Prediction of the short-term efficacy of anti-VEGF therapy for neovascular age-related macular degeneration using optical coherence tomography angiography

Background To evaluate whether the specific choroidal neovascularization(CNV)characteristics measured using optical coherence tomography angiography(OCTA)can predict the 6-month prognosis of neovascular age-related macular degeneration(nAMD)after anti-vascular endothelial growth factor(anti-VEGF)therapy.Methods Patients with type 1,type 2,or mixed-type neovascularization(NV)were prospectively included.Participants underwent an initial loading phase of three consecutive monthly intravitreal injections of Conbercept(0.5 mg)and were switched to a pro re nata(PRN)treatment strategy.OCTA images were evaluated for eyes that underwent follow-up assessments for more than 6 months.CNV lesions were manually segmented,and the CNV area,vessel area,greatest vascular caliber(GVC),and greatest linear dimension(GLD)were compared between responders and non-responders.Two masked graders independently measured the above-mentioned parameters using OCTA,and consistency was assessed using the intraclass correlation coefficient(ICC)values.Multiple logistic regression analysis was performed to evaluate the effect of a 3-month change in the CNV area,GLD,and GVC on the 6-month response to anti-VEGF agents.Results Among the 60 eyes of 60 patients with nAMD,39 were responders and 21 were non-responders.The proportion of CNV types was significantly different between responders and non-responders(P=0.009).Patients with type 2 or mixed NV seemed more likely to respond to the treatment(28.2%vs.0.0%,and 30.8%vs.23.8%,respectively).The change in GVC showed a significant difference between responders(−4.98±17.17μm)and non-responders(11.01±14.10μm)after three monthly intravitreal anti-VEGF injections.Multiple logistic regression analysis showed that only the change in GVC remained significant after controlling for baseline GVC,injection number,and CNV type(adjusted OR=1.083;P=0.008).Conclusions Type 2 and mixed-type NV were significantly associated with a better response to anti-VEGF therapy.Changes in GVC after 3 months of treatment were significantly associated with a response to anti-VEGF therapy at 6 months.

Association between exposure to a mixture of organochlorine pesticides and hyperuricemia in U.S.adults:A comparison of four statistical models

The association between the exposure of organochlorine pesticides(OCPs)and serum uric acid(UA)levels remained uncertain.In this study,to investigate the combined effects of OCP mixtures on hyperuricemia,we analyzed serum OCPs and UA levels in adults from the National Health and Nutrition Examination Survey(2005–2016).Four statistical models including weighted logistic regression,weighted quantile sum(WQS),quantile g-computation(QGC),and bayesian kernel machine regression(BKMR)were used to assess the relationship between mixed chemical exposures and hyperuricemia.Subgroup analyses were conducted to explore potential modifiers.Among 6,529 participants,the prevalence of hyperuricemia was 21.15%.Logistic regression revealed a significant association between both hexachlorobenzene(HCB)and trans-nonachlor and hyperuricemia in the fifth quintile(OR:1.54,95%CI:1.08–2.19;OR:1.58,95%CI:1.05–2.39,respectively),utilizing the first quintile as a reference.WQS and QGC analyses showed significant overall effects of OCPs on hyperuricemia,with an OR of 1.25(95%CI:1.09–1.44)and 1.20(95%CI:1.06–1.37),respectively.BKMR indicated a positive trend between mixed OCPs and hyperuricemia,with HCB having the largest weight in all three mixture analyses.Subgroup analyses revealed that females,individuals aged 50 years and above,and those with a low income were more vulnerable to mixed OCP exposure.These results highlight the urgent need to protect vulnerable populations from OCPs and to properly evaluate the health effects of multiple exposures on hyperuricemia using mutual validation approaches.

Associations of Socioeconomic Status Inequity with Incident Age-related Macular Degeneration in Middle-Aged and Elderly Population

Background:The relationship between socioeconomic status(SES)inequity and incident age-related macular degeneration(AMD)remains unclear.We aim to investigate whether low SES increases the risk of AMD and to explore the effect of a healthy lifestyle on this association.Methods:This prospective cohort study included 316,663 UK Biobank individuals.SES inequity was identiffed via latent class analysis using education,household income,and occupational status.Healthy lifestyle score was calculated based on smoking,alcohol drinking,and physical activity(PA).Incident AMD was deffned according to diagnosis records.Cox proportional hazards models were used to evaluate the relationship of low SES and AMD.Interrelationships of healthy lifestyle score on SES–AMD association were explored,including modiffcation,mediation,and joint effects.Results:During the average 12.2 years of follow-up,6,355 AMD cases were diagnosed.Participants with medium SES(hazard ratio:1.10[95%conffdence interval(CI)1.01 to 1.21])and low SES(hazard ratio:1.22[95%CI 1.11 to 1.34])had an increased risk of incident AMD compared to participants with high SES.PA signiffcantly affected this association.Moreover,the association between low SES and AMD was signiffcantly mediated(11.3%,95%CI:6.56 to 23.0)by smoking.Similarly,alcohol drinking suppressed(9.59%,95%CI:4.00 to 23.2)the association between high SES and AMD.Besides,a signiffcant joint effect of SES and healthy lifestyle score was found.Conclusions:We provide further evidence for the relationship of socioeconomic inequity,healthy lifestyle,and incident AMD.Future public health strategies should aim to reduce socioeconomic inequity to prevent AMD.