Investigation of choroidal structure changes after intravitreal anti-VEGF therapy for retinal vein occlusion.

BACKGROUND: We aimed to investigate the effect of retinal vein occlusion (RVO) on the posterior segment structures of the eye and its changes with intravitreal anti-Vascular Endothelial Growth Factor (VEGF) treatment. METHODS: This prospective longitudinal study included 29 eyes of 29 patients with RVO (17 males and 12 females) followed for 6 months. The best corrected visual acuity (BCVA), macula, choroid ticknesses and choroidal vascularity index (CVI) obtained by spectral-domain optical coherence tomography were recorded at baseline and the first, third, and sixth months after the first injection. Results were compared with fellow eyes (non-affected eyes) and age- and sex-matched controls. RESULTS: BCVA increased significantly in the 6th month, more in the first month of injection (p < 0.05 for each). Central macular tickness, subfoveal choroid tickness, stromal and total area of choroid decreased significantly after injection (p < 0.05 for each). CVI values increased significantly, especially in the 1st month after injection (p < 0.05 for each). In eyes with Branch RVO, there was a significant decrease in the macular thickness of the occlusive areas with treatment, while there was no statistically significant change in the non-occlusive macular thickness. CONCLUSION: Observation of changes in choroidal structure may be useful to assess the activity of RVO and predict the efficacy of anti-VEGF therapy.

Frailty and Polypharmacy in Primary Care.

INTRODUCTION: The Clinical Frailty Scale (CFS) is a clinical judgement-based frailty tool developed from the Canadian Study of Health and Aging. Many studies on the measurement of frailty and its effect on clinical outcomes have been conducted on patients hospitalized, especially in intensive care units. The purpose of this study is to examine the relationship between polypharmacy and frailty on outpatient older adult patients in primary care. MATERIALS AND METHOD: This cross-sectional study included 298 patients who were aged ≥65 years and admitted to Yenimahalle Family Health Center between May-2022 and July-2022. Frailty was evaluated by using CFS. Polypharmacy was defined as five medications or more and "excessive polypharmacy" as 10 medications or more. The medications below five are grouped as "no polypharmacy". RESULTS: There was a statistically significance between age groups, gender, smoking status, marital status, polypharmacy status, and FS (p = .003 and η2: .20; p < .001 and Cohen d: .80; p = .018 and Cohen d: .35; p < .001 and Cohen d: 1.10 and p < .001 and η2: 1.45 respectively). A strong, positive correlation was found between polypharmacy and the frailty score. CONCLUSION: Polypharmacy, especially excessive polypharmacy, may be a promising adjunct to frailty in identifying older patients whose health is more likely to worsen. Providers in primary care should also consider frailty when prescribing drugs.