Background: Colletotrichum species are plant-pathogenic fungi increasingly recognized as a cause of human keratitis, a condition that is often difficult to diagnose. Even with antifungal therapy, patients may suffer vision loss or require surgical enucleation. Here, we report a case of keratitis caused by Colletotrichum gloeosporioides (C. gloeosporioides) following plant branch injury, ultimately confirmed by metagenomic next-generation sequencing (mNGS). Case Description: A 43-year-old male farmer sustained a left eye injury from a tea tree branch while working in the fields and presented with ocular pain and blurred vision. During the clinical evaluation, slit-lamp microscopy revealed an 8 mm & times; 7 mm corneal ulcer, and a corneal scraping was subsequently performed for mycological analysis. The filamentous fungus isolated from the corneal scraping could not be identified by morphological assessment or mass spectrometry, and was ultimately confirmed as C. gloeosporioides by mNGS. After receiving natamycin antifungal therapy, the patient's ocular infection improved significantly, and he was subsequently discharged in good condition. Conclusions: mNGS may provide more accurate pathogen identification than mass spectrometry. Furthermore, by synthesizing previous reports and the present case, it has been observed that keratitis caused by C. gloeosporioides following plant-related injuries is often associated with severe symptoms and poor prognosis, with ulcer depth and extent being key factors influencing outcomes. This case may raise awareness of C. gloeosporioides keratitis.
Background: Selective laser trabeculoplasty (SLT) is a first-line treatment for open-angle glaucoma (OAG) or ocular hypertension (OHT). However, the optimal SLT protocol remains unsettled. Randomized controlled trials (RCTs) comparing 180 degrees and 360 degrees SLT have yielded conflicting outcomes. This systematic review and meta-analysis aimed to determine which approach provides superior efficacy and safety. Methods: We searched PubMed, Embase, Cochrane, and Web of Science through November 8, 2025 for RCTs comparing 180 degrees with 360 degrees SLT in OAG or OHT. We excluded conference abstracts. The primary outcome was intraocular pressure (IOP). Secondary outcomes included treatment success, visual acuity, and adverse events. We assessed the risk of bias with the Cochrane risk-of-bias tool for randomized trials, and estimated mean differences (MDs) and risk ratios (RRs) with 95% confidence intervals (CIs) using a random-effects model. Trial sequential analysis (TSA) evaluated the robustness of evidence. Results: We included six studies comprising 892 eyes. 180 degrees SLT was associated with higher IOP at 1 month (MD 1.17 mmHg; 95% CI: 0.52-1.81; P<0.01; I-2=36%), 3 months (MD 0.96 mmHg; 95% CI: 0.45-1.47; P<0.01; I-2=0%), 6 months (MD 1.03 mmHg; 95% CI: 0.14-1.92; P=0.02; I-2=58%), and 12 months (MD 1.63 mmHg; 95% CI: 0.66-2.60; P<0.01; I-2=0%). Treatment success (RR 0.72; 95% CI: 0.58-0.90; P<0.01; I-2=50%) and pain or discomfort rates (RR 0.63; 95% CI: 0.50-0.81; P<0.01; I-2=0%) were lower with 180 degrees SLT. There was no difference between groups in visual acuity (MD -0.002 logMAR; 95% CI: -0.029 to 0.026 logMAR; P=0.90; I-2=41%) and adverse events risk (RR 1.08; 95% CI: 0.69-1.68; P=0.75; I-2=0%). TSA showed robust evidence for the superiority of 360 degrees vs. 180 degrees SLT on IOP. Conclusions: 180 degrees SLT was inferior to 360 degrees SLT for IOP control and treatment success in OAG or OHT, yet it was associated with a lower risk of pain or discomfort. These findings support 360 degrees SLT as the preferred protocol, though evidence is limited by the number of trials, heterogeneity, and follow-up. High-quality, long-term RCTs are required to validate these findings.
Background and Objective: Peripheral corneal melt is a progressive stromal thinning of the cornea, commonly caused by immune-mediated inflammation. It frequently presents as peripheral ulcerative keratitis (PUK), often associated with systemic autoimmune diseases. While prior publications have discussed the condition's etiology and treatment, emerging evidence on immunotherapies and ocular surface reconstruction warrants an updated review. This review summarizes the pathophysiology, diagnosis, and medical and surgical management of peripheral corneal melt to guide clinicians in treating the disease. Methods: A literature search was conducted using Google Scholar and PubMed for English-language studies published from January 1989 to October 2025 addressing the diagnosis and management of peripheral corneal melts PUK. Non-English studies with English abstracts were included when containing relevant data. Key Content and Findings: Peripheral corneal melt primarily results from immune complex deposition and complement activation, exacerbated by the anatomic vascular vulnerability of the peripheral cornea. Differentiation between autoimmune and infectious causes of melting is critical, as mismanagement may lead to rapid perforation. Systemic corticosteroids and immunosuppression remain first-line therapy, and surgery is reserved for cases when there is imminent risk of perforation. Surgical techniques include tissue adhesives, conjunctival resection, amniotic membrane transplant, corneal grafting, and limbal stem cell transplantation, which are selected based on severity and individual circumstances. Conclusions: Peripheral corneal melt is an eye emergency often signaling an underlying systemic disease. Early recognition, accurate identification of the underlying cause, systemic control, and properly timed surgery are essential to prevent permanent vision loss and achieve successful outcomes.
Background and Objective: Age-related macular degeneration (AMD) is a leading cause of vision loss, with oxidative damage and inflammation recognized as contributors to disease progression. Anthocyanins, lutein (L), and zeaxanthin (Z) are antioxidants found in blueberries and goji berries, and multiple preclinical studies hypothesize that these berries could help mitigate AMD progression. However, few human studies have been reported. The purpose of this article is to provide a narrative review of the evidence regarding blueberries and goji berries in AMD. Methods: A literature search of MEDLINE via Ovid, Embase via Ovid, Web of Science, Cochrane Database of Systematic Reviews, and Google Scholar was conducted in June 2024 and updated in November 2025. While there was no exclusion based on publication date, non-English language studies and grey literature were excluded. Five original articles met the inclusion criteria. Key Content and Findings: Only one prospective study investigated the impact of blueberry intake on AMD, reporting at least one serving of blueberries once per week reduced the total risk of disease by 28%. Of the four prospective goji berry studies, three reported an increase in macular pigment optical density (MPOD), two observed an improvement in best corrected visual acuity (BCVA), and one reported that goji berry supplementation could protect against macular hypopigmentation and drusen accumulation. Limitations across most studies included variations in dosing, primarily small to moderate sample sizes, and short durations. Other variables that could influence responses to dietary interventions, such as genetic variability, baseline dietary information, and the food matrix, were inconsistently reported. Conclusions: While results suggest potential benefits, larger, standardized studies are necessary to clarify the mechanisms and effects of these foods on AMD. Clinicians should only consider mentioning blueberries and goji berries as part of a broader diet that is rich in antioxidants, as this may help contribute to overall eye health. This study may help address patients' questions regarding the use of blueberries and goji berries, as well as their over-the-counter products, in the management of AMD.
