Abstract
Neovascular age-related macular degeneration (nAMD), glaucoma and cataract are leading causes of blindness and visual impairment among elderly patients. With an aging population and constrained healthcare resources, optimising medical care systems to deliver cost-effective and safe treatments for these conditions is critical. While randomized controlled trials provide evidence of treatment efficacy under optimal conditions, real-world data (RWD) complements this by offering insights into effectiveness and cost-effectiveness in everyday clinical practice, enhancing our understanding of how treatments perform in real-life settings. This thesis presents real-world outcomes for these three eye diseases at Tays Eye Centre from 2008 to 2020.
In Study I, evaluation of anti-VEGF treatment outcomes in nAMD patients, visual acuity was maintained for up to three years in patients who received persistent treatment using a pro re nata regimen. No significant difference in the incidence of endophthalmitis was observed between injections administered by nurses versus physicians. Study II extended these findings, demonstrating that visual acuity could be preserved over a follow-up period of up to 10 years.
Study III explored the potential impact of anti-VEGF injections on glaucoma progression in patients with nAMD, suggesting that these injections may accelerate the disease’s progression.
Study IV examined five-year glaucoma progression rates, revealing that the proportion of fast (5-7%) and moderate (16-18%) progressors in this cohort was consistent with rates reported in similar glaucoma clinics worldwide.
Study V analysed frequency and safety of immediate sequential bilateral cataract surgery (ISBCS) between 2008 and 2020, showing that ISBCS is a safe procedure, with a significant increase in the proportion of ISBCS cases over the study period.
In summary, by leveraging RWD, researchers and clinicians can gain a more comprehensive understanding of the effectiveness, safety, and utilization patterns of treatments for nAMD, glaucoma, and cataract. This thesis explores the role of real- world data in evaluating the outcomes of these prevalent ocular diseases to ultimately improve patient outcomes in ophthalmology.
In Study I, evaluation of anti-VEGF treatment outcomes in nAMD patients, visual acuity was maintained for up to three years in patients who received persistent treatment using a pro re nata regimen. No significant difference in the incidence of endophthalmitis was observed between injections administered by nurses versus physicians. Study II extended these findings, demonstrating that visual acuity could be preserved over a follow-up period of up to 10 years.
Study III explored the potential impact of anti-VEGF injections on glaucoma progression in patients with nAMD, suggesting that these injections may accelerate the disease’s progression.
Study IV examined five-year glaucoma progression rates, revealing that the proportion of fast (5-7%) and moderate (16-18%) progressors in this cohort was consistent with rates reported in similar glaucoma clinics worldwide.
Study V analysed frequency and safety of immediate sequential bilateral cataract surgery (ISBCS) between 2008 and 2020, showing that ISBCS is a safe procedure, with a significant increase in the proportion of ISBCS cases over the study period.
In summary, by leveraging RWD, researchers and clinicians can gain a more comprehensive understanding of the effectiveness, safety, and utilization patterns of treatments for nAMD, glaucoma, and cataract. This thesis explores the role of real- world data in evaluating the outcomes of these prevalent ocular diseases to ultimately improve patient outcomes in ophthalmology.
| Original language | English |
|---|---|
| Place of Publication | Tampere |
| Publisher | Tampere University |
| ISBN (Electronic) | 978-952-03-3757-5 |
| ISBN (Print) | 978-952-03-3756-8 |
| Publication status | Published - 2025 |
| Publication type | G5 Doctoral dissertation (articles) |
Publication series
| Name | Tampere University Dissertations - Tampereen yliopiston väitöskirjat |
|---|---|
| Volume | 1163 |
| ISSN (Print) | 2489-9860 |
| ISSN (Electronic) | 2490-0028 |