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 change in vision at 100 weeks for eyes with CRVO-related macular edema. Design, Setting, and Participants:This prospective, 3-arm, double-masked, randomized noninferiority trial (Lucentis, Eylea, Avastin in Vein Occlusion [LEAVO] Study) took place from December 12, 2014, through December 16, 2016, at 44 UK National Health Service ophthalmology departments. Inclusion criteria included age 18 years or older, visual impairment due to CRVO-related macular edema of less than 12 months with best-corrected visual acuity (BCVA) Early Treatment Diabetic Retinopathy Study letter score (approximate Snellen equivalent) in the study eye between 19 (20/400) and 78 (20/32), and spectral domain optical coherence tomography imaging central subfield thickness of 320 μm or greater. Data were analyzed from March 4, 2019, to April 26, 2019. Interventions:Participants were randomized (1:1:1) to receive repeated intravitreal injections of ranibizumab (0.5 mg/0.05 mL) (n = 155), aflibercept (2.0 mg/0.05 mL) (n = 154), or bevacizumab (1.25 mg/0.05 mL) (n = 154) for 100 weeks. Main Outcomes and Measures:Adjusted mean change in BCVA in the study eye at 100 weeks wherein noninferiority was concluded if the lower bounds of the 95% CI of both the intention-to-treat and the per protocol analyses were above -5 letters. Results:Of 463 participants, 265 (57.2%) were male, with a mean (SD) age of 69.1 (13.0) years. The mean (SD) gain in BCVA letter score was 12.5 (21.1) for ranibizumab, 15.1 (18.7) for aflibercept, and 9.8 (21.4) for bevacizumab at 100 weeks. Aflibercept was noninferior to ranibizumab (intention-to-treat-adjusted mean BCVA difference, 2.23 letters; 95% CI, -2.17 to 6.63 letters; P < .001). Bevacizumab was not noninferior to ranibizumab (intention-to-treat-adjusted mean BCVA difference, -1.73 letters; 95% CI, -6.12 to 2.67 letters; P = .07). The per protocol analysis conclusions were similar. Fewer mean injections were given in the aflibercept group (10.0) than in the ranibizumab (11.8) group (mean difference at 100 weeks, -1.9; 95% CI, -2.9 to -0.8). Conclusions and Relevance:Mean changes in vision after treatment of macular edema due to CRVO were no worse using aflibercept compared with ranibizumab. Mean changes in vision using bevacizumab compared with ranibizumab were inconclusive regarding vision outcomes (ie, the change in visual acuity from baseline, on average, may be worse or may not be worse when using bevacizumab compared with ranibizumab). Trial Registration:ISRCTN13623634.
journal_name
JAMA Ophthalmoljournal_title
JAMA ophthalmologyauthors
Hykin P,Prevost AT,Vasconcelos JC,Murphy C,Kelly J,Ramu J,Hounsome B,Yang Y,Harding SP,Lotery A,Chakravarthy U,Sivaprasad S,LEAVO Study Group.doi
10.1001/jamaophthalmol.2019.3305subject
Has Abstractpub_date
2019-08-29 00:00:00eissn
2168-6165issn
2168-6173pii
2748911pub_type
杂志文章abstract:IMPORTANCE:To date, only a few studies have directly compared nonpenetrating surgery (NPS) and trabeculectomy (TE). Therefore, there is no strong evidence as to which surgical technique leads to the best results in terms of ocular hypotensive effect and safety. OBJECTIVE:To compare the hypotensive effect and safety of...
journal_title:JAMA ophthalmology
pub_type: 杂志文章,meta分析,评审
doi:10.1001/jamaophthalmol.2013.5059
更新日期:2013-12-01 00:00:00
abstract:IMPORTANCE:Although anti-vascular endothelial growth factor treatment of neovascular age-related macular degeneration (AMD) results in improved vision overall, loss of substantial vision can occur. Understanding the processes that lead to loss of vision may lead to preventive strategies. OBJECTIVE:To determine the inc...
journal_title:JAMA ophthalmology
pub_type: 杂志文章,随机对照试验
doi:10.1001/jamaophthalmol.2014.1019
更新日期:2014-08-01 00:00:00
abstract:Importance:Optical coherence tomographic angiography (OCT-A) is able to visualize retinal microvasculature without the need for injection of fluorescein contrast dye. Nevertheless, it is only able to capture a limited view of macula and does not show leakage. Objectives:To evaluate the retinal microvasculature using O...
journal_title:JAMA ophthalmology
pub_type: 杂志文章
doi:10.1001/jamaophthalmol.2016.5877
更新日期:2017-04-01 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: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:Importance:Although the association between suture colonization and postoperative infections remains hypothetical, measures to reduce perioperative suture colonization may minimize postoperative infections. The suture colonization rate in adjustable suture strabismus surgery is not well defined, and the effect of povid...
journal_title:JAMA ophthalmology
pub_type: 杂志文章,随机对照试验
doi:10.1001/jamaophthalmol.2016.2926
更新日期:2016-10-01 00:00:00
abstract:Importance:Congenital stationary night blindness (CSNB) implies a stable condition, with the major symptom being nyctalopia present at birth. Pediatric clinical presentation and the course of different genetic subtypes of CSNB have not, to our knowledge, been well described in the era of molecular genetic diagnosis. O...
journal_title:JAMA ophthalmology
pub_type: 杂志文章
doi:10.1001/jamaophthalmol.2018.0185
更新日期:2018-04-01 00:00:00
abstract:Importance:Visual impairment and visual disorders often co-occur with other chronic conditions. Understanding patterns of multimorbidity is important for reducing health care use and improving health outcomes. Objective:To identify chronic condition patterns and their association with visual impairment and health care...
journal_title:JAMA ophthalmology
pub_type: 杂志文章
doi:10.1001/jamaophthalmol.2020.0052
更新日期:2020-04-01 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 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
pub_type: 杂志文章
doi:10.1001/jamaophthalmol.2013.7664
更新日期:2014-04-01 00:00:00
abstract:OBJECTIVE:To assess the benefit of increased follow-up and treatment with ranibizumab between months 24 and 36 in the Ranibizumab for Edema of the Macula in Diabetes (READ-2) Study. DESIGN:Prospective, interventional, multicenter follow-up of a randomized clinical trial. METHODS:Patients who agreed to participate bet...
journal_title:JAMA ophthalmology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1001/2013.jamaophthalmol.91
更新日期:2013-02-01 00:00:00
abstract:Importance:Preservation of peripheral visual field (VF) is considered an advantage for anti-vascular endothelial growth factor agents compared with panretinal photocoagulation (PRP) for treatment of proliferative diabetic retinopathy. Long-term data on VF are important when considering either treatment approach. Objec...
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.2019.5939
更新日期:2020-03-01 00:00:00
abstract:IMPORTANCE:The publication of the US Physician Payments Sunshine Act provides insight into the financial relationship between physicians and the pharmaceutical industry. This added transparency creates new opportunities of using objective data to better understand prior research that implicates pharmaceutical promotion...
journal_title:JAMA ophthalmology
pub_type: 杂志文章
doi:10.1001/jamaophthalmol.2016.1678
更新日期:2016-08-01 00:00:00
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...
journal_title:JAMA ophthalmology
pub_type: 杂志文章
doi:10.1001/jamaophthalmol.2020.3690
更新日期:2020-10-01 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:The coronavirus disease 2019 pandemic illustrates the increasingly important role of telemedicine as a method of clinician-patient interaction. However, electronic applications (apps) for the testing of ophthalmology vital signs, such as visual acuity, can be published and used without any verification of ac...
journal_title:JAMA ophthalmology
pub_type: 杂志文章
doi:10.1001/jamaophthalmol.2020.6177
更新日期:2021-01-14 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: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:Vitreoretinal lymphoma is a diagnostic challenge and the pathophysiology is still unclear. Objective:To describe an imaging finding seen on optical coherence tomography (OCT) of patients with vitreoretinal lymphoma. Design, Setting, and Participants:This case series study was a retrospective medical record...
journal_title:JAMA ophthalmology
pub_type: 杂志文章
doi:10.1001/jamaophthalmol.2018.5835
更新日期:2019-02-01 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...
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pub_type: 杂志文章
doi:10.1001/jamaophthalmol.2018.0846
更新日期:2018-06-01 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:It is well established from different population-based studies that visual impairment is associated with increased mortality rate. However, to our knowledge, the association of visual impairment with increased mortality rate has not been reported among indigenous Australian individuals. Objective:To assess ...
journal_title:JAMA ophthalmology
pub_type: 杂志文章,多中心研究
doi:10.1001/jamaophthalmol.2017.6787
更新日期:2018-05-01 00:00:00
abstract:IMPORTANCE:Accurate diagnosis of choroidal melanoma is challenging and has important implications for both physicians and patients. We assessed the utility of quantification of fundus autofluorescence in the evaluation and follow-up of choroidal nevomelanocytic tumors. OBJECTIVE:To assess the utility of autofluorescen...
journal_title:JAMA ophthalmology
pub_type: 杂志文章
doi:10.1001/jamaophthalmol.2013.4007
更新日期:2013-08-01 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:Glaucoma-related adverse events constitute serious complications of cataract removal in infancy, yet long-term data on incidence and visual outcome remain lacking. Objective:To identify and characterize incident cases of glaucoma and glaucoma-related adverse events (glaucoma + glaucoma suspect) among childr...
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pub_type: 杂志文章
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更新日期:2020-12-17 00:00:00
abstract:IMPORTANCE:Progressive geographic atrophy (GA) of the retinal pigment epithelium leads to loss of central vision. To identify GA in age-related macular degeneration and assess treatment, correlation of function observed on microperimetry with structure observed on optical coherence tomographic (OCT) images may be of va...
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pub_type: 杂志文章
doi:10.1001/jamaophthalmol.2016.1535
更新日期:2016-08-01 00:00:00
abstract:IMPORTANCE:Eye and vision disease burden should help guide ophthalmologic research prioritization. The Global Burden of Disease (GBD) Study 2010 compiled data from 1990 to 2010 on 291 diseases and injuries, 1160 disease and injury sequelae, and 67 risk factors in 187 countries. The Cochrane Database of Systematic Revie...
journal_title:JAMA ophthalmology
pub_type: 杂志文章
doi:10.1001/jamaophthalmol.2014.3527
更新日期:2015-01-01 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...
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pub_type: 杂志文章
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更新日期:2016-05-01 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:Contemporary data on use of eye care by US adults are critical, as the prevalence of age-related eye disease and vision impairment are projected to increase in the coming decades. Objectives:To provide nationally representative estimates on self-reported use of eye care by adults aged 50 to 80 years, and to...
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pub_type: 杂志文章
doi:10.1001/jamaophthalmol.2019.1927
更新日期:2019-06-20 00:00:00