Week in review: New glaucoma screening recommendations, anti-VEGF injection delays, protective effect of diabetes meds

A weekly roundup of ophthalmic news from around the web.

USPSTF says no need to routinely screen asymptomatic adults for glaucoma. The United States Preventive Services Task Force (USPSTF) has issued a recommendation statement regarding primary open-angle glaucoma (POAG) screening in adults. It has concluded that “evidence is insufficient to assess the balance of benefits and harms of screening for glaucoma in adults”, and therefore does not recommend routine POAG screening in asymptomatic people aged ≥40 years, instead asking clinicians to use their own judgment on a patient-by-patient basis. The USPSTF notes that more studies are needed to bolster the evidence around glaucoma screening, including ones focusing on Black and Latino populations and the accuracy of risk assessment tools. JAMA

If possible, don’t delay those bevacizumab injections for AMD. The COVID-19 pandemic has led to delays or cancelations in both ophthalmic surgeries and office visits for treatments. A single-center, retrospective, observational study conducted in Israel compared outcomes for 53 patients who missed their intravitreal bevacizumab injections for AMD (“nonadherent”) and 24 patients who completed clinic visits as usual (“adherent”) during the country’s 6-week lockdown period from May to June 2020. Mean best-corrected visual acuity was stable in the adherent group and worsened in the nonadherent group (0.07 vs 0.26 logMAR change, respectively), and more patients in the nonadherent group had a logMAR decrease of ≥0.10. Therefore, even a short delay in scheduled follow-up visits may have a negative effect on vision. International Ophthalmology

Can use of diabetes medications protect against eye disease? To answer that question, researchers looked at data from 3 cohorts of the prospective population-based Rotterdam Study consisting of 11,260 participants (mean age 65.1 years), 28.4% of whom had diagnosed type 2 diabetes (T2D). Of the participants with T2D, 57.7% were prescribed metformin, 20.8% were prescribed other T2D medications, and 21.5% received no medications. Rates of open-angle glaucoma (OAG) and AMD were higher in the untreated population than in the population given metformin; however, cataract rates were the same between the groups. Use of any diabetes medication was associated with a reduced risk of OAG and AMD compared with no medication. Additional studies may be needed to confirm these associations. JAMA Ophthalmology