Current opinion in ophthalmology
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This article reviews the potentially adverse neurodevelopmental effects of early exposure to general anesthesia and examines a changing paradigm in the management of pediatric glaucoma. ⋯ As the potential long-term adverse neurodevelopmental effects of general anesthesia become better understood, pediatric glaucoma specialists should be cognizant of the relative lifelong risks and benefits of repeat examinations under anesthesia in young patients.
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To update concepts in Value-Based Medicine, especially in view of the Patient Protection and Affordable Care Act. ⋯ Value-Based Medicine provides a standardized methodology, integrating critical, patient, quality-of-life preferences, and societal costs, to allow the highest quality, most cost-effective care. Central to Value-Based Medicine is the concept that all patients deserve the interventions that provide the greatest patient value (improvement in quality of life and/or length of life).
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Curr Opin Ophthalmol · May 2011
Review Comparative StudyRanibizumab versus bevacizumab for the treatment of neovascular age-related macular degeneration.
This paper reviews the recent literature regarding the effectiveness, efficacy and safety of intravitreal bevacizumab as compared with ranibizumab for the treatment of neovascular age-related macular degeneration (nAMD). ⋯ Numerous clinical trials, including the Comparison of AMD Treatment Trial, are underway examining the comparative efficacy of ranibizumab versus bevacizumab for the treatment of nAMD. While these studies may demonstrate clinical noninferiority of one anti-VEGF compound over another, they may not be adequately powered to detect important differences in ocular and systemic safety. Large-scale, appropriately powered safety studies need to be conducted to evaluate differences in safety.
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Treatment for diabetic macular edema (DME) is continuously evolving. While focal laser photocoagulation remains the standard of care, a new wave of studies is emerging that shows benefit of adjunctive therapy for DME. ⋯ The goal of this article is to briefly summarize recent data from these trials, in order to aid the clinician in evaluating the most appropriate and up-to-date nonsurgical management options in treating diabetic macular edema. The key points are to summarize the most recent peer-reviewed literature regarding therapy for diabetic macular edema. Particular attention is paid to focal laser, corticosteroid, and anti-VEGF therapies.