Clinical Characteristics and Management of Wet Age-Related Macular Degeneration at Cipto Mangunkusumo Hospital Kirana, Jakarta, Indonesia
Article Sidebar
Main Article Content
Abstract
Introduction: Age-related macular degeneration (AMD) is a leading cause of blindness globally, with wet AMD being particularly debilitating. The prevalence of AMD is increasing, necessitating a deeper understanding of its clinical characteristics and management. This study aims to investigate the demographic and clinical features, management, and treatment outcomes of wet AMD at Cipto Mangunkusumo Hospital during January-December 2022.
Methods: A retrospective descriptive study was conducted, analyzing medical records of wet AMD patients treated during the specified period. Data analysis included patient demographics, clinical characteristics, treatment modalities, and outcomes.
Results: Of 129 eyes from 122 patients, 115 eyes met the inclusion criteria. The majority were female (55.7%) with an average age of 67 years. Most patients presented with blurry vision (93.9%) and received Patizra anti-VEGF injections (60.9%). Hypertension was the most common risk factor (28.7%). Anti-VEGF treatment significantly reduced central macular thickness (p < 0.05) but had no significant impact on visual acuity. Avastin and Patizra injections similarly influenced macular thickness but not visual acuity. There were no significant differences between loading and non-loading dose groups in terms of outcomes.
Conclusion: Anti-VEGF treatment effectively reduces central macular thickness in wet AMD patients, regardless of the specific agent used. However, it does not significantly improve visual acuity. Further research is needed to explore differences between loading and non-loading dose protocols, compare treatment strategies, and investigate demographic risk factors. Consistency in visual acuity documentation using the ETDRS format is recommended for future studies.
Keywords
Age-related macular degeneration, wet AMD, anti-VEGF treatment, central macular thickness, visual acuity
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
References
2. Pennington KL, DeAngelis MM. Epidemiology of Age-related macular degeneration (AMD): associations with cardiovascular disease phenotypes and lipid factors. Vol. 3, Eye and Vision. BioMed Central Ltd; 2016.
3. Vyawahare H, Shinde P. Age-Related Macular Degeneration: Epidemiology, Pathophysiology, Diagnosis, and Treatment. Cureus. 26 September 2022;
4. Hadziahmetovic M, Malek G. Age-related macular degeneration Revisited: From Pathology and Cellular Stress to Potential Therapies. Vol. 8, Frontiers in Cell and Developmental Biology. Frontiers Media S.A.; 2021.
5. Johnston SS, Wilson K, Huang A, Smith D, Varker H, Turpcu A. Retrospective analysis of first-line anti-vascular endothelial growth factor treatment patterns in wet age-related macular degeneration. Adv Ther. 2013;30(12):1111–27.
6. Johnston RL, Carius HJ, Skelly A, Ferreira A, Milnes F, Mitchell P. A Retrospective Study of Ranibizumab Treatment Regimens for Neovascular Age-related macular degeneration (nAMD) in Australia and the United Kingdom. Adv Ther. 1 Maret 2017;34(3):703–12.
7. Jonas JB, Cheung CMG, Panda-Jonas S. Updates on the epidemiology of age-related macular degeneration. Vol. 6, Asia-Pacific Journal of Ophthalmology. Asia-Pacific Academy of Ophthalmology; 2017. hlm. 493–7.
8. Pugazhendhi A, Hubbell M, Jairam P, Ambati B. Neovascular macular degeneration: A review of etiology, risk factors, and recent advances in research and therapy. Vol. 22, International Journal of Molecular Sciences. MDPI AG; 2021. hlm. 1–25.
9. Thapa R, Bajimaya S, Paudyal G, Khanal S, Tan S, Thapa SS, dkk. Prevalence of and risk factors for Age-related macular degeneration in Nepal: The Bhaktapur retina study. Clinical Ophthalmology. 22 Mei 2017;11:963–72.
10. Parfitt A, Boxell E, Amoaku WM, Bradley C. Patient-reported reasons for delay in diagnosis of age-related macular degeneration: A national survey. BMJ Open Ophthalmol. 1 Oktober 2019;4(1).
11. Abusharkh FH, Kurdi L, Shigdar RW, Mandura RA, Alattas K. Prevalence and Associated Risk Factors of Age-related macular degeneration in the Retina Clinic at a Tertiary Center in Makkah Province, Saudi Arabia: A Retrospective Record Review. Cureus. 12 Maret 2023;
12. Amarakoon S, Martinez-Ciriano JP, van den Born LI, Baarsma S, Missotten T. Bevacizumab in age-related macular degeneration: a randomized controlled trial on the effect of on-demand therapy every 4 or 8 weeks. Acta Ophthalmol. 1 Februari 2019;97(1):107–12.
13. Calvo P, Abadia B, Ferreras A, Ruiz-Moreno O, Leciñena J, Torrón C. Long-Term Visual Outcome in Wet Age-related macular degeneration Patients Depending on the Number of Ranibizumab Injections. J Ophthalmol. 2015;2015.
14. Aichi R, Nagai N, Ohkoshi K, Ozawa Y. Impact of Treating Age-related macular degeneration before Visual Function Is Impaired. J Clin Med. 1 Oktober 2022;11(19).
15. Hanhart J, Wiener R, Totah H, Brosh K, Zadok D. Pseudophakia as a surprising protective factor in neovascular age-related macular degeneration. J Fr Ophtalmol. 1 Mei 2023;46(5):527–35.
16. Figurska M, Rękas M. Three-year outcomes of wet Age-related macular degeneration treatment in polish therapeutic programs. Medicina (Lithuania). 1 Januari 2022;58(1).
17. Sagong M, Woo SJ, Lee Y. Real-world effectiveness, treatment pattern, and safety of ranibizumab in korean patients with neovascular age-related macular degeneration: Subgroup analyses from the luminous study. Clinical Ophthalmology. 2021;15:1995–2011.
18. Kristianto B, Andayani A, Mas AA, Triningrat P, Made N, Suryathi A, dkk. Clinical characteristics and demographics figures of patients with Age-related macular degeneration at a tertiary-level hospital in Denpasar, Bali. Intisari Sains Medis | Intisari Sains Medis [Internet]. 2021;12(1):298–301. Available from: https://www.nei.nih.gov/learn-
19. Ashraf M, Souka AAR. Aflibercept in age-related macular degeneration: Evaluating its role as a primary therapeutic option. Eye (Basingstoke). 1 November 2017;31(11):1523–36.
20. Solomon SD, Lindsley K, Vedula SS, Krzystolik MG, Hawkins BS. Anti-vascular endothelial growth factor for neovascular agerelated macular degeneration. Vol. 2019, Cochrane Database of Systematic Reviews. John Wiley and Sons Ltd; 2019.
21. Motarjemizadeh Q, Aidenloo S, Abbaszadeh M. Intravitreal Bevacizumab with or without Triamcinolone for Wet Age-related Macular Degeneration: Twelve-month Results of a Prospective, Randomized Investigation. 2018; Available from: http://journals.lww.com/mejo.