Ophthalmology
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Endovascular thrombectomy for patients with large-core ischaemic stroke presenting up to 24 h after onset (ATLAS): a systematic review and individual patient data meta-analysis with central imaging adjudication

The authors aimed to evaluate the efficacy and safety of endovascular thrombectomy in patients with large-core ischaemic stroke presenting within 24 hours of onset, a group often excluded from such treatments. Their systematic review and meta-analysis of individual patient data from six trials found that endovascular thrombectomy significantly improved functional outcomes and reduced mortality compared to medical management, although the benefits were less clear for patients with very large ischaemic core volumes (≥150 mL). Overall, the findings suggest that endovascular thrombectomy is beneficial for most patients with large-core ischaemic strokes, except in cases of extensive ischaemic changes presenting beyond 6 hours.

Impact of introducing RTS,S/AS01_E malaria vaccine on mortality in young children in Ghana, Kenya, and Malawi: an observational evaluation of a cluster-randomised implementation programme

This study evaluates the impact of the RTS,S/AS01_E malaria vaccine on mortality rates in young children in Ghana, Kenya, and Malawi over a 46-month period following its introduction in 2019. The authors aimed to determine whether the vaccine significantly reduced overall mortality in children eligible for three doses compared to non-eligible children, finding a notable reduction in mortality, with approximately one in eight deaths averted in areas with moderate vaccine coverage. The results underscore the importance of accelerating malaria vaccine deployment in regions where malaria remains a leading cause of child mortality.

Enpatoran, a Toll-like receptor 7/8 inhibitor, in moderate-to-severe systemic lupus erythematosus: findings from Cohort B of a multicentre, international, double-blind, placebo-controlled dose-finding phase 2 trial

This study aimed to evaluate the efficacy and safety of enpatoran, a TLR7/8 inhibitor, in improving disease activity in patients with moderate-to-severe systemic lupus erythematosus (SLE) compared to placebo. Although enpatoran showed improved British Isles Lupus Assessment Group-based Composite Lupus Assessment (BICLA) response rates at various doses, the primary objective of demonstrating a statistically significant dose-response relationship was not achieved. Overall, enpatoran was well tolerated among participants.

The role of community-based blood pressure screening in improving hypertension care

The authors argue against the viewpoint that mass blood pressure screening detracts from hypertension care, positing instead that community-based screening can enhance hypertension detection, especially in underserved populations. They emphasize that such screening, when conducted with validated methods, can effectively identify individuals with elevated blood pressure and raise awareness about hypertension, ultimately supporting better management and control of the condition. The paper advocates for integrating community screening with primary care to address the global challenge of hypertension.

Long-term effects of colonoscopy screening on colorectal cancer incidence and mortality: a multicountry, population-based randomised controlled trial

This study aimed to evaluate the long-term effects of colonoscopy screening on colorectal cancer incidence and mortality over a 13-year follow-up period. The results indicated that screening significantly reduced the incidence of colorectal cancer but did not show a corresponding reduction in mortality, with both groups experiencing lower-than-expected mortality rates. The findings suggest that while colonoscopy screening is effective in lowering cancer incidence, its impact on mortality may be less pronounced than anticipated.

Genotype-phenotype correlations in RPGRIP1-associated retinal dystrophy in a nationwide Japanese cohort

The authors aimed to investigate genotype-phenotype correlations in patients with RPGRIP1-associated retinal dystrophy within a nationwide Japanese cohort. Their findings revealed distinct clinical phenotypes—Leber congenital amaurosis (LCA) and achromatopsia (ACHM)—associated with specific genetic variants, particularly the prevalent exon 18 deletion. These results enhance understanding of the disease's clinical spectrum and have implications for diagnosis and treatment strategies.

Have Deprivation Amblyopia Outcomes Improved for Infants with Unilateral Cataracts?

The authors investigate whether treatment outcomes for monocular deprivation amblyopia due to congenital cataracts have improved over the past few decades. Their study, which included 80 children, found that visual acuity outcomes remain disappointing, with no significant differences in corrected distance visual acuity across three time periods. Additionally, a high prevalence of strabismus and the need for multiple subsequent surgeries highlight ongoing challenges in managing this condition.

Tubercular Retinitis: Clinical Spectrum and Multimodal Imaging Features of an Insufficiently Characterized Entity

This study aims to characterize tubercular retinitis (TBR), a rare form of ocular tuberculosis, by defining its clinical spectrum, multimodal imaging features, and natural course, while differentiating it from similar chorioretinal lesions. The authors found that TBR lesions predominantly present as purely retinal inflammation without choroidal involvement, and they exhibit distinct imaging characteristics compared to tubercular retinochoroiditis (TBRC). The findings suggest that multimodal imaging is crucial for diagnosing and distinguishing between these entities in patients with ocular tuberculosis.

Risk of non-infectious uveitis associated with disease-modifying therapies for multiple sclerosis

The authors aimed to determine whether disease-modifying therapies (DMTs) for multiple sclerosis (MS) influence the risk of developing non-infectious uveitis (NIU). Their study found that certain DMT classes, particularly nucleic acid synthesis inhibitors/S1P modulators and fumarates, are associated with a reduced incidence of NIU compared to glatiramer acetate, suggesting potential for personalized MS treatment and repurposing these therapies for NIU in other populations.

Combined Oral Ivermectin and 5% Permethrin Cream to Treat Severe Scabies

The authors aimed to determine whether a higher dose of oral ivermectin (400 μg/kg) combined with 5% permethrin cream is more effective than the standard dose (200 μg/kg) in curing severe scabies. In a randomized trial involving 132 adults, they found no significant difference in cure rates between the two dosing regimens, with 75% in the higher-dose group and 82% in the standard-dose group achieving cure. The study concluded that the higher dose of ivermectin does not provide superior efficacy compared to the standard dose when used with permethrin cream.