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Treatments for dry age-related macular degeneration and Stargardt disease : a systematic review
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Waugh, Norman, Loveman, Emma, Colquitt, Jill, Royle, Pamela, Yeong, Jian Lee, Hoad, Geraldine and Lois, Noemi (2018) Treatments for dry age-related macular degeneration and Stargardt disease : a systematic review. Health Technology Assessment, 22 (27). doi:10.3310/hta22270 ISSN 1366-5278.
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Official URL: http://dx.doi.org/10.3310/hta22270
Abstract
Background
Age-related macular degeneration (AMD) is the leading cause of visual loss in older people. Advanced AMD takes two forms, neovascular (wet) and atrophic (dry). Stargardt disease (STGD) is the commonest form of inherited macular dystrophy.
Objective
To carry out a systematic review of treatments for dry AMD and STGD, and to identify emerging treatments where future NIHR research might be commissioned.
Design
Systematic review.
Methods
We searched MEDLINE, EMBASE, Web of Science and The Cochrane Library from 2005 to 13 July 2017 for reviews, journal articles and meeting abstracts. We looked for studies of interventions that aim to preserve or restore vision in people with dry AMD or STGD. The most important outcomes are those that matter to patients: visual acuity (VA), contrast sensitivity, reading speed, ability to drive, adverse effects of treatment, quality of life, progression of disease and patient preference. However, visual loss is a late event and intermediate predictors of future decline were accepted if there was good evidence that they are strong predictors of subsequent visual outcomes. These include changes detectable by investigation, but not necessarily noticed by people with AMD or STGD. ClinicalTrials.gov, the World Health Organization search portal and the UK Clinical Trials gateway were searched for ongoing and recently completed clinical trials.
Results
The titles and abstracts of 7948 articles were screened for inclusion. The full text of 398 articles were obtained for further screening and checking of references and 112 articles were included in the final report. Overall, there were disappointingly few good-quality studies (including of sufficient size and duration) reporting useful outcomes, particularly in STGD. However we did identify a number of promising research topics, including drug treatments, stem cells, new forms of laser treatment, and implantable intraocular lens telescopes. In many cases, research is already under way, funded by industry or governments
| Item Type: | Journal Article | ||||||
|---|---|---|---|---|---|---|---|
| Subjects: | R Medicine > RE Ophthalmology | ||||||
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School | ||||||
| Library of Congress Subject Headings (LCSH): | Retinal degeneration -- Treatment, Eye -- Diseases -- Treatment | ||||||
| Journal or Publication Title: | Health Technology Assessment | ||||||
| Publisher: | NIHR Health Technology Assessment programme | ||||||
| ISSN: | 1366-5278 | ||||||
| Official Date: | 30 May 2018 | ||||||
| Dates: |
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| Volume: | 22 | ||||||
| Number: | 27 | ||||||
| Number of Pages: | 168 | ||||||
| DOI: | 10.3310/hta22270 | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | Published | ||||||
| Access rights to Published version: | Open Access (Creative Commons) | ||||||
| Date of first compliant deposit: | 19 June 2018 | ||||||
| Date of first compliant Open Access: | 19 June 2018 | ||||||
| RIOXX Funder/Project Grant: |
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