Use of anti-vascular endothelial growth factor drugs for eye disease in Tuscany: Development and test of indicators of treatment intensity

Gianni Virgili, Gian Marco Tosi, Michele Figus, Stanislao Rizzo, Vittoria Murro, Dario Pasquale Mucciolo*, Giuseppe Roberto, Rosa Gini

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Purpose: We aimed to develop indicators based on electronic administrative data to compare treatment intensity at a hospital level in Tuscany, Italy. Methods: Data from 3 university hospitals (UHs), 11 local hospitals (LHs) and 2 private hospitals were analysed. Patients newly treated with an intravitreal injection were followed up for 365 days. Indicator #1 concerned hospitals with >80% of injections linked to a drug and patients with all injections linked to a drug. Indicator #2 included patients who received ⩾3 injections during the first 90 days, regardless of injection-drug linkage. Results: Indicator #1 was computed on four hospitals and included 3210 patients (48.3%). The average number of injections was 3.24 in the largest UH1. Compared to the latter, indicator #1 was significantly lower in UH2 and UH3 (−0.47 and −0.58, respectively; p < 0.001). Indicator #2 was computed on all hospitals and included 2789 patients (41.9%). UH1 delivered about 4.33 injections. Compared to the latter, LH4 delivered +0.62 injections (p < 0.001) and nine other hospitals delivered between −0.22 and −0.94 injections (p < 0.05). Conclusion: The two indicators proved to have the potential for supporting clinicians and policy makers in promoting the appropriate treatment intensity with intravitreal anti-vascular endothelial growth factor drugs.

Original languageEnglish
Pages (from-to)1440-1447
Number of pages8
JournalEuropean Journal of Ophthalmology
Issue number6
Early online date30 Oct 2019
Publication statusPublished - 01 Nov 2020
Externally publishedYes

Bibliographical note

Funding Information:
The author(s) received no financial support for the research, authorship and/or publication of this article.

Publisher Copyright:
© The Author(s) 2019.

Copyright 2020 Elsevier B.V., All rights reserved.


  • Anti-vascular endothelial growth factor
  • appropriate treatment intensity
  • health records
  • indicator
  • intravitreal drugs
  • retina
  • treatment

ASJC Scopus subject areas

  • Ophthalmology


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