Ophthalmology

OCTA-derived FAZ and large-vessel metrics predict 2-year DR progression and VA loss

In this 2-year prospective cohort of 309 eyes with type 2 diabetes, baseline OCTA parameters predicted DR progression and visual acuity decline. Enlarged, more irregular superficial FAZ and higher superficial large-vessel perfusion and vessel density independently increased odds of DR progression. Lower whole-vessel density in the superficial plexus was also associated with progression, suggesting capillary dropout alongside large-vessel remodeling. Adding FAZ perimeter and superficial large-vessel density to clinical models improved AUC for progression prediction from 0.709 to 0.822. 1

360° prophylactic laser during PPV improves single-surgery success for RRD without extra complications

This meta-analysis pooled 13 randomized and observational studies including 3639 eyes undergoing PPV for rhegmatogenous retinal detachment. Adjunctive 360° prophylactic laser increased single-surgery anatomic success versus focal laser (OR 1.82; 95% CI 1.40–2.39). Final BCVA and BCVA improvement did not differ between 360° and focal laser strategies. Rates of epiretinal membrane, proliferative vitreoretinopathy, cystoid macular edema, and macular hole were similar between groups. 2

Baseline DR severity independently signals higher long-term mortality risk in diabetes

This SOURCE consortium cohort linked EHR and National Death Index data for 524,687 adults with diabetes seen in eye care. Over a mean 5.4 years, 7% of patients died, with mortality risk strongly increasing with higher baseline DR severity. Compared with diabetes without DR, adjusted mortality hazard increased for NPDR without DME (HR 1.34) and NPDR with DME (HR 1.31). Risk was substantially higher for PDR without DME (HR 2.28) and PDR with DME (HR 1.87), despite adjustment for clinical confounders. 3