30-Second Takeaway
- YAG capsulotomy nearly doubles progression to proliferative DR and related complications in NPDR after cataract surgery
- GLP-1 receptor agonists are linked to higher 1-year NAION risk than DPP-4 inhibitors in type 2 diabetes
- Adding intravitreal steroids to anti-VEGF for RVO edema slightly improves outcomes but increases IOP and cataract surgery
- ROP screening intervals can be modestly reduced, but Pacific infants need stricter criteria to avoid missed treatment
- Lapses in DR follow-up are common and associated with substantially higher odds of vision impairment
Week ending February 21, 2026
Nine new data points reshaping diabetic eye care, ROP screening, macular disease management, and imaging biomarkers
YAG capsulotomy substantially increases progression risk in NPDR postcataract eyes
In 10,750 matched NPDR postcataract eyes, YAG capsulotomy was associated with almost double the 1-year risk of progression to proliferative DR. YAG-treated eyes also had higher risks of vitreous hemorrhage, tractional retinal detachment, and need for panretinal photocoagulation. Risks remained elevated in patients with at least five years’ duration of NPDR before cataract surgery. The authors recommend systematic retinal screening and close follow-up after YAG in diabetic patients with NPDR.
GLP-1 receptor agonists linked to higher NAION risk than DPP-4 inhibitors
Among over 523,000 adults with type 2 diabetes, GLP-1 RA initiators had a higher 1-year NAION risk than DPP-4 inhibitor initiators. The adjusted risk ratio for NAION was 2.56 with GLP-1 RAs, with an absolute risk difference of 11.3 per 100,000 at one year. Risk was greatest in the first six months of therapy and higher in younger patients, men, smokers, and those with marked A1c reduction. Ophthalmologists should consider GLP-1 RA exposure when evaluating new optic neuropathy and inform high-risk patients about possible NAION symptoms.
Anti-VEGF plus steroid modestly improves RVO edema outcomes but raises cataract and IOP risk
This meta-analysis of 20 RCTs including 2,040 patients found that anti-VEGF plus corticosteroid improved BCVA versus anti-VEGF alone in RVO macular edema. Combination therapy reduced central macular thickness, edema recurrence, and the need for PRN anti-VEGF injections. However, combination treatment increased intraocular pressure within the normal range and substantially raised cataract surgery risk. Benefits were more pronounced in CRVO, and triamcinolone and dexamethasone implants each showed specific anatomic or visual advantages. Clinicians must weigh fewer injections and slightly better visual outcomes against heightened monitoring burden and cataract risk.
ROP screening reductions are possible but unsafe in some higher-GA and Pacific infants
This validation study analyzed 5,058 infants and 23,557 encounters from a multicenter US ROP database using ROP Check software. Some proposed encounter-reducing screening modifications would have missed infants who reached treatment criteria before the recommended gestational age. Cutting the last half-week of gestational-age screening reduced encounters by 2.5% without missing treatment-warranted infants. Using an “if necessary” rule for birthweight under 1400 g and gestational age under 30 weeks in non-Pacific infants cut encounters by 7.8% safely. Pacific infants remained higher risk, requiring more sensitive screening thresholds to avoid missed treatment.
References
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Additional Reads
Optional additional studies from this edition.