This review aims to provide an update on the clinical presentation, diagnosis, and treatment of ocular syphilis. While ocular syphilis is not a new phenomenon, recent resurgence in the incidence of overall syphilis, particularly among HIV-positive individuals, has sparked a new interest in an old disease. The challenge of ocular syphilis is manifold: firstly, it manifests in a spectrum of ways that can occur at any stage of the disease, with the most common finding being panuveitis. It may occur as early as 6 weeks after transmission and may be the only presenting feature of systemic syphilis; secondly, the relationship between HIV and syphilis has been established, as primary syphilis facilitates HIV transmission and HIV may modify the natural course of syphilis, increasing the propensity of the disease to progress to neurosyphilis. The authors present the latest updates to the changing landscape of ocular syphilis.
Diabetic retinopathy (DR) is a common microvascular complication of diabetes mellitus. The evidence connecting dietary intake and DR is emerging, but uncertain. We conducted a systematic review to comprehensively summarize the current understanding of the associations between dietary consumption, DR and diabetic macular edema (DME). We systematically searched PubMed, Embase, Medline, and the Cochrane Central Register of Controlled Trials between January 1967 to May 2022 for all studies investigating the effect of diet on DR and DME. Of the 4962 articles initially identified, 54 relevant articles were retained. Our review found that higher intakes of fruits, vegetables, dietary fibers, fish, a Mediterranean diet, oleic acid, and tea were found to have a protective effect against DR. Conversely, high intakes of diet soda, caloric intake, rice, and choline were associated with a higher risk of DR. No association was seen between vitamin C, riboflavin, vitamin D, and milk and DR. Only one study in our review assessed dietary intake and DME and found a risk of high sodium intake for DME progression. Therefore, the general recommendation for nutritional counseling to manage diabetes may be beneficial to prevent DR risk, but prospective studies in diverse diabetic populations are needed to confirm our findings and expand clinical guidelines for DR management.
Background Bevacizumab is the only agent that many people can afford, yet there are only limited data on whether it improves macular oedema (MO) secondary to retinal vein occlusion (RVO) in real‐world clinical practice. Here we studied 12‐month real‐world treatment outcomes of bevacizumab for RVO‐related MO. Methods This was a multicentre, observational study analysing 12‐month data from the Fight Retinal Blindness! (FRB) database. We studied treatment‐naïve eyes with MO secondary to RVO commencing bevacizumab therapy between June 2009 and June 2019. Visual acuity (VA) and central subfield thickness (CST) were measured at baseline, 6 and 12 months. The primary outcome was a change in VA from baseline to 12 months. Results Two hundred and twenty treatment naive eyes were analyzed. The baseline VA for BRVO was better than CRVO (55.8 vs. 42.6 LogMAR letters) and this gap widened over the 12‐month period, with a 12‐month VA change of +14.0 (95% CI 11.1, 16.8) letters for BRVO and + 11.9 (95% CI 6.4, 17.4) for CRVO. The mean CST at baseline was 511 μm for BRVO and 627 μm for CRVO, falling at 12 months by −155 μm (−190, −121) in BRVO and −198 μm (−252, −145) in CRVO. The median number of injections for BRVO and CRVO completers was 7 (5, 9). Conclusions Bevacizumab can be an effective treatment of RVO‐MO in a real‐world setting with outcomes approaching those reported by the seminal clinical trials. The functional and anatomical outcomes of intravitreal therapy were better for BRVO than CRVO.
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