Creuzot Garcher Catherine P, Srour Mayer, Baudin Florian, Dot Corinne, Nghiem-Buffet Sylvia, Girmens Jean-Francois, Collin Cedric, Ponthieux Anne, Delcourt Cécile
Department of Ophthalmology, University Hospital, Dijon, France.
Department of Ophthalmology, Centre Hospitalier Intercommunal de Créteil, Université de Paris Est Créteil, Créteil, France.
Ophthalmol Ther. 2023 Oct;12(5):2687-2701. doi: 10.1007/s40123-023-00772-3. Epub 2023 Aug 2.
The aim of this study was to describe the management of neovascular age-related macular degeneration (nAMD) in French patients between 2008 and 2018.
This was a retrospective longitudinal cohort study using exhaustive nationwide health records from the French National Health Information database. Enrollment criteria were adults aged ≥ 50 years, nAMD diagnosis, or reimbursement for nAMD treatments (anti-vascular epithelial growth factor [VEGF] injection or dynamic phototherapy with verteporfin). Exclusion criteria were high myopia, diagnosis of other retinal diseases, and treatments for other macular diseases (dexamethasone implant, laser). Main outcome measures were consumption of medical care and nAMD treatments per calendar year and number of years of follow-up.
Between 2008 and 2018, we identified 342,961 patients who have been treated for nAMD. Median duration of ophthalmological follow-up exceeded 7 years (90 months). The median annual number of ophthalmology consultations decreased from nine visits in year 1 after treatment initiation to four visits from year 7 onwards. The median duration of nAMD treatment was 10.1 months for all patients, with 48.5% of patients undergoing treatment for < 1 year. Only 24.4% of patients had maintained treatment at year 11. Patients remaining under treatment had a median of four anti-VEGF treatments per year throughout the 10-year study period. Ranibizumab was the more common first-line treatment (67.5% of patients) compared to aflibercept (32.4%). About 20% of patients who initiated treatment switched treatment at least once.
LANDSCAPE provides exhaustive nationwide data on the real-world management of nAMD in France over a 10-year period. Further investigation into short treatment duration is required, especially in terms of understanding its relation to visual outcomes.
本研究旨在描述2008年至2018年间法国患者新生血管性年龄相关性黄斑变性（nAMD）的治疗情况。
这是一项回顾性纵向队列研究，使用了来自法国国家健康信息数据库的详尽全国健康记录。纳入标准为年龄≥50岁的成年人、nAMD诊断或nAMD治疗报销（抗血管内皮生长因子[VEGF]注射或维替泊芬动态光动力疗法）。排除标准为高度近视、其他视网膜疾病诊断以及其他黄斑疾病治疗（地塞米松植入、激光）。主要结局指标为每年的医疗保健和nAMD治疗消耗量以及随访年数。
2008年至2018年间，我们确定了342,961例接受nAMD治疗的患者。眼科随访的中位持续时间超过7年（90个月）。治疗开始后第1年眼科会诊的年中位次数从9次降至第7年及以后的4次。所有患者nAMD治疗的中位持续时间为10.1个月，48.5%的患者治疗时间<1年。在第11年，只有24.4%的患者仍在接受治疗。在整个10年研究期间，仍在接受治疗的患者每年接受抗VEGF治疗的中位次数为4次。与阿柏西普（32.4%）相比，雷珠单抗是更常见的一线治疗药物（67.5%的患者）。约20%开始治疗的患者至少更换过一次治疗方案。
LANDSCAPE提供了法国10年间nAMD实际治疗情况的详尽全国数据。需要对短治疗持续时间进行进一步研究，尤其是在了解其与视觉结局的关系方面。
