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Acute retinal artery occlusion is associated with a significantly higher short-term risk of acute stroke. Although rates of recommended evaluation and preventive measures have improved over time, opportunities remain to optimize vascular risk mitigation following retinal artery occlusion. Elevated stroke risk persisted throughout the first 30 days following presentation for all subgroups: all retinal artery occlusion (IRR: 5.67; 95% confidence interval: [2.38, 13.5]; p<0.0001), CRAO (IRR: 5.14; 95% confidence interval: [2.29, 11.6]; p<0.0001), and BRAO (IRR: 6.67; 95% confidence interval: [1.98, 22.4]; p=0.002). Beyond 30 days, stroke risk remained modestly elevated for up to 1 year. myocardial infarction risk showed no statistically significant increase in any subgroup.
Current evidence, of very low certainty throughout and resting on only 3 randomized trials, does not demonstrate superior anatomical or visual outcomes with fluorinated gas over room air after macular hole surgery. Confidence intervals remain compatible with a clinically important benefit of gas, the one trial powered for noninferiority did not establish it for air in holes of 400 micrometers or smaller, and the only stratified data above 520 micrometers favored gas. Randomized trials in larger holes, with posturing standardized between arms, are needed.
Preoperative anti-vascular endothelial growth factor is associated with less intraoperative and early postoperative hemorrhage and fewer reoperations at diabetic vitrectomy, with the lowest hemorrhage rates when injection precedes surgery by 1 to 7 days. The evidence does not identify a precise optimal interval; higher tractional retinal detachment and reoperation rates beyond 14 days derive from a single cohort. Interval associations are hypothesis-generating given observational, low-certainty evidence.
Trabeculectomy remains imperfect (modest long-term success, notable complications), driving the search for better glaucoma surgery. A randomized trial by Landers et al. found that adding a single intravitreal bevacizumab injection to standard mitomycin-C trabeculectomy markedly improved 3-year complete (medication-free) success from 71% to 92% and qualified success from 89% to 98.5%, without increasing complications. Early reduction in bleb vascularity may explain the benefit. The results suggest a simple adjunct can make traditional trabeculectomy far more reliable and warrant confirmation in broader populations and other subconjunctival procedures.
A 5-infusion course of veligrotug administered over 12 weeks was generally well tolerated and led to rapid and significant improvements in diplopia, proptosis, and disease activity, with a durable response through week 52. Veligrotug may become a promising new treatment option for active Thyroid eye disease (TED).
Satralizumab demonstrated clinically meaningful improvements in proptosis, CAS, and diplopia and had a favorable safety profile in participants with thyroid eye disease (TED). Interleukin-6 pathway inhibition with subcutaneous satralizumab represents an efficacious and well-tolerated treatment option for patients with thyroid eye disease.
Cetirizine, ibuprofen, and prednisone were associated with reduced incidence of diabetic macular edema and proliferative diabetic retinopathy in adults with type 2 diabetes mellitus, with effect sizes comparable to those of the fenofibrate positive control. These findings support prospective evaluation of anti-inflammatory medications for the prevention of vision-threatening diabetic retinopathy.
Having a small CDR is an accepted structural predisposition for NAION, but the absolute incidence remains low. Retrospective data contain too many biases to support strong clinical recommendations, especially for patients who have never had NAION. In the absence of a proven mechanism linking GLP-1 RAs to optic-nerve injury and of prospective incidence data, theoretical ophthalmic concerns should not deter use of these agents, which have demonstrated substantial overall health benefits. The pharmaceutical industry should fund rigorous prospective studies to resolve the question.
Grading VCDR suffers from high interobserver variability and may be prone to fatigue and other subjective effects. Human graders in this cohort estimated only 2 eyes to have a VCDR >0.8, whereas the ML model estimated 87 eyes above this threshold. Perhaps the ML model could be capturing a “truer” physical anatomy, or it could be standardizing an otherwise noisy metric in such a way that it becomes mathematically more predictive of specialist-diagnosed glaucoma than human-graded VCDR.
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