Study Highlights Growing Treatment Burden of Retinal Diseases in Finland

A recent study conducted by Finnish researchers Hanna Heloterä, Anna-Mari Viita, and Juha Laine sheds light on the increasing workload in ophthalmology departments due to the rising use of anti-vascular endothelial growth factor (VEGF) drugs for retinal diseases. The study, which analyzed Finnish registry data, provides valuable insights into the challenges posed by an aging population and lifestyle changes, along with the evolving landscape of ophthalmology registries.

The Rise of Anti-VEGF Treatments

The introduction of intravitreal anti-VEGF inhibitors has expanded treatment options for conditions such as:

       • Neovascular age-related macular degeneration (nAMD).

       • Diabetic macular edema (DME).

       • Retinal vein occlusion (RVO).

       • Myopic choroidal neovascularization (mCNV).

While these advancements have improved patient outcomes, they have also significantly increased the treatment burden in ophthalmology clinics.

Study Overview

The researchers conducted a retrospective analysis of registry data for patients receiving intravitreal injections from 2015 to 2022. The study focused on the use of ranibizumab (Lucentis), aflibercept (Eylea), and bevacizumab (Avastin) for treating nAMD, DME, RVO, and mCNV.

Key Findings: Registry Data Analysis

     1. Increase in Workload:

           • The total number of patients with nAMD, DME, RVO, and mCNV increased by 199.6% between 2015 and 2021.

           • Administered anti-VEGF injections grew significantly, though the rate of increase began to slow:

                 - 23.7% increase (2019–2020).

                 - 10.3% increase (2020–2021).

                 - 6.7% increase (2021–2022).

     2. New Patient Trends:

           • The annual number of new patients across all diagnoses varied between 255 and 458 from 2015 to 2021.

           • New patients starting anti-VEGF treatment ranged from 489 to 572 between 2019 and 2021.

     3. Condition-Specific Growth:

       • The largest patient group was treated for nAMD, with a 73.8% increase in cases from 2015 (191 patients) to 2021 (332 patients).

       • Patients diagnosed with RVO grew by 188.5% during the same period (2015: 26 patients; 2021: 75 patients).

       • The number of patients with DME remained relatively stable, while cases of mCNV stayed low throughout the observation period.

Implications for Ophthalmology

The findings underscore the growing treatment demands faced by ophthalmology departments. The authors highlighted that:

       • Aging populations and lifestyle changes will continue to drive an increase in patients with retinal vascular diseases.

       • Registry data is critical for creating evidence-based strategies to address these challenges, though understanding the limitations and quality of registries is essential.

Future Directions

The study emphasizes the need for data-driven discussions about resource allocation in ophthalmology departments. The researchers concluded:

“Our study led to a heightened understanding of the Finnish registry landscape and demonstrated an increased workload by intravitreal injections in ophthalmology departments. Confidently, these data will facilitate discussions about changing resource needs in ophthalmology departments and registry studies in the future.”

By addressing these challenges, healthcare providers can better manage the rising demands for retinal disease treatments, ensuring improved patient outcomes and more efficient clinic operations.

Reference:

Heloterä H, Viita AM, Laine J. Evolution of workload associated with anti-VEGF treatments for AMD, DME, RVO and mCNV in hospital district of Southwest Finland. Clin Ophthalmol. 2024;18:3645-3655; https://doi.org/10.2147/OPTH.S479816