Purpose Diabetic retinopathy (DR) is one of the leading causes of blindness worldwide. Accurate investigative tools are essential for the early diagnosis and monitoring of the disease. Optical coherence tomography angiography (OCTA) is a recently developed technology that enables visualisation of the retinal microvasculature. Methods A systematic review of the literature was performed to examine the diagnostic use of OCTA in DR to date. Medline, EMBASE, and Cochrane databases were searched to find relevant studies. Sixty-one original studies were selected for the review. Results and discussion OCTA has demonstrated the ability to identify microvascular features of DR such as microaneurysms, neovascularisation, and capillary non-perfusion. Furthermore, OCTA is enabling quantitative evaluation of the microvasculature of diabetic eyes. It has demonstrated the ability to detect early microvascular changes, in eyes with or without clinically evident DR. It has also been shown to detect progressive changes in the foveal avascular zone, and vascular perfusion density, with worsening severity of disease. It provides three-dimensional visualisation of the individual retinal vascular networks and is thereby enhancing our understanding of the role of the deeper vasculature in the pathogenesis of diabetic retinopathy and maculopathy. Conclusion However, limitations exist with current OCTA technology, in respect to the small field of view, image quality, projection artefact, and inaccuracies in analysis of the deeper vascular layers. While questions remain regarding its practical applicability in its present form, with continuing development and improvement of the technology, the diagnostic value of OCTA in diabetic retinopathy is likely to become evident.

Objectives: The purpose of this study was to examine the aetiology, investigation and management of ophthalmia neonatorum (ON) presenting to a tertiary referral children’s hospital over 5 years. Methods: The eye swab data of all neonates presenting to Children’s Health Ireland at Temple Street (Dublin, Ireland) between 1st January 2013 and 3rd September 2018 was analysed. The medical records of all patients with positive eye swab results were retrospectively reviewed. Results: A total of 157 neonates had positive eye swab results. 54 cases were identified as ON. Chlamydia trachomatis (20.4%) was the most common organism identified, followed by Staphylococcus aureus (18.5%), Haemophilus influenzae (14.8%), Moraxella catarrhalis (7.4%), Streptococcus pneumoniae (5.6%), Escherischia coli (3.7%), Klebsiella pneumoniae (1.9%) and Pseudomonas aeruginosa (1.9%). A bacterial culture swab was tested in all cases (100%), a C. trachomatis/N. gonorrhoeae PCR swab in 70.4% and a viral PCR swab in 35.2%. On subanalysis of the cases that had C. trachomatis/N. gonorrhoeae PCR testing, C. trachomatis was responsible for 28.9% of cases. 50% of cases were hospitalised, intravenous antibiotics were administered in 46.3% and macrolide therapy was prescribed in 38.9%. Conclusions: C. trachomatis was the most common cause of ON in this study and may be responsible for an even higher proportion of cases due to incomplete testing. In keeping with studies in different populations, S. aureus, H. influenzae and S. pneumoniae were also common. As a result, an improved management algorithm for cases of ON has been introduced in this centre.

Introduction The purpose of this study was to report the real-world treatment outcomes using a treat-and-extend intravitreal bevacizumab protocol in cystoid macular oedema (CMO) secondary to central retinal vein occlusion (CRVO). Methods We conducted a retrospective case series of consecutive adult patients with CMO secondary to CRVO who presented between 1st January 2019 and 31st December 2021. All included patients were treated with bevacizumab using a treat-and-extend protocol, were followed up for a minimum of 6 months and had a clinical examination including best-corrected visual acuity (BCVA) and optical coherence tomography (OCT) at every visit. The primary outcome measure was mean change in BCVA. Results Thirty-three eyes of 33 patients were included in the study. The mean change in BCVA from baseline was + 24.5 (Median 18, SD 21.5) letters, with a mean follow-up duration of 18.5 (SD 8.9) months. The mean number of injections was 9.5 (SD 1.9) in year 1 and 7.8 (SD 2.8) in year 2. 87.9% of patients were still requiring active treatment, with a maximum interval achieved of 4-weekly in 18.2%, 6-weekly in 42.4%, 8-weekly in 6.1%, 10-weekly in 15.2%, and 12-weekly in 6.1%. The mean maximum interval achieved of those requiring ongoing treatment was 6.8 (SD 2.4) weeks. Multiple regression analyses showed that a higher baseline BCVA was negatively associated with mean visual acuity gain (P < 0.001) and positively associated with final BCVA (P < 0.001). Conclusion The use of intravitreal bevacizumab in a treat-and-extend regimen is effective in treating CMO secondary to CRVO, in a real-world setting.