Search

Background: Anti-vascular endothelial growth factor (anti-VEGF) therapy has revolutionized the management of various ocular conditions, including diabetic macular edema (DME), retinal vein occlusion (RVO)-related macular edema (ME), and neovascular age-related macular degeneration (nAMD). However, there remains a need to systematically assess its effectiveness across these distinct conditions. Methodology: A systematic review was conducted to identify studies evaluating the efficacy of anti-VEGF therapy in improving ocular outcomes in patients with DME, RVO-related ME, and nAMD. PubMed, Embase, and Cochrane Library databases were searched for relevant articles published up to 2024. Studies meeting the inclusion criteria were critically appraised, and data on the proportion of patients gaining ≥ 15 Early Treatment Diabetic Retinopathy Study (ETDRS) letters in best-corrected visual acuity (BCVA), mean change in BCVA (ETDRS letters), and reduction in central macular thickness (CMT) (μm) were extracted and synthesized. Results: The systematic review identified 18 studies comprising randomized controlled trials, prospective studies, retrospective analyses, and observational studies. Anti-VEGF therapy demonstrated efficacy across all three conditions, with varying proportions of patients experiencing improvements in BCVA and reductions in CMT. Notably, the proportion of patients gaining ≥ 15 ETDRS letters ranged from 18.1% to 44.8% in DME, while mean changes in BCVA ranged from +4.2 letters to +21.4 letters in RVO-related ME and nAMD. Reductions in CMT ranged from 183.1 μm to 294 μm in DME and RVO-related ME. Conclusion: Anti-VEGF therapy represents a cornerstone in the management of DME, RVO-related ME, and nAMD, with significant improvements observed in BCVA and reductions in CMT across diverse patient populations. While our findings support the effectiveness of anti-VEGF therapy in improving ocular outcomes, further research is warranted to compare its efficacy with alternative treatment modalities and to elucidate its long-term safety profile. [ABSTRACT FROM AUTHOR]

Purpose: Health literacy (HL) is the degree in which individuals are able to access, comprehend, and use publicly available health resources and services. A previous study was done in the Kingdom of Saudi Arabia (KSA) assessing the prevalence of HL, the study shows that almost half of KSA residents had limited HL. Most studies that show the level of HL and its relationship to emergency department (ED) utilization were conducted outside KSA. This study aims to assess the association between HL and utilization of ED services and to estimate the prevalence, factors, and outcomes of low HL in KSA. Patients and methods: A cross-sectional study was conducted among 903 participants in KSA over a period of 2 months (April and May 2023) using an online survey. Participants were asked about sociodemographic characteristics (age, sex, nationality, marital status, education, work status, income), associated factors (chronic diseases, psychiatric disorders, Covid-19 infection, Covid-19 vaccination, ED visits), and Health Literacy (read, access, understand, evaluation, decision). A health literacy instrument for adults (HELIA), which consists of the previously mentioned five subscales, was used to estimate the level of HL and its association with the risk factors. Results: Almost 529 (58.58%) and 374 (41.42%) had limited HL and adequate HL, respectively. Participants with limited HL were mostly aged 35– 45 years (61.7%), men (p < 0.05) (68.9%), divorced (65.9%), non-Saudi (69.6%), and had elementary level of education (66.7%). Participants with adequate HL had master's and PhD degree (48.1%), were healthcare students or graduates (62.8%, p < 0.05), had an income > 30 thousand riyals (55.6%, p < 0.05), were previously infected with COVID-19 (43%), and did not visit ED in the preceding year (42.3%). Conclusion: A high prevalence of low HL among KSA residents was observed. There was no significant difference in ED utilization between participants who had adequate and limited HL. [ABSTRACT FROM AUTHOR]