Results of the switch from intravitreal ranibizumab to intravitreal aflibercept therapy in patients with neovascular age-related macular degeneration: A 42-month retrospective real-world study.

AIM: The study aimed to evaluate the functional and anatomical results of patients treated with intravitreal ranibizumab (IVR) for neovascular age-related macular degeneration (n-AMD) but switched to intravitreal aflibercept (IVA) treatment due to insufficient response treatment. MATERIAL AND METHODS: At least six doses of n-AMD were administered IVR to 33 patients who were switched to IVA treatment due to insufficient response and were included in the study. The patients were evaluated at the beginning of the IVR treatment during the transition to IVA treatment and at 6, 12, 18, 24, 30, 36, and 42 months of IVA treatment. RESULTS: After an average of 10.1 ± 5.04 IVR injections, the patients who were accepted as insufficient response were treated with IVA. The central macular thickness of the patients was evaluated at the beginning of the treatment, immediately before, and after the initiation of IVA treatment at 6, 12, 18, 24, 30, 36, 42 months. It was as follows: 325.21 ± 123.04, 351.42 ± 126.09, 284.81 ± 112.65, 296.68 ± 89.17, 282.61 ± 81.58, 292.27 ± 109, 92,269.75 ± 97.14, 267.50 ± 87.56, and 266.82 ± 88.35 µm. According to the best-corrected visual acuity (BCVA), it was initially 0.89 ± 0.65; 1.08 ± 0.53 during the transition to IVA; 0.91 ± 0.46 6 months after IVA; 12th 1.14 ± 0.59; 0.94 ± 0.55 at 18th; 1.07 ± 0.49 at 24th; 1.15 ± 0.57 at 30th; 1.06 ± 0.45 at 36th, and 1.13 ± 0.46 LogMAR ( Logarithm of the Minimum Angle of Resolution) at the 42nd month. CONCLUSION: In conclusion, in n-AMD patients with inadequate response to intravitreal ranibizumab or with relapse, and therefore, switched to aflibercept treatment, the anatomical improvement and sustainment were observed, however, functional recovery could not be achieved.

Indoor/outdoor concentrations and elemental composition of PM10/PM2.5 in urban/industrial areas of Kocaeli City, Turkey.

This study presents indoor/outdoor PM2.5 and PM10 concentrations measured during winter and summer in 15 homes in Kocaeli, which is one of the most industrialized areas in Turkey. Indoor and outdoor PM2.5 and PM10 mass concentrations and elemental composition were determined using an X-ray fluorescence spectrometer. Quantitative information was obtained on mass concentrations and other characteristics such as seasonal variation, indoor/outdoor (I/O) ratio, PM2.5/PM10 ratio, correlations and sources. Average indoor and outdoor PM2.5 concentrations were 29.8 and 23.5 microg/m(3) for the summer period, and 24.4 and 21.8 microg/m(3) for the winter period, respectively. Average indoor and outdoor PM10 concentrations were 45.5 and 59.9 microg/m(3) for the summer period, and 56.9 and 102.3 microg/m(3) for the winter period, respectively. A varimax rotated factor analysis (FA) was performed separately on indoor and outdoor datasets in an effort to identify possible heavy metal sources of PM2.5 and PM10 particle fractions. FA of outdoor data produced source categories comprising polluted soil, industry, motor vehicles, and fossil fuel combustion for both PM fractions, while source categories determined for indoor data for both PM2.5 and PM10 comprised industry, polluted soil, motor vehicles, and smoking, with an additional source category of cooking activities detected for the PM2.5 fraction. Practical Implications In buildings close to industrial areas or traffic arteries, outdoor sources may have an important effect on indoor air pollution. Therefore, indoor and outdoor investigations should be conducted simultaneously to assess the relationship between indoor and outdoor pollution. This study presents the simultaneous measurement of PM fractions (PM2.5 and PM10) and their elemental compositions to determine the sources of respirable PM and the heavy metals bound to these particles in indoor air. Factor analysis of indoor data indicated that the contribution of outdoor pollutant sources to indoor pollution was about 70%, making these sources the most significant for indoor heavy metal pollution, wheras other sources of indoor pollution included smoking and cooking activities.