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Quality-adjusted life years in macular oedema due to age-related macular degeneration, diabetes and central retinal vein occlusion: the impact of anti-VEGF agents in a tertiary centre in Greece

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Abstract

Introduction

Neovascular age-related macular degeneration (nAMD), diabetic macular oedema (DME), and macular oedema due to central retinal vein occlusion (CRVO) are leading causes of vision loss, currently managed with anti-vascular endothelial growth factor injections (anti-VEGF). The aim of this study was to calculate QALYs in patients with nAMD, DME, and CRVO treated with anti-VEGF agents (QALYs+) in a Greek tertiary hospital setting and compare them to theoretical QALYs that the patients would have without treatment (QALYs−).

Material and Methods

The study included 143 treatment-naive patients with macular oedema due to nAMD (n = 79), DME (n = 57), and CRVO (n = 7), who received anti-VEGF injections as monotherapy according to the Treat-and-Extend (T&E) protocol. The anti-VEGF agents were ranibizumab and aflibercept in equivalent fractions. QALYs where calculated by the formula QALY = Utility Value × Time, where “Time” refers to the follow-up period of the study. For QALYs−, we assumed that visual acuity remained unchanged during this period.

Results

Mean follow-up time was 1.3 ± 1.2 years in the nAMD group, 1 ± 1.3 years in the DME group, and 0.5 ± 1 years in the CRVO group. There was no statistically significant difference between QALYs− and QALYs+ in all three ocular pathologies for the study period (p > 0.05 for each of the three statistical tests performed).

Discussion/Conclusion

Possible explanations for the lack of significant difference between QALYs − and QALYs + in nAMD, DME, and CRVO groups, may be the short time horizon used in this analysis, the inclusion of data from the better-seeing eye (BSE) and the specific socio-economic, geographical and health care characteristics of this rural Greek area.

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Acknowledgements

This study is part of an e-poster that has stand out in the 2019 EURETINA in Vienna.

Funding

No funding has been received for this study.

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Author notes

  1. Nikolaos T. Voutsas and Eleni Papageorgiou contributed equally to this work and also all the statistical analysis was handled by Vasilis A. Dimitriou.

Authors and Affiliations

  1. Department of Ophthalmology, University Hospital of Larissa, Mezourlo Area, 41110, Larissa, Greece

    Nikolaos T. Voutsas, Eleni Papageorgiou, Alexandra Tantou, Evangelia E. Tsironi & Maria Kotoula

  2. Department of Mathematics, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Vassilis A. Dimitriou

  3. Department of Ophthalmology, Faculty of Medicine, University of Thessaly, Larissa, Greece

    Evangelia E. Tsironi

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  1. Nikolaos T. Voutsas
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Contributions

NTV contributed to original idea, acquisition, collection of data, and writing of the manuscript. MK and EP contributed to original idea, study design, interpretation of data, and writing of manuscript revision. AT contributed to acquisition, collection and analysis of data. ET contributed to study supervision and interpretation of data. VAD contributed to statistical Analysis of data. All authors read and approved the final manuscript.

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Correspondence to Nikolaos T. Voutsas.

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Statement of Ethics

Τhis study was performed according to the Declaration of Helsinki. Each subject gave his informed consent for including his data in this study. The study was approved by the Institutional Review Βoard of the university hospital of Larissa (Study number 452019/2016).

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Voutsas, N.T., Papageorgiou, E., Tantou, A. et al. Quality-adjusted life years in macular oedema due to age-related macular degeneration, diabetes and central retinal vein occlusion: the impact of anti-VEGF agents in a tertiary centre in Greece. Int Ophthalmol 42, 2673–2684 (2022). https://doi.org/10.1007/s10792-022-02256-y

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