Abstract:
Importance:Macular edema (ME) is the leading cause of decreased visual acuity (VA) associated with retinal vein occlusion (RVO). Identifying factors associated with better outcomes in RVO eyes treated with anti-vascular endothelial growth factor (VEGF) therapy may provide information useful in counseling patients. Objective:To investigate baseline characteristics associated with 6-month VA and central subfield thickness (CST) outcomes in participants in the Study of Comparative Treatments for Retinal Vein Occlusion 2 (SCORE2). Design, Setting, and Participants:A total of 362 patients with central RVO or hemi-RVO were enrolled between September 17, 2014, and November 18, 2015, and randomized 1:1 in a masked fashion to receive bevacizumab or aflibercept. At month 6, 348 participants (96%) had VA outcomes measured and 335 participants (93%) had spectral domain optical coherence tomography outcomes measured. The current data analysis was conducted from February 27, 2017, to April 7, 2017. Interventions:Eyes were randomly assigned to receive an intravitreal injection of bevacizumab, 1.25 mg, or aflibercept, 2.0 mg, at baseline and every 4 weeks, with the primary outcome measured at 6 months. Main Outcomes and Measures:Change from baseline in VA letter score (VALS), VALS gain of 15 or more, change from baseline in CST, CST less than 300 µm, and resolution of ME. Baseline factors associated with 6-month outcome at the 0.05 level in univariate regressions were included in multivariate regressions, with those significant after multiplicity control by the Hochberg method reported. Results:The mean (SD) age of patients was 69 (12) years, and 43% were women. Younger patient age (odds ratio [OR], 0.95 per year of age; 95% CI, 0.93-0.98; P = .007) and lower baseline VALS (OR, 0.96 per letter; 95% CI, 0.94-0.98; P < .001) were associated with a 6-month VALS gain of 15 or greater. Compared with bevacizumab, aflibercept treatment was associated with a higher odds of ME resolution (OR, 3.59; 95% CI, 2.22-5.80; P < .001) and CST less than 300 µm (OR, 5.30; 95% CI, 2.40-11.67; P = .001), but not with a better VA outcome. Macular edema was less likely to resolve in eyes that received anti-VEGF treatment prior to study participation (OR, 0.33; 95% CI, 0.17-0.64; P = .03). Conclusions and Relevance:In eyes treated with bevacizumab or aflibercept, younger age and worse baseline VALS were associated with better 6-month VA outcomes. Aflibercept treatment was associated with more favorable spectral domain optical coherence tomography outcomes but not VA outcomes. These findings may be useful in assessing expected response at month 6 after monthly injection of anti-VEGF agents for treating ME due to CRVO and HRVO. Trial Registration:clinicaltrials.gov Identifier: NCT01969708.
journal_name
JAMA Ophthalmoljournal_title
JAMA ophthalmologyauthors
Scott IU,VanVeldhuisen PC,Ip MS,Blodi BA,Oden NL,King J,Antoszyk AN,Peters MA,Tolentino M,SCORE2 Investigator Group.doi
10.1001/jamaophthalmol.2017.1141subject
Has Abstractpub_date
2017-06-01 00:00:00pages
639-649issue
6eissn
2168-6165issn
2168-6173pii
2626158journal_volume
135pub_type
杂志文章,多中心研究,随机对照试验abstract::IMPORTANCE Advanced glycation end products have been implicated in the pathogenesis of age-related macular degeneration (AMD). OBJECTIVE To investigate the relationship between serum carboxymethyllysine (CML), a major circulating advanced glycation end product, and AMD in older adults. DESIGN, SETTING, AND PARTICIPANT...
journal_title:JAMA ophthalmology
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abstract:Importance:Some eyes with neovascular age-related macular degeneration (AMD) have persistent exudation despite frequent intravitreal anti-vascular endothelial growth factor (VEGF) injections. Adjuvant therapies that further reduce edema may improve vision outcomes. Objective:To compare the short-term effect of topical...
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pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2020-05-01 00:00:00
abstract:IMPORTANCE:We describe a sign that can be used as a rapid and noninvasive adjunct to aid in the diagnosis of foveal hypoplasia. OBJECTIVE:To describe a concentric macular rings sign found on infrared reflectance (IRR) images in patients with foveal hypoplasia. DESIGN, SETTING, AND PATIENTS:We studied 13 patients with...
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abstract:Importance:Ocular manifestations and outcomes in children with confirmed coronavirus disease 2019 (COVID-19), relevant affecting factors, and differences in ocular disease between children and adults have yet to be fully understood. Objective:To investigate ocular manifestations and clinical characteristics of childre...
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abstract:Importance:Examining costs and consequences of different low-vision (LV) programs provides important information about resources needed to expand treatment options efficiently. Objective:To examine the costs and consequences of LV rehabilitation or basic LV services. Design, Setting, and Participants:The US Departmen...
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doi:10.1001/jamaophthalmol.2018.0797
更新日期:2018-05-01 00:00:00
abstract:IMPORTANCE:Macular telangiectasia type 2 is a bilateral disease with characteristic alterations of the macular capillary network and neural atrophy. Vascular and neurodegenerative hypotheses have been proposed to explain these clinical findings, but many questions regarding the pathogenesis remain. OBSERVATIONS:We rep...
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abstract:IMPORTANCE:The presence of choroidal hyperreflective foci in Stargardt disease is, to our knowledge, a potentially new finding. Evaluation of these foci may aid in better understanding of the disease process. OBJECTIVES:To report the presence of choroidal hyperreflective foci in spectral-domain optical coherence tomog...
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abstract:IMPORTANCE:Anterior chamber seeding following intraophthalmic artery chemotherapy is rarely reported. OBJECTIVES:To describe clinicopathologic observations in eyes in which intraophthalmic artery chemotherapy for retinoblastoma failed and to report anterior chamber involvement. OBSERVATIONS:A retrospective case serie...
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pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2015-09-01 00:00:00
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pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2016-10-01 00:00:00
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pub_type: 杂志文章
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更新日期:2016-08-01 00:00:00
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pub_type: 杂志文章,多中心研究
doi:10.1001/jamaophthalmol.2018.2019
更新日期:2018-08-01 00:00:00
abstract:IMPORTANCE:The effect of glaucoma on nonglaucomatous medical conditions and resultant secondary health care costs is not well understood. OBJECTIVE:To assess self-reported medical conditions, the use of medical services, and total health care costs among Medicare beneficiaries with glaucoma. DESIGN, SETTING, AND PART...
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更新日期:2016-04-01 00:00:00
abstract:Importance:After long-duration spaceflight, morphological changes in the optic nerve head (ONH) and surrounding tissues have been reported. Objective:To develop methods to quantify ONH and surrounding tissue changes using preflight and postflight optical coherence tomographic scans of the ONH region. Design, Setting,...
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pub_type: 杂志文章
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更新日期:2019-11-07 00:00:00
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更新日期:2016-12-01 00:00:00
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更新日期:2019-01-01 00:00:00
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更新日期:2019-04-01 00:00:00
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更新日期:2017-02-01 00:00:00
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更新日期:2019-11-14 00:00:00
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