Abstract:
Importance:Medical and surgical interventions for glaucoma are effective only if they are affordable to patients. Little is known about how affordable glaucoma interventions are in developing and developed countries. Objective:To compare the prices of topical glaucoma medications, laser trabeculoplasty, and trabeculectomy relative with median annual household income (MA-HHI) for countries worldwide. Design, Setting and Participants:Cross-sectional observational study. For each country, we obtained prices for glaucoma medications, laser trabeculoplasty, and trabeculectomy using government pricing data, drug databases, physician fee schedules, academic publications, and communications with local ophthalmologists. Prices were adjusted for purchasing power parity and inflation to 2016 US dollars, and annual therapy prices were examined relative to the MA-HHI. Interventions costing less than 2.5% of the MA-HHI were considered affordable. Main Outcomes and Measures:Daily cost for topical glaucoma medications, cost of annual therapy with glaucoma medications, laser trabeculoplasty, and trabeculectomy relative to MA-HHI in each country. Results:Data were obtained from 38 countries, including 17 developed countries and 21 developing countries, as classified by the World Economic Outlook. We observed considerable variability in intervention prices compared with MA-HHI across the countries and across interventions, ranging from 0.1% to 5% of MA-HHI for timolol, 0.1% to 27% for latanoprost, 0.2% to 17% for laser trabeculoplasty, and 0.3% to 42% for trabeculectomy. Timolol was the most affordable medication in all countries studied and was 2.5% or more of MA-HHI in only 2 countries (5%). The annual cost of latanoprost was 2.5% or more of MA-HHI in 15 countries (41%) (15 developing countries [75%] and no developed countries). The cost of laser trabeculoplasty was 2.5% or more of the MA-HHI in 15 countries (44%) (11 developing countries [65%] and 4 developed countries [24%]). The cost of trabeculectomy was 2.5% or more of the MA-HHI in 28 countries (78%) (18 developing countries [95%] and 10 developed countries [59%]). In 18 countries (53%), laser trabeculoplasty cost less than a 3-year latanoprost supply. Conclusions and Relevance:For many patients worldwide, the costs of medical, laser, and incisional surgical interventions were 2.5% or more of the MA-HHI. Successfully reducing global blindness from glaucoma requires addressing multiple contributing factors, including making glaucoma interventions more affordable.
journal_name
JAMA Ophthalmoljournal_title
JAMA ophthalmologyauthors
Zhao PY,Rahmathullah R,Stagg BC,Almobarak F,Edward DP,Robin AL,Stein JDdoi
10.1001/jamaophthalmol.2018.3672subject
Has Abstractpub_date
2018-11-01 00:00:00pages
1271-1279issue
11eissn
2168-6165issn
2168-6173pii
2698098journal_volume
136pub_type
杂志文章abstract:IMPORTANCE:This study confirmed the long-term outcomes of the ZB5M phakic intraocular lens (PIOL). OBJECTIVE:To evaluate the potential long-term risk associated with ZB5M PIOL implantation. DESIGN, SETTING, AND PARTICIPANTS:A retrospective, nonrandomized, consecutive cohort study of a total of 208 eyes implanted with...
journal_title:JAMA ophthalmology
pub_type: 杂志文章
doi:10.1001/jamaophthalmol.2013.5595
更新日期:2013-12-01 00:00:00
abstract:Objective:To compare oral voriconazole with placebo in addition to topical antifungals in the treatment of filamentous fungal keratitis. Design, Setting, and Participants:The Mycotic Ulcer Treatment Trial II (MUTT II), a multicenter, double-masked, placebo-controlled, randomized clinical trial, was conducted in India ...
journal_title:JAMA ophthalmology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1001/jamaophthalmol.2016.4096
更新日期:2016-12-01 00:00:00
abstract:IMPORTANCE:Children with a history of amblyopia, even if resolved, exhibit impaired visual-auditory integration and perceive speech differently. OBJECTIVE:To determine whether a history of amblyopia is associated with abnormal visual-auditory speech integration. DESIGN, SETTING, AND PARTICIPANTS:Retrospective observa...
journal_title:JAMA ophthalmology
pub_type: 杂志文章
doi:10.1001/jamaophthalmol.2014.3307
更新日期:2015-01-01 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,...
journal_title:JAMA ophthalmology
pub_type: 杂志文章
doi:10.1001/jamaophthalmol.2017.6226
更新日期:2018-02-01 00:00:00
abstract::Within 20 years of its discovery 100 years ago, vitamin A was recognized as critical to normal eyes, growth, and survival. Clinical interest subsequently contracted to its importance in preventing xerophthalmia, until this ophthalmologist stumbled, quite accidently, on its role in fighting life-threatening infections....
journal_title:JAMA ophthalmology
pub_type: 历史文章,杂志文章
doi:10.1001/jamaophthalmol.2013.5309
更新日期:2014-01-01 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...
journal_title:JAMA ophthalmology
pub_type: 杂志文章
doi:10.1001/jamaophthalmol.2015.5479
更新日期:2016-04-01 00:00:00
abstract:Importance:Although low-income populations have more eye problems, whether they face greater difficulty obtaining eye care appointments is unknown. Objective:To compare rates of obtaining eye care appointments and appointment wait times for those with Medicaid vs those with private insurance. Design, Setting, and Par...
journal_title:JAMA ophthalmology
pub_type: 杂志文章,多中心研究
doi:10.1001/jamaophthalmol.2018.0813
更新日期:2018-06-01 00:00:00
abstract:IMPORTANCE:Patients and clinicians need to accurately assess the risks and benefits of pars plana vitrectomy for proliferative diabetic retinopathy, but clinical trial data may not reflect real-world experience. OBJECTIVE:To prospectively audit the complications of vitrectomy for proliferative diabetic retinopathy and...
journal_title:JAMA ophthalmology
pub_type: 杂志文章,多中心研究
doi:10.1001/jamaophthalmol.2015.4587
更新日期:2016-01-01 00:00:00
abstract:Importance:Certain features of the lamina cribrosa may be associated with increased risk of glaucoma progression. Objectives:To compare the rates of retinal nerve fiber layer (RNFL) thinning in patients with open-angle glaucoma with or without lamina cribrosa (LC) defects and to evaluate factors associated with the ra...
journal_title:JAMA ophthalmology
pub_type: 杂志文章
doi:10.1001/jamaophthalmol.2018.6941
更新日期:2019-04-01 00:00:00
abstract:Importance:The frequency of anti-vascular endothelial growth factor (VEGF) injections has grown exponentially with the introduction of bevacizumab, ranibizumab, and most recently aflibercept. The cost associated with these medications has garnered significant national attention, warranting a granular analysis of their ...
journal_title:JAMA ophthalmology
pub_type: 杂志文章
doi:10.1001/jamaophthalmol.2019.1971
更新日期:2019-06-20 00:00:00
abstract:IMPORTANCE:Tuberculosis is an endemic infectious disease in developing countries. Patients receiving treatment for systemic tuberculosis may develop paradoxical growth of tuberculomas in the brain, which can lead to vision loss. OBSERVATIONS:We describe 3 patients who had paradoxical development of tuberculomas in the...
journal_title:JAMA ophthalmology
pub_type: 杂志文章
doi:10.1001/jamaophthalmol.2013.4840
更新日期:2013-11-01 00:00:00
abstract:Importance:Uveitis has been associated with psoriatic arthritis, but to our knowledge, the relationship between uveitis and psoriasis is unsettled among researchers. Objective:To evaluate the risk of incident uveitis among people with psoriasis. Design, Setting, and Participants:This nationwide, retrospective cohort ...
journal_title:JAMA ophthalmology
pub_type: 杂志文章,多中心研究
doi:10.1001/jamaophthalmol.2017.0569
更新日期:2017-05-01 00:00:00
abstract:IMPORTANCE:Descemet stripping automated endothelial keratoplasty (DSAEK) for isolated endothelial dysfunction has become the preferred surgical option for many corneal surgeons. However, there are limited large-scale reports on DSAEK survival and clinical variables affecting the risk of rejection and failure after fail...
journal_title:JAMA ophthalmology
pub_type: 杂志文章,多中心研究
doi:10.1001/jamaophthalmol.2014.352
更新日期:2014-06-01 00:00:00
abstract:IMPORTANCE:We conducted a series of phase 1 clinical trials to elucidate the efficacy and safety of the selective Rho kinase inhibitor K-115 as a candidate drug for the treatment of glaucoma. We report the intraocular pressure (IOP)-lowering effects and safety of K-115 based on our results. OBJECTIVE:To study the IOP-...
journal_title:JAMA ophthalmology
pub_type: 杂志文章,随机对照试验
doi:10.1001/jamaophthalmol.2013.323
更新日期:2013-10-01 00:00:00
abstract:Importance:The comparative clinical effectiveness of ranibizumab, aflibercept, and bevacizumab for the management of macular edema due to central retinal vein occlusion (CRVO) is unclear. Objective:To determine whether intravitreal aflibercept or bevacizumab compared with ranibizumab results in a noninferior mean chan...
journal_title:JAMA ophthalmology
pub_type: 杂志文章
doi:10.1001/jamaophthalmol.2019.3305
更新日期:2019-08-29 00:00:00
abstract:IMPORTANCE:The optic disc pit (ODP) has been considered a region of localized susceptibility to the damage of glaucoma. OBJECTIVE:To determine whether the rate of retinal nerve fiber layer (RNFL) thinning differs according to the presence and structural characteristics of an ODP in primary open-angle glaucoma. DESIGN...
journal_title:JAMA ophthalmology
pub_type: 杂志文章
doi:10.1001/jamaophthalmol.2015.2453
更新日期:2015-10-01 00:00:00
abstract:IMPORTANCE:Myopia (nearsightedness) has its onset in childhood and affects about one-third of adults in the United States. Along with its high prevalence, myopia is expensive to correct and is associated with ocular diseases that include glaucoma and retinal detachment. OBJECTIVE:To determine the best set of predictor...
journal_title:JAMA ophthalmology
pub_type: 杂志文章,多中心研究
doi:10.1001/jamaophthalmol.2015.0471
更新日期:2015-06-01 00:00:00
abstract:Importance:Knowledge of the incidence and progression of diabetic retinopathy (DR) after gastric bypass surgery (GBP) in patients with obesity and diabetes could guide the management of these patients. Objective:To investigate the incidence of diabetic ocular complications in patients with type 2 diabetes after GBP co...
journal_title:JAMA ophthalmology
pub_type: 杂志文章
doi:10.1001/jamaophthalmol.2020.5892
更新日期:2021-01-14 00:00:00
abstract:IMPORTANCE:Few studies have been published on the association of the radiation dose received to the eyes during radiotherapy (RT) for childhood cancer and the risk for later cataract. OBJECTIVE:To investigate the risk for cataract after treatment of nonretinoblastoma solid cancer in childhood. DESIGN, SETTING, AND PA...
journal_title:JAMA ophthalmology
pub_type: 杂志文章
doi:10.1001/jamaophthalmol.2015.6088
更新日期:2016-04-01 00:00:00
abstract:Importance:Identifying the course of glaucomatous visual field (VF) loss that progresses from normal to perimetric blindness is important for treatment and prognostication. Objective:To model the process of glaucomatous VF decay over the entire perimetric range from normal to perimetric blindness. Design, Setting, an...
journal_title:JAMA ophthalmology
pub_type: 杂志文章
doi:10.1001/jamaophthalmol.2016.0118
更新日期:2016-05-01 00:00:00
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...
journal_title:JAMA ophthalmology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1001/jamaophthalmol.2020.0724
更新日期:2020-05-01 00:00:00
abstract:IMPORTANCE:The clinical features of the follicular subtype of ocular adnexal lymphoma (OAL) have not been previously evaluated in a large cohort. OBJECTIVE:To characterize the clinical features of follicular OAL. DESIGN, SETTING, AND PARTICIPANTS:We performed a retrospective multicenter study that involved 6 eye canc...
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pub_type: 杂志文章,多中心研究
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更新日期:2014-07-01 00:00:00
abstract:Importance:Congenital Zika syndrome (CZS) is known to be associated with severe malformations in newborns. Although microcephaly is the hallmark of this disease, the ocular findings are important given the severe visual impairment that has been observed in these patients. Regardless of the increased number of CZS cases...
journal_title:JAMA ophthalmology
pub_type: 杂志文章
doi:10.1001/jamaophthalmol.2017.3595
更新日期:2017-11-01 00:00:00
abstract:IMPORTANCE:Acanthamoeba keratitis is a debilitating eye disease that requires effective topical drug therapy. Currently, there is no standard in vitro test to evaluate anti-Acanthamoeba drugs. OBJECTIVE:To develop a practical in vitro complete-kill assay to assess anti-Acanthamoeba drugs. DESIGN AND SETTING:Isolates ...
journal_title:JAMA ophthalmology
pub_type: 杂志文章
doi:10.1001/jamaophthalmol.2013.5062
更新日期:2013-11-01 00:00:00
abstract:Importance:There are limited published data on the phenotype of retinitis pigmentosa (RP) related to CNGB1 variants. These data are needed both for prognostic counseling of patients and for understanding potential treatment windows. Objective:To describe the detailed clinical and molecular genetic findings in a series...
journal_title:JAMA ophthalmology
pub_type: 杂志文章
doi:10.1001/jamaophthalmol.2016.5213
更新日期:2017-02-01 00:00:00
abstract:Importance:Unverifiable publications in applications for ophthalmology residencies could be a serious concern if they represent publication dishonesty. Objective:To determine the rate of unverifiable publications among applicants offered an interview. Design:Retrospective review of 322 ophthalmology residency applica...
journal_title:JAMA ophthalmology
pub_type: 杂志文章
doi:10.1001/jamaophthalmol.2018.0846
更新日期:2018-06-01 00:00:00
abstract:IMPORTANCE:Schnabel cavernous degeneration (SCD) has been observed in eyes with uveal melanoma (UM), but, to our knowledge, a definitive study establishing the association between SCD and UM has not been conducted. OBJECTIVE:To explore an association between SCD and UM. DESIGN, SETTING, AND PARTICIPANTS:A historical ...
journal_title:JAMA ophthalmology
pub_type: 杂志文章
doi:10.1001/jamaophthalmol.2013.8182
更新日期:2014-05-01 00:00:00
abstract:IMPORTANCE:Although trabeculotomy is a glaucoma surgical procedure for modest intraocular pressure (IOP) reduction, some eyes exhibit very low IOP during the early postoperative period. To our knowledge, the reason and its effect have not been investigated. OBJECTIVES:To investigate ciliochoroidal detachment (CCD) imm...
journal_title:JAMA ophthalmology
pub_type: 杂志文章
doi:10.1001/jamaophthalmol.2015.5765
更新日期:2016-03-01 00:00:00
abstract:OBJECTIVE:To evaluate the association between vitreous fluid levels of inflammatory factors and macular edema in patients with branch retinal vein occlusion (BRVO). METHODS:In 39 patients with BRVO and macular edema and 21 individuals with idiopathic macular hole (MH) serving as controls, vitreous fluid samples were o...
journal_title:JAMA ophthalmology
pub_type: 杂志文章
doi:10.1001/2013.jamaophthalmol.228
更新日期:2013-02-01 00:00:00
abstract:OBJECTIVE:To investigate the efficacy of WINROP (https://winrop.com), an algorithm based on serial measurements of neonatal body weight to predict proliferative retinopathy of prematurity (ROP), in a Korean population of preterm infants. METHODS:The records of preterm infants with gestational age less than 32 weeks wh...
journal_title:JAMA ophthalmology
pub_type: 杂志文章
doi:10.1001/jamaophthalmol.2013.566
更新日期:2013-01-01 00:00:00