Ophthalmology

Cataract surgery linked to modest, early rise in conversion from dry to neovascular AMD

In the IRIS Registry cohort of 80,106 matched eyes with early/intermediate dry AMD, cataract surgery was associated with higher conversion to nvAMD (HR 1.22, 95% CI 1.16–1.30). The association was strongest in year 1 (approximately HR 2.5) and attenuated to about unity by year 4, suggesting a time-limited effect. At six years the cumulative incidence was 17.7% after surgery versus 15.2% without surgery (absolute risk difference ≈ 3.3%). Authors note surveillance bias or unrecognized pre-existing nvAMD may explain the early signal rather than a sustained causal effect. 1

Levodopa exposure associated with lower 3‑year conversion to neovascular AMD

In a TriNetX target-trial emulation, new users of levodopa ± carbidopa had lower 3-year risk of conversion to nAMD versus pantoprazole (HR 0.67, 95% CI 0.45–0.98). A second comparator (gabapentin) produced a similar association (HR 0.69, 95% CI 0.50–0.95). Dopamine receptor D2 agonists did not show statistically significant risk reductions in adjusted analyses. The observational design and residual confounding limit causal inference; findings support prospective testing of dopaminergic approaches. 2

Anti‑VEGF retreatment after LTFU yields less visual benefit if vision was stable at return

In 976 eyes with center-involved DME returning after ≥6 months LTFU, 32.7% with stabilized VA achieved visual gain versus 62.0% with vision decline (p<0.001). Odds of visual improvement were lower among those who returned with stable VA (OR 0.29, 95% CI 0.22–0.38). Anatomical response was smaller but still present, and more anti‑VEGF injections increased odds of benefit. Patients returning with stabilized VA of 20/50 or better did not reliably gain vision despite anatomical improvement. 3