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Clinical Trials |

Surgical Removal vs Observation for Idiopathic or Ocular Histoplasmosis Syndrome–Associated Subfoveal Choroidal Neovascularization:  Vision Preference Value Scale Findings From the Randomized SST Group H Trial: SST Report No. 17

Arch Ophthalmol. 2008;126(12):1626-1632. doi:10.1001/archopht.126.12.1626.
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Objective  To determine whether patients receiving observation vs surgery for subfoveal choroidal neovascularization that was idiopathic or associated with histoplasmosis differed in preference values assigned to their health and vision status.

Methods  Before and after enrollment, patients rated their current vision on a scale from 0 (blind) to 100 (perfect vision) and rated blindness and perfect vision on a scale from 0 (dead) to 100 (perfect health and vision). Scores for current vision were converted to a preference value scale (0 represents death; 100, perfect health and vision).

Results  In 170 patients, no significant difference existed between the observation and surgery arms in median vision preference values at baseline (74 vs 70) or at the 12- (74 vs 78) or 24-month follow-up (77 vs 73) (P > .05). Preference values did not differ between arms for subgroups defined by age, unilateral vs bilateral choroidal neovascularization, or good vs poor baseline visual acuity.

Conclusions  Submacular surgery was no better than observation in the preference values patients assigned to their health status, despite previously reported improvements in vision-specific quality of life.

Trial Registration  clinicaltrials.gov Identifier: NCT00000150

Clinical Relevance  Ophthalmologists should consider the effects on different measures of quality of life when determining treatment for patients similar to those in the Submacular Surgery Trials Group H Trial.

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Figure.

Mean change in Submacular Surgery Trials Vision Preference Value Scale (VPVS) scores from baseline to scheduled follow-up times, by study arm, for all patients (A), patients 50 years or younger at baseline (B), patients older than 50 years (C), patients classified as having unilateral choroidal neovascularization (CNV) at baseline (D), patients classified as having bilateral CNV (E), patients with visual acuity (VA) of 20/100 or better in the study eye at baseline (F), and patients with VA worse than 20/100 in the study eye (G). The best possible score on the VPVS is 100; the worst possible score, 0. Positive changes denote improvements from baseline scores.

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