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Implementation and Adoption

Implementation and Adoption steps: proven clinical application leads to clinical practice

For medical advances to benefit society, they must reach the targeted patients and be correctly implemented. NEI conducts comparative effectiveness research to help doctors and patients make evidence-based medical decisions.

Comparison of Age-Related Macular Degeneration Treatment Trials (CATT). The development of drugs that stop the growth of new blood vessels, such as Lucentis and Avastin, has dramatically improved visual outcomes for the millions of Americans with AMD and diabetic retinopathy. The Comparison of AMD Treatments Trials (CATT) established the equivalency of these two drugs, giving patients, in consultation with their ophthalmologists, a choice in effective treatment options for the disease.

In April 2012, the Department of Health and Human Services Office of the Inspector General (OIG) reported that increasing the usage of the less expensive drug has the potential to save Medicare billions of dollars, with patients also saving millions of dollars in copayments.

Laser-Ranibizumab-Triamcinolone for Proliferative Diabetic Retinopathy. The trial was designed with three major treatment groups of patients. The first group received the standard care of treatment—in this trial, laser light to destroy abnormal vessels; the second was treated with laser and injected with Lucentis; and the third received laser plus triamcinolone. The results demonstrate that, compared to patients treated only with laser, vision improved in patients who received the Lucentis along with the laser treatment for the two years of the trial, and they experienced few side effects. Equally important, the trial showed that patients treated with triamcinolone plus laser had similar visual acuity gains as those receiving laser alone. However, many of the patients treated with triamcinolone developed vision-threatening side effects such as cataracts and glaucoma, which also required treatment. This comparative effectiveness trial is one of many protocols conducted by the Diabetic Retinopathy Clinical Research Network ( supported by NEI. is a collaborative network of scientists and eye doctors. It supports the identification, design, and implementation of clinical research on diabetic retinopathy. An important priority is to examine a broad range of promising new therapeutic approaches for patients with diabetic eye disease.

Last updated: July 23, 2019