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November 1996

The Case Report: When Small Is Beautiful

Author Affiliations

Madison, Wis; Baltimore, Md

Arch Ophthalmol. 1996;114(11):1413. doi:10.1001/archopht.1996.01100140613016

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In this age of randomized clinical trials and molecular analyses of hereditary diseases, designer drugs, and epidemiological explorations, we often are asked, "Wherefore the case report?" With an n often of 1, its significance is never statistical and its message rarely generalizable. Compared with its big sisters, the full-length clinical and research articles, the lowly case report has less text, fewer references, and often not even a page of its own. How can it survive?

The answer, quite simply, is that some of the best case reports have had as profound an effect on ophthalmology as articles many times their size. For example, the observation that some patients with diabetes who had large chorioretinal scars never developed proliferative retinopathy led to considering panretinal photocoagulation as a therapy. The recognition that macular holes might close following spontaneous separation of the posterior vitreous from the retina led to considering vitrectromy in the

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