Atrophy slowed 41% and acuity fell anyway, and two OCT machines that disagree by 65 microns

The edition in brief

Seventy-seven eyes of 58 patients completed two years of intravitreal pegcetacoplan for geographic atrophy at one centre, averaging 18 injections at 1.3-month intervals. Among the 49 eyes with pre-treatment annual imaging, the square-root atrophy growth rate fell from 0.33 ± 0.21 mm/year before treatment to 0.19 ± 0.11 mm/year, a 41% reduction (P<0.001), and 71 of 72 eyes maintained or further slowed their growth rate in the second year - while mean visual acuity fell from 63 ± 14 to 55 ± 16 letters (P<0.001). Microperimetry across 37 grid points in 46 eyes with intermediate age-related macular degeneration found ribbon-type reticular pseudodrusen associated with lower baseline retinal sensitivity than lesion-free retina (mean difference 0.72 ± 0.24 dB, P=0.002) while dot-type was not, and regions carrying both ribbon-type pseudodrusen and soft drusen declined fastest (interaction P=0.005). A multi-institutional series across three families identified EFEMP1 p.Arg140Trp as a cause of late-onset, predominantly peripheral rod degeneration distinct from Doyne honeycomb dystrophy, with four of five at-risk relatives showing delayed dark adaptation despite 20/20 acuity and normal fundi. In 182 Korean patients with biallelic USH2A variants, c.2802T>G accounted for 23.6% of alleles and was present in 45.1% of patients, while the European hotspot variants were absent entirely. And in 97 highly myopic adults, two swept-source OCT devices differed by 61 to 71 µm in choroidal thickness using vendor software (intraclass correlation 0.63), a discrepancy that fell to 2.26 µm with a common deep learning segmentation model (0.98).