Kocaeli University Faculty of Medicine, Department of Ophthalmology, Kocaeli, Turkey.
University of Health Sciences Turkey, Derince Training and Research Hospital, Clinic of Ophthalmology, Kocaeli, Turkey.
Turk J Ophthalmol. 2022 Jun 29;52(3):179-185. doi: 10.4274/tjo.galenos.2021.37075.
To analyze the current preferences of ophthalmologists for the treatment of macular edema and age-related macular degeneration (AMD) and to evaluate off-label use of bevacizumab in Turkey.
All members of the Turkish Ophthalmological Association were contacted by e-mail to complete an anonymous, 47-question internet-based survey. The second part of the survey (questions 36-47) was evaluated.
When current legal regulations were considered, ophthalmologists used bevacizumab as the first-line agent in patients with diabetic macular edema (DME), AMD, and retinal vein occlusion (RVO) (58.25%, 55.89%, and 52.29%, respectively). When economic and legal constraints were disregarded, the participants' preference for bevacizumab in the treatment of DME, AMD, and RVO decreased (11.64%, 10.58%, and 10.93%, respectively). Approximately three-quarters (75.75%) of ophthalmologists stated that dispensing multiple syringes from a single bevacizumab bottle could increase the risk of endophthalmitis. Most participants (93.68%) did not feel legally safe from harm caused by off-label bevacizumab use. However, 66.43% of ophthalmologists stated that bevacizumab is as effective as other anti-vascular endothelial growth factor (anti-VEGF) drugs.
Bevacizumab is widely used as a first-line treatment for all indications of anti-VEGF use in the current reimbursement conditions, which preclude the right of ophthalmologists to treat according to their own preferences.
分析眼科医生目前对治疗黄斑水肿和年龄相关性黄斑变性（AMD）的偏好，并评估贝伐单抗在土耳其的超适应证使用情况。
通过电子邮件联系所有土耳其眼科协会成员，完成一份匿名的、包含 47 个问题的网络调查。评估调查的第二部分（问题 36-47）。
在考虑当前法律规定的情况下，眼科医生将贝伐单抗作为糖尿病性黄斑水肿（DME）、AMD 和视网膜静脉阻塞（RVO）患者的一线治疗药物（分别为 58.25%、55.89%和 52.29%）。当不考虑经济和法律限制时，参与者在治疗 DME、AMD 和 RVO 时对贝伐单抗的偏好程度降低（分别为 11.64%、10.58%和 10.93%）。大约四分之三（75.75%）的眼科医生表示，从一个贝伐单抗瓶中分配多个注射器可能会增加眼内炎的风险。大多数参与者（93.68%）认为，由于贝伐单抗的超适应证使用而遭受的伤害，他们在法律上并不安全。然而，66.43%的眼科医生表示，贝伐单抗与其他抗血管内皮生长因子（anti-VEGF）药物一样有效。
在当前的报销条件下，贝伐单抗被广泛用作所有抗 VEGF 适应证的一线治疗药物，这限制了眼科医生根据自己的偏好进行治疗的权利。
