4 results on '"Victor Chong"'
Search Results
2. Improving the cost-effectiveness of photographic screening for diabetic macular oedema: A prospective, multi-centre, UK study
- Author
-
Gordon Prescott, Graham Scotland, P Dodson, Ken Swa, Sam Philip, Alan Fleming, Keith A Goatman, H Wharton, Victor Chong, Simon P. Harding, John A. Olson, C Santiago, Roly Megaw, Roger T. Staff, Peter F. Sharp, Deborah M Broadbent, Shyamanga Borooah, Graham P. Leese, and Caroline Styles
- Subjects
Adult ,Male ,medicine.medical_specialty ,Cost effectiveness ,Cost-Benefit Analysis ,Sensitivity and Specificity ,Macular Edema ,Cellular and Molecular Neuroscience ,Automation ,Optical coherence tomography ,Ophthalmology ,medicine ,Photography ,Humans ,Mass Screening ,Prospective Studies ,Macular edema ,Mass screening ,Aged ,Diabetic Retinopathy ,medicine.diagnostic_test ,business.industry ,Diabetic retinopathy ,A300 ,Middle Aged ,medicine.disease ,Quality Improvement ,Sensory Systems ,United Kingdom ,Quality-adjusted life year ,Optometry ,Maculopathy ,Female ,Quality-Adjusted Life Years ,business ,Tomography, Optical Coherence ,Retinopathy - Abstract
Background/aims:\ud Retinal screening programmes in England and Scotland have similar photographic grading schemes for background (non-proliferative) and proliferative diabetic retinopathy, but diverge over maculopathy. We looked for the most cost-effective method of identifying diabetic macular oedema from retinal photographs including the role of automated grading and optical coherence tomography, a technology that directly visualises oedema. \ud \ud Methods: Patients from seven UK centres were recruited. The following features in at least one eye were required for enrolment: microaneurysms/dot haemorrhages or blot haemorrhages within one disc diameter, or exudates within one or two disc diameters of the centre of the macula. Subjects had optical coherence tomography and digital photography. Manual and automated grading schemes were evaluated. Costs and QALYs were modelled using microsimulation techniques. \ud \ud Results: 3540 patients were recruited, 3170 were analysed. For diabetic macular oedema, England’s scheme had a sensitivity of 72.6% and specificity of 66.8%; Scotland’s had a sensitivity of 59.5% and specificity of 79.0%. When applying a ceiling ratio of £30 000 per quality adjusted life years (QALY) gained, Scotland’s scheme was preferred. Assuming automated grading could be implemented without increasing grading costs, automation produced a greater number of QALYS for a lower cost than England’s scheme, but was not cost effective, at the study’s operating point, compared with Scotland’s. The addition of optical coherence tomography, to each scheme, resulted in cost savings without reducing health benefits. \ud \ud Conclusions: Retinal screening programmes in the UK should reconsider the screening pathway to make best use of existing and new technologies.
- Published
- 2016
3. Efficacy and safety of intravitreal aflibercept injection in wet age-related macular degeneration: outcomes in the Japanese subgroup of the VIEW 2 study.
- Author
-
Yuichiro Ogura, Hiroko Terasaki, Fumi Gomi, Mitsuko Yuzawa, Tomohiro Iida, Miki Honda, Koichi Nishijo, Olaf Sowade, Tetsushi Komori, Ursula Schmidt-Erfurth, Christian Simader, and Victor Chong
- Subjects
RETINAL degeneration treatment ,DEGENERATION (Pathology) ,BIOPHARMACEUTICAL research ,THERAPEUTIC equivalency in drugs ,HEALTH outcome assessment ,OPHTHALMOLOGY - Abstract
Background/aims To evaluate efficacy and safety of intravitreal aflibercept (IVT-AFL) in Japanese patients with wet age-related macular degeneration (wAMD) from the VIEW 2 trial. Methods In this double-masked study, patients were randomised to: 0.5 mg IVT-AFL every 4 weeks (0.5q4); 2 mg IVT-AFL every 4 weeks (2q4); 2 mg IVT-AFL every 8 weeks (2q8) after 3 monthly injections; or 0.5 mg ranibizumab every 4 weeks (Rq4). Main efficacy outcomes included vision maintenance and bestcorrected visual acuity (BCVA) at week 52. Results At week 52, all Japanese patients in the IVTAFL groups (n=70) maintained vision, compared with 96% of Japanese patients (n=23/24) treated with ranibizumab. Japanese patients in all treatment groups showed improvement in BCVA after treatment. The Rq4, 2q4 and 2q8 groups experienced similar gains in BCVA from baseline. The 0.5q4 group had higher gains due to an unexpected drop in BCVA between screening and baseline. Central retinal thickness and mean area of choroidal neovascularisation decreased in all treatment groups with similar magnitude. Ocular treatmentemergent adverse events were balanced across treatment groups. Conclusions IVT-AFL was effective and well tolerated in Japanese patients. Outcomes in this population were consistent with those in the overall VIEW 2 population. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
4. Guidelines for the management of neovascular age-related macular degeneration by the European Society of Retina Specialists (EURETINA).
- Author
-
Schmidt-Erfurth, Ursula, Victor Chong, Loewenstein, Anat, Larsen, Michael, Souied, Eric, Schlingemann, Reinier, Eldem, Bora, Monés, Jordi, Richard, Gisbert, and Bandello, Francesco
- Subjects
- *
RETINAL degeneration , *VASCULAR endothelial growth factors , *NEOVASCULARIZATION , *FOLLOW-up studies (Medicine) , *BIOMARKERS , *VISUAL acuity , *OPTICAL coherence tomography - Abstract
Age-related macular degeneration (AMD) is still referred to as the leading cause of severe and irreversible visual loss world-wide. The disease has a profound effect on quality of life of affected individuals and represents a major socioeconomic challenge for societies due to the exponential increase in life expectancy and environmental risks. Advances in medical research have identified vascular endothelial growth factor (VEGF) as an important pathophysiological player in neovascular AMD and intraocular inhibition of VEGF as one of the most efficient therapies in medicine. The wide introduction of anti-VEGF therapy has led to an overwhelming improvement in the prognosis of patients affected by neovascular AMD, allowing recovery and maintenance of visual function in the vast majority of patients. However, the therapeutic benefit is accompanied by significant economic investments, unresolved medicolegal debates about the use of offlabel substances and overwhelming problems in large population management. The burden of disease has turned into a burden of care with a dissociation of scientific advances and real-world clinical performance. Simultaneously, ground-breaking innovations in diagnostic technologies, such as optical coherence tomography, allows unprecedented high-resolution visualisation of disease morphology and provides a promising horizon for early disease detection and efficient therapeutic follow-up. However, definite conclusions from morphologic parameters are still lacking, and valid biomarkers have yet to be identified to provide a practical base for disease management. The European Society of Retina Specialists offers expert guidance for diagnostic and therapeutic management of neovascular AMD supporting healthcare givers and doctors in providing the best state-of-the-art care to their patients. [ABSTRACT FROM AUTHOR]
- Published
- 2014
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.