The edition · Ophthalmology
Two years of warning before the visual field moves
OCT angiography flagged glaucoma progression a mean 2.3 years before perimetry did, at some cost in specificity; four years of pegcetacoplan preserved about three times more retinal tissue when started early; and a third of the children in two Jammu blind schools were blind from avoidable causes.
The edition in brief
Four findings for ophthalmology. In 180 eyes followed for a mean 5.1 years in the Diagnostic Innovations in Glaucoma Study, event-based progression was detected in 32.2% by OCT angiography vessel density, 25.0% by OCT nerve fibre layer thickness and 32.8% by visual field. Where progression occurred, OCT angiography was the earliest signal in 37.4% of eyes, with a mean lead time of 2.3 years over perimetry (95% CI 1.3 to 3.2) against 1.5 years for OCT (0.6 to 2.4); specificity in 45 stable eyes was 68.9% for OCT angiography against 75.6% for OCT. Pooled data from OAKS, DERBY and the GALE open-label extension show 48 months of pegcetacoplan reduced geographic atrophy growth by up to 24% against projected sham, preserving 1.88 mm2 of retina overall; in non-subfoveal atrophy, early treatment preserved up to 3.16 mm2 against 1.11 mm2 with treatment delayed by 24 months, and the risk of progression to absolute scotoma fell by 32% and 43% at the central 4 and 16 loci. The FDA approved a supplement to Biocon Biologics' aflibercept-jbvf biosimilar YESAFILI on 20 August. A survey of 82 residents of two blind schools in Jammu found 67% of blindness congenital, the whole globe and retina most often affected, and 35% of causes avoidable. And an 83305-patient cohort found open angle glaucoma suspects convert to glaucoma at 6.1% a year, supporting risk-stratified follow-up intervals ranging from six months to six years.
OCT angiography moves first, and it costs you some specificity
OCT angiography vessel density detected glaucoma progression a mean 2.3 years before the visual field did (95% CI 1.3 to 3.2), but flagged about three in ten stable eyes as progressing - a complementary signal, not a replacement.
Delaying pegcetacoplan by two years costs about two-thirds of the tissue saved
Forty-eight months of pegcetacoplan cut geographic atrophy growth by up to 24%, and starting early rather than two years later preserved about three times more retinal tissue in non-subfoveal disease (3.16 mm2 vs 1.11 mm2).
FDA clears a supplement to Biocon's aflibercept biosimilar
The FDA approved a supplement to Biocon Biologics' aflibercept-jbvf biosimilar YESAFILI (BLA 761274) on 20 August 2026 - an administrative change to an existing licence, with no new indication and nothing altered clinically.
A third of blindness in two Jammu blind schools was avoidable
Among 82 residents of two Jammu blind schools, 67% of blindness was congenital and 35% of causes were avoidable, with the whole globe, retina and cornea the most affected sites.
Send the patient home from the injection knowing three words
Send every intravitreal injection patient home with three written warning symptoms - new or worsening pain, worsening vision, increasing redness - and a number answered out of hours, with the instruction to be seen the same day.
Not every glaucoma suspect needs to be seen every year
Open angle glaucoma suspects convert at 6.1% a year overall but from 2.0% in the untreated under-50s to 16.7% in treated over-70s - enough spread to justify risk-stratified follow-up intervals rather than annual review for everyone.
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