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Subsequent to publication of Age-Related Eye Disease Study (AREDS) report No. 8,1 an increasing number of articles have linked age-related macular degeneration (AMD) and cataract surgery.2 - 5 The studies have relevance to AREDS report No. 8 for which cataract surgery was not considered a reason for participant exclusion. The AREDS Coordinating Center acknowledged, in correspondence with me (Roy C. Milton, PhD, written communication, October 19, 2006), that 161 participants were unilaterally pseudophakic and that another 507 required cataract surgery during the study. Such information was not included in the published article.
The recent articles suggest that cataract surgery should be an indication for exclusion in AMD therapy trials such as that described in AREDS report No. 8. I question whether the AREDS investigators now wonder whether the selection process was flawed with respect to the inclusion of eyes that underwent cataract surgery and whether they have considered reevaluation of the data following exclusion of such participants.
They might also consider excluding those participants who developed neovascular AMD during the initial months of the trial. The study described in AREDS report No. 8 was conducted without the benefit of fluorescein angiographic detection of the primary outcome, the progression to neovascular AMD. Some of the enrollees might have had occult neovascular AMD at the time of enrollment, which leads one to ask, how many of the participants developed stereoscopic fundus photography indication (the examination technique used by the authors of AREDS report No. 8) of neovascular AMD within, say, the first 8 months? Should not, for conservative analysis, those participants have also been eliminated from the clinical significance calculations?
Correspondence: Dr Hawkins, Retina-Vitreous Associates, 1200 Binz, Ste 400, Houston, TX 77004 (office@rvahouston.com).
Financial Disclosure: None reported.
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
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