Ferhina S. Ali

A randomized clinical trial to evaluate ready-made spectacles in an adult population in India

BACKGROUND Ready-made spectacles (RMS) have advantages; however, visual performance and satisfaction has not been evaluated. METHODS A 1-month, double-masked, randomized clinical trial comparing planned continued use and visual performance of RMS to Custom Spectacles (CS) in adults aged 18-45 years with > or =1 diopter (D) of uncorrected refractive error (URE). RESULTS A total of 373 of 400 participants (93%) completed; mean age was 30 +/- 9 years, and 58% were female. Average URE was 2.21 +/- 1.31D and habitual vision was 0.58 +/- 0.21 logMAR (logarithm of Minimum Angle of Resolution, 20/63(+1) Snellen acuity). Ten participants with habitual vision better than 20/40 were excluded (3%). A lower proportion in the RMS group intended to continue to wear the study spectacles after 1 month (165/183, 90% vs 174/180, 97%, P = 0.02). Spectacle vision in the eye with lower URE was 0.08 +/- 0.15 vs 0.02 +/- 0.08, P < 0.0001 and higher URE was 0.12 +/- 0.18 vs 0.02 +/- 0.08, P < 0.0001 (logMAR) for RMS and CS. Subgroup analyses excluding participants with astigmatism > or =2.00 D and anisometropia > or =1.00 D (74/363, 20%) found no difference in planned continued use (139/143, 97% vs 141/146, 97%, P = 1.0) for RMS vs CS. CONCLUSIONS While vision is slightly better with CS, 90% of an adult population with URE planned to continue to use their RMS at 1 month. Furthermore, if those without high astigmatism or anisometropia are excluded, virtually all are satisfied with RMS and there is no difference when compared with CS. The findings of this study support the use of RMS for the delivery of refractive services in settings where there is a high level of need, limited resources and low access to refractive services.

Loss to Follow-up Among Patients With Neovascular Age-Related Macular Degeneration Who Received Intravitreal Anti–Vascular Endothelial Growth Factor Injections

Importance Loss to follow-up (LTFU) after anti–vascular endothelial growth factor (anti-VEGF) injections increases the risk of vision loss among patients with neovascular age-related macular degeneration (nAMD). Objective To report rates of LTFU among patients with nAMD after anti-VEGF injections and to identify risk factors associated with LTFU in this population. Design, Setting, and Participants This retrospective cohort study of data from 9007 patients who received anti-VEGF injections for treatment of nAMD was performed at an urban, private retina practice with multiple locations from April 1, 2012, to January 12, 2016. Main Outcomes and Measures Rates of LTFU after anti-VEGF injections. Loss to follow-up was defined as receipt of 1 or more injections with no subsequent follow-up visit within 12 months. Results Among the 9007 patients (mean [SD] age, 81.2 [8.8] years; 5917 [65.7%] female; 7905 [87.8%] white), 2003 (22.2%) were LTFU. Odds of LTFU were greater among patients 81 to 85 years of age (odds ratio [OR], 1.58; 95% CI, 1.38-1.82; P < .001), 86 to 90 years of age (OR, 2.29; 95% CI, 2.00-2.62; P < .001), and more than 90 years of age (OR, 3.31; 95% CI, 2.83-3.86; P < .001) compared with patients 80 years of age and younger. Odds of LTFU among African American patients (OR, 1.47; 95% CI, 1.00-2.16; P = .05), Asian patients (OR, 2.63; 95% CI, 1.71-4.03; P < .001), patients of other race (OR, 3.07; 95% CI, 1.38-6.82; P = .006), and patients of unreported race (OR, 2.29; 95% CI, 1.96-2.68; P < .001) were greater than odds of LTFU among white patients. Odds of LTFU were greater among patients with regional adjusted gross income of

Ready-made and custom-made eyeglasses in India: a cost-effectiveness analysis of a randomised controlled trial

50 000 or less (OR, 1.52; 95% CI, 1.30-1.79; P < .001),

Glaucoma and Dry Eye

51 000 to

Loss to Follow-Up in Patients with Proliferative Diabetic Retinopathy after Panretinal Photocoagulation or Intravitreal Anti-VEGF Injections

75 000 (OR, 1.35; 95% CI, 1.17-1.56; P < .001), and

Pneumatic Retinopexy Experience and Outcomes of Vitreoretinal Fellows in the United States: A Multicenter Study

76 000 to

Outcomes of Pars Plana Vitrectomy for Epiretinal Membrane in Eyes With Coexisting Dry Age-related Macular Degeneration

100 000 (OR, 1.28; 95% CI, 1.08-1.50; P = .004) compared with patients with incomes greater than

Multifocal Choroiditis with Peripheral Subretinal Fibrosis and Optic Nerve Involvement

100 000. Odds of LTFU for patients living 21 to 30 miles (OR, 1.33; 95% CI, 1.05-1.69; P = .02) and more than 30 miles (OR, 1.55; 95% CI, 1.28-1.88; P < .001) from clinic were greater compared with patients who lived 10 miles or less from the clinic. Odds of LTFU were greater among patients who received unilateral injections (OR, 1.44; 95% CI, 1.28-1.61; P < .001) than among patients who received bilateral injections. Conclusions and Relevance We found a high rate of LTFU after anti-VEGF injections among patients with nAMD and identified multiple risk factors associated with LTFU among this population. Although our results may not be generalizable, data on LTFU in a clinical practice setting are needed to understand the scope of the problem so that interventions may be designed to improve outcomes.

Bilateral Retinal Whitening in a Hospitalized Patient

Objective Ready-made spectacles have been suggested as a less resource-intensive treatment for the millions of people living with uncorrected refractive error (URE) in low-income environments. In spite of this interest, there have been no published economic evaluations examining the cost-effectiveness of ready-made spectacles. This study aims to determine the relative cost-effectiveness of offering ready-made spectacles (RMS) relative to no intervention as well as the relative cost-effectiveness of custom-made spectacles (CS) relative to RMS to treat URE. Methods and analysis The relative cost-effectiveness of RMS relative to CS and no intervention was tested through a cost-effectiveness analysis from the health service provider perspective conducted alongside a double-masked randomised controlled trial in an urban hospital in Delhi, India. Participants were adults aged 18–45 years with ≥1 dioptre (D) of URE. Results There was no significant difference between the effectiveness of the CS and RMS interventions in improving visual acuity, but the CS was over four times the price of the RMS per patient (204 INR (US

A Randomized Clinical Trial Evaluating Ready-Made Spectacles in an Adult Population in India

2.42) and 792 INR (US