European journal of ophthalmology
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To describe the results obtained in patients with neovascular age-related macular degeneration treated with ranibizumab 0.5 mg on an as-needed basis from the start after 1 year of follow-up. ⋯ As-needed treatment from the start achieved stabilization of visual acuity and a moderate decrease of retinal thickness with a low number of injections, but did not achieve the same efficacy as regular monthly injections.
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This work was inspired by a recent juridical development in Italy, whose purpose is to prevent rejection of damage claims whenever it is not possible to prove a causal link between iatrogenic illicit behavior and damage to the patient, despite the fact that the patient has clearly suffered physical or mental injury. In view of this, some European countries-e.g., France and Germany-have recently come up with a new damage interpretation called loss of chance, i.e., the missed opportunity to get a more favorable outcome through different or more timely and efficient therapies. ⋯ For example, glaucoma and macular degeneration are common, serious, and potentially blinding diseases in which delayed diagnosis and therapy reduce the chances not only to limit injuries, but also to stop future progress of the disease. Hence, the authors emphasize that a good practice is the only way for ophthalmologists to avoid malpractice claims related to the new developments in tort law in Italy and in other European countries following the creation of new definitions of damage.