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ArticleGraefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie2017

The predictability of ocriplasmin treatment effects: is there consensus among retinal experts? Results from the EXPORT study.

Thomas Bertelmann, Joachim Wachtlin, Stefan Mennel, Michael J Koss, Mathias M Maier, Ricarda G Schumann, Sara Kazerounian, Hanna Daniel, Steffen Schmitz-Valckenberg, EXPORT study group

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In one paragraph

Article in Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Thomas BertelmannDepartment of Ophthalmology, University Medical Center Goettingen, Robert-Koch-Straße 40, 35075, Goettingen, Germany. thomas.bertelmann@med.uni-goettingen.de.
Joachim WachtlinDepartment of Ophthalmology, Sankt Gertrauden Krankenhaus, Berlin, Germany.
Stefan MennelDepartment of Ophthalmology, Feldkirch State Hospital, Feldkirch, Austria.
Michael J KossAugenzentrum Nymphenburger Höfe/Augenklinik Herzog Carl Theodor, Munich, Germany.
Mathias M MaierDepartment of Ophthalmology, Klinikum rechts der Isar, Technische Universität München, München, Germany.
Ricarda G SchumannDepartment of Ophthalmology, Ludwig-Maximilian-University, Munich, Germany.
Sara KazerounianDepartment of Ophthalmology, Knappschaftskrankenhaus Sulzbach, Sulzbach, Germany.
Hanna DanielDepartment of Biometry and Medical Epidemiology, Philipps-University, Marburg, Germany.
Steffen Schmitz-ValckenbergGRADE Reading Center and Department of Ophthalmology, University of Bonn, Bonn, Germany.
EXPORT study group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo evaluate the agreement and predictability of ocriplasmin treatment effects among retinal experts (raters) by assessment of retinal imaging data of eyes treated for vitreomacular traction in nine different centers in Germany and Austria.

methodsRetrospective cohort study. Combined confocal near-infrared scanning laser ophthalmoscopy and spectral-domain optical coherence tomography images (Spectralis® device, Heidelberg Engineering GmbH, Germany) from 136 eyes of 135 subjects were reviewed by 14 raters using an internet-based grading database and a standardized questionnaire. In addition to the images taken within 2 days prior to treatment, age, gender, and lens status were disclosed to the raters. Treatment success was defined as a complete cleavage of the posterior vitreous cortex at day 28±5. Main outcome was the agreement and predictability among raters for assessment of treatment success.

resultsRaters generally accepted starting ocriplasmin treatment (chance for treatment success ≥ 1%) in 22.4 to 69.1% (median 53.2%) of eyes (moderate intra- and interrater agreements with kappa-values of 0.6 and 0.48). The likelihood for a high potential treatment success (equal or higher than 25%) was judged by the raters in 43.4% to 86.0% (median 62.6%) of eyes (moderate intra- and fair interrater agreements with kappa-values of 0.56 and 0.22). Allocating eyes for high potential treatment success overall increased the odds by 3.07, with odds ratios of single raters up to 4.06 to 6.16.

conclusionsThese results underscore the importance of training health care providers in the evaluation of retinal imaging data and also to define characteristic morphological features better in the presence of vitreoretinal interface diseases. The better results of single raters in the predictability of treatment success by the allocation of eyes in the high-potential group indicates the high relevance of the meticulous analysis of retinal images.

Indexed as

ConsensusVisual AcuityAgedAged, 80 and overFemaleFibrinolysinFollow-Up StudiesHumansIntravitreal InjectionsMaleMiddle AgedOphthalmoscopyPeptide FragmentsRetinaRetinal PerforationsRetrospective StudiesFibrinolysinmicroplasminPeptide FragmentsImage analysisMacular holeMacular tractionOcriplasminSpectral-domain optical coherence tomographyVitreomacular interface disease

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.