ABSTRACT
AIM: To evaluate the efficacy and safety of intravitreal corticoid as an adjunctive therapy to anti-vascular endothelial growth factor (VEGF) treatment of neovascular age-related macular degeneration (nvAMD). METHODS: Four databases including PubMed, Embase, Cochrane Library, and the clinicaltrials.gov were comprehensively searched for studies comparing intravitreal corticoid plus anti-VEGF (IVC/IVA) vs anti-VEGF monotherapy (IVA) in patients with nvAMD. GRADE profiler was used to assess the quality of outcomes. Best-corrected visual acuity (BCVA), central macular thickness (CMT) and adverse events including the occurrence of severe elevation of intraocular pressure (IOP) and the progress of cataract were extracted from the eligible studies. Review Manager (RevMan) 5.3 was used to analyze the data. RESULTS: There was no statistic difference of mean change in BCVA at 6 and 12mo between IVC/IVA and IVA group [95% confidence interval (CI): -2.28 to 4.24, P=0.55; 95%CI: -3.01 to 8.70, P=0.34]. No statistic difference was found in the change of CMT between two groups at 6mo time point (95%CI: -17.98 to 16.42, P=0.93) while the CMT reduction in IVC/IVA group was significantly more obvious than IVA group at 12mo time point [mean difference (MD)=-44.08, 95%CI: -80.52 to -7.63, P=0.02]. The risk of occurrence of severe elevation of IOP in the IVC/IVA group was higher than that in the IVA group (95%CI: 1.92 to 9.48; P=0.0004). Cataract progression risk was calculated no statistic difference between two groups (95%CI: 0.74 to 4.66; P=0.18). CONCLUSION: No visual or anatomical benefits are observed in IVC/IVA group at 6mo. At 12mo, the CMT of the IVC/IVA group is significantly lower than that of the IVA group. Risk of severe elevation of IOP is significantly higher when treated by IVC/IVA.
ABSTRACT
Nitrogen (N) and phosphorus (P) from non-point source (NPS) pollution in Nansi Lake Basin greatly influenced the water quality of Nansi Lake, which is the determinant factor for the success of East Route of South-North Water Transfer Project in China. This research improved Johnes export coefficient model (ECM) by developing a method to determine the export coefficients of different land use types based on the hydrological and water quality data. Taking NPS total nitrogen (TN) and total phosphorus (TP) as the study objects, this study estimated the contributions of different pollution sources and analyzed their spatial distributions based on the improved ECM. The results underlined that the method for obtaining output coefficients of land use types using hydrology and water quality data is feasible and accurate, and is suitable for the study of NPS pollution at large-scale basins. The average output structure of NPS TN from land use, rural breeding and rural life is 33.6, 25.9, and 40.5%, and the NPS TP is 31.6, 43.7, and 24.7%, respectively. Especially, dry land was the main land use source for both NPS TN and TP pollution, with the contributed proportions of 81.3 and 81.8% respectively. The counties of Zaozhuang, Tengzhou, Caoxian, Yuncheng, and Shanxian had higher contribution rates and the counties of Dingtao, Juancheng, and Caoxian had the higher load intensities for both NPS TN and TP pollution. The results of this study allowed for an improvement in the understanding of the pollution source contribution and enabled researchers and planners to focus on the most important sources and regions of NPS pollution.
