Gomi Fumi, Kawasaki Ryo, Ogura Yuichiro, Iwasaki Kosuke, Takeshima Tomomi, Yamabe Masafumi, Imai Kota
Department of Ophthalmology, Hyogo Medical University.
Department of Vision Informatics, Osaka University Graduate School of Medicine.
Ann Clin Epidemiol. 2024 Jan 26;6(2):42-50. doi: 10.37737/ace.24007. eCollection 2024.
Although intravitreal anti-vascular endothelial growth factor therapy is currently considered the first-line treatment for chorioretinal vascular diseases in Japan, information regarding its treatment pattern is scarce. This study investigated the patterns of anti-vascular endothelial growth factor treatment for chorioretinal vascular diseases.
A health insurance claims database from acute care hospitals was used to estimate treatment intervals and continuation and drop-out rates regarding the anti-vascular endothelial growth factor. Patients aged ≥50 years diagnosed with neovascular age-related macular degeneration or aged ≥18 years diagnosed with diabetic macular edema or retinal vein occlusion were analyzed.
Data were included for 76,535, 49,704, and 37,681 patients with neovascular age-related macular degeneration, diabetic macular edema, and retinal vein occlusion, respectively; exactly 8,111, 2,283, and 6,896 received the treatment, respectively. The mean and median interval ranges during the maintenance phase by treatment initiation year were 94-100 and 73-80, 111-120 and 98-102, and 97-103 and 87-93 days for neovascular age-related macular degeneration, diabetic macular edema, and retinal vein occlusion, respectively, without any trend over time. A tendency to increase the treatment continuation rate was indicated in later years by Kaplan-Meier curves. The drop-out rate in the treatment initiation year (2016) was 32% from 63% (2009), 53% from 69% (2014), and 36% from 47% (2013) for neovascular age-related macular degeneration, diabetic macular edema, and retinal vein occlusion, respectively.
For all these diseases, the treatment intervals did not change remarkably, and a tendency toward improved treatment continuation was suggested.
尽管玻璃体内注射抗血管内皮生长因子疗法目前被认为是日本脉络膜视网膜血管疾病的一线治疗方法，但关于其治疗模式的信息却很少。本研究调查了脉络膜视网膜血管疾病的抗血管内皮生长因子治疗模式。
使用来自急性护理医院的医疗保险索赔数据库来估计抗血管内皮生长因子的治疗间隔、持续率和退出率。对年龄≥50岁诊断为新生血管性年龄相关性黄斑变性或年龄≥18岁诊断为糖尿病性黄斑水肿或视网膜静脉阻塞的患者进行分析。
分别纳入了76535例、49704例和37681例新生血管性年龄相关性黄斑变性、糖尿病性黄斑水肿和视网膜静脉阻塞患者的数据；分别有8111例、2283例和6896例接受了治疗。按治疗起始年份划分，维持期的平均和中位间隔范围分别为：新生血管性年龄相关性黄斑变性94 - 100天和73 - 80天，糖尿病性黄斑水肿111 - 120天和98 - 102天，视网膜静脉阻塞97 - 103天和87 - 93天，且无随时间变化的趋势。Kaplan - Meier曲线显示后期有治疗持续率增加的趋势。治疗起始年份（2016年）的退出率分别为：新生血管性年龄相关性黄斑变性从63%（2009年）降至32%，糖尿病性黄斑水肿从69%（2014年）降至53%，视网膜静脉阻塞从47%（2013年）降至36%。
对于所有这些疾病，治疗间隔没有显著变化，且有治疗持续情况改善的趋势。
