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Wydanie specjalne czerwiec 2017
str. 40 - 44

Program lekowy „Leczenie neowaskularnej (wysiękowej) postaci zwyrodnienia plamki związanego z wiekiem” – doświadczenia własne po pierwszym roku jego funkcjonowania

Drug Prescription Program „Treatment of Neovascular (Exudative) Form of Age-related Macular Degeneration” – Own Experience after First Year of Management

Małgorzata Seredyka-Burduk ^1,2 , Magdalena Pol ¹ , Grażyna Malukiewicz1, Bartłomiej Kałużny ^1,2

¹ Klinika Chorób Oczu, Wydział Lekarski Collegium Medicum Uniwersytetu Mikołaja Kopernika w Toruniu
Kierownik: prof. dr hab. n. med. Grażyna Malukiewicz
² Zakład Optometrii, Wydział Lekarski Collegium Medicum Uniwersytetu Mikołaja Kopernika w Toruniu
Kierownik: dr hab. m. med. Bartłomiej Kałużny

Summary: Introduction: Age-related macular degeneration is the leading cause of severe and irreversible visual loss in developed countries. Early diagnosis and therapy gives the chance to save visual function.
Aim: The aim of the study is to present our own experience and way of thinking about National Health Fund Drug Prescription Program: “Treatment of neovascular (exudative) form of age-related macular degeneration”, especially the process of patients qualification.
Material and Methods: Retrospective analysis of the 167 eyes with neovascular age-related macular degeneration, which were included to therapy with intravitreal injection, was performed. We show epidemiologic evaluation of patients qualified to therapy and compare outcomes of treatment in two groups of patients – new (group I) and continuing the therapy (group II).
Results: The average time needed for the decision of the qualification committee was 2.29 ± 1.55 days in Group I and 2.06 ± 2.0 days in group II, while the time before first treatment in drug prescription program was 11.31 ± 5.12 days in group I and 16.19 ± 12.64 days in group II. During the time of waiting for the therapy, we found visual acuity reduction in 30 cases of group I and in 35 cases of group II. The average lesion size was 3.58 ± 1.9 DA (disc area) in group I and 3.91 ± 2.41 DA in group II. Central retinal thickness at the day of qualification was 534.3 ± 157.94 μm in group I and 447.54 ± 133.95 μm in group II, and increased on average accordingly to 536.48 ± 153.53 μm and 463.63 ± 137.89 μm. The difference was not statistically significant in both groups.
Discussion: We consider the Drug Prescription Program valuable in preventing blindness in many patients. In spite of that positive argument we discuss a lot of disadvantages, among them: poor access to general ophthalmologists giving too late diagnosis, reduced opportunity of specialized centers to treat enough number of nAMD patients, and first of all, probably limited reimbursement.
Conclusions: Drug prescription program for age-related macular degeneration increased accessibility to therapy and thereby gave the chance to keep central vision in many patients. Qualification of the patients to the therapy by the committee seem not to delay the start of the treatment. Efficiency of Drug Prescription Program depend on the huge activity of the medical staff as well as cooperation between ophthalmology health service and both patients and their families.

Słowa kluczowe: neowaskularna postać zwyrodnienia plamki związanego z wiekiem (nAMD), program lekowy, kwalifikacja do programu lekowego.

Keywords: neovascular age-related macular degeneration (nAMD), drug program, program qualification.

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