Between 2015 and 2017, the number of annual total anti-
VEGF injections increased from 60 412 to 93 589 (+24.5% annual change) and of
aflibercept injections from 8299 to 20 833 (+58.7% annual change). The 3-year average for total anti-
VEGF injections ranged from 9.6 to 21.1 (median 13.3) per 1000 citizens between hospital districts and for
aflibercept injections from 0.8 to 4.0 (median 1.9). According to the primary protocol for wet AMD, during 2015-2017, the number of total anti-
VEGF injections increased from 10.9 to 15.2 per 1000 citizens with the pro re
nata (PRN) protocol and from 11.3 to 18.9 with the treat-and-extend regimen (TER). The 3-year average of
aflibercept injections as a second-line treatment, but not the total number of anti-
VEGF or
bevacizumab injections, inversely correlated with new onset
visual impairments (R = -0.505, P = 0.027) in the hospital districts. The number of
visual impairments did not differ between the hospital districts according to the PRN and TER protocols (1.23 ± 0.41 and 1.14 ± 0.67, respectively, per 1000 citizens aged ≥64 years, P = 0.713).
CONCLUSION: