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Leinonen S, Harju M, Hagman J, Honkamo M, Marttila L, Määttä M, Saarela V, Vaajanen A, Vesti E, Komulainen J. The Finnish current care guideline for open-angle glaucoma. Acta Ophthalmol 2024; 102:151-171. [PMID: 38174651 DOI: 10.1111/aos.16612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 11/10/2023] [Accepted: 12/08/2023] [Indexed: 01/05/2024]
Abstract
This article is an English translation of the 4th Finnish Current Care Guideline for diagnostics, treatment and follow-up of primary open-angle glaucoma, normal-tension glaucoma and pseudoexfoliative glaucoma. This guideline is based on systematic literature reviews and expert opinions with Finland's geographical and operational healthcare environment in mind.
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Affiliation(s)
- Sanna Leinonen
- Tays Eye Centre, Tampere University Hospital and Tampere University, Tampere, Finland
| | - Mika Harju
- Helsinki University and Helsinki University Hospital, Helsinki, Finland
| | - Juha Hagman
- Seinäjoki Central Hospital, Seinäjoki, Finland
| | | | | | | | | | - Anu Vaajanen
- Mehiläinen, Helsinki, Finland
- Terveystalo, Helsinki, Finland
| | - Eija Vesti
- Turku University Hospital and Turku University, Turku, Finland
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Changes of the Types and Daily Costs of Topical Antiglaucoma Medications from 2006 to 2021 in China. J Clin Pharm Ther 2023. [DOI: 10.1155/2023/7966922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
Purpose. To investigate the changes of the types and daily costs of topical antiglaucoma medications from 2006 to 2021 in China, providing evidence for optimizing treatment regimen and medical insurance policy. Methods. The types of topical antiglaucoma drugs except complementary and traditional medicines and associated price information were collected from the largest pharmaceutical database in China (YAOZH database). The daily costs of each drug, the average income level, and the daily cost of topical antiglaucoma medications relative with daily disposable income were calculated and compared between 2006 and 2021. Results. The options of topical antiglaucoma drugs increased remarkably to 32 types in 2021, of which prostaglandin analogs comprised the largest proportion (31.25%). There were 10 types of the same brand drugs available in 2006 and 2021, the mean daily cost of which decreased from $0.39 ± 0.30 to $0.28 ± 0.23 (
). As the average daily disposable income of Chinese residents grew greatly, the proportion of the daily cost of topical antiglaucoma medications in daily disposable income in 2021 declined significantly from 32.52% to 5.78% (all the drugs,
) and 3.94% (without unit dose package,
) in rural areas and from 9.95% to 2.31% (all the drugs,
) and 1.57% (without unit dose package,
) in urban areas. Conclusions. Topical antiglaucoma medications available become much more abundant in China. With the increase of residents’ disposable income and reduction of daily costs of topical antiglaucoma medications, the drug treatment for glaucoma becomes more affordable both in rural and urban areas.
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Romera Romero P, Duch S, Moreno-Montañés J, Botella García J, Balboa Miró M, Loscos Arenas J. Survey of glaucoma surgical preferences among glaucoma specialists in Spain. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2022; 97:310-316. [PMID: 35292224 DOI: 10.1016/j.oftale.2022.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 04/17/2021] [Indexed: 06/14/2023]
Abstract
PURPOSE To evaluate the spectrum of glaucoma surgery undertaken among members of the Spanish Glaucoma Society (SEG). METHODS A 10 question web-based anonimous survey was mailed through the Annals of the Spanish Glaucoma Society to all its members on January, February and July 2019 to determine their preferred surgical approach. MAIN OUTCOME MEASURES Age, type of Glaucoma, surgery undertaken, type of anti-scarring strategy and prothesis introduced for the last 10 surgeries since the survey was received. The surgeon experience was registered in years of practice. RESULTS A total of 97 SEG members across the country answered the survey. Sixty-two (63.4%) responders had more than 10 years of experience. Primary open angle glaucoma was the most frequent type of glaucoma (60.6%). The most popular surgery was deep-sclerectomy (37.3%) followed by trabeculectomy (17,6%) and the collagen microshunt (XEN® Allergan Inc., Irvine, CA) (14.1%). Glaucoma drainage device (GDD) was used in 10.5% of the cases. Up to 21.7% of surgeries were reinterventions, where GDD was used in 27.3% and trabeculectomy in 20.3% of the cases. Glaucoma surgery was combined with phacoemulsification in 47.3% of the eyes. Mitomycin C (MMC) was used in 54,8% of the cases, collagen matrix (Ologen®, Aeon Astron Corporation, Taipei, Taiwan) was used alone in 8.2% of the cases and in 13,7% combined with MMC. MMC was used in a soaked sponge in 79% of cases (concentrations of 0.02% in 99% and 0.04% in 1%) and in 21% of cases MMC was injected subconjunctivally (concentrations of 0,01% in 81% and 0.02% in 19%). CONCLUSIONS Although the glaucoma surgeon performs a wide range of surgical techniques, deep sclerectomy remains the most widely used surgical technique in Spain. Combined cataract and glaucoma surgery is performed almost in half of the patients and MMC is the most frequently selected antifibrotic agent, alone or combined with collagen matrix. The new minimal invasive surgical techniques represent the 20% of the total.
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Affiliation(s)
- P Romera Romero
- Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain; RETICS Oftared RD16/0008/0011. «Enfermedades oculares: prevención, detección temprana, tratamiento y rehabilitación de patologías oculares». Instituto de Salud Carlos III. Ministerio de Ciencia e Innovación, Madrid, Spain.
| | - S Duch
- RETICS Oftared RD16/0008/0011. «Enfermedades oculares: prevención, detección temprana, tratamiento y rehabilitación de patologías oculares». Instituto de Salud Carlos III. Ministerio de Ciencia e Innovación, Madrid, Spain; Innova Ocular BC, Barcelona, Spain
| | - J Moreno-Montañés
- RETICS Oftared RD16/0008/0011. «Enfermedades oculares: prevención, detección temprana, tratamiento y rehabilitación de patologías oculares». Instituto de Salud Carlos III. Ministerio de Ciencia e Innovación, Madrid, Spain; Clínica Universidad de Navarra, Pamplona, Spain
| | - J Botella García
- Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - M Balboa Miró
- Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - J Loscos Arenas
- Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain; RETICS Oftared RD16/0008/0011. «Enfermedades oculares: prevención, detección temprana, tratamiento y rehabilitación de patologías oculares». Instituto de Salud Carlos III. Ministerio de Ciencia e Innovación, Madrid, Spain
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Abstract
In clinical glaucoma research, the measurement of patient reported outcomes, functional assessment of disability, and health economic impact is critical. However, valid, time-efficient and comprehensive tools are not available and several current instruments lack in the appropriate precision for measuring the various dimensions of glaucoma-related quality of life (QoL), including functioning and mobility. Furthermore, statistical methods are inconsistently and sometimes incorrectly used in otherwise sound clinical studies. Standardizing and improving methods of patient-centered data collection and analysis in glaucoma studies are imperative. This paper outlines recommendations and provides a discussion of some of the pertinent issues relating to the optimization of patient-reported outcomes research in glaucoma.
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Karvonen E, Stoor K, Luodonpää M, Hägg P, Kuoppala J, Lintonen T, Ohtonen P, Tuulonen A, Saarela V. Prevalence of glaucoma in the Northern Finland Birth Cohort Eye Study. Acta Ophthalmol 2019; 97:200-207. [PMID: 30198084 DOI: 10.1111/aos.13912] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 08/09/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE To report the prevalence of glaucoma in the Northern Finland Birth Cohort (NFBC) Eye Study. METHODS Subjects of the population-based Northern Finland 1966 Birth Cohort (NFBC), aged 45-49 years at the time of the field examination, were randomized to eye screening (50%) and control (50%) groups. The eye examination protocol included best corrected visual acuity (BCVA), measurements of intraocular pressure and central corneal thickness, Humphrey 24-2 perimetry, stereoscopic optic nerve head (ONH) and retinal nerve fibre layer (RNFL) photography and imaging with optical coherence tomography (OCT), scanning laser polarimetry (GDx) and scanning laser ophthalmoscopy (HRT). The diagnosis of glaucoma was made by two independent general ophthalmologists and three independent glaucoma experts based on the evaluation of the ONH and RNFL photographs and the visual fields. RESULTS Totally, 10 321 subjects of the NFBC main study were alive in Finland in 2011, and they were randomized to the NFBC Eye Study group (n = 5155) and the control group (n = 5166). Of the randomized subjects, 3039 of 5155 (59%) responded and had sufficient data for the study. Glaucoma was suspected in 172 subjects (5.7%) at the first phase of the evaluation protocol. The interobserver agreement between two screening ophthalmologists was moderately good (kappa value 0.54 [95% confidence intervals (CI) 0.46-0.61]). Finally, definite glaucoma was found in 33 subjects (1.1% [95% CI 0.8-1.5]). CONCLUSION The study provides up-to-date information on the prevalence of glaucoma in a middle-aged Caucasian population in Finland. The baseline data reported here allows the evaluation of the cost-effectiveness of screening later on.
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Affiliation(s)
- Elina Karvonen
- Department of Ophthalmology PEDEGO Research Unit and Medical Research Center University of Oulu and Oulu University Hospital Oulu Finland
| | - Katri Stoor
- Department of Ophthalmology PEDEGO Research Unit and Medical Research Center University of Oulu and Oulu University Hospital Oulu Finland
| | - Marja Luodonpää
- Department of Ophthalmology PEDEGO Research Unit and Medical Research Center University of Oulu and Oulu University Hospital Oulu Finland
| | - Pasi Hägg
- Department of Ophthalmology PEDEGO Research Unit and Medical Research Center University of Oulu and Oulu University Hospital Oulu Finland
| | | | - Timo Lintonen
- Department of Ophthalmology PEDEGO Research Unit and Medical Research Center University of Oulu and Oulu University Hospital Oulu Finland
| | - Pasi Ohtonen
- Division of Operative Care Medical Research Center University of Oulu and Oulu University Hospital Oulu Finland
| | - Anja Tuulonen
- Tays Eye Centre Tampere University Hospital Tampere Finland
| | - Ville Saarela
- Department of Ophthalmology PEDEGO Research Unit and Medical Research Center University of Oulu and Oulu University Hospital Oulu Finland
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MacCormick IJC, Williams BM, Zheng Y, Li K, Al-Bander B, Czanner S, Cheeseman R, Willoughby CE, Brown EN, Spaeth GL, Czanner G. Accurate, fast, data efficient and interpretable glaucoma diagnosis with automated spatial analysis of the whole cup to disc profile. PLoS One 2019; 14:e0209409. [PMID: 30629635 PMCID: PMC6328156 DOI: 10.1371/journal.pone.0209409] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 12/05/2018] [Indexed: 11/25/2022] Open
Abstract
Background Glaucoma is the leading cause of irreversible blindness worldwide. It is a heterogeneous group of conditions with a common optic neuropathy and associated loss of peripheral vision. Both over and under-diagnosis carry high costs in terms of healthcare spending and preventable blindness. The characteristic clinical feature of glaucoma is asymmetrical optic nerve rim narrowing, which is difficult for humans to quantify reliably. Strategies to improve and automate optic disc assessment are therefore needed to prevent sight loss. Methods We developed a novel glaucoma detection algorithm that segments and analyses colour photographs to quantify optic nerve rim consistency around the whole disc at 15-degree intervals. This provides a profile of the cup/disc ratio, in contrast to the vertical cup/disc ratio in common use. We introduce a spatial probabilistic model, to account for the optic nerve shape, we then use this model to derive a disc deformation index and a decision rule for glaucoma. We tested our algorithm on two separate image datasets (ORIGA and RIM-ONE). Results The spatial algorithm accurately distinguished glaucomatous and healthy discs on internal and external validation (AUROC 99.6% and 91.0% respectively). It achieves this using a dataset 100-times smaller than that required for deep learning algorithms, is flexible to the type of cup and disc segmentation (automated or semi-automated), utilises images with missing data, and is correlated with the disc size (p = 0.02) and the rim-to-disc at the narrowest rim (p<0.001, in external validation). Discussion The spatial probabilistic algorithm is highly accurate, highly data efficient and it extends to any imaging hardware in which the boundaries of cup and disc can be segmented, thus making the algorithm particularly applicable to research into disease mechanisms, and also glaucoma screening in low resource settings.
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Affiliation(s)
- Ian J. C. MacCormick
- Department of Eye & Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, United Kingdom
- Centre for Clinical Brain Sciences, University of Edinburgh, Chancellor's Building, Edinburgh, United Kingdom
| | - Bryan M. Williams
- Department of Eye & Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, United Kingdom
| | - Yalin Zheng
- Department of Eye & Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, United Kingdom
- St Paul’s Eye Unit, Royal Liverpool University Hospitals NHS Trust, Liverpool, United Kingdom
| | - Kun Li
- Medical Information Engineering Department, Taishan Medical School, TaiAn City, ShanDong Province, China
| | - Baidaa Al-Bander
- Department of Electrical Engineering and Electronics, University of Liverpool, Brownlow Hill, Liverpool, United Kingdom
| | - Silvester Czanner
- School of Computing, Mathematics and Digital Technology, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, Manchester, United Kingdom
| | - Rob Cheeseman
- St Paul’s Eye Unit, Royal Liverpool University Hospitals NHS Trust, Liverpool, United Kingdom
| | - Colin E. Willoughby
- Biomedical Sciences Research Institute, Faculty of Life & Health Sciences, Ulster University, Coleraine, Northern Ireland
- Department of Ophthalmology, Royal Victoria Hospital, Belfast, Northern Ireland
| | - Emery N. Brown
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
- Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - George L. Spaeth
- Glaucoma Research Center, Wills Eye Hospital, Philadelphia, Pennsylvania, United States of America
| | - Gabriela Czanner
- Department of Eye & Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, United Kingdom
- St Paul’s Eye Unit, Royal Liverpool University Hospitals NHS Trust, Liverpool, United Kingdom
- Department of Applied Mathematics, Faculty of Engineering and Technology, Liverpool John Moores University, Liverpool, United Kingdom
- * E-mail:
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Tuulonen A, Kataja M, Syvänen U, Miettunen S, Uusitalo H. Right services to right patients at right time in right setting in Tays Eye Centre. Acta Ophthalmol 2016; 94:730-735. [PMID: 27422769 DOI: 10.1111/aos.13168] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Accepted: 05/16/2016] [Indexed: 11/30/2022]
Abstract
PURPOSE The report describes the concepts behind procedures implemented in Tays Eye Centre to enable improved access to care and improved productivity. METHODS The strategy was developed in 2009 after hospital district decided to construct a new eye hospital which was opened in 2012. The following principles were implemented: (i) identification of high-volume patient groups: the 'big four' eye diseases accounting for 70% of patient visits and costs: age-related macular degeneration (AMD), glaucoma, retinal diseases and cataract; (ii) stratification and prioritization of patient care based on risk of permanent visual disability; (iii) standardization of services for low-risk patients; (iv) maximization of productivity; and (v) shared care. The impact of the new strategy on access to care and productivity is reported for years 2011-2015. RESULTS In 2011-2015, the total number of services provided increased 46% while the work contribution increased 15%. The number of referrals increased 76% and the number of outpatient appointments increased 2.5-fold. Simultaneously, the number of delayed follow-up visits decreased to zero. Age-related macular degeneration (AMD) injections increased 1.8-fold. However, after 50% yearly increase in Age-related macular degeneration (AMD) injections, a plateau was reached in 2014 with a 3% decline in 2014-2015 with no changes in treatment indications. In the beginning of 2016, the number of injections has started to increase again (+9% compared to 2015). The total number of surgical procedures increased 98%. The annual number of cataract surgeries increased 64% and bilateral surgeries from 11% to 39%. CONCLUSION Revised operational concepts and new facilities together with a 15% increase in work contribution led to a 46% increase in overall productivity, improved access to care and the clearance of delayed services. Efforts continue to further refine cost-effective care and to define the appropriate levels of services.
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Affiliation(s)
- Anja Tuulonen
- Tays Eye Centre; Tampere University Hospital; Tampere Finland
| | - Marko Kataja
- Tays Eye Centre; Tampere University Hospital; Tampere Finland
| | - Ulla Syvänen
- Tays Eye Centre; Tampere University Hospital; Tampere Finland
| | - Sirpa Miettunen
- Tays Eye Centre; Tampere University Hospital; Tampere Finland
| | - Hannu Uusitalo
- Tays Eye Centre; Tampere University Hospital; Tampere Finland
- Research and Development Centre for Ophthalmic Innovations (SILK); Department of Ophthalmology; University of Tampere; Tampere Finland
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The Visual Function Questionnaire: Utility Index: Does It Measure Glaucoma-related Preference-based Status? J Glaucoma 2016; 25:822-829. [DOI: 10.1097/ijg.0000000000000441] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
PURPOSE OF REVIEW The review evaluates the past 18-month literature related to cost-effectiveness of treating ocular hypertension (OHT) and give an opinion of the state of research. RECENT FINDINGS Three studies question the value of intensive monitoring in OHT and glaucoma. One study suggests that implementing Ocular Hypertension Treatment Study - European Glaucoma Prevention Study (OHTS-EGPS) risk prediction in every day practice overestimates the risk of open-angle glaucoma. While two models suggest that treating all intraocular pressures above 21 mmHg would be cost-saving (but disagree on the impact of this strategy on conversion to glaucoma), another study in turn suggests than we could safely reduce medications in almost half of the patients. Two studies suggest that effective early treatment could decrease follow-up costs in OHT and one modeling study suggests that using laser in preference to medication would be cost effective in glaucoma. SUMMARY The results of this time-limited review are confusing as they challenge many current beliefs to continue to do more than what we are currently doing. We have a huge gap in understating whether we are currently doing the 'right' things in our every day practices.
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Hagman J. Comparison of resource utilization in the treatment of open-angle glaucoma between two cities in Finland: is more better? Acta Ophthalmol 2013. [DOI: 10.1111/aos.12181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Hagman J. Comparison of resource utilization in the treatment of open-angle glaucoma between two cities in Finland: is more better? Acta Ophthalmol 2013; 91 Thesis 3:1-47. [PMID: 23621767 DOI: 10.1111/aos.12141] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Glaucoma is a progressive optic neuropathy associated with neural rim loss of the optic disc and the retinal nerve fibre layer typically causing visual field (VF) deterioration. Generally, glaucomatous lesions in the eye and in the visual field progress slowly over the years. In population-based cross-sectional studies, the percentage of unilateral or bilateral visual impairment varied between 3-12%. In screening studies, 0.03-2.4% of patients have been found to suffer visual impairment. Glaucoma has previously been associated with substantial healthcare costs and resource consumption attributable to the treatment of the disease. The disease also causes reduction in health-related quality of life (HRQoL) in patients with glaucoma. OBJECTIVE AND METHODS This study compares patients with diagnosed open-angle glaucoma from two geographically different regions in Finland. A total of 168 patients were examined, 85 subjects from an area with higher per patient treatment costs (Oulu) and 83 patients from a region with lower per patient treatment costs (Turku). All patients had a history of continuous glaucoma medication use for a period of 11 years. For each patient, the total direct costs from glaucoma treatment were calculated and the total amount of resource consumption was determined from registries and patient records. Each patient underwent a clinical examination with visual field assessment and fundus photography. These data were used to determine the current stage of disease for each patient. Health-related quality of life questionnaire (15D) was used in determining each patient's subjective HRQoL score. RESULTS When applying the current diagnostic criteria for open-angle glaucoma, a total of 40% of patients did not to display any structural or functional damage suggesting glaucoma after 11 years of continuous medical treatment and follow-up. Patients with higher glaucoma stage (worse disease) were found to have statistically higher treatment costs compared with those at lower disease stages. Resource consumption was also greater in the patients in higher glaucoma stage. Patients in the Oulu district consumed more resources, and glaucoma treatment was more expensive than in the Turku area. The total treatment cost in Oulu and Turku was 6010 € and 4452 €, respectively, for the whole 11-year period. There was no statistically significant difference in quality-of-life scores between the two areas. No difference was noted between the higher-spending and lower-spending areas in this respect. However, when the population was analysed as a whole, patients with higher glaucoma stage were found to have lower vision-based 15D scores compared with those at lower disease stages. This observation was made also at both districts independently. CONCLUSIONS Major cost source in open-angle glaucoma treatment is medication, up to 74% of annual costs. In addition, it seems that higher resource consumption and higher treatment costs do not increase the patients' HRQoL as assessed by the 15D instrument.
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Affiliation(s)
- Juha Hagman
- Department of Ophthalmology, Faculty of Medicine, Institute of Clinical Medicine, University of Oulu, Oulu, Finland
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De Fendi LI, Arruda GV, Scott IU, Paula JS. Mitomycin C versus5-fluorouracil as an adjunctive treatment for trabeculectomy: a meta-analysis of randomized clinical trials. Clin Exp Ophthalmol 2013; 41:798-806. [DOI: 10.1111/ceo.12097] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Lígia I De Fendi
- Department of Ophthalmology; Otorhinolaryngology and Head and Neck Surgery; School of Medicine of Ribeirão Preto; University of São Paulo
- Department of Ophthalmology; School of Medicine of Marília; São Paulo Brazil
| | - Gustavo V Arruda
- Department of Radiotherapy; School of Medicine of Marília; São Paulo Brazil
| | - Ingrid U Scott
- Departments of Ophthalmology and Public Health Sciences; Penn State College of Medicine; Hershey Pennsylvania USA
| | - Jayter S Paula
- Department of Ophthalmology; Otorhinolaryngology and Head and Neck Surgery; School of Medicine of Ribeirão Preto; University of São Paulo
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Qian CXY, Duperré J, Hassanaly S, Harissi-Dagher M. Pre- versus post-dilation changes in intraocular pressure: their clinical significance. Can J Ophthalmol 2012; 47:448-52. [DOI: 10.1016/j.jcjo.2012.07.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2012] [Revised: 07/07/2012] [Accepted: 07/13/2012] [Indexed: 10/26/2022]
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