We've been duped by dark chocolate.

A new study published in JAMA Ophthalmology found that neither retinal perfusion nor visual function improved in individuals who consumed dark chocolate compared with those who consumed milk chocolate.

Why did we think dark chocolate had visual benefits?

Because two research teams (here and here) reported that consumption of flavanol-rich chocolate (aka dark chocolate) improved visual contrast sensitivity presumably by improving the oxygenation of the retina. Both studies measured subjective rather than objective findings.

Tell me about the new study.

The research team studied 22 patients. Half of them consumed dark chocolate and the other half consumed milk chocolate. Visual acuity, contrast sensitivity, and OCT angiography cube scans were acquired at baseline and again 2 hours after chocolate consumption. The research team measured the change in retinal perfusion via OCT angiography.

What did they find?

No change in retinal perfusion or contrast sensitivity was detected after consumption of either dark or milk chocolate.

The take home:

The authors state that although their study did not find any visual benefits, that doesn't mean there are none. They suggest further trials with larger sample sizes to confidently rule in or out possible long-term benefits.


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Do doctors agree on how to treat myopia progression?

No, they don't.
A new study surveyed almost 800 pediatric ophthalmologists from all over the world, asking their preferred method of treatment for myopia. Spoiler alert: They all didn't pick the same one.

What were some differences?

1. For starters, only 57% of those surveyed even chose to treat myopia progression.
2. Pharmacologic treatment was the most popular modality in most regions, but optical treatment was preferred in Europe and Central Asia.

Why the variability?

The authors found that treatment choice was affected by the clinician’s geography, clinical experience, and, more specifically, experience treating myopia progression. Pharmacologic treatment was significantly more popular among physicians who had been treating myopia for 1 to 2 years and those with less than 15 years of clinical experience overall.

What did they agree on?

Most physicians considered a myopia progression rate of ~1.00 D/year as the main guideline on when to initiate treatment. Also, the majority of physicians across all regions used two or more treatment modalities and behavioral treatment was the most popular modality used by more than 90% of respondents.

The take home:

Currently, there is no standardized treatment for myopia progression. The authors suggest that given the myopia epidemic, formal treatment guidelines need to be made by medical organizations.


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Thanks for reading!