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2. Strategy for the management of complex retinal detachments: the European vitreo-retinal society retinal detachment study report 2
- Author
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BENMERZOUGA N, METTI F, RAZZARI A, MIESBAUER P, SCHÖNHERR U, ZEYNALOVA Z, BASHIR SJ, JACOB J, KOCH P, LADHA R, SMETS E, STALMANS P, DARE A, DEVENYI R, LAM WC, SHAHEEDA M, POTAMITIS T, CHRISTENSEN SR, RAYES E, MORTADA H, SHOUMAN A, HOLM M, ALBINET P, AMAR JP, BECQUET F, BERROD JP, BOULZE M, BOSCHER C, COURJARET JC, DENION E, FOURMAUX, E, GUIGOU S, HAMON F, LAFONTAINE PO, LE ROUIC JF, LEYNAUD JL, NOCHEZ Y, PERONE JM, RYSANEK B, SOYEUR R, BOPP S, BRIX A, HÖHN F, KUSSEROW C, LUCKE K, MOHR A, SCHÜLER A, WEINBERGER A, GOTZARIDIS S, KARATZENIS D, STEFANIOTOU M, K. TSILIMBARIS MK, TSOURIS D, TSANG CW, GABOR R, SZIJARTO Z, BABU N, BANKER AS, BAPAYE M, KELKAR A, ENTEZARI, M, FATEH MOGHADAM HF, RAMEZANI A, SAFARPOUR LIMA B, OMER K, BOSCIA F, CHIARA FRENO M, CIAN R, DONVITO G, FACINO M, LESNONI G, LIUZZI, F, METE M, MININNI F, MOCHI B, PRIMAVERA V, PERTILE G, TURCO I, VASTARELLA P, FONG K, LEE M, VP LOO A, ARAGON HARRISON O, FLORES AGUILAR M, LOPEZ MONTERO LM, LOPEZCARASA HERNANDEZ G, VELASCO I, BOEYDEN V, BOSSCHA M, DE VRIES KNOPPERT W, LINDSTEDT, E. RENARDEL DE LAVALETTE VW, VAN DEN BIESEN PR, ALHASSAN M, BAERLAND TP, BOBER AM, FORSAA V, FOSSEN K, VARHAUG P, ATIENZA J.r. NF, CISIECKI S, FRYCZKOWSKI P, KOWAL LANGE A, MICHALEWSKA Z, MICHALEWSKI J, NAWROCKI J, NOWOSIELSKA A, ODROBINA D, PIETRAS TRZPIEL M, ZAKRZEWSKA A, MEIRELES A, TEIXEIRA S, ELSHAFEI M, DANIELESCU C, TALU S, ALTYNBAEV U, GORIN A, SEREJINE I, EL DEEB M, DAVIDOVIC S, IGNJATOVIC Z, STEFANICKOVA J, VENTER L, CHANG W, JO YL, KIM JY, LEE J, LIM ST, SAGONG M, ASCASO FJ, CASTRO J, CORDOVES L. DESCO ESTEBAN C, MORENO MANRESA J, VILAPLANA D, JANIEC S, TOMIC Z, BEN YAHIA S, ACAR N, GÜNGEL H, KAPRAN Z, OSMANBASOGLU O, OZDEK S, TOPBAS S, TOTAN Y, ÜNVER YB, CHICHUR D, DOBROVOLSKEY O, KOZLOVSKA I, LYTVYNCHUK L, PHYLYPCHUK O, POSTOLOVSKA A, SERGIIENKO A, SHEVCHYK V, WINDER S, CULOTTA J, KIM S, KING J, KURUP SK, LIN SJ, PACURARIU R, ROTH D, SINCLAIR S, WEBER P, DOAN H, TUNG T., ROMANO, MARIO, Benmerzouga, N, Metti, F, Razzari, A, Miesbauer, P, Schönherr, U, Zeynalova, Z, Bashir, Sj, Jacob, J, Koch, P, Ladha, R, Smets, E, Stalmans, P, Dare, A, Devenyi, R, Lam, Wc, Shaheeda, M, Potamitis, T, Christensen, Sr, Rayes, E, Mortada, H, Shouman, A, Holm, M, Albinet, P, Amar, Jp, Becquet, F, Berrod, Jp, Boulze, M, Boscher, C, Courjaret, Jc, Denion, E, Fourmaux, E, Guigou, S, Hamon, F, Lafontaine, Po, LE ROUIC, Jf, Leynaud, Jl, Nochez, Y, Perone, Jm, Rysanek, B, Soyeur, R, Bopp, S, Brix, A, Höhn, F, Kusserow, C, Lucke, K, Mohr, A, Schüler, A, Weinberger, A, Gotzaridis, S, Karatzenis, D, Stefaniotou, M, K., TSILIMBARIS MK, Tsouris, D, Tsang, Cw, Gabor, R, Szijarto, Z, Babu, N, Banker, A, Bapaye, M, Kelkar, A, Entezari, M, FATEH MOGHADAM, Hf, Ramezani, A, SAFARPOUR LIMA, B, Omer, K, Boscia, F, CHIARA FRENO, M, Cian, R, Donvito, G, Facino, M, Lesnoni, G, Liuzzi, F, Mete, M, Mininni, F, Mochi, B, Primavera, V, Romano, Mario, Pertile, G, Turco, I, Vastarella, P, Fong, K, Lee, M, VP LOO, A, ARAGON HARRISON, O, FLORES AGUILAR, M, LOPEZ MONTERO, Lm, LOPEZCARASA HERNANDEZ, G, Velasco, I, Boeyden, V, Bosscha, M, DE VRIES KNOPPERT, W, Lindstedt, E., RENARDEL DE LAVALETTE VW, VAN DEN BIESEN, Pr, Alhassan, M, Baerland, Tp, Bober, Am, Forsaa, V, Fossen, K, Varhaug, P, ATIENZA J. r., Nf, Cisiecki, S, Fryczkowski, P, KOWAL LANGE, A, Michalewska, Z, Michalewski, J, Nawrocki, J, Nowosielska, A, Odrobina, D, PIETRAS TRZPIEL, M, Zakrzewska, A, Meireles, A, Teixeira, S, Elshafei, M, Danielescu, C, Talu, S, Altynbaev, U, Gorin, A, Serejine, I, EL DEEB, M, Davidovic, S, Ignjatovic, Z, Stefanickova, J, Venter, L, Chang, W, Jo, Yl, Kim, Jy, Lee, J, Lim, St, Sagong, M, Ascaso, Fj, Castro, J, CORDOVES L., DESCO ESTEBAN C, MORENO MANRESA, J, Vilaplana, D, Janiec, S, Tomic, Z, BEN YAHIA, S, Acar, N, Güngel, H, Kapran, Z, Osmanbasoglu, O, Ozdek, S, Topbas, S, Totan, Y, Ünver, Yb, Chichur, D, Dobrovolskey, O, Kozlovska, I, Lytvynchuk, L, Phylypchuk, O, Postolovska, A, Sergiienko, A, Shevchyk, V, Winder, S, Culotta, J, Kim, S, King, J, Kurup, Sk, Lin, Sj, Pacurariu, R, Roth, D, Sinclair, S, Weber, P, Doan, H, and Tung, T.
- Abstract
OBJECTIVE: To study the outcome of the treatment of complex rhegmatogenous retinal detachments (RRDs). DESIGN: Nonrandomized, multicenter, retrospective study. PARTICIPANTS: One hundred seventy-six surgeons from 48 countries spanning 5 continents reported primary procedures for 7678 RRDs. METHODS: Reported data included clinical manifestations, the method of repair, and the outcome. MAIN OUTCOME MEASURES: Failure of retinal detachment repair (level 1 failure rate), remaining silicone oil at the study's conclusion (level 2 failure rate), and need for additional procedures to repair the detachments (level 3 failure rate). RESULTS: The main categories of complex retinal detachments evaluated in this investigation were: (1) grade B proliferative vitreoretinopathy (PVR; n = 917), (2) grade C-1 PVR (n = 637), (3) choroidal detachment or significant hypotony (n = 578), (4) large or giant retinal tears (n = 1167), and (5) macular holes (n = 153). In grade B PVR, the level 1 failure rate was higher when treated with a scleral buckle alone versus vitrectomy (P = 0.0017). In grade C-1 PVR, there was no statistically significant difference in the level 1 failure rate between those treated with vitrectomy, with or without scleral buckle, and those treated with scleral buckle alone (P = 0.7). Vitrectomy with a supplemental buckle had an increased failure rate compared with those who did not receive a buckle (P = 0.007). There was no statistically significant difference in level 1 failure rate between tamponade with gas versus silicone oil in patients with grade B or C-1 PVR. Cases with choroidal detachment or hypotony treated with vitrectomy had a significantly lower failure rate versus treatment with scleral buckle alone (P = 0.0015). Large or giant retinal tears treated with vitrectomy also had a significantly lower failure rate versus treatment with scleral buckle (P = 7×10(-8)). CONCLUSIONS: In patients with retinal detachment, when choroidal detachment, hypotony, a large tear, or a giant tear is present, vitrectomy is the procedure of choice. In retinal detachments with PVR, tamponade with either gas or silicone oil can be considered. If a vitrectomy is to be performed, these data suggest that a supplemental buckle may not be helpful. FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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- 2013
3. Strategy for the management of uncomplicated retinal detachments: the European vitreo-retinal society retinal detachment study report 1
- Author
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BENMERZOUGA N, METTI F, RAZZARI A, MIESBAUER P, SCHÖNHERR U, ZEYNALOVA Z, BASHIR SJ, JACOB J, KOCH P, LADHA R, SMETS E, STALMANS P, DARE A, DEVENYI R, LAM WC, SHAHEEDA M, POTAMITIS T, CHRISTENSEN SR, RAYES E, MORTADA H, SHOUMAN A, HOLM M, ALBINET P, AMAR JP, BECQUET F, BERROD JP, BOULZE M, BOSCHER C, COURJARET JC, DENION E, FOURMAUX, E, GUIGOU S, HAMON F, LAFONTAINE PO, LE ROUIC JF, LEYNAUD JL, NOCHEZ Y, PERONE JM, RYSANEK B, SOYEUR R, BOPP S, BRIX A, HÖHN F, KUSSEROW C, LUCKE K, MOHR A, SCHÜLER A, WEINBERGER A, GOTZARIDIS S, KARATZENIS D, STEFANIOTOU M, K. TSILIMBARIS MK, TSOURIS D, TSANG CW, GABOR R, SZIJARTO Z, BABU N, BANKER AS, BAPAYE M, KELKAR A, ENTEZARI, M, FATEH MOGHADAM HF, RAMEZANI A, SAFARPOUR LIMA B, OMER K, BOSCIA F, CHIARA FRENO M, CIAN R, DONVITO G, FACINO M, LESNONI G, LIUZZI, F, METE M, MININNI F, MOCHI B, PRIMAVERA V, PERTILE G, TURCO I, VASTARELLA P, FONG K, LEE M, VP LOO A, ARAGON HARRISON O, FLORES AGUILAR M, LOPEZ MONTERO LM, LOPEZCARASA HERNANDEZ G, VELASCO I, BOEYDEN V, BOSSCHA M, DE VRIES KNOPPERT W, LINDSTEDT, E. RENARDEL DE LAVALETTE VW, VAN DEN BIESEN PR, ALHASSAN M, BAERLAND TP, BOBER AM, FORSAA V, FOSSEN K, VARHAUG P, ATIENZA J.r. NF, CISIECKI S, FRYCZKOWSKI P, KOWAL LANGE A, MICHALEWSKA Z, MICHALEWSKI J, NAWROCKI J, NOWOSIELSKA A, ODROBINA D, PIETRAS TRZPIEL M, ZAKRZEWSKA A, MEIRELES A, TEIXEIRA S, ELSHAFEI M, DANIELESCU C, TALU S, ALTYNBAEV U, GORIN A, SEREJINE I, EL DEEB M, DAVIDOVIC S, IGNJATOVIC Z, STEFANICKOVA J, VENTER L, CHANG W, JO YL, KIM JY, LEE J, LIM ST, SAGONG M, ASCASO FJ, CASTRO J, CORDOVES L. DESCO ESTEBAN C, MORENO MANRESA J, VILAPLANA D, JANIEC S, TOMIC Z, BEN YAHIA S, ACAR N, GÜNGEL H, KAPRAN Z, OSMANBASOGLU O, OZDEK S, TOPBAS S, TOTAN Y, ÜNVER YB, CHICHUR D, DOBROVOLSKEY O, KOZLOVSKA I, LYTVYNCHUK L, PHYLYPCHUK O, POSTOLOVSKA A, SERGIIENKO A, SHEVCHYK V, WINDER S, CULOTTA J, KIM S, KING J, KURUP SK, LIN SJ, PACURARIU R, ROTH D, SINCLAIR S, WEBER P, DOAN H, TUNG T., ROMANO, MARIO, Benmerzouga, N, Metti, F, Razzari, A, Miesbauer, P, Schönherr, U, Zeynalova, Z, Bashir, Sj, Jacob, J, Koch, P, Ladha, R, Smets, E, Stalmans, P, Dare, A, Devenyi, R, Lam, Wc, Shaheeda, M, Potamitis, T, Christensen, Sr, Rayes, E, Mortada, H, Shouman, A, Holm, M, Albinet, P, Amar, Jp, Becquet, F, Berrod, Jp, Boulze, M, Boscher, C, Courjaret, Jc, Denion, E, Fourmaux, E, Guigou, S, Hamon, F, Lafontaine, Po, LE ROUIC, Jf, Leynaud, Jl, Nochez, Y, Perone, Jm, Rysanek, B, Soyeur, R, Bopp, S, Brix, A, Höhn, F, Kusserow, C, Lucke, K, Mohr, A, Schüler, A, Weinberger, A, Gotzaridis, S, Karatzenis, D, Stefaniotou, M, K., TSILIMBARIS MK, Tsouris, D, Tsang, Cw, Gabor, R, Szijarto, Z, Babu, N, Banker, A, Bapaye, M, Kelkar, A, Entezari, M, FATEH MOGHADAM, Hf, Ramezani, A, SAFARPOUR LIMA, B, Omer, K, Boscia, F, CHIARA FRENO, M, Cian, R, Donvito, G, Facino, M, Lesnoni, G, Liuzzi, F, Mete, M, Mininni, F, Mochi, B, Primavera, V, Romano, Mario, Pertile, G, Turco, I, Vastarella, P, Fong, K, Lee, M, VP LOO, A, ARAGON HARRISON, O, FLORES AGUILAR, M, LOPEZ MONTERO, Lm, LOPEZCARASA HERNANDEZ, G, Velasco, I, Boeyden, V, Bosscha, M, DE VRIES KNOPPERT, W, Lindstedt, E., RENARDEL DE LAVALETTE VW, VAN DEN BIESEN, Pr, Alhassan, M, Baerland, Tp, Bober, Am, Forsaa, V, Fossen, K, Varhaug, P, ATIENZA J. r., Nf, Cisiecki, S, Fryczkowski, P, KOWAL LANGE, A, Michalewska, Z, Michalewski, J, Nawrocki, J, Nowosielska, A, Odrobina, D, PIETRAS TRZPIEL, M, Zakrzewska, A, Meireles, A, Teixeira, S, Elshafei, M, Danielescu, C, Talu, S, Altynbaev, U, Gorin, A, Serejine, I, EL DEEB, M, Davidovic, S, Ignjatovic, Z, Stefanickova, J, Venter, L, Chang, W, Jo, Yl, Kim, Jy, Lee, J, Lim, St, Sagong, M, Ascaso, Fj, Castro, J, CORDOVES L., DESCO ESTEBAN C, MORENO MANRESA, J, Vilaplana, D, Janiec, S, Tomic, Z, BEN YAHIA, S, Acar, N, Güngel, H, Kapran, Z, Osmanbasoglu, O, Ozdek, S, Topbas, S, Totan, Y, Ünver, Yb, Chichur, D, Dobrovolskey, O, Kozlovska, I, Lytvynchuk, L, Phylypchuk, O, Postolovska, A, Sergiienko, A, Shevchyk, V, Winder, S, Culotta, J, Kim, S, King, J, Kurup, Sk, Lin, Sj, Pacurariu, R, Roth, D, Sinclair, S, Weber, P, Doan, H, and Tung, T.
- Abstract
OBJECTIVE: To study success and failure in the treatment of uncomplicated rhegmatogenous retinal detachments (RRDs). DESIGN: Nonrandomized, multicenter retrospective study. PARTICIPANTS: One hundred seventy-six surgeons from 48 countries spanning 5 continents provided information on the primary procedures for 7678 cases of RRDs including 4179 patients with uncomplicated RRDs. METHODS: Reported data included specific clinical findings, the method of repair, and the outcome after intervention. MAIN OUTCOME MEASURES: Final failure of retinal detachment repair (level 1 failure rate), remaining silicone oil at the study's conclusion (level 2 failure rate), and need for additional procedures to repair the detachment (level 3 failure rate). RESULTS: Four thousand one hundred seventy-nine uncomplicated cases of RRD were included. Combining phakic, pseudophakic, and aphakic groups, those treated with scleral buckle alone (n = 1341) had a significantly lower final failure rate than those treated with vitrectomy, with or without a supplemental buckle (n = 2723; P = 0.04). In phakic patients, final failure rate was lower in the scleral buckle group compared with those who had vitrectomy, with or without a supplemental buckle (P = 0.028). In pseudophakic patients, the failure rate of the initial procedure was lower in the vitrectomy group compared with the scleral buckle group (P = 3×10(-8)). There was no statistically significant difference in failure rate between segmental (n = 721) and encircling (n = 351) buckles (P = 0.5). Those who underwent vitrectomy with a supplemental scleral buckle (n = 488) had an increased failure rate compared with those who underwent vitrectomy alone (n = 2235; P = 0.048). Pneumatic retinopexy was found to be comparable with scleral buckle when a retinal hole was present (P = 0.65), but not in cases with a flap tear (P = 0.034). CONCLUSIONS: In the treatment of uncomplicated phakic retinal detachments, repair using scleral buckle may be a good option. There was no significant difference between segmental versus 360-degree buckle. For pseudophakic uncomplicated retinal detachments, the surgeon should balance the risks and benefits of vitrectomy versus scleral buckle and keep in mind that the single-surgery reattachment rate may be higher with vitrectomy. However, if a vitrectomy is to be performed, these data suggest that a supplemental buckle is not helpful.
- Published
- 2013
4. The European glaucoma prevention study design and baseline description of the participants
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Miglior, S, Zeyen, T, Pfeiffer, N, Cunha-Vaz, J, Linsen, M, Pellicci, L, Janssens, A, Van der Veken, A, Nerinckx, F, Boeyden, V, Detry-Morel, M, Kestelijn, P, Van den Abeele, K, Jacobs, K, Decock, C, Goethals, M, Pourjavan, S, Maris, K, Kersten, I, Vogel, A, Herkel, U, Schwenn, O, Maser-Wahle, M, Funk, J, Schmidt, B, Akbariyeh, N, Burk, R, Thomsen, A, Grehn, F, Marquardt, D, Orzalesi, N, Rossetti, L, Ferrante, M, Mandelli, L, Marini, S, Bagno, S, Bertoni, G, Blini, M, De Molfetta, M, Bonomi, L, Morbio, R, Marraffa, M, Maraini, G, Gandolfi, S, Williams, S, Cimino, L, Dondi, P, Lumbroso, B, Manni, G, Cocco, F, Glorialanza, G, Maria Villani, C, Pocobelli, A, Cesareo, M, Cupo, G, Neuschuler, R, Pernini, C, Catalani, R, Ribeiro, L, Faria, I, Moura Pereira, J, Chingui, S, Duarte, L, Carvalheira, F, Baltar, A, Simao, A, Arede, J, Magalhaes, A, Abrantes, P, Reina, M, Pedro Silva, J, Romano, G, Silva, S, Adamsons, I, Caprioli, J, Torri, V, Poli, D, Nerviani, C, Tinazzi, A, Miglior S., Zeyen T., Pfeiffer N., Cunha-Vaz J., Linsen M. -C., Pellicci L., Janssens A., Van der Veken A., Nerinckx F., Boeyden V., Detry-Morel M., Kestelijn P., Van den Abeele K. V., Jacobs K., Decock C., Goethals M., Pourjavan S., Maris K., Kersten I., Vogel A., Herkel U., Schwenn O., Maser-Wahle M., Funk J., Schmidt B., Akbariyeh N., Burk R., Thomsen A., Grehn F., Marquardt D., Orzalesi N., Rossetti L., Ferrante M., Mandelli L., Marini S., Bagno S., Bertoni G., Blini M., De Molfetta M., Bonomi L., Morbio R., Marraffa M., Maraini G., Gandolfi S., Williams S., Cimino L., Dondi P., Lumbroso B., Manni G., Cocco F., Glorialanza G., Maria Villani C., Pocobelli A., Cesareo M., Cupo G., Neuschuler R., Pernini C., Catalani R., Ribeiro L., Faria I., Moura Pereira J., Chingui S., Duarte L., Carvalheira F., Baltar A., Simao A., Arede J., Magalhaes A., Abrantes P., Reina M., Pedro Silva J., Romano G., Silva S., Adamsons I., Caprioli J., Torri V., Poli D., Nerviani C., Tinazzi A., Miglior, S, Zeyen, T, Pfeiffer, N, Cunha-Vaz, J, Linsen, M, Pellicci, L, Janssens, A, Van der Veken, A, Nerinckx, F, Boeyden, V, Detry-Morel, M, Kestelijn, P, Van den Abeele, K, Jacobs, K, Decock, C, Goethals, M, Pourjavan, S, Maris, K, Kersten, I, Vogel, A, Herkel, U, Schwenn, O, Maser-Wahle, M, Funk, J, Schmidt, B, Akbariyeh, N, Burk, R, Thomsen, A, Grehn, F, Marquardt, D, Orzalesi, N, Rossetti, L, Ferrante, M, Mandelli, L, Marini, S, Bagno, S, Bertoni, G, Blini, M, De Molfetta, M, Bonomi, L, Morbio, R, Marraffa, M, Maraini, G, Gandolfi, S, Williams, S, Cimino, L, Dondi, P, Lumbroso, B, Manni, G, Cocco, F, Glorialanza, G, Maria Villani, C, Pocobelli, A, Cesareo, M, Cupo, G, Neuschuler, R, Pernini, C, Catalani, R, Ribeiro, L, Faria, I, Moura Pereira, J, Chingui, S, Duarte, L, Carvalheira, F, Baltar, A, Simao, A, Arede, J, Magalhaes, A, Abrantes, P, Reina, M, Pedro Silva, J, Romano, G, Silva, S, Adamsons, I, Caprioli, J, Torri, V, Poli, D, Nerviani, C, Tinazzi, A, Miglior S., Zeyen T., Pfeiffer N., Cunha-Vaz J., Linsen M. -C., Pellicci L., Janssens A., Van der Veken A., Nerinckx F., Boeyden V., Detry-Morel M., Kestelijn P., Van den Abeele K. V., Jacobs K., Decock C., Goethals M., Pourjavan S., Maris K., Kersten I., Vogel A., Herkel U., Schwenn O., Maser-Wahle M., Funk J., Schmidt B., Akbariyeh N., Burk R., Thomsen A., Grehn F., Marquardt D., Orzalesi N., Rossetti L., Ferrante M., Mandelli L., Marini S., Bagno S., Bertoni G., Blini M., De Molfetta M., Bonomi L., Morbio R., Marraffa M., Maraini G., Gandolfi S., Williams S., Cimino L., Dondi P., Lumbroso B., Manni G., Cocco F., Glorialanza G., Maria Villani C., Pocobelli A., Cesareo M., Cupo G., Neuschuler R., Pernini C., Catalani R., Ribeiro L., Faria I., Moura Pereira J., Chingui S., Duarte L., Carvalheira F., Baltar A., Simao A., Arede J., Magalhaes A., Abrantes P., Reina M., Pedro Silva J., Romano G., Silva S., Adamsons I., Caprioli J., Torri V., Poli D., Nerviani C., and Tinazzi A.
- Abstract
Objectives: The European Glaucoma Prevention Study seeks to evaluate the efficacy of reducing intraocular pressure (IOP), with dorzolamide to prevent or delay patients affected by ocular hypertension from developing primary open-angle glaucoma. Design: Randomized, double-blinded, controlled clinical trial. Participants: Patients (age ≥ 30 years) were enrolled from 18 European centers. The patients fulfilled a series of inclusion criteria including the measurements of IOP (22-29 mmHg), two normal and reliable visual fields (VFs) (on the basis of mean defect and corrected pattern standard deviation/corrected loss of variance of standard 30/11 Humphrey or Octopus perimetry), and normal optic disc as determined by the Optic Disc Reading Center (vertical and horizontal cup-to-disc ratios; asymmetry between the two eyes ≤ 0.4). Intervention: Patients were randomized to the treatment with dorzolamide or a placebo. Main Outcome Measures: End points are VF and/or optic disc changes. A VF change during the follow-up must be confirmed by two further positive tests. Optic disc change is defined by the agreement of two out of three independent observers evaluating optic disc stereo-slides. Results: One thousand seventy-seven subjects were randomized between January 1, 1997 and May 31, 1999. The mean age was 57.03 ± 10.3 years; 54.41% were women and 99.9% were Caucasian. Mean IOP was 23.6 ± 1.6 mmHg in both eyes. Mean visual acuity was 0.97 ± 0.11 in both eyes; mean refraction was 0.23 ± 1.76 diopters in the right eye and 0.18 ± 1.79 diopters in the left eye. Previous use of medication for ocular hypertension was reported by 38.4% of the patients, systemic hypertension by 28.1%, cardiovascular diseases by 12.9%, and diabetes mellitus by 4.7%. The qualifying VFs were normal and reliable according to protocol criteria. Conclusions: The mean IOP of the patients enrolled in the European Glaucoma Prevention Study is consistent with the estimated mean IOP (within the range of 22-29 mmH
- Published
- 2002
5. Central corneal thickness in the European Glaucoma Prevention Study
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Pfeiffer, N, Torri, V, Miglior, S, Zeyen, T, Adamsons, I, Cunha-Vaz, J, Linsen, Mc, Pellicci, L, Janssens, A, van der Veken, A, Nerinckx, F, Boeyden, V, Kestelijn, P, Van den Abeele, K, Jacobs, K, Decock, C, Goethals, M, Pourjavan, S, Maris, K, Kersten, I, Vogel, A, Herkel, U, Schwenn, O, Maser-Wahle, M, Funk, J, Schmidt, B, Akbariyeh, N, Burk, R, Thomsen, A, Grehn, F, Marquardt, D, Orzalesi, N, Rossetti, L, Ferrante, M, Mandelli, L, Bertoni, G, Blini, M, De Molfetta, M, Bonomi, L, Morbio, R, Marraffa, M, Maraini, G, Gandolfi, S, Williams, S, Cimino, L, Dondi, P, Lumbroso, B, Marini, G, Centofanti, M, Cocco, F, Glorialanza, G, Villani, Cm, Pocobelli, A, Cesareo, M, Cupo, G, Neuschuler, R, Pernini, C, Catalani, R, Ribeiro, L, Faria, I, Pereira, Jm, Chingui, S, Duarte, L, Carvalheira, F, Baltar, A, Simao, A, Arede, J, Magalhaes, A, Abrantes, P, Reina, M, Silva, Jp, Romano, G, Silva, S, Floriani, I, Poli, D, Tinazzi, A, Caprioli, J, Wormald, R, Hejil, A, Airaksinen, J, Michaelis, J, Mandelli, La, Bagno, S, Shedden, A, Gottfried, E, Hutzelmann, J, Rusk, C, Reines, S, Spector, R, Hombrey, J, Snyder, H, Gacos, J, Snapinn, S, Getson, A, Amos, J, Serruys, K, Malbecq, W, John, E, Chapman, J, Beck, J, Tessi, C, Rao, N, Bottari, Fp, D'Achille, R, Wilkins, A, Magerl, K, Bauer, C, Derouwaux, C, Cunha, M, Santana, R, Andrade, Lg, Bule, S, Melo, R, Baumont, H, Bonaventura, I, Pfeiffer, N, Torri, V, Miglior, S, and The European Glaucoma Prevention Study, G
- Subjects
Adult ,Male ,Intraocular pressure ,medicine.medical_specialty ,genetic structures ,Settore MED/06 - Oncologia Medica ,Glaucoma, ocular hypertension, central corneal thickness ,Ocular hypertension ,Glaucoma ,Thiophenes ,Placebo ,law.invention ,Cornea ,Diabetes Complications ,Sex Factors ,Double-Blind Method ,Randomized controlled trial ,Dorzolamide ,law ,Diabetes mellitus ,Ophthalmology ,medicine ,Humans ,Intraocular Pressure ,Aged ,Ultrasonography ,Sulfonamides ,business.industry ,Age Factors ,Middle Aged ,medicine.disease ,eye diseases ,Surgery ,medicine.anatomical_structure ,Female ,Ocular Hypertension ,sense organs ,business ,medicine.drug - Abstract
Purpose: To measure central corneal thickness (CCT) within the participants of the European Glaucoma Prevention Study (EGPS). This study was designed to test if lowering intraocular pressure (IOP) by means of dorzolamide is able to prevent or delay conversion from ocular hypertension to glaucoma. Design: Randomized, double-masked, controlled, observational clinical trial. Participants: Eight hundred fifty-four of 1077 ocular hypertensive participants within the EGPS were investigated. Four hundred twenty-nine patients were treated with dorzolamide and 425 patients received placebo. Intervention: Treatment with dorzolamide or placebo (the vehicle of dorzolamide) in 1 or both eyes. Main Outcome Measures: Central corneal thickness as measured by ultrasound pachymetry (DGH-500 Pachette; DGH Technologies, Exton, PA). The CCT measurements were obtained in the morning before measuring IOP. Five measurements were taken from each eye of each patient within 5 minutes of application of anesthetic eye drops. Results: Mean CCT was 572.6±37.4 μm (range, 458.5-695.6 μm). The CCT was higher in younger patients, male patients, and diabetic patients. Mean CCTs for the 429 patients receiving dorzolamide were 574.2±38.48 μm (range, 458.5-695.6 μm) and 571.0±36.21 μm (469.7-690.1 μm) for the 425 patients receiving placebo (P = 0.205). Central corneal thickness did not correlate with refraction, baseline IOP, or systemic hypertension. Conclusion: Central corneal thickness measurements within the EGPS were greater than those reported in other studies of normal eyes without ocular hypertension. Larger CCT measurements correlated with male gender, younger age, and diabetes. © 2007 American Academy of Ophthalmology.
- Published
- 2007
6. Reproducibility of evaluation of optic disc change for glaucoma with stereo optic disc photographs
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Miglior, S, Zeyen, T, Pfeiffer, N, Cunha-Vaz, J, Linsen, Mc, Pellicci, L, Janssens, A, van der Veken, A, Nerinckx, F, Boeyden, V, Czupper, M, Wendrix, G, Detry-Morel, M, Kestelyn, P, Van den Abeele, K, Jacobs, K, Decock, C, Goethals, M, Pourjavan, S, Maris, K, Deghislage, C, Kersten, I, Vogel, A, Herkel, U, Schwenn, O, Maser-Wahle, M, Funk, J, Schmidt, B, Akbariyeh, N, Burk, R, Thomsen, A, Grehn, F, Marquardt, D, Orzalesi, N, Rossetti, L, Ferrante, M, Mandelli, L, Marini, S, Bertoni, G, Blini, M, De Molfetta, M, Bonomi, L, Morbio, R, Marraffa, M, Maraini, G, Gandolfi, S, Williams, S, Cimino, L, Dondi, P, Lumbroso, B, Manni, G, Cocco, F, Glorialanza, G, Villani, Cm, Pocobelli, A, Cesareo, M, Cupo, G, Neuschuler, R, Pernini, C, Catalani, R, Ribeiro, L, Faria, I, Pereira, Jm, Chingui, S, Duarte, L, Carvalheira, F, Baltar, A, Simao, A, Arede, J, Magalhaes, A, Abrantes, P, Reina, M, Silva, Jp, Romano, G, Silva, S, Torri, V, Poli, D, Nerviani, C, Tinazzi, A, Floriani, I, Adamsons, I, Caprioli, J, Wormald, R, Heijl, A, Airaksinen, J, Michaelis, J, Shedden, A, Gottfried, E, Hutzelmann, J, Rusk, C, Reines, S, Spector, R, Hombrey, J, Snyder, H, Gacos, J, Snapinn, S, Getson, A, Amos, J, Serruys, K, Malbecq, W, John, E, Chapman, J, Beck, J, Tessi, C, Rao, N, Bottari, Fp, D'Achille, R, Wilkins, A, Bauer, C, Derouwaux, C, Van der Straeten, A, Cunha, M, Santana, R, Andrade, Lg, Bule, S, Melo, R, Baumont, H, and Bonaventura, I
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medicine.medical_specialty ,genetic structures ,Optic Disk ,Optic disk ,Glaucoma ,Interobserver reproducibility ,Cohen's kappa ,Double-Blind Method ,Ophthalmology ,Optic Nerve Diseases ,medicine ,Photography ,Humans ,Observer Variation ,Reproducibility ,business.industry ,Outcome measures ,Reproducibility of Results ,medicine.disease ,eye diseases ,Confidence interval ,medicine.anatomical_structure ,sense organs ,business ,Optic disc - Abstract
PURPOSE To determine the reproducibility of the assessment for glaucomatous change in serial optic disc stereo-slides. DESIGN Masked interobserver variability study. PARTICIPANTS Serial optic disc stereo-slides from 40 patients. METHODS Three independent ophthalmologists evaluated for change a set of two serial 20 degrees optic disc color stereo-slides of 40 patients. This test set was not from European Glaucoma Prevention Study (EGPS) patients. Each observer performed two evaluations at least 30 days apart and was masked from the temporal sequence of the slides and his or her previous evaluation. Each patient was graded as changed or stable by two-out-of-three agreement. A kappa statistic was used to calculate the intra- and interobserver reproducibility as well as the assignment reproducibility (first consensus versus second consensus). The same procedure was followed to test the reproducibility when another experienced ophthalmologist was added to one of the three reading centers. MAIN OUTCOME MEASURES Reproducibility in evaluating glaucomatous optic disc change. RESULTS The intraobserver reproducibility (95% confidence interval [CI]) in the evaluation of change ranged between 0.79 (0.45-1.14) and 1.00 (0.69-1.31). The interobserver reproducibility (95% CI) in the evaluation of change ranged between 0.45 (0.15-0.75) and 0.75 (0.44-1.06). The assignment reproducibility (first consensus versus second consensus in the evaluation of change) between the senior EGPS readers was 0.94 (0.63-1.25). The assignment reproducibility when another experienced ophthalmologist replaced one of the readers was 0.94 (0.63-1.25). CONCLUSIONS The assignment reproducibility of three expert readers looking for glaucomatous change in serial optic disc stereo-slides was excellent. It remained so when one of the three experts was replaced by another experienced reader.
- Published
- 2003
7. Implications of bevacizumab on vascular endothelial growth factor and endostatin in human choroidal neovascularisation
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Tatar, O, primary, Shinoda, K, additional, Kaiserling, E, additional, Claes, C, additional, Eckardt, C, additional, Eckert, T, additional, Pertile, G, additional, Boeyden, V, additional, Scharioth, G B, additional, Yoeruek, E, additional, Szurman, P, additional, Bartz-Schmidt, K U, additional, Group, Tuebingen Bevacizumab Study, additional, and Grisanti, S, additional
- Published
- 2008
- Full Text
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8. Early effects of intravitreal triamcinolone acetonide on inflammation and proliferation in human choroidal neovascularization.
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Tatar O, Adam A, Shinoda K, Kaiserling E, Boeyden V, Claes C, Eckardt C, Eckert T, Pertile G, Scharioth GB, Yoeruek E, Szurman P, Bartz-Schmidt KU, and Grisanti S
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- Aged, Aged, 80 and over, Antigens, CD metabolism, Antigens, Differentiation, Myelomonocytic metabolism, Choroidal Neovascularization metabolism, Choroidal Neovascularization pathology, Choroidal Neovascularization surgery, Combined Modality Therapy, E-Selectin metabolism, Female, Humans, Immunoenzyme Techniques, Inflammation drug therapy, Inflammation metabolism, Injections, Intercellular Adhesion Molecule-1 metabolism, Laser Coagulation, Leukocyte Common Antigens metabolism, Leukocyte Count, Macular Degeneration surgery, Male, Middle Aged, Photochemotherapy, Retina transplantation, Retrospective Studies, Thy-1 Antigens metabolism, Vitreous Body, Anti-Inflammatory Agents therapeutic use, Choroidal Neovascularization drug therapy, Leukocytes pathology, Lymphocyte Activation, Macrophages pathology, Triamcinolone Acetonide therapeutic use, Vascular Endothelial Growth Factor A metabolism
- Abstract
Objective: To evaluate the early effects of triamcinolone acetonide (TA) on inflammation, proliferation, and vascular endothelial growth factor (VEGF) in human choroidal neovascularization (CNV)., Methods: Retrospective review of an interventional case series of 29 patients who underwent macular translocation. Fourteen CNV membranes without previous therapy (control CNV group) and 4 CNV membranes excised 3 days after photodynamic therapy (PDT CNV group) comprised the control groups. Eleven patients were treated with intravitreal TA (TA CNV group; n = 5) or PDT and TA combined (PDT+TA CNV group; n = 6) 3 to 9 days preoperatively. The CNV membranes were stained for cytokeratin 18, CD34, VEGF, intercellular adhesion molecule-1 (ICAM-1), E-selectin, CD68, CD45, Ki-67, and Thy-1., Results: Treatment with TA and PDT+TA resulted in increased immunostaining of ICAM-1 in endothelial cells and the stroma and a higher percentage of Thy-1 expression than controls. The density of macrophages was significantly increased in PDT+TA CNV membranes. Leukocyte density and proliferative activity were lower in TA and PDT+TA CNV membranes. The total VEGF score was significantly increased in TA and PDT+TA CNV membranes compared with the control CNV membranes. Evidence of VEGF in the retinal pigment epithelium of PDT+TA CNV membranes was stronger than in control CNV membranes., Conclusions: Triamcinolone acetonide has no inhibitory effect on macrophage infiltration or ICAM-1, Thy-1, or VEGF expression in CNV membranes in the early term. The clinical benefits of TA are probably not based on pure antiinflammatory or VEGF-suppressing mechanisms.
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- 2009
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9. Effect of bevacizumab on inflammation and proliferation in human choroidal neovascularization.
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Tatar O, Yoeruek E, Szurman P, Bartz-Schmidt KU, Adam A, Shinoda K, Eckardt C, Boeyden V, Claes C, Pertile G, Scharioth GB, and Grisanti S
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- Aged, Aged, 80 and over, Antibodies, Monoclonal, Humanized, Bevacizumab, Cell Proliferation drug effects, Choroidal Neovascularization metabolism, Choroidal Neovascularization surgery, Endostatins metabolism, Female, Humans, Immunologic Techniques, Inflammation pathology, Leukocytes pathology, Macrophages pathology, Male, Middle Aged, Preoperative Care, Retrospective Studies, Staining and Labeling, Tissue Distribution, Angiogenesis Inhibitors therapeutic use, Antibodies, Monoclonal therapeutic use, Choroidal Neovascularization drug therapy, Choroidal Neovascularization pathology
- Abstract
Objective: To evaluate the effect of bevacizumab (Avastin; Genentech, Inc, South San Francisco, California) on inflammation and proliferation in human choroidal neovascularization (CNV) secondary to age-related macular degeneration., Methods: Retrospective review of interventional series of 38 patients who underwent choroidal neaovascular membrane (CNVM) extraction. Twenty-four patients received intravitreal bevacizumab 1 to 154 days preoperatively (bevacizumab CNV group). Fourteen patients received no preoperative therapy (control CNV group). The CNVM were stained for cytokeratin 18, CD68, CD45, intercellular adhesion molecule (ICAM)-1, E-selectin, Ki-67, Thy-1, and endostatin., Results: No significant difference was detected in ICAM-1 and E-selectin expression between groups. The density of leukocytes in the bevacizumab CNV group (median, 271.61 cells/mm(2)) was higher than in the control CNV group (median, 116.87 cells/mm(2); P = .07), but without significance. Density of macrophages (median, 4661.95 cells/mm(2)), proliferative activity (median, 160.19 cells/mm(2)), and percentage of Thy-1-expressing vessels (median, 100%) were significantly higher in the bevacizumab CNV group than in the control CNV group (median, 882.66 cells/mm(2), P < .001; median, 34.34 cells/mm(2), P < .001; and median, 80%, P < .001, respectively). Endostatin immunoreactivity was considerably stronger in the retina pigment epithelium (RPE)-Bruch membrane complex (median, 3; range, 2-3; P < .001), and stroma (median, 3; range, 1-3; P < .001) of the bevacizumab CNV group than control CNV group (median, 1.5; range, 0-3 and median, 1; range, 0-3, respectively)., Conclusions: Unexpectedly, CNVM from patients treated by bevacizumab are characterized by significantly high inflammatory and proliferative activity and enhanced endostatin expression. These characteristics need to be considered when protocols for combination therapies are established.
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- 2008
- Full Text
- View/download PDF
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