Fenofibrate slows diabetic retinopathy but has not been shown to save vision, and glaucoma progression often returns

The edition in brief

A meta-analysis restricted to randomised trials, including LENS, found fenofibrate reduced diabetic retinopathy progression (RR 0.77, 95% CI 0.68 to 0.88; moderate certainty), about 45 fewer events per 1,000, but no trial showed a benefit for visual acuity, and venous thromboembolism was higher in the one trial that reported it (RR 1.52). In 635 glaucomatous eyes followed after a first visual field progression event at a US centre, recurrence reached 13.8% at three years and 43.5% at ten; faster prior loss, higher intraocular pressure after the event and older age were associated with recurrence, and each 10% greater pressure reduction with lower risk (HR 0.89). An Indian study of 122 eyes having small incision cataract surgery found sub-Tenon anaesthesia faster in onset with fewer adverse events than peribulbar, at the cost of less complete akinesia. The FDA recorded a supplement to a generic tafluprost application, an administrative action. The pearl covers retinopathy screening intervals.