Studies Flashcards
EMGT
Early manifest glaucoma trial
IOP reduction in open angle glaucoma
* Early treatment reduces glaucoma risk
* Risk factors identified:
1. High IOP
2. Disc haem
3. ^Age
4. VF defects
OHTS:
The ocular hypertension treatment study
1. Effect of topical treatment for POAG
* Topical management reduced incidence by 60%
2. Determine factors predicting POAG progression
* ^IOP
* ^Age
* Large vertical CDR
* Thin CCT
CNTGS:
Collaborative Normal-Tension Glaucoma Study
1. Lowering IOP effect on VF loss in NTG
* IOP reduction slows VF loss
* By 5 years 12% progressed, unlike 35% of control
1. Define factors for VF loss
- Reducing IOP by 30% was beneficial
- Disc haem, base VF defect. Age
- Systemic hypotension (nocturnal dips) > VF loss progression
DCCT:
Diabetes Control and Complications Trial
1. Blood glucose control on T1-DM complications
- Intensive glucose control > 50% decreased DR progression
- 75% reduced risk of DR development
1. Intensive vs conventional therapy
- Intensive therapy of HbA1c < 7%
DCR.net:
Diabetic Retinopathy Clinical Research Network
1. Compare DR/DME management
- Ranibizumab w/laser is more effective than laser mono
- Aflibercept is superior for worse baseline VA > otherwise all equal
- Ranibizumab requires less follow-up management than PRP, and less side effects
RESTORE:
- DME improvement with ranibizumab
- 5 letter injection mono/combined improvement from 1 letter improved laser mono therapy
- Significant reduction of central retinal thickness
UKPDS:
United Kingdom Prospective Diabetes Study
1. Blood glucose control on T2-DM complications
- Reduced risk of microvascular complication
1. Effect of intensive control
- Intensive group reached HbA1c 7% from conventional 7.9%
CVOS:
Central Vein Occlusion Study
1. Natural history of CRVO
- Significant loss of VA
- Worse following progression from non-ischemic to ischemic
- 1/3 ischemic cases > neovasc
1. Efficacy of PRP
- PRP decreases NV complications
- Indicated in ischemic cases showing early NV
BVOS:
Branch Retinal Vein Occlusion Study
1. Progression of BRVO
- BRVO > Persistent vision loss
- Requires active treatment
- 1/3 develop NV
1. Grid laser photocoagulation for BRVO macular edema
- 2 Line improvement, reduced ME
1. Effect of pan retinal photocoagulation
- Decreases incidence of vit haem and NV glaucoma
CRUISE:
Central Retinal Vein Occlusion Study
1. Ranibizumab for macular edema secc. to CRVO
- 14 letter gain at 6mo
- IOP increases, no systemic problems
BRAVO:
Branch Retinal Vein Occlusion Evaluation of Efficacy and Safety of Ranibizumab
1. Assess ranibizumab for ME seccondary to BRVO
- 17 letter gain at 6mo compared to sham’s 7
- central retinal thickness decreased
- Monthly injections for at least 6mo indicated
PEDIG Amblyopia treatment:
Pediatric Eye Disease Investigator Group
1. Atropine vs Patching for amblyopic 3-7yo
- Both improved 3 lines
- Atropine ^ complicance
- Light sensitivity/reduced near vision for atropine
- Patches caused discomfort
PEDIG Adaptation for amblyopia:
Pediatric Eye Disease Investigator Group
1. Refractive correction on amblyopia
- 2/3 improve VA by 2 or more lines
- influenced by severity
- Refractive correction is indicated as first step > most improvement by 12w
PEDIG history of esotropia:
Pediatric Eye Disease Investigator Group
1. Infantile esotropia study
- Untreated esotropia rarely resolves
- prognosis depends on baseline esotropia
- Sx is indicated before 2y
ONTT:
Optic Neuritis Treatment Trial
1. Steroids on acute optic neuritis
- Intravenous steroids > faster recovery, decreased incidence of MS development
- Oral prednisolone has little VA recovery, with increased optic neuritis recurrence
AREDS:
Age Related Eye Disease Study
1. AREDS 1:
- antioxidant / zinc /beta-carotene reduced AMD progression by 25%
- High risk group had reduced risk of vision loss by 20%
2. AREDS 2:
- Lutein / Zeaxanthin replaced beta-carotene for safety for smokers
- Omega-3 addition did not show significance
Current suppliment contains:
Lutein, Zeaxanthin, Vit-C/E, Zinc, and Copper
CITT:
Convergence Insufficiency Treatment Trial Study Group
1. Compare BV exercises for 6-17yo
- Office based vision therapy (flippers and prism): most effective
- Home based pencil pushup: less effective
- Home based computer therapy: moderate effect
SCUT:
Steroids for Corneal Ulcer Trial
1. Bacterial keratitis management
- Steroids had no significant benefit and would need a tailored approach to be considered
HEDS:
Herpetic Eye Disease Study Group
1. HEDS1: Steroids and Acyclovir
- Prednisolone with Acyclovir is beneficial
1. HEDS2: Long term acyclovir
- 400mg BID reduced recurrence
LAMP:
Low-concentration Atropine For Myopia Progression
1. Compare atropine concentrations
At one year axial length decreased progression
- 0.05% > -0.27D (indicated for older, or quickly progressing)
- 0.025% > -0.46D (generally good)
- 0.01% > -0.59D (indicated for younger)
- Placebo > -0.81D
Side effects increased with dosage
