gms | German Medical Science

Background: Monthly follow-up visits after initial 3 injections of Lucentis™ (Ranibizumab) in patients with choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD) are often not performed due to logistic reasons. Thus, visual acuity (VA) results are not comparable to those obtained under study conditions.

Methods: A pilot study has been started by the University Eye Hospital Bonn in collaboration with 10 referring ophthalmologists setting up an online platform for concerted AMD patient care. Patients’ master file data as well as diagnosis, injection data, VA, macular thickness, and morphologic criteria are recorded, and fundus photographs, angiography files, and optical coherence tomography (OCT) pictures are uploaded. In case of missing control visits, VA loss of more than 5 letters, or increase of macular thickness of more than 100µm during follow-up safety mechanisms are automatically activated alerting the hospital and the referring ophthalmologist and thus guarantying prompt patient contact. Furthermore, thorough documentation enables the evaluation of quality parameters for cross-sector AMD treatment.

Results: Both, the University Eye Hospital and the referring ophthalmologists agreed upon common standards for diagnosis and treatment of AMD. So far, 91 patients have been entered into the data base, with a total of 328 injections. Automated alert emails have been generated 3,4 times per patient on average in case of disease progression or missed follow-up visits.

Conclusion: The conjoint online network leads to a better supervision of injections and follow-up visits, and actively counteracts prolonged control intervals. Concerted access to the follow-up parameters of each patient improves patient care and prompt re-treatment in case of disease progression.