Universität zu Köln

Brinkmann, Christian K., Chang, Petrus, Schick, Tina, Heimes, Britta, Voegeler, Jessica, Haegele, Birgit, Kirchhof, Bernd, Holz, Frank G., Pauleikhoff, Daniel, Ziemssen, Focke, Liakopoulos, Sandra, Spital, Georg and Schmitz-Valckenberg, Steffen (2019). Baseline diagnostics and initial treatment decision for anti-vascular endothelial growth factor treatment in retinal diseases Comparison between results by study physician and reading centers (ORCA/OCEAN study). Ophthalmologe, 116 (8). S. 753 - 766. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1433-0423

Full text not available from this repository.

Abstract

Background The ORCA module of the non-interventional OCEAN study investigated the use of retinal imaging diagnostics in the clinical treatment of patients undergoing vascular endothelial growth factor (VEGF) inhibitor treatment as part of routine clinical care. This article analyzes the agreement between the diagnosis documented by the treating ophthalmologist and the evaluation of reading centers at baseline as well as the effect on the response to treatment during the course. Methods A total of 396 patients (age 75.4 years) were enrolled in which ranibizumab treatment was indicated by the treating ophthalmologist due to either diabetic macular edema (DME), neovascular age-related macular degeneration (nvAMD) or retinal venous occlusion (RVO). Over a period of 24 months, patient and examination data, treatments and interpretation of retinal imaging data by the treating ophthalmologist were systematically recorded. Furthermore, retinal imaging data were also evaluated by three reading centers. Results In 338 out of 396 (85.4%) study eyes, the baseline diagnosis of the treating ophthalmologist was confirmed by the reading centers (DME 87.5%, nvAMD 82.3%, RVO 94.9%). In 17 of the remaining 58 eyes with a discrepant diagnosis, there was at least a consensus with respect to the indications for VEGF inhibitor therapy. The differential diagnoses included a variety of different retinal diseases. During follow-up of up to 3 months, eyes with a consistent diagnosis showed a clear increase in visual acuity (6.4 versus 2.7 letters, p= 0.05) and greater decrease in central retinal thickness (-112.3 versus -24.4 mu m, p< 0.0001). Discussion The initial treatment decision for anti-VEGF therapy with consideration of the differential diagnoses can be challenging. Accurate evaluation of the clinical and imaging findings along with appropriate expertise appear to be important. The observation of superior initial response in eyes with a consensus of the diagnosis at baseline underlines the relevance of an adequate initial assessment for a successful treatment outcome.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Brinkmann, Christian K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Chang, Petrus UNSPECIFIED UNSPECIFIED UNSPECIFIED Schick, Tina UNSPECIFIED UNSPECIFIED UNSPECIFIED Heimes, Britta UNSPECIFIED UNSPECIFIED UNSPECIFIED Voegeler, Jessica UNSPECIFIED UNSPECIFIED UNSPECIFIED Haegele, Birgit UNSPECIFIED UNSPECIFIED UNSPECIFIED Kirchhof, Bernd UNSPECIFIED UNSPECIFIED UNSPECIFIED Holz, Frank G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Pauleikhoff, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED Ziemssen, Focke UNSPECIFIED UNSPECIFIED UNSPECIFIED Liakopoulos, Sandra UNSPECIFIED UNSPECIFIED UNSPECIFIED Spital, Georg UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmitz-Valckenberg, Steffen UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-145635
DOI:	10.1007/s00347-018-0805-y
Journal or Publication Title:	Ophthalmologe
Volume:	116
Number:	8
Page Range:	S. 753 - 766
Date:	2019
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1433-0423
Language:	German
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CHOROIDAL NEOVASCULARIZATION; MACULAR DEGENERATION; VISUAL-ACUITY; THERAPY; RANIBIZUMAB; OPHTHALMOLOGISTS; AGREEMENT; OUTCOMES Multiple languages Ophthalmology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/14563