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    ABSTRACT: Purpose. To survey the management of patients with neovascular age-related macular degeneration (nvAMD) in Spain. Methods. An observational retrospective multicenter study was conducted. The variables analyzed were sociodemographic characteristics, foveal and macular thickness, visual acuity (VA), type of treatment, number of injections, and the initial administration of a loading dose of an antiangiogenic drug. Results. 208 patients were followed up during 23.4 months in average. During the first and second years, patients received a mean of 4.5 ± 1.8 and 1.6 ± 2.1 injections of antiangiogenic drugs, and 5.4 ± 2.8 and 3.6 ± 2.2 follow-up visits were performed, respectively. The highest improvement in VA was observed at 3 months of follow-up, followed by a decrease in the response that stabilized above baseline values until the end of the study. Patients who received an initial loading dose presented greater VA gains than those without. Conclusions. Our results suggest the need for a more standardized approach in the management and diagnosis of nvAMD receiving VEGF inhibitors. To achieve the visual outcomes reported in pivotal trials, an early diagnosis, proactive approach (more treating than follow-up visits), and a close monitoring might be the key to successfully manage nvAMD.
    Journal of Ophthalmology 01/2014; 2014:346360. DOI:10.1155/2014/346360 · 1.94 Impact Factor
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    ABSTRACT: BACKGROUND: Previous studies have proven that long-lasting success in the therapy of neovascular age-related macular degeneration (AMD) and other neovascular retinal diseases depends on monthly follow-up examinations to assess visual acuity and retinal morphology. MATERIALS AND METHODS: The interactive database Bonn ophthalmology online network (BOON) offers a platform for patient monitoring, increasing control reliability and providing a tool for permanent communication between treating centers and referring ophthalmologists. The BOON data-based project started in 2009 at the department of ophthalmology at Bonn University and ten referring ophthalmology practices. It was programmed to communicate diagnostic findings, images and patient appointments online. In order to react promptly the system gave immediate notice if patients had missed a follow-up appointment or the condition had worsened. Patients were recruited in 2009 and 2010 and were followed for 1 year. Each patient had an electronic master file with several registers in which, besides personal data, precise diagnostic findings, imaging and reports were quickly and easily entered by means of detailed check box and drop-down menus. Each follow-up was registered and an alert email was sent to the referring physician in cases of missed appointments or disease progression. RESULTS AND CONCLUSIONS: The BOON database supports the requirements for a fast and detailed communication between treating and referring physicians in the treatment of patients with AMD as well as other retinal diseases. It was programmed to support data exchange and monthly control visits and thus a better patient management. Results will show whether this helps to enhance long-term treatment success in neovascular diseases.
    Der Ophthalmologe 05/2013; · 0.72 Impact Factor
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    ABSTRACT: Hintergrund Eine Vielzahl vorausgegangener Studien konnte zeigen, dass die erfolgreiche und dauerhafte Therapie der neovaskulären altersabhängigen Makuladegeneration (AMD) und anderer Netzhauterkrankungen von einem engmaschigen, genau strukturierten Therapieschema mit monatlichen Visus- und Befundkontrollen abhängt. Zur Optimierung des Kontrollschemas und für einen permanenten Austausch zwischen Klinik und niedergelassenen Augenärzten wurde die interaktive Datenbank BOON entwickelt. Material und Methoden Das im Jahr 2009 gestartete Projekt ermöglicht einen interaktiven, jederzeit abrufbaren Online-Austausch der Patientenbefunde einschließlich Bilder und Termine zwischen der Universitäts-Augenklinik Bonn und 10 niedergelassenen Augenärzten. In einer Datenbank wurden elektronische Karteikarten angelegt, in denen neben üblichen Patientenstammdaten auch detaillierte Diagnoseeingaben durch Auswählen von Check-Boxen vorgenommen wurden. Automatisch generierte „Alert-E-Mails“ informieren Zuweiser und Klinik über die Nichteinhaltung von Kontrollterminen oder Befundverschlechterung. Ergebnisse und Schlussfolgerung Die BOON-Datenbank fördert die notwendige schnelle und ausführliche Kommunikation zwischen Klinik und Zuweisern bei der Behandlung von Patienten mit AMD und anderen Netzhauterkrankungen. Sie erleichtert die Verfolgung der Befundentwicklung und die Einhaltung des geplanten Therapieschemas.
    Der Ophthalmologe 01/2013; DOI:10.1007/s00347-013-2823-0 · 0.72 Impact Factor