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Physician elucidates treatment burden for AMD, DME
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KOLOA, Hawaii — Commonly, patients with age-related macular degeneration or with diabetic macular edema ask their ophthalmologists how long they can expect to need anti-VEGF injections and whether or not they will improve.
“The answer to that is about 35% with AMD [will improve] and 50% or 60% with macular edema [will improve],” Andrew P. Schachat, MD, said at Retina 2014. “For AMD, the message is, it gets worse over time. Diabetic macular edema, however, does get better and does stabilize.”
Patients also want to know how many injections to expect over how many years.
Andrew P. Schachat
For AMD, using data from several studies with varying follow-up periods ranging from 2 to 7 years, Schachat said, “You might tell patients, on average, to expect 21 injections over 7 years.”
The number one reason for discontinuing treatment in one study was lack of apparent treatment response. Other reasons were, in order, disease inactivity, failure to follow-up for unknown reasons and death.
Whereas AMD seems to worsen over time and DME stabilizes, the patient with diabetes has more concerning general health issues.
“Systemically they’re doing poorly, but their eyes are doing better,” Schachat said. For patients with diabetes, Schachat said patients could expect about 11 to 14 injections over 3 years. —by Patricia Nale
Disclosure: Schachat is a consultant for Bausch + Lomb and Allergan.
Reference
Rasmussen A, et al. Ophthalmology. 2013;doi:10.1016/j.ophtha.2013.05.018.