References

Czech and Slovak Ophthalmology

518

Original article

Efficiency Evaluation of Non-Infectious Uveitis

Krásná

Jana

Mezerová

Veronika

Krásný

Jan

https://orcid.org/0000-0002-0341-0094

21 5 2013

Authors compared clinical and economic effeciency of treatment of the classical corticosteroids therapy and modern immunosuppressive treatment or their combination. Retrospective evaluation carried out in 2012, covering 2006–2011, monitored sample of 27 patients, 16 women and 11 men, 45 eyes with disabilities. The average age in the last year of follow-up monitoring was 30.2, ranging from 14 to 76 years. The mean duration of disease for the whole sample is 16.5 years with a range from 6 to 36 years. Three basic diagnoses were included in investigated group: chronic iridocyclitis in 59 % of eyes, intermediate uveitis in 30 % of eyes and sympathetic ophthalmia in 11 % of eyes. The optimal treatment not be determined, however, combined corticosteroid sparing therapy was the most beneficial to maintain in terms of visual acuity with minimal side effects and cost effectiveness. Successful outcomes of treatment were observed for intermediate uveitis, because the visual acuity improved in nine letetters of ETDRS chart in the study. Satisfactory treatment was proved in chronic iridocyclitis and sympathetic ophthalmia in general, because visual acuity improved in a few letters of ETDRS chart, in the same line as in the beginning of the six-year follow-up. Rounded average annual prize for treatment including pharmacotherapy, outpatient and inpatient care and laboratory follow-up was in chronic iridocyclitis € 990, in intermediate uveitis € 310 and sympathetic ophthalmia € 1550. Pharmacotherapy exceeded the financial appraisal of specialized medical and inpatient care in total cost.

uveitis corticosteorids immunosuppression costeffectivness

References

Adeoti, C.: Prevalence and causes of blindness in a tropical African population. West African J Med, 2004; 23: 249–252.

Baker, K.B., Spurrier, N.J., Watkins, A.S.: Retention time for corticosteroid- -sparing systemic immunosuppressive agent in patient with inflammatory eye disease. Br J Ophthalmol, 2006, 90: 1481–1485.

Bodaghi, B., Kobet, G., Richard, B.: One year analysis of the cost of uveitis treatment in France: a retrospective chart review. Acta Ophthalmol, 2008, 86: 101, Abstrakt rešerše NTK.

Buch, H., Vinding, T., et al.: Prevalence and causes of visual apartment and blindness among 9980 Scandinavian adults: the Copenhagen city eye study. Ophthalmology, 2004; 111: 53–61.

Cunningham, E. T., Wender, J. D.: Practical approach to the use of corticosteroids in patiens with uveitis. Can J Ophthalmol, 2010; 4: 352–358.

De Smet, M., D., Taylor, S., et al.: Understanding uveitis: The impact of research on visual outcomes. Progress in Retinal and Eye Research, 2011, 30: 452–470.

Doležal, T. a kol.: Základy farmakoekonomiky pro lékafie, lékárníky a další pracovníky ve zdravotnictví, Praha ČFES, 2007; s. 136.

Durrani, O.M., Tehrani, N.N., et al.: Degree, duration, and causes of visual loss in uveitis. Br J Ophthalmol, 2004; 88: 1159–1166.

Dušek, L., Pitrová, Š, et al.: Informační zázemí České oftalmologické společnosti ČLS JEP pro monitoring a hodnocení léčby vlhké formy věkem podmíněné makulární degenerace – národní projekt AMADEUS. Čes a slov Oftal, 66; 2010: 99–109.

Frick, K.D., Gower, E.W., et al.: Economic impact of visual impairment and blindness in the United States. Ophthalmology, 2007; 12: 544–550.

Iwase, A., Araie, M., Tomidokoro, A.: Prevalence and causes of low vision and blindness in a Japanes adult population. Ophthalmology, 2006; 113: 1354 – 1362.

Jabs, D.A.., Nussenblatt, R.B. et al.: tandardization of uveitis nomenclature for reporting clinical data. Result of the First International Workshop. Am. J.Ophthalmol., 140, 2005: 509 –516.

Kacmaz, R.O., Kemoen, J.H., et al.: Cyclosporine for ocular infalmmatory diseases. Ophthalmology, 2010; 3: 576–584.

Kilmarin, D. J., Forrester , J. V., Dick, A.D.: Cyclosporin A therapy in refraktory non-infectious childhood uveitis. Br J Ophthalmology, 1998; 82: 737–742.

Lee, W.J., Greenwood, R., Taylor, H. A.: Randomized trial of Tacrolimus versus Tacrolimus and Prednisone for maintance of disease remission in noninfectious uveitis. Ophthalmology, 2009; 2: 155–163.

Malik, A.R, Pavesio, C.: The use low- -dose Methotrexate in children with chronic anterior and intermediate uveitis. Br J Ophthalmol, 2005; 89: 806–808.

Brevíř 2006. 15. vydání, Praha, Medical tribune CZ, 2006. (ISBN 80- 903708-0-2).

Brevíř 2007. 16. vydání, Praha, Medical tribune CZ, 2007. (ISBN 978-80- 903708-7-6).

Brevífi 2008. 17. vydání, Praha:Medical tribune CZ, 2008.(ISBN 978-80- 87135-05-1).

Brevífi 2009. 18. vydání, Praha: Medical tribune CZ, 2009. (ISBN 978-80- 87135-14-3).

Brevífi 2010. 18. vydání, Praha: Medical tribune CZ, 2010. (ISBN 978-80- 87135-21-1).

Brevífi 2011. 19. vydání, Praha:Medical tribune CZ, 2011. (ISBN 978-80- 87135-26-6).

Menezo, V., Lau, CH., Comer, M.: Clinical outcome of chronic immunosuppression in patiens with non-infectious uveitis. Clin. and Experiment. Ophthalmol, 2005; 33: 16–21.

Pasadhika, S., Kempen, J.H. et al: Azathioprine for ocular inflammatory disease. Am J Ophthalmol, 2009, 148: 500– 509.

Pato, E., Munoz-Fernandes, S. et al.: Systematic review of th effectivness of immunosuppressants and biological therapies in the treatment of autoimmune posterior uveitis. Seminars in arthritis and rheumatism, 2011; 4: 314 – 323.

Práznovcová, L., Strnad, L.: Farmakoekonomika pro lékaře, farmaceuty a manažery zdravotnických zařízení. Praha, Maxdorf, 2005, s. 85.

Říhová, E., a kol.: Uveitidy., Praha: Grada Publishing, 2009, s. 134.

Říhová, E., Šišková, A.: Léčba neinfekční uveitidy. Remedia, 2002; 12: 179– 84.

Seroczyńska, M., Gralek, M., Kanigowska, K.: Analysis of the changes in the cause of blindness and siginificant vision loos among children and young adult born between 1974 and 2004. Medycyna wieku rozwojowego, 2007; 11: 193–216.

Sherwin, J.C., Dean, W.H., Medcalfe, N.H.: Cause s of blindness at Nkhoma Eye Hospital, Malawi. Europ J Ophthalmol, 2008; 18: 1002–1006.

Sloper, C.M., Powel, R., Dua, H.S.: Tacrolimus (FK 506) in the treatment of posterior uveitis refractory to Cyclosporine. Ophthalmology, 1999; 4: 723–728.