Transactions of the American Ophthalmological Society
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Trans Am Ophthalmol Soc · Jan 2007
Macular holes and macular pucker: the role of vitreoschisis as imaged by optical coherence tomography/scanning laser ophthalmoscopy.
The pathogenesis of macular pucker and macular holes is poorly understood. Anomalous posterior vitreous detachment (PVD) and vitreoschisis have been proposed as possible mechanisms. This study used clinical imaging to seek vitreoschisis and study the topographic features of macular pucker and macular holes. ⋯ Vitreoschisis was detected in about half of all eyes with macular hole and macular pucker. The topographic and structural features in eyes with macular hole with retinal contraction differed in comparison to eyes with macular pucker alone, suggesting that although each condition may begin with anomalous PVD, differences in subsequent cell migration and proliferation probably result in the different clinical appearances detected in this study.
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Trans Am Ophthalmol Soc · Jan 2007
The goal of value-based medicine analyses: comparability. The case for neovascular macular degeneration.
To evaluate the comparability of articles in the peer-reviewed literature assessing the (1) patient value and (2) cost-utility (cost-effectiveness) associated with interventions for neovascular age-related macular degeneration (ARMD). ⋯ The majority of cost-utility studies performed on interventions for neovascular macular degeneration are value-based medicine studies and thus are comparable. Value-based analyses of neovascular ARMD monotherapies demonstrate the power of value-based medicine to improve quality of care and concurrently maximize the efficacy of healthcare resource use in public policy. The comparability of value-based medicine cost-utility analyses has important implications for overall practice standards and public policy. The adoption of value-based medicine standards can greatly facilitate the goal of higher-quality care and maximize the best use of healthcare funds.