The Natural History and Prognosis of Neovascular Age-Related Macular Degeneration: A Systematic Review of the Literature and Meta-analysis
Section snippets
Search Strategy to Identify Relevant Studies
We conducted a comprehensive review of all studies published in the English literature involving untreated patients with neovascular AMD, including control arms of clinical trials for treatment-naive patients with neovascular AMD. We performed an electronic search in Medline, Current Contents, and the Cochrane Library for interventional or observational studies published from 1980 through August 15, 2005. Search terms used were macular degeneration (Medical Subject Heading) or maculopathy and
Study Characteristics
Of the 53 eligible studies, 28 were RCTs, an additional 12 were prospective, and 13 were retrospective. In all, 43 of the studies provided level I or II evidence and the remaining studies provided level III or IV evidence. Of the 28 RCTs, 14 had a Jadad quality score of 4 or 5 and 14 had a score of 1 to 3. The majority of the studies were from North America (23) or Europe (24), with 6 from other regions of the world.
Patient Characteristics
From the selected studies, there were 4362 treatment-naive neovascular AMD
Study Utility/Summary of Analyses
To the best of our knowledge, this is the first systematic literature review of the untreated natural history of changes in VA in eyes with neovascular AMD. Our findings confirm a rapid progression to severe central vision loss after the onset and diagnosis of neovascular AMD. Distance VA was the most frequently used marker of disease progression, and there was relatively scarce information and inconsistent reporting on the choroidal neovascularization subtype, development of comorbidities, and
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Manuscript no. 2006-1160.
Funding provided by Pfizer Inc.