Skip to main content
Skip to main content
Back to Grand Rounds
Grand RoundsWeekly Evidence Brief

Ophthalmology

Edition

30-Second Takeaway

  • Brolucizumab beat PRP for vision and PDR regression with fewer ocular adverse events in treatment-naïve PDR.
  • DSDO lenses modestly outperformed DIMS for axial control and suppressed physiologic growth in non-myopes, especially younger children.
  • GLP-1 receptor agonists correlated with broad systemic and ocular vascular risk reductions in patients with DR.

Week ending April 25, 2026

Targeted retinal therapies, imaging biomarkers, and perioperative data are refining risk, treatment, and screening decisions

Brolucizumab superior to PRP for visual outcomes and PDR regression

JAMA OPHTHALMOLOGYApr 23, 2026

In CONDOR, 689 treatment-naïve PDR patients were randomized 1:1 to brolucizumab 6 mg or PRP and followed for 96 weeks. At week 54, brolucizumab improved BCVA versus PRP (mean +0.2 vs -4.2 letters; difference 4.4; 95% CI, 2.4-6.4; P < .001). More brolucizumab-treated eyes had no PDR at week 54 compared with PRP (63.6% vs 22.4%; difference 39.4; P < .001). Ocular adverse events were less frequent with brolucizumab than PRP (34.3% vs 49.1%), though intraocular inflammation details are truncated in the abstract.

DSDO lenses modestly outperform DIMS and suppress physiologic axial growth

OPHTHALMOLOGYApr 23, 2026

This prospective multicenter real-world study followed 1541 children and adolescents using DSDO or DIMS lenses, or no correction if non-myopic. In myopes, axial elongation was lower with DSDO versus DIMS at 6 months (0.07 vs 0.09 mm; P = 0.026) and 12 months (0.17 vs 0.19 mm; P = 0.019). Greater benefit was observed in children aged ≤10 years and in low-myopia subgroups, emphasizing early individualized prescribing. In non-myopes, DSDO lenses reduced physiologic axial growth versus untreated controls at 12 months (0.18 vs 0.29 mm; P = 0.01), especially in mild hyperopia or emmetropia.

GLP-1 receptor agonists associated with fewer systemic and ocular events in DR

AMERICAN JOURNAL OF OPHTHALMOLOGYApr 24, 2026

Using TriNetX data, 173,216 adults with T2D and DR were analyzed, with 30,613 GLP-1 RA users after propensity matching. GLP-1 RA use was associated with reduced myocardial infarction, coronary revascularization, heart failure exacerbation, and ischemic stroke risks over two years. Risks of lower extremity amputation, acute kidney injury, and renal replacement therapy were also lower in GLP-1 RA users. Progression to proliferative DR, retinal vein occlusion, and neovascular glaucoma was reduced, while retinal artery occlusion and NAION showed no clear association.

References

Numbered in order of appearance. Click any reference to view details.

Additional Reads

Optional additional studies from this edition.

Edition context

Clinical signal

  • Anti-VEGF, specifically brolucizumab, can reasonably be considered a primary option over PRP for treatment-naïve PDR in appropriate patients.
  • Spectacle-based myopia control and even IOP-lowering therapy may meaningfully slow axial elongation when deployed early and selectively.
  • GLP-1 RAs appear to reshape macrovascular, renal, and ocular vascular risk trajectories in patients already carrying a DR diagnosis.