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Purpose:
Neovascular age-related macular degeneration (nAMD) and diabetic macular edema (DME) are major public health issues that significantly affect the visual acuity and quality of life in adults, posing important challenges for healthcare systems. Our purpuse was to evaluate clinical characteristics and treatment patterns for patients with AMD and DME in a Colombian HMO from 2012 to 2022.
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Methods:
We conducted a retrospective observational study using a claims database with ICD-10 codes. Demographic and clinical data, including treatment regimens and visual acuity, were corroborated from electronic health records. Snellen scale measurements were converted to the ETDRS system to evaluate visual gains.
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Results:
The study included 1685 nAMD (mean age 78.1 ±10.6) and 1210 DME (mean age 68.0 ±11.6) patients. Intravitreal therapy was administered to 1638 nAMD and 1181 DME patients, predominantly with ranibizumab and aflibercept. On average, patients received 4.26 ±2.53 injections with ranibizumab and 4.45 ±2.56 injections of aflibercept in their first year of treatment, with 59.6% having received fewer than three injections. Average visual acuity improvement after 12 months of treatment was +2.73 letters. Those with baseline visual acuity ≥20/200 experienced the most significant gains post-loading dose, with an increase of +12.5 letters (13.2 for AMD and 18.3 for DME), which was sustained after 12 months.
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Conclusions:
The study shows modest visual acuity improvements in a real-world setting, potentially due to the suboptimal injection frequency. The findings highlight the need for improved treatment strategies to alleviate AMD and DME's burden and enhance patient outcomes in Colombia.