Evidence map›Paper›PMID 33354933›Full record

ArticleActa ophthalmologica2021

Real-world treatment outcomes of neovascular Age-related Macular Degeneration in the Netherlands.

Frank D Verbraak, Dirk L Ponsioen, Odette A M Tigchelaar-Besling, Vuong Nguyen, Mark C Gillies, Daniel Barthelmes, Caroline C W Klaver

Open access · hybridAbstract readComparative StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Acta ophthalmologica, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 3 pooled it
1.4field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

16 citing papers in PubMed, 3 syntheses or guidelines pooled it, 22 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. The ideal intravitreal injection setting: office, ambulatory surgery room or operating theatre? A narrative review and international survey.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2023
    Pooled it
  4. Real-world treatment outcomes of aflibercept versus bevacizumab for neovascular age-related macular degeneration.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2026
    Observational
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  6. A cost-minimization analysis of anti-VEGFs for the treatment of neovascular age-related macular degeneration in the Netherlands.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2025
    Article
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  12. Cost-minimisation analysis of a treat-and-extend regimen with anti-VEGFs in patients with neovascular age-related macular degeneration.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2022
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  14. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 6 institutions in 3 countries.

Frank D VerbraakDepartment of Ophthalmology, Amsterdam University Medical Center, Amsterdam, The Netherlands.ORCID https://orcid.org/0000-0001-7560-1423
Dirk L PonsioenDepartment of Ophthalmology, Isala Clinic, Zwolle, The Netherlands.
Odette A M Tigchelaar-BeslingDepartment of Ophthalmology, Amphia Clinic, Breda, The Netherlands.
Vuong NguyenThe Save Sight Institute, Sydney Medical School, University of Sydney, Sydney, NSW, Australia.
Mark C GilliesThe Save Sight Institute, Sydney Medical School, University of Sydney, Sydney, NSW, Australia.
Daniel BarthelmesDepartment of Ophthalmology, Zurich University Medical Clinic, Zurich, Switzerland.
Caroline C W KlaverDepartment of Ophthalmology, Radboud University Medical Clinic, Nijmegen, The Netherlands.
The University of Sydney · AUAmphia Ziekenhuis · NLAmsterdam University Medical Centers · NLIsala · NLRadboud University Nijmegen · NLUniversity of Zurich · CH

Funding

Bayer Netherlands
6 · The paper itself

Abstract

purposeTo compare treatment outcomes of treatment-naïve eyes with neovascular age-related macular degeneration (nAMD) with bevacizumab as the first-line treatment, according to the guidelines of the Dutch Ophthalmological Society, with those treated first with either ranibizumab or aflibercept, as used in many other countries, all treated using a treat-and-extend strategy.

methodsData were obtained from the prospectively designed Fight Retinal Blindness! outcomes registry. The primary outcome was the mean change from baseline in visual acuity of all treated eyes, after 12, 24 and 36 months of treatment. Secondary outcomes were the number of injections, the number of visits and the rate of switching to a second anti-VEGF drug.

resultsThe study included 703 treatment-naïve eyes with nAMD with 12 months follow-up, 373 eyes with 24 months follow-up, and 171 eyes with 36 months follow-up in the Netherlands, and 1131, 652, and 303 treatment-naïve eyes with respectively 12, 24, and 36 months of follow-up in all other countries. The change in visual acuity from baseline did not differ between the Netherlands and the other countries at any follow-up time. The median number of injections, visits and the proportion of eyes switching treatment was significantly higher in the Netherlands than in the other countries.

conclusionStarting anti-VEGF treatment for nAMD with bevacizumab, as is mandatory in the Netherlands, delivers outcomes similar to those starting treatment with either ranibizumab or aflibercept, but at a cost of more frequent injections, and visits, and more frequent switching treatment to a second drug.

Indexed as

Visual AcuityAgedAged, 80 and overAngiogenesis InhibitorsBevacizumabFemaleFollow-Up StudiesHumansIncidenceIntravitreal InjectionsMacula LuteaMaleNetherlandsRanibizumabReceptors, Vascular Endothelial Growth FactorRecombinant Fusion ProteinsafliberceptAngiogenesis InhibitorsBevacizumabRanibizumabReceptors, Vascular Endothelial Growth FactorRecombinant Fusion ProteinsVascular Endothelial Growth Factor Aanti-VEGF treatmentneovascular age-related macular degeneration (nAMD)quality registrationreal-world data

Identifiers

PMID33354933
PMCPMC8519105
OpenAlexW3116998337

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.