One- and two-year visual outcomes from the Moorfields age-related macular degeneration database: a retrospective cohort study and an open science resource.
Aged
Angiogenesis Inhibitors
/ administration & dosage
Electronic Health Records
Female
Follow-Up Studies
Humans
Intravitreal Injections
Male
Ranibizumab
/ administration & dosage
Receptors, Vascular Endothelial Growth Factor
/ administration & dosage
Recombinant Fusion Proteins
/ administration & dosage
Retrospective Studies
Time Factors
Treatment Outcome
Vascular Endothelial Growth Factor A
/ antagonists & inhibitors
Visual Acuity
/ physiology
Wet Macular Degeneration
/ drug therapy
age-related macular degeneration
anti-vegf
choroidal neovascularization
electronic medical record
real-world
visual outcome
Journal
BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874
Informations de publication
Date de publication:
21 06 2019
21 06 2019
Historique:
entrez:
24
6
2019
pubmed:
24
6
2019
medline:
9
6
2020
Statut:
epublish
Résumé
To analyse treatment outcomes and share clinical data from a large, single-centre, well-curated database (8174 eyes/6664 patients with 120 756 single entries) of patients with neovascular age-related macular degeneration (AMD) treated with anti-vascular endothelial growth factor (VEGF). By making our depersonalised raw data openly available, we aim to stimulate further research in AMD, as well as set a precedent for future work in this area. Retrospective, comparative, non-randomised electronic medical record (EMR) database cohort study of the UK Moorfields AMD database with data extracted between 2008 and 2018. Including one eye per patient, 3357 eyes/patients (61% female). Extraction criteria were ≥1 ranibizumab or aflibercept injection, entry of 'AMD' in the diagnosis field of the EMR and a minimum of 1 year of follow-up. Exclusion criteria were unknown date of first injection and treatment outside of routine clinical care at Moorfields before the first recorded injection in the database. Primary outcome measure was change in VA at 1 and 2 years from baseline as measured in Early Treatment Diabetic Retinopathy Study letters. Secondary outcomes were the number of injections and predictive factors for VA gain. Mean VA gain at 1 year and 2 years were +5.5 (95% CI 5.0 to 6.0) and +4.9 (95% CI 4.2 to 5.6) letters, respectively. Fifty-four per cent of eyes gained ≥5 letters at 2 years, 63% had stable VA (±≤14 letters), 44% of eyes maintained good VA (≥70 letters). Patients received a mean of 7.7 (95% CI 7.6 to 7.8) injections during year 1 and 13.0 (95% CI 12.8 to 13.2) injections over 2 years. Younger age, lower baseline VA and more injections were associated with higher VA gain at 2 years. This study benchmarks high quality EMR study results of real life AMD treatment and promotes open science in clinical AMD research by making the underlying data publicly available.
Identifiants
pubmed: 31230012
pii: bmjopen-2018-027441
doi: 10.1136/bmjopen-2018-027441
pmc: PMC6596999
doi:
Substances chimiques
Angiogenesis Inhibitors
0
Recombinant Fusion Proteins
0
Vascular Endothelial Growth Factor A
0
aflibercept
15C2VL427D
Receptors, Vascular Endothelial Growth Factor
EC 2.7.10.1
Ranibizumab
ZL1R02VT79
Types de publication
Comparative Study
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e027441Subventions
Organisme : Department of Health
ID : CS-2014-14-023
Pays : United Kingdom
Organisme : NEI NIH HHS
ID : K23 EY029246
Pays : United States
Informations de copyright
© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
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