi.org/10.1155/2023/3165965
spellingShingle Haidar Khalil
Siegfried Mariacher
Rupert Strauss
Dominika Podkowinski
Klemens Waser
Matthias Bolz
Evaluating the Treatment of Diabetic Macular Edema with Aflibercept Based on a Regional Network of Ophthalmologic Care Givers
Journal of Ophthalmology
title Evaluating the Treatment of Diabetic Macular Edema with Aflibercept Based on a Regional Network of Ophthalmologic Care Givers
title_full Evaluating the Treatment of Diabetic Macular Edema with Aflibercept Based on a Regional Network of Ophthalmologic Care Givers
title_fullStr Evaluating the Treatment of Diabetic Macular Edema with Aflibercept Based on a Regional Network of Ophthalmologic Care Givers
title_full_unstemmed Evaluating the Treatment of Diabetic Macular Edema with Aflibercept Based on a Regional Network of Ophthalmologic Care Givers
title_short Evaluating the Treatment of Diabetic Macular Edema with Aflibercept Based on a Regional Network of Ophthalmologic Care Givers
title_sort evaluating the treatment of diabetic macular edema with aflibercept based on a regional network of ophthalmologic care givers
url http://dx.doi.org/10.1155/2023/3165965
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