The effect of sample medication use on subsequent anti-VEGF agent selection for neovascular age-related macular degeneration

Purpose: To examine the effect of medication sample use (ranibizumab or aflibercept) on future anti-vascular endothelial growth factor (VEGF) agent selection in neovascular age-related macular degeneration (nvAMD). Design: Retrospective cohort study. Methods: nvAMD patients who underwent an initial anti-VEGF injection with a sample medication were compared to nvAMD control patients who never received a medication sample. Charts from 2017 through 2020 were reviewed for data regarding demographics, anti-VEGF agent selection, and visual acuity outcomes for both groups. Anti-VEGF agent selection for the first four injections and at one year were examined in both the sample and control groups. Results: Adherence to the initial agent was high between first and subsequent injections (2nd, 3rd, 4th injection, and 1 year) in both sample (96.2%, 95.9%, 91.9%, 93.4%, respectively) and control groups (98.1%, 94.2%, 94.9%, 87.8%, respectively). Bevacizumab usage was significantly lower among eyes receiving samples relative to controls at the second (1.9% vs. 38.7%, p<0.001), third (3.1% vs. 41.3%, p<0.001), fourth injections (4.7% vs. 40.4%, p<0.001), and at 1 year (0% vs. 33.8%, p<0.001). Aflibercept usage was significantly higher in sample eyes relative to controls at the second (78.3% vs. 43.4%, p<0.001), third (76.3% vs. 41.5%, p<0.001), and fourth injections (76.7% vs. 43.4%, p<0.001), and at 1 year (77.0% vs. 52.7%, p<0.001). Conclusions: Eyes receiving a sample anti-VEGF agent (ranibizumab or aflibercept) for their initial injection were less likely to receive bevacizumab at future visits relative to eyes that did not receive an anti-VEGF sample, even after one year of treatment.

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Profiling Cognitive Performance and Sleep Quality Measures in Patients with Age-Related Macular Degeneration (Preprint)

10.2196/preprints.27040 ◽

2021 ◽

Author(s):

Mehrdad Afarid ◽

Hooman Rezaie ◽

Behzad Khademi1 ◽

Mohammad Nami

Keyword(s):

Sleep Quality ◽

Macular Degeneration ◽

Cognitive Performance ◽

Cognitive Functions ◽

Age Related Macular Degeneration ◽

Control Groups ◽

Age Related ◽

Significant Difference ◽

The Mean ◽

And Control

BACKGROUND This study aimed at profiling cognitive functions in patients with age-related macular degeneration (AMD). OBJECTIVE The aim of our study was to evaluate cognitive functions in patients diagnosed with AMD METHODS This cross-sectional investigation enrolled 45 patients with AMD and 45 age- and sex-matched controls. The overall cognitive performance in AMD sufferer versus control subjects was asses using the Persian version of the Addenbrooke’s Cognitive Examination battery (ACE-R). Subjects’ sleep quality was also evaluated using the Pittsburgh Sleep Quality Index (PSQI). The mean global assessment and subscale scores were statistically compared between groups. RESULTS The mean global scores for ACE-R in AMD and control groups (80.4±12.3 and 86 ± 9.6, respectively) were found to be statistically different (p=0.018). On the other hand there was no significant difference (p=0.793) between the AMD and control groups in terms of PSQI scores (9.7±2.8 and 9.8±2.8, respectively). CONCLUSIONS AMD patients seem to have cognitively underperformed in memory and verbal fluency domains compared to the control group. Evidence on cognitive impairments in patients with AMD may possibly herald neurocognitive insufficiencies and have common pathological mechanisms with dementias.

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Increased levels of circulating CD34+ cells in neovascular age-related macular degeneration: relation with clinical and OCT features

European Journal of Ophthalmology ◽

10.5301/ejo.5001012 ◽

2018 ◽

Vol 28 (1) ◽

pp. 80-86

Author(s):

Caner Kara ◽

Pınar Ç. Özdal ◽

Emrullah Beyazyıldız ◽

Nurgül E. Özcan ◽

Mehmet Y. Teke ◽

...

Keyword(s):

Stem Cells ◽

Stem Cell ◽

Macular Degeneration ◽

Age Related Macular Degeneration ◽

Control Group ◽

Study Group ◽

Control Groups ◽

Age Related ◽

Significant Difference ◽

And Control

Purpose: To investigate the levels of circulating CD34+ stem cells in patients with neovascular type age-related macular degeneration (AMD) and its relation with clinical and optical coherence tomography (OCT) findings. Methods: The study consisted of 55 patients: 28 patients (18 male and 10 female) with neovascular type AMD as a study group and 27 patients (12 male and 15 female) scheduled for cataract surgery as a control group. The level of CD34+ stem cells was measured by ﬂow cytometry. Demographic and clinical data were recorded. Results: The mean ages of patients in the study and control groups were 71 ± 8 and 68 ± 6 years, respectively. There was no statistically significant difference in terms of age, sex, or systemic disease association between study and control groups. However, smoking status was significantly higher in the study group (67.9% vs 37.0%; p = 0.02). Stem cell levels were significantly higher in the study group (1.5 ± 0.9 vs 0.5 ± 0.3; p<0.001), but there was no relation between stem cell levels and clinical and OCT findings. Conclusions: Increased circulating CD34+ stem cell levels were observed in patients with choroidal neovascular membrane associated with AMD, but no significant relation was found between cell levels and clinical and OCT findings.

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Profiling Cognitive Performance and Sleep Quality Measures in Patients with Age-Related Macular Degeneration

10.31235/osf.io/ksc9e ◽

2021 ◽

Author(s):

Amirsaeid Moloodi ◽

Hooman Rezaie ◽

Behzad Khademi ◽

Mohammad Nami

Keyword(s):

Sleep Quality ◽

Macular Degeneration ◽

Cognitive Performance ◽

Age Related Macular Degeneration ◽

Control Group ◽

Control Groups ◽

Age Related ◽

Significant Difference ◽

The Mean ◽

And Control

Objective: This study aimed at profiling cognitive functions in patients with age-related macular degeneration (AMD).Method: This cross-sectional investigation enrolled 45 patients with AMD and 45 age- and sex-matched controls. The overall cognitive performance in AMD sufferer versus control subjects was asses using the Persian version of the Addenbrooke’s Cognitive Examination battery (ACE-R). Subjects’ sleep quality was also evaluated using the Pittsburgh Sleep Quality Index (PSQI). The mean global assessment and subscale scores were statistically compared between groups.Results: The mean global scores for ACE-R in AMD and control groups (80.4±12.3 and 86 ± 9.6, respectively) were found to be statistically different (p=0.018). On the other hand there was no significant difference (p=0.793) between the AMD and control groups in terms of PSQI scores (9.7±2.8 and 9.8±2.8, respectively). Conclusion: AMD patients seem to have cognitively underperformed in memory and verbal fluency domains compared to the control group. Evidence on cognitive impairments in patients with AMD may possibly herald neurocognitive insufficiencies and have common pathological mechanisms with dementias.

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Medical Compliance of Fibrate and the Decreased Risk of Age-Related Macular Degeneration in Dyslipidemia-Related Diseases: A Population-Based Cohort Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18010301 ◽

2021 ◽

Vol 18 (1) ◽

pp. 301

Author(s):

Kai Wang ◽

Ming-Ju Hsieh ◽

Hsiang-Wen Chien ◽

Chia-Yi Lee ◽

Chao-Bin Yeh ◽

...

Keyword(s):

Macular Degeneration ◽

Population Based ◽

Age Related Macular Degeneration ◽

Diagnostic Code ◽

Control Groups ◽

Age Related ◽

Dry Amd ◽

Medical Compliance ◽

Cox Proportional Hazard Regression ◽

And Control

The purpose of the current study is to evaluate the incidence of age-related macular degeneration (AMD) in dyslipidemia-related diseases with or without the use of fibrate. Patients were defined as dyslipidemia-related diseases according to the diagnostic code and lab exam arrangement, then the population was divided into those with fibrate application and those without via 1:2 ratios of propensity-score matching. The primary outcome is the development of AMD after dyslipidemia-related diseases by the Cox proportional hazard regression. Besides, the relationship between the medical compliance of fibrate, presented as medical possession ratio (MPR), and the AMD development was also analyzed. A total of 22,917 patients and 45,834 individuals were enrolled in the study and control groups. There were 572 and 1181 events of any AMD development in the study and control groups which showed identical risk of AMD (aHR: 0.94, 95% CI: 0.85–1.04). However, a reduced risk of any AMD was found in those patients reached a baseline MPR more than 20% (aHR: 0.729, 95% CI: 0.599–0.887, p = 0.0016) and overall MPR more than 5% three years after the diagnosis of dyslipidemia-related diseases (aHR: 0.712, 95% CI: 0.557–0.909, p = 0.0065). Besides, a lower risk of dry-AMD was also found in those patients with the above conditions (aHR: 0.736, 95% CI: 0.599–0.906, p = 0.0038 and aHR: 0.721, 95% CI: 0.557–0.934, p = 0.0133, respectively). In conclusion, the use of fibrate with fair initial medical compliance will decrease the incidence of AMD in patients with dyslipidemia-related diseases, especially for the development of dry-AMD.

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Reactivation of CNV after discontinuation of bevacizumab treatment of age-related macular degeneration

Ophthalmologica ◽

10.1159/000514539 ◽

2021 ◽

Author(s):

Sankha Amarakoon ◽

Jose P Martinez-Ciriano ◽

Seerp Baarsma ◽

L Ingeborgh van den Born ◽

Tom Missotten

Keyword(s):

Macular Degeneration ◽

Intravitreal Bevacizumab ◽

Age Related Macular Degeneration ◽

Recurrence Rates ◽

Anti Vegf ◽

Age Related ◽

Bevacizumab Treatment ◽

Final Treatment ◽

One Year ◽

The One

Introduction: Treatment of exudative age-related macular degeneration (ARMD) has shifted to pro re nata and treat-extend-stop strategies. However, a rational discontinuation strategy is lacking. To develop such a strategy, it is important to determine choroidal neovascularization (CNV) recurrence rates after anti-VEGF treatment is discontinued. Methods: This prospective, single-centre clinical trial enrolled 191 patients with exudative ARMD. Patients were randomly assigned to receive intravitreal bevacizumab injections every 4, 6, or 8 weeks for one year. CNV activity was determined in the 157 patients who completed the one-year treatment regimen. Patients with inactive CNV were then followed for signs of CNV reactivation. Results: After one year of treatment, 66 (42%) of the 157 patients still had signs of persistent active CNV. Of the remaining 91 (58%) patients, 61 (67%) needed retreatment for active CNV within the first year after discontinuation of treatment (mean 4.28±0.29 months). CNV was reactivated in 50 (80%) of the 61 patients within 6 months after their final treatment for CNV. Conclusion: Based on quiescent disease, anti-VEGF therapy was discontinued in 58% of patients after they received bevacizumab injections every 4, 6, or 8 weeks for one year; 67% showed reactivated CNV within the year after discontinuation. The high reactivation rate of CNV shown in this study, should help clinicians develop rational discontinuation protocols.

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The Relationship between Neovascular Age-Related Macular Degeneration and Erectile Dysfunction

Journal of Ophthalmology ◽

10.1155/2013/589274 ◽

2013 ◽

Vol 2013 ◽

pp. 1-6

Author(s):

Harun Çakmak ◽

Tolga Kocatürk ◽

Sema Oruç Dündar ◽

Mehmet Dündar ◽

Müjdat Karabulut

Keyword(s):

Erectile Dysfunction ◽

Macular Degeneration ◽

Erectile Function ◽

Age Related Macular Degeneration ◽

Control Group ◽

Neovascular Amd ◽

Control Groups ◽

High Association ◽

Age Related ◽

And Control

Purpose. To evaluate association between erectile dysfunction (ED) and neovascular age-related macular degeneration (AMD).Methods. 195 men enrolled in this cross-sectional study. 90 of them had neovascular AMD and 105 of them were healthy volunteers. The International Index of Erectile Function (IIEF) questionnaire’s erectile function (EF) domain was used to assess ED. The patients in the study and control groups were statistically compared according to visual acuity, EF score, and body mass index.Results. The mean ages were 62 (54.5–73) and 60 (54–68), in the neovascular AMD and control groups, respectively. The total EF scores were 9 (6–16) in neovascular AMD and 18 (9.5–27) in control group. The results of IIEF questionnaire on neovascular AMD patients revealed that 85 men (94.4%) had some degree of ED, whereas 68 men (64.8%) had some degree of ED on control group. Patients with neovascular AMD had a significantly higher incidence of ED than control patients (). There was a significant association between ED and neovascular AMD ().Conclusions. Our results suggested that neovascular AMD has a high association with ED.

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Thyroid dysfunction as a modifiable risk factor for age-related macular degeneration: A case-control investigation

10.21203/rs.3.rs-44137/v1 ◽

2020 ◽

Author(s):

Mohsen Farvardin ◽

Seyed esmaeil mousavi ◽

Kamran Zare ◽

Somaye Bazdar ◽

Zahra Farvardin ◽

...

Keyword(s):

Macular Degeneration ◽

Thyroid Dysfunction ◽

Case Control ◽

Age Related Macular Degeneration ◽

Control Groups ◽

Age Related ◽

Significant Difference ◽

History Of ◽

And Control ◽

Wet Amd

Abstract Background: Age-related macular degeneration (AMD) is regarded amongst as a common conditions resulting in visual impairment in elderly. Age and gender are unmodifiable risk factors for AMD, obesity, smoking, and hyperlipidemia are known to be modifiable culprits. This has remained controversial for hypertension and thyroid dysfunction. The present study attempted to investigate possible links between thyroid dysfunction and incidence of wet AMD.Methods: The present case-control study enrolled a total number of 90 patients with wet AMD and 90sex-, age-matched control subjects through a convenient sequential sampling method. Thyroid hormones were profiled in serum assay. Statistical measures were done to compare means between groups.Results: Our findings showed a significant difference in free T4 levels between the between wet AMD and control groups (p = 0.002), though this has not been the case for T3 and TSH l. In addition, there were no differences in serum lipid profile between groups. Although there found to be no significant difference in the past history of hypertension and hyperlipidemia between wet AMD and control groups, history of smoking was higher in controls) (p = 0.039).Conclusion: Based on our findings retinal examination and proper screening need to perhaps be a part of the overall health examination especially in elderly subjects with thyroid dysfunction. The clinical significance and related recommendations on the above need ti substantiated in future community-based research.

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Association between NF-kB polymorphism and age-related macular degeneration in a high-altitude population

PLoS ONE ◽

10.1371/journal.pone.0251931 ◽

2021 ◽

Vol 16 (6) ◽

pp. e0251931

Author(s):

Yan Xin ◽

Kang Zefeng ◽

Li Ling ◽

Guan Ruijuan

Keyword(s):

High Altitude ◽

Macular Degeneration ◽

Lipid Level ◽

Allele Frequencies ◽

Age Related Macular Degeneration ◽

Control Group ◽

Control Groups ◽

Age Related ◽

Significant Difference ◽

And Control

Objective To investigate the association between the nuclear factor kappa B (NF-kB) gene polymorphism and age-related macular degeneration (AMD) in a high-altitude population. Methods Fifty-five patients with AMD and 57 control subjects were recruited from the Qinghai Provincial People’s Hospital, China. Genomic DNA was extracted from the blood sample of each participant. Four NF-kB polymorphisms (rs3774959, rs3774932, rs3774937, and rs230526) were genotyped using a MassARRAY system. The genotype and allele frequencies were compared between the case and control groups using the chi-squared test or Fisher’s exact test. Results There was no significant difference in sex, age, hypertension, diabetes, blood lipid level or smoking and drinking status between the AMD and control groups (P > 0.05). The genotype distributions of four NF-kB polymorphisms were in accordance with Hardy-Weinberg equilibrium in the control group (P > 0.05). The frequencies of genotype AA of rs3774932 and genotype CC of rs3774937 were nominally significantly higher in the AMD group than in the control group (P = 0.046 and 0.023, respectively), although these associations did not survive the Bonferroni correction (corrected P > 0.05). Genotype distributions of rs3774959 and rs230526 were not significantly different between the two groups (P = 0.08 and 0.16, respectively). No significant difference in the allele frequencies of the four polymorphisms was found between the AMD and control groups (P > 0.05). Conclusions Genotype AA of rs3774932 and genotype CC of rs3774937 in NF-kB might be risk factors for AMD.

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Predictive Factors for Long-Term Outcomes of Cataract Surgery in Patients Receiving Active Treatment for Neovascular Age-Related Macular Degeneration

Journal of Clinical Medicine ◽

10.3390/jcm10143124 ◽

2021 ◽

Vol 10 (14) ◽

pp. 3124

Author(s):

Eun Young Choi ◽

Tae Young Kim ◽

Christopher Seungkyu Lee

Keyword(s):

Cataract Surgery ◽

Macular Degeneration ◽

Predictive Factors ◽

Active Treatment ◽

Age Related Macular Degeneration ◽

Long Term Outcomes ◽

Anti Vegf ◽

Age Related ◽

One Year

Background: the safety and efficacy of cataract surgery in eyes with exudative neovascular age-related macular degeneration (nAMD), receiving active treatment, remain unclear. We evaluated the long-term outcomes and associated predictive factors of cataract surgery in eyes with exudative nAMD. Methods: this retrospective cohort study included 65 eyes (61 patients) treated with anti-vascular endothelial growth factor (VEGF) injections within six months preoperatively. Changes in best-corrected visual acuity (BCVA) and anti-VEGF treatment patterns from before to up to four years after surgery were assessed. Predictive factors were identified in association with one-year surgical outcomes. Results: the BCVA improved at six months (p < 0.001) and was maintained for three years postoperatively. The interval between anti-VEGF injections increased 3.4 times postoperatively (p = 0.001). Risk factors for poor BCVA were low preoperative BCVA (p < 0.001) and prolonged nAMD duration (p = 0.003). Prolonged nAMD duration and short exudation-free period were associated with more frequent postoperative anti-VEGF treatments (p = 0.028 and p = 0.003, respectively). AMD subtypes were not associated with both vision and injection pattern outcomes. Conclusions: patients with cataracts receiving nAMD treatment can safely undergo surgery with favorable long-term visual benefits. The preoperative BCVA, nAMD duration, and exudation-free period are potential predictors of surgery outcomes.

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