Background: The aim of this study is to compare the effect of sodium–glucose cotransporter-2 inhibitors (SGLT-2i), glucagon-like peptide-1 receptor agonists (GLP-1RA), and dipeptidyl peptidase-4 inhibitors (DPP-4i) on the risk of diabetic retinopathy (DR) in patients with type 2 diabetes (DM2). Methods: We systematically searched the databases Pubmed, Embase, and Clinicaltrials up to October 2, 2023, for randomized clinical trials (RCTs) of drugs from the GLP-1RA, SGLT-2i, and DPP-4i groups, with at least 24 weeks duration, including adult patients with DM2 and reported ocular complications. A pairwise meta-analysis was performed to calculate the odds ratio (OR) of DR incidents. Results: Our study included 61 RCTs with a total of 188,463 patients and 2773 DR events. Pairwise meta-analysis showed that included drug groups did not differ in the risk of DR events: GLP1-RA vs. placebo (OR 1.08; CI 95% 0.94, 1.23), DPP-4i vs. placebo (OR 1.10; CI 95% 0.84, 1.42), SGLT2i vs. placebo (OR 1.02; CI 95% 0.76, 1.37). Empagliflozin may be associated with a lower risk of DR, but this sub-analysis included only three RCTs (OR 0.38; 95% CI 0.17, 0.88, p = 0.02). Conclusions: Based on currently available knowledge, it is challenging to conclude that the new antidiabetic drugs significantly differ in their effect on DR complications.

Takayasu’s arteritis (TA) is a type of vasculitis in which inflammation develops in large vessels, especially in the aorta and its branches. Our study aims to determine the prevalence and type of ocular manifestations in TA. A systematic literature search was conducted in December 2022 using three electronic databases (PubMed, Scopus, and Web of Science). The following data were extracted from each article: the name of the first author; the patient’s age, sex, and origin (continent); circumstances connected with the diagnosis of TA; symptoms given by the patients; reported ocular manifestations; and administered treatment. The final analysis was based on data collected from 122 cases. Retinal ischemia, followed by optic neuropathy, cataract, and retinal artery occlusion, were the most prevalent eye conditions associated with the disease. Systemic steroid therapy, vascular procedures, and methotrexate were mainly used to treat pulseless disease. Patients mostly complained of gradual vision acuity loss, sudden vision acuity loss, ocular pain, and amaurosis fugax. The diagnosis of Takayasu’s arteritis should be considered in patients presenting symptoms of visual decline/loss, ocular pain, or signs of retinal ischemia, optic neuropathy, or early cataract formation. A proper diagnosis is crucial to ensure the patient receives treatment without significant delay.

Arteritic Anterior Ischemic Optic Neuropathy in the Course of Giant Cell Arteritis After COVID-19 - Article abstract #933471

Buerger's disease, also known as thromboangiitis obliterans, is a disorder of primarily small and medium arteries and veins of the arms and legs. We have failed to find a comprehensive review discussing a possible link between the disease and the eyes. The aim of this study is to review current knowledge on the topic of ocular manifestations in the course of Buerger's disease. The Medline and Web of Science databases were searched without a time or language limit. We have managed to review 13 articles, describing the involvement of the eyes in thromboangiitis obliterans. It appears that patients suffering from Buerger's disease may develop nonarteritic anterior ischemic optic neuropathy (NAION), occlusive retinal vasculitis and periphlebitis, papillophlebitis, central retinal artery occlusion (CRAO), branch retinal artery occlusion (BRAO), normal tension glaucoma (NTG), uveitis, chorioretinal atrophy, retinitis, papillitis, optic atrophy, changes typical for hypertensive retinopathy. Additionally the abnormalities in electroretinography might be present. The treatment options and the possible outcome depend on the type of ocular manifestations, so it seems impossible to propose a universal therapy. We would like to raise awareness of the possible ocular manifestations in the course of Buerger's disease.

Purpose: The purpose of this study was to evaluate retinal and choroidal vascularization parameters in patients with type 2 diabetes mellitus (DM), without diabetic retinopathy (DR), and to compare them to healthy controls. Patients and methods: Seventy-four eyes from 74 patients (40 eyes in the DM group and 34 eyes in the control group) were included in the study. Optical coherence tomography angiography RTVue XR Avanti was used to obtain 3× 3mm scans of the macula. The choroidal vascularity index (CVI), superficial and deep capillary plexus vascular densities (SCP and DCP, respectively), and choroidal thickness (CT) were measured. Results: In the diabetic group, SCP was lower in the superior and nasal segments (48.68 vs 50.62, p=0.02; 45.50 vs 48.82, p=0.02, respectively). The DCP did not differ between the groups. CVI was significantly lower in the study group in all measured segments, including central and parafoveal (31.73 vs 48.86 and 50.32 vs 59.58, p< 0.001, respectively). CT was larger in the study group only at the center of the macula (281.89μm vs 268.37μm p< 0.001) and in the inferior segment (337.47μm vs 329.40μm, p< 0.001). In the multivariate regression, clinical and vascularization parameters affecting CVI and CT were analyzed after adjusting for age and sex. Decreased central CVI was associated with the presence of DM, lower central SCP, and bigger foveal avascular zone area (b=− 0.68, b=0.47, b=− 0.21). Parafoveal CVI was also negatively affected by DM (b= − 0.46) and positively by parafoveal SCP (b= 0.44). Increased central CT was found to be positively associated with higher central SCP (b=0.48) and male sex (b=0.20). Conclusion: The results of our study confirmed a reduction of SCP and CVI in diabetic patients without DR. DM and SCP are age and sex independent parameters affecting CVI. Central CT is affected by SCP and sex, rather than the presence of diabetes.

Ocular manifestations have been described in the course of various types of vasculitis. However, there seems to be no routine ophthalmological examinations for patients suffering from those diseases. To ensure holistic care we aimed to investigate any retinal and choroidal abnormalities in patients suffering from primary vasculitis. The objective was to use non-invasive methods, which would not be time- and cost-consuming, yet would be helpful in routine tests. We conducted a prospective and observational study in 41 patients (78 eyes) with 5 types of primary vasculitis, including: Takayasu’s arteritis; giant cell arteritis; Buerger’s disease; granulomatosis with polyangiitis; and polyarteritis nodosa. A total of 44 healthy individuals were enrolled in the control group for comparison (88 eyes). With the use of optical coherence tomography, optical coherence tomography angiography, and MATLAB, the following parameters were assessed: choroidal thickness; vascularity index; area and perimeter of foveal avascular zone; and circularity index. The following parameters were lower in the study group compared to the control group: mean nasal and temporal CTs; mean central, temporal, and nasal CVI; and mean CI. In contrast, the results of mean central CT as well as the area and perimeter of FAZ were higher in the study group. The differences were statistically significant in the case of all parameters except for CI. Conducting routine ophthalmological examinations in patients diagnosed with vasculitis by assessment of the retina and choroid by measuring parameters like CT, CVI, area and perimeter of FAZ, and CI could be beneficial, as it may detect pathological changes before any ocular symptoms alarm the patients. CVI seems to be especially promising for choroidal evaluation, as it appears to be less influenced by various factors compared to CT.