Week in Review: Timely Corneal Ulcer Treatment, Ocular Effects of Bariatric Surgery, Uveitis Recurrence After COVID-19 Vaccination

A weekly roundup of ophthalmic news from around the web.

If corneal ulcers are treated promptly, good outcomes are obtainable in underserved populations. Among a population of 205 patients diagnosed with corneal ulcers at a clinic in a lower socioeconomic area of New York City, those who were older, had central ulcer location, and had isolation of gram-negative rods were more likely to have greater ulcer size and worse visual acuity at diagnosis. One hundred thirty-four of the ulcers were cultured, and 91 (68%) had ≥1 microbial organisms, most commonly Staphylococcus spp. Seventy-one percent of samples taken from contact lens users also had ≥1 microbial organisms. Nearly all patients were given antibiotics, and at the 3-month follow-up visit only 20% of patients were deemed to need surgical intervention. Taken together, these findings indicate, according to the authors, that “timely diagnosis and prompt referral to subspecialty care is crucial to optimize clinical outcomes, particularly in underserved communities where emergency department utilization is high.” Journal of Ophthalmic Inflammation and Infection

Bariatric surgery could potentially have a protective effect against ocular complications. The risk of developing future diabetic retinopathy (DR) was compared between a group of 42,408 patients included in the TriNet X U.S. Collaborative Network medical record database who underwent bariatric surgery for morbid obesity and a control group of 831,791 patients who had a morbid obesity diagnosis but did not have bariatric surgery. Those in the surgery group had a reduced risk of developing either proliferative (relative risk [RR] 0.32) or nonproliferative DR (RR 0.45) compared with those in the control group. Bariatric surgery patients were also less likely to develop age-related macular degeneration, retinal vein occlusion, and new cataract diagnoses. These findings are similar to those seen in earlier studies, but the authors note that information on follow-up times and certain sociodemographic factors (e.g., household income) was lacking in this study. Eye (London)

In patients with diagnosed uveitis, COVID-19 vaccination might increase the risk of additional outbreaks. Investigators reviewed COVID-19 vaccination records from all South Koreans diagnosed with uveitis between January 2015 and February 2021 (~500,000 people) and found that 8.6% of individuals experienced uveitis in the 3 months following vaccination, primarily anterior uveitis. The risk of uveitis was highest between the first and second vaccinations, but was sustained through the 6-month and 1-year postvaccination periods. The authors caution that “it remains unclear whether COVID-19 vaccination increases the risk of uveitis recurrence,” as other published studies have reported no or negligible increases in uveitis, but recommend that clinicians monitor their patients with a history of uveitis who have had a recent COVID-19 vaccination. JAMA Ophthalmology