What bed corrected acuity must you have to be eligible for NICE treatment?
6/12 - 6/96
Apart from va what other criteria are required to benefit from NICE approved treatment ?
- No permanent structural change to fovea
- Evidence of disease progression (reduced va, blood vessel growth verified by FFA)
- Lesion size less than 12 disc area in greatest linear dimension
What is the Eylea loading dose regime?
3 x monthly
3 x two monthly
At the seventh visit with Eylea if oct fluid increases or va reduces what is the management?
Inject and reduce follow up to 6 weeks.
A patient has had 3 x 12 weekly injections and is still dry what is the management?
Discharge to stable clinic.
With Lucentis what happens after initial 3 monthly loading dose?
Patient may be switched to PRN basis if dry. If they reactivate a treat and extend protocol could be followed.
A patient is switched from lucentis having received more than 7 injections in last 12 visits. What Eylea protocol should she be started on?
3 x two monthly injections then follow Eylea protocol as per 7th visit.
If a patient is responding poorly to Eylea at 3rd visit what is management?
Consider switch to Lucentis
At what point does NICE consider cessation of therapy due to failure?
If va has dropped by >30 letters despite treatment or vision drops to <15 letters caused only by amd lesion. Treatment should be withheld permanently.
What are the benefits of treatment?
95% achieve stability of visual acuity and in 30% increase V/a
What is the risk of complete visual loss?
What systemic risks are there to anti-vEGF?
MI or stroke
What is the rate of retinal tear?
1 in 8000
What is the rate of retinal detachment?
1 in 50000
When do patients require an IOP check?