Survey of Intravitreal Injection Preferences for the Treatment of Age-Related Macular Degeneration and Macular Edema Among Members of the Turkish Ophthalmological Association

Objectives: To analyze the current preferences of ophthalmologists for the treatment of macular edema and age-related macular degeneration (AMD) and to evaluate off-label use of bevacizumab in Turkey. Materials and Methods: All members of the Turkish Ophthalmological Association were contacted by e-...

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Bibliographic Details
Published in:Turk oftalmoloji gazetesi 2022-06, Vol.52 (3), p.179-185
Main Authors: Karabas, V. Levent, Tokuc, Ecem Onder, Sermet, Figen
Format: Article
Language:English
Subjects:
aflibercept
age-related macular degeneration
anti-vegf
bevacizumab
Care and treatment
diabetic macular edema
Dropsy
Edema
Laws, regulations and rules
Macular degeneration
off-label
Ophthalmology
Original
Physiological aspects
ranibizumab
retinal vein occlusion
Surveys
Vascular endothelial growth factor
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Summary:Objectives: To analyze the current preferences of ophthalmologists for the treatment of macular edema and age-related macular degeneration (AMD) and to evaluate off-label use of bevacizumab in Turkey. Materials and Methods: All members of the Turkish Ophthalmological Association were contacted by e-mail to complete an anonymous, 47-question internet-based survey. The second part of the survey (questions 36-47) was evaluated. Results: When current legal regulations were considered, ophthalmologists used bevacizumab as the first-line agent in patients with diabetic macular edema (DME), AMD, and retinal vein occlusion (RVO) (58.25%, 55.89%, and 52.29%, respectively). When economic and legal constraints were disregarded, the participants' preference for bevacizumab in the treatment of DME, AMD, and RVO decreased (11.64%, 10.58%, and 10.93%, respectively). Approximately three-quarters (75.75%) of ophthalmologists stated that dispensing multiple syringes from a single bevacizumab bottle could increase the risk of endophthalmitis. Most participants (93.68%) did not feel legally safe from harm caused by off-label bevacizumab use. However, 66.43% of ophthalmologists stated that bevacizumab is as effective as other anti-vascular endothelial growth factor (anti-VEGF) drugs. Conclusion: Bevacizumab is widely used as a first-line treatment for all indications of anti-VEGF use in the current reimbursement conditions, which preclude the right of ophthalmologists to treat according to their own preferences. Keywords: Anti-VEGF, bevacizumab, aflibercept, ranibizumab, off-label, diabetic macular edema, age-related macular degeneration, retinal vein occlusion
ISSN:1300-0659
2149-8695
2147-2661
2149-8709
DOI:10.4274/tjo.galenos.2021.37075