First Author: K.Pachkoria UK
Co Author(s): M. Masih S. Farrel R. Desai K. Karia A. Stein A. Lobo 0 0 0 0 0 0 0 0 0
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Increasing patient demand for intravitreal injection for treatment of wet AMD appears to be the main catalyst of current capacity woes in many eye clinics across the UK. Engagement of Allied Health Personnel (AHP) in AMD clinics might resolve capacity issues. We report 12 months results of clinical outcomes and side effects in patients undergoing Ranibizumab treatment for wet-AMD in a low capacity community setting runned by AHP and compare our results with the local UK outcome data and published clinical trials.
Low capacity community AMD center at Moorfields EyeHospital in Bedford, Bedfordshire, UK.
AHP staff comprised specifically trained optometrists, nurses, medical photographer, AMD coordinator, and reception staff led by one medical retina (MR) consultant. Intravitreal injections were undertaken by trained nurse under the supervision of a MR consultant. Demographic, treatment, visual acuity measurements (Month 3 and Month 12) and side effects were recorded retrospectively from June 2012 till April 2013. Patients received 3 initial injections at 4 weekly intervals and then further dosing was based on individual response to treatment.
One hundred and five eyes of 100 patients were included. Patients had an average of 6.1 injections. Mean time from diagnosis to first injection was 12.3 days. The primary outcome in terms of mean change in BCVA score in the Early Treatment Diabetic Retinopathy Study eye chart was 6.6 at 3 months and 7.5 letters at 12 months. There were less patient at 3 months maintaining and gaining vision (81% vs 11%) compared to 12 months (87% vs 22%) follow up. Endophthalmitis was recorded in 1%, acute post-injection IOP rise in 30%, possible thromboembolic events in 2%.
The results of our study show that the primary outcome in terms of mean change in BCVA at 3 and 12 months are comparable with local UK outcome data and published clinical trials. Good team working of Allied Health Personnel is capable of providing safe and efficient AMD clinic. Thus, engagement of AHP is a promising action that might smooth out current and future AMD capacity issues.