Purpose: To describe the first 13 years of anti-vascular endothelial growth factor (anti-VEGF) therapy from the perspective of a public ophthalmic department serving a local community of almost one million people.
Methods: Retrospective registry study. Data from Oslo University Hospital, Norway were collected from 2006 through 2018. Hospital episode statistics were searched for episodes of care encompassing intravitreal anti-VEGF procedures. Patient-specific ID numbers, diagnoses, and drug codes were registered. In general, bevacizumab was used as first-line treatment, with aflibercept reserved for resistant cases from 2013.
Results: The number of unique patients treated per year increased from 130 in 2006 to 3428 in 2018. In 2018, 2488 (73%) patients had also received treatment the previous year. The number of yearly injections increased from 228 in 2006 to 25 570 in 2018. In 2018 the diagnosis macular degeneration constituted 69% of injections, diabetic retinopathy constituted 15%, retinal vein occlusion constituted 13%, and other diagnoses constituted 3%. In the same year 49% of injections were with bevacizumab, 46% with aflibercept, 4% with ranibizumab, and 1% with dexamethasone implants. The bevacizumab to aflibercept ratio was almost 1:1 for macular degeneration and diabetic retinopathy; for retinal vein occlusion the ratio was 13:7.
Conclusion: In 13 years there was an approximately 100-fold increase in the number of yearly intravitreal injections. A majority of patients received long-term treatment. Macular degeneration was the most common diagnosis. Using bevacizumab as first-line treatment, with aflibercept reserved for resistant cases from 2013, eventually resulted in a nearly 1:1 ratio in drug usage.
Keywords: aflibercept; anti-vascular endothelial growth factor therapy; bevacizumab; intravitreal injections; ranibizumab.
© 2019 The Authors. Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation.