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[年龄相关性黄斑变性治疗与成本随视力改善的关系]

[Relationship between treatment and cost with visual acuity improvement in age-related macular degeneration].

作者信息

Casanovas-Marsal Josep-Oriol, Viladés Palomar Elisa, Bartol-Puyal Francisco de Asís, Hernández Vian Rubén, Pablo Júlvez Luis E

机构信息

Servicio Aragonés de Salud. Hospital Universitario Miguel Servet. Servicio de Oftalmología. Zaragoza. España..

Servicio Aragonés de Salud. Hospital Universitario Miguel Servet. Servicio de Oftalmología. Zaragoza. España.

出版信息

An Sist Sanit Navar. 2023 Nov 27;46(3):e1052. doi: 10.23938/ASSN.1052.

Abstract

BACKGROUND

We examined the relationship between visual acuity changes (VA) and the cost of care and treatment with anti-vascular endothelial growth factors (antiVEGF) in patients diagnosed with age-related exudative macular degeneration (exudative AMD).

METHODS

Observational, longitudinal, retrospective study of patients ≥50 years of age diagnosed with exudative AMD, with a log-MAR VA between 0.6 and 0.06. and 0.06. Follow-up and treatment were done in our tertiary hospital between January 1, 2014 and December 31, 2018.

RESULTS

The study included 778 patients; 62.2% female and mean age 79.83±7.94 years; 957 eyes had exudative AMD. Mean of final VA (0.65±0.45) increasing 3.2% compared to initial values. Ranibizumab was administered to 60.3% of the eyes, aflibercept to 10.2% and ranibizumab + aflibercept (mixed group) to 29.5%. Significant increase in VA was seen in the group with the mixed treatment, with no inter-group differences. Although follow-up/treatment was longer for the mixed group, they received fewer anti-VEGF injections and optical coherence tomography (OCT). The total expenditure per year and treated eye was € 1,972.7±824.5; costs were higher for visit, OCT, and treatment in the aflibercept group, and lower for fluorescein angiography, antiVEGF treatment, and total costs in the mixed group. Decimal VA gain had a cost of € 872±1,077.7 with no significant inter-group differences.

CONCLUSIONS

AntiVEGF treatments (ranibizumab, aflibercept, or both) maintained VA in patients with exudative AMD. Overall, care and treatment costs were lower in the group that received both drugs.

摘要

背景

我们研究了年龄相关性渗出性黄斑变性(渗出性AMD)患者的视力变化(VA)与抗血管内皮生长因子(抗VEGF)治疗费用之间的关系。

方法

对年龄≥50岁、确诊为渗出性AMD、对数最小分辨角视力(log-MAR VA)在0.6至0.06之间的患者进行观察性、纵向、回顾性研究。随访和治疗于2014年1月1日至2018年12月31日在我们的三级医院进行。

结果

该研究纳入778例患者;女性占62.2%,平均年龄79.83±7.94岁;957只眼患有渗出性AMD。最终视力平均值(0.65±0.45)较初始值提高了3.2%。60.3%的眼接受了雷珠单抗治疗,10.2%接受了阿柏西普治疗,29.5%接受了雷珠单抗+阿柏西普(联合组)治疗。联合治疗组的视力有显著提高,组间无差异。虽然联合组的随访/治疗时间更长,但他们接受的抗VEGF注射和光学相干断层扫描(OCT)较少。每年每只治疗眼的总费用为1972.7±824.5欧元;阿柏西普组的就诊、OCT和治疗费用较高,联合组的荧光素血管造影、抗VEGF治疗和总费用较低。十进制视力增益的成本为872±1077.7欧元,组间无显著差异。

结论

抗VEGF治疗(雷珠单抗、阿柏西普或两者联合)可维持渗出性AMD患者的视力。总体而言,接受两种药物治疗的组的护理和治疗费用较低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8970/10783600/b09795413725/assn-46-03-e1052-g1.jpg

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