Primary cornea guttata (PCG) is a corneal endothelial condition characterized by small, focal excrescences on Descemet’s membrane. Although it may mimic early Fuchs endothelial corneal dystrophy (FECD), PCG is usually asymptomatic, with no associated corneal edema or visual impairment. The clinical significance of PCG remains incompletely understood. This scoping review aimed to synthesize available evidence regarding the epidemiology, clinical presentation, endothelial morphometry, and risk factors associated with PCG. A systematic search was conducted according to Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews guidelines across multiple databases, including PubMed, ScienceDirect, ClinicalKey, EBSCOhost, Ovid, Web of Science, and Google Scholar, yielding 540 records. After removing duplicates and screening titles and abstracts, seven full-text articles were assessed, with five studies ultimately included in the final synthesis. Across these studies, PCG was most commonly observed in middle-aged to elderly individuals, with a higher prevalence in women. Most cases were detected incidentally during routine ophthalmologic examinations, without evidence of corneal edema or progression to FECD. Morphometric analyses reported decreased endothelial cell density and increased polymegethism and pleomorphism in specific populations, although findings varied. Prevalence differed across ethnic groups, with higher rates reported in Hispanic populations and variable findings among Asian cohorts. Identified risk factors included age, female sex, lower body weight, lower body mass index, and smoking history. Overall, PCG exhibits consistent demographic and clinical patterns but remains under-researched, with limited longitudinal data and an unclear natural history. These findings highlight the need for further studies to better understand the pathophysiology, progression, and clinical implications of PCG.
Purpose: Patients with suspected primary angle closure (PAC) are at higher risk of progressing to PAC and angle-closure glaucoma (ACG). Peripheral laser iridotomy (PLI) is considered an effective measure to increase the opening of the anterior chamber angle. Methods: A prospective cohort study was conducted to evaluate, using anterior segment optical coherence tomography, the changes in anterior chamber angle parameters in patients diagnosed with suspected angle closure who underwent YAG laser PLI. Comparisons were made between pre- and postoperative measurements of angle opening distance (AOD), trabecular–iris space area (TISA), and scleral spur angle (SSA) at 500 μm and 750 μm from the scleral spur. Results: The majority of the patients studied were female (n = 14, 70%), with a mean age of 57.7 ± 9.4 years. The mean prelaser best-corrected visual acuity was 0.61 ± 0.37, and the mean refraction was + 1.79 ± 1.1 D. The mean intraocular pressure decreased from 18.5 ± 3.09 mmHg preoperatively to 17.6 ± 2.44 mmHg postoperatively, showing a statistically significant difference (P < 0.05). Significant increases were also observed in AOD 500 and 750 μm, TISA 500 and 750 μm, and SSA following PLI. Conclusion: PLI leads to a significant widening of the anterior chamber angle in patients with suspected angle closure, which may help prevent progression to ACG.
Purpose: Describe the population of patients with infectious keratitis during 5 years in a tertiary hospital in Bogotá, Colombia. Materials and Methods: Retrospective observational cross-sectional study conducted from 2017 to 2021. Clinical records of all patients with infectious keratitis were reviewed, and sex, age, risk factors for keratitis, complications at the moment of initial consultation, and best corrected visual acuity (BCVA) were described, as were clinical and microbiological diagnoses. BCVA discriminated by previous treatment and etiology was evaluated. Results: Nine hundred and seventy-three cases were reviewed. The mean age was 44.61, and males were slightly more affected. Contact lens use was the most commonly presented risk factor, present in 181 (18.6%). Patients who had received treatment with corticosteroids were more likely to have a BCVA of worse than 20/400 (x2 test 4.86, P < 0.05). BCVA was better than 20/40 in 56.42%, 20/40–20/400 in 26.73%, and worse than 20/400 in 16.86% of patients. Patients with fungal or parasite keratitis were more likely to have a BCVA of worse than 20/400 with an OR if 7.8. 54.16% of patients had bacterial keratitis; the second most frequent etiology was viral, followed by fungal, and lastly, parasites. Cultures were taken in 10.38% of the patients, out of which 54 had positive culture results; the culture positivity proportion was 63.72%. Conclusions: Infectious keratitis was more common in middle-aged males, and contact lens use was more frequently reported than trauma. Patients were more likely to have a worse BCVA if they had received corticosteroids prior to initial consultation, and patients who presented with fungal or parasitic infections were more likely to have a worse BCVA. Bacterial keratitis followed by viral keratitis was the most commonly clinically diagnosed etiological agent. About 63.72% of cultures were positive, and bacterial infection was the most common microbiological diagnosis with Pseudomonas aeruginosa as the most frequently reported germ.
Pregnancy represents a uniquely dynamic biological state characterized by extensive immune adaptation and metabolic restructuring, processes that are essential for maternal–fetal tolerance and successful gestation. Although these systemic changes have traditionally been examined within obstetric and immunologic contexts, their potential implications for ocular physiology and disease behavior have received comparatively limited attention. In clinical practice, this disconnect is not uncommon; ocular manifestations are often interpreted as isolated events even when they emerge in the setting of profound systemic change. The present systematic review aimed to examine the emerging concept of maternal ocular immunometabolism and to synthesize current evidence linking pregnancy-associated metabolic–immune reprogramming with ophthalmic alterations and disease outcomes. A systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations using major electronic databases and predefined eligibility criteria. Thirty-one studies were ultimately included for qualitative synthesis following structured screening, full-text assessment, and risk-of-bias evaluation. Available evidence suggests that pregnancy-induced immunometabolic adaptation may influence several ophthalmic pathways through coordinated alterations in cytokine signaling, immune-cell phenotypes, glucose metabolism, oxidative stress, and endothelial function. These changes appear to contribute to variations in uveitis activity, diabetic retinopathy progression, retinal vascular instability, and neuroinflammatory responses, although the strength and consistency of evidence remain variable across disease categories. Taken together, the literature suggests that the eye may reflect broader maternal biological adaptation during pregnancy rather than function as an isolated organ system. Further prospective studies integrating immunologic, metabolic, and ophthalmic biomarkers are needed to establish clinically applicable predictive frameworks for maternal–fetal care.
Purpose: The purpose of this study was to find the prevalence of dry eye disease in pregnant women with gestational diabetes mellitus and to compare it with age matched nondiabetic pregnant women. Materials and Methods: The study was conducted on 60 patients. Evaluation was done using Schirmer’s test 1 and 2 and tear break-up time (TBUT) test, ocular surface disease index (OSDI) questionnaire, and corneal fluorescein staining score scoring system, and the readings were noted down. Dilated fundus examination was done to rule out any diabetic retinopathy changes. Results: Schirmer’s test 1 and 2 values were significantly lower in the gestational diabetes mellitus (GDM) group compared to controls (P < 0.001 and P = 0.046, respectively). OSDI scores were significantly higher in GDM women (P = 0.018), whereas TBUT values were low with no significant difference (P = 0.125). Conclusion: Gestational diabetes mellitus is associated with reduced tear secretion and higher OSDI scores, indicating an increased risk of dry eye. Routine ocular surface evaluation in GDM may aid in early detection and management.
Purpose: To determine the variation in intraocular pressure (IOP) measured during the induction and maintenance phases of general anesthesia compared with clinic measurements in pediatric and adult patients undergoing ophthalmic or strabismus surgery at Hospital de San José, Bogotá. Materials and Methods: This descriptive cross-sectional study with an analytical component included pediatric and adult patients undergoing strabismus or pediatric ophthalmic surgery between March 2024 and March 2025. IOP was measured in the outpatient clinic using Goldmann tonometry and during general anesthesia with a Perkins tonometer at induction and maintenance. Sociodemographic and clinical data were collected. The Mann–Whitney test was used for age-group comparisons, and the Wilcoxon signed-rank test for paired comparisons across the three measurement phases. Results: A total of 151 patients (302 eyes) were included; 62.3% were younger than 18 years. The median IOP was 12 mmHg in clinic, 11 mmHg during induction, and 12 mmHg during maintenance, with statistically significant differences across phases (P < 0.0001). Pediatric patients had significantly lower IOP in all phases (P < 0.001). Most anesthetic agents, except propofol, produced significant decreases during maintenance. Succinylcholine, cisatracurium, and rocuronium were associated with significant IOP reduction, whereas vecuronium showed no significant changes. Conclusions: IOP significantly decreased during the induction and maintenance phases of anesthesia compared with clinic measurements. Although statistically significant, the mean variation of approximately 1 mmHg is unlikely to be clinically relevant. These findings suggest that IOP measurements obtained during induction or maintenance may be clinically interchangeable, while outpatient measurements remain the gold standard.
Introduction: Periocular sebaceous carcinoma (SC) is an uncommon but aggressive malignancy that often mimics benign or other malignant eyelid lesions, leading to delayed or incorrect clinical diagnosis. This study evaluated clinical–pathological concordance in periocular SC and explored the potential role of ancillary diagnostic tools in improving diagnostic accuracy. Methods: A retrospective review was conducted of 92 eyelid tumors submitted with a clinical diagnosis or suspicion of SC to the McGill University Health Centre–McGill University Ocular Pathology and Translational Research Laboratory between 2006 and 2018. Histopathological diagnoses were compared with initial clinical impressions to determine concordance rates and identify patterns of misdiagnosis. Results: SC was histopathologically confirmed in 28 of 92 (30%) cases. Among confirmed SC cases, 14 (50%) were clinically suspected as SC, while the remainder were misdiagnosed as basal cell carcinoma (BCC) (36%), squamous cell carcinoma (14%), chalazion (14%), or other benign lesions. Of the 64 tumors not confirmed as SC, common clinical impressions included chalazion (42%), BCC (27%), and chronic inflammation (22%). Overall, half of the true SC cases were not clinically recognized. Conclusion: Periocular SC demonstrates substantial clinical–pathological discordance, frequently masquerading as benign or alternative malignant lesions. Histopathological confirmation remains essential, even for clinically innocuous presentations. Emerging adjuncts such as Preferentially Expressed Antigen in Melanoma immunostaining and artificial intelligence–assisted digital pathology may enhance diagnostic precision and support earlier, more appropriate management.
Chagas disease (CD) is a systemic condition in which ocular involvement remains underrecognized. This narrative review synthesizes evidence on ophthalmic manifestations of CD, from acute entry-related findings to chronic and immunosuppression-associated complications. A comprehensive literature search was conducted in reference databases, including classical and contemporary studies without restrictions on publication date, language, or study design. In the acute phase, manifestations are classically represented by Romaña’s sign, including conjunctivitis and keratitis, and experimental data support ocular tissues as parasite reservoirs. In the chronic phase, subtle retinal pigment epithelium alterations, rod dysfunction, autonomic changes in intraocular pressure, and optic nerve involvement have been reported. Advanced imaging techniques, such as optical coherence tomography (OCT) and OCT-angiography, reveal structural and vascular changes, although findings remain inconsistent. In immunosuppressed patients, parasite reactivation may lead to severe retinitis. Overall, ocular involvement in CD appears multifactorial and underestimated, highlighting the need for further prospective studies.
Objective: The objective of this study was to determine optic nerve head (ONH) and peripapillary vessel density using optical coherence tomography angiography (OCT-A) postuncomplicated phacoemulsification (phaco) with intraocular lens implantation. Methodology: This was a prospective observational study. Forty participants who do not have any ocular pathology other than cataract were included in the study after informed consent. All participants underwent uncomplicated phaco with intraocular lens implantation. OCT-A of the ONH and peripapillary area was performed preoperatively and at 1 week, 1 month, and 3 months postoperatively. Results: Postphaco intraocular pressure (IOP) decreased from 13.9 ± 2.5 mmHg to 12.7 ± 1.7 mmHg at 3 months postoperatively (P = 0.005). In the Phaco group, the mean ONHvd improved from 62.95% ±1.75% to 63.69% ±1.89% (P = 0.004) at 3 months, and the mean PPAvd also improved from 63.36% ±2.08% to 64.21% ±2.05% (P = 0.002). Conclusion: Cataract surgery reduces IOP significantly and improves perfusion around the ONH. Long-term follow-up is needed to assess if this effect is sustained.
Purpose: The purpose of the study was to compare macular ganglion cell analysis (GCA), optic nerve head (ONH) parameters, and retinal nerve fiber layer thickness (RNFL) analysis on spectral domain-optical coherence tomography (OCT) in pseudoexfoliation syndrome, early pseudoexfoliative glaucoma compared to normal subjects. Secondary Objectives: To compare the diagnostic ability of these OCT parameters to diagnose early pseudoexfoliative glaucoma. To compare the prevalence of pseudoexfoliation syndrome, early pseudoexfoliative glaucoma in patients with outdoor compared to indoor occupation. Methods: Forty-four normal subjects, 44 patients with pseudoexfoliation syndrome, and 47 patients with early pseudoexfoliative glaucoma were included in this prospective, cross-sectional study in a tertiary care hospital. OCT measurements-macular ganglion cell thickness – average, minimum, and in various quadrants; ONH parameters – rim area, disc area, rim/disc area, average, superior, and inferior NRR; RNFL thickness-superior and inferior were analyzed. Area under the receiver operating characteristic curve (AUROC) was performed to calculate the diagnostic accuracy to discriminate between pseudoexfoliation syndrome versus early pseudoexfoliative glaucoma. Results: All the above-mentioned OCT parameters were significantly different (P = 0.001) among normal, pseudoexfoliation syndrome, and early pseudoexfoliative glaucoma groups. Diagnostic accuracy to discriminate between early pseudoexfoliative glaucoma versus pseudoexfoliation syndrome was found to be excellent for inferior RNFL, with highest AUROC 0.943; good for average RNFL (AUROC 0.891) and superior RNFL (AUROC 0.814), fair for rim area (AUROC 0.748), whereas other variables proved to be less impactful. Pseudoexfoliation syndrome and early pseudoexfoliation glaucoma groups were having more patients 28 (35.8%) and 25 (32.1%), respectively, with outdoor occupation. Conclusion: Regular follow-up of patients with pseudoexfoliation syndrome by documenting OCT glaucoma parameters to diagnose early pseudoexfoliative glaucoma is recommended.
Background and Objectives: To assess the results of a pre- and post-lens quality of life (QoL) questionnaire. Determine the effect of glasses with a faded red filter on the degree of severity of the Hardy, Rand and Rittler (HRR) Richmond test in color blind people and classify the type of dyschromatopsia and its severity. Materials and Methods: Observational-prospective study, carried out in patients with color blindness in a population of northern Mexico who used faded chromatic lenses. Patients ≥ 6 years old, with altered Ishihara test, Richmond HRR tests before and after 2 months of wearing the color faded glasses, were included. Results: 51 individuals diagnosed with dyschromatopsia were included. Fifty (98%) were men and 1 was a woman (2%). The mean age was 27.1 years. When classifying the patients, the deutan group was 66.7% and the protan made up 31.4%. The severe degree was the most prevalent with 59.2%. The mean of incorrect results in HRR Richmond prior to wearing the lenses was 45%, after the use of the lenses a mean of 26% errors was obtained. The QoL improved after the use of lenses by 3.9 points according to the questionnaire. Conclusions: This tool made it possible for the majority of individuals, who were initially classified as having a severe degree of dyschromatopsia, after the use of lenses, to pass in a large percentage to a mild degree of dyschromatopsia and report improvement in QoL.
Introduction: Open globe injury (OGI) is an ophthalmological emergency involving a full-thickness breach of the eye wall and represents a preventable cause of visual impairment, particularly in the pediatric population. Despite its clinical significance, there are limited epidemiological reports in Mexico describing its clinical characteristics, associated mechanisms, and visual outcomes. Objective: The objective is to describe the clinical-epidemiological profile, anatomical lesion characteristics, therapeutic management, and visual outcomes in pediatric patients with OGI treated at a tertiary referral ophthalmology center in Mexico City. Materials and Methods: A retrospective and observational study was conducted, including 111 patients between 2017 and 2024. Demographic variables, injury type, affected anatomical zone, initial and final visual acuity, presence of intraocular foreign bodies, administered treatments, and posttraumatic complications were analyzed. Quantitative variables were reported using the median values and interquartile ranges (IQR). Results: A total of 111 cases were included, with a median age of 8 years; 73.9% were male. Penetrating injuries accounted for 85.6% of cases and the left eye was affected in 58.6%. Zone 1 was the most frequently compromised (48.7%). The most common causative objects were wood/vegetable matter (19.8%), glass (17.1%), and stone (10.8%). The median initial visual acuity was 2.70 logMAR (IQR 1.80–3.70), improving to a final median of 0.88 logMAR (IQR 0.28–2.09), with visual improvement observed in 76.8% of patients. The most common associated lesions were corneal laceration (91.0%), iris prolapse (67.6%), and traumatic cataract (56.8%). Follow-up complications included corneal scarring (36.7%) and retinal detachment (19.4%). Only one case resulted in the loss of the eyeball. Conclusions: Pediatric OGI predominantly affected school-aged males, typically involving penetrating mechanisms occurring within the home environment. Early surgical intervention facilitated anatomical preservation of the globe in 99% of cases and led to significant visual improvement in the majority. These results constitute the first national record of its kind, providing key evidence for the development of preventive strategies and targeted care for the pediatric population in Mexico.
Introduction: Pseudoexfoliation syndrome is a systemic disorder of unknown etiology, leading to primary cell changes, and is characterized by the accumulation of fibrillar material in the anterior segment of the eye and other organ systems. Primary angle-closure suspects (PACSs) more commonly present in the age group of 60 years and above. Hence, it is mandatory for ophthalmologists to do proper evaluation and prevent endothelial damage and Glaucoma. Methods: Sixty patients who met the inclusion criteria were included for this cross-sectional study over 18 months period, and they were divided into Group A and Group B, consisting of 30 patients each. Group A had PACSs without pseudoexfoliation, and Group B had PACSs with pseudoexfoliation. Every patient underwent a routine examination of the eyes. In all the patients, corneal endothelial morphology and central corneal thickness (CCT) were evaluated, and the results were tabulated and analyzed statistically. Results: The majority of subjects in both groups were found in the age group of 61–70 years. The majority of subjects in both groups were female. The mean endothelial density in Group A was more than in Group B, which was statistically significant with P = 0.009. There was no significant difference in the mean coefficient of variation between the two groups. The mean 6A in Group A was more than Group B, which was statistically significant with P = 0.001. CCT in Group A was more than Group B, which was statistically significant with P = 0.03. Conclusion: Our study found that Group A had better endothelial cell morphology and CCT, compared to Group B, indicating that PXF affects corneal endothelial morphology and CCT significantly.
Abstract To characterize the clinicopathological spectrum of retinal astrocytic lesions in tuberous sclerosis complex (TSC) occurring in conjunction with central nervous system (CNS) involvement, with emphasis on histopathologically confirmed CNS disease and paired brain–eye correlation. A case-based narrative review of the literature from 1993 to 2024 was performed to identify the individual patients with TSC in whom retinal astrocytic lesions and CNS abnormalities were documented concomitantly. Patient-level demographic, ocular, neuroimaging, histopathologic, and management data were extracted. In addition, we report the new case of a 23-year-old patient with TSC presenting with a large retinal astrocytic hamartoma and biopsy-proven subependymal giant cell astrocytoma (SEGA), supported by multimodal retinal imaging, neuroimaging, and CNS histopathology. Twenty-four published patients met inclusion criteria, and one new institutional case was added, yielding a total of 25 patients. CNS histopathological confirmation was uncommon and documented in only three patients across the entire dataset, including the present case. Retinal astrocytic lesions exhibited marked heterogeneity in morphology, laterality, and clinical behavior, ranging from stable hamartomas to aggressive, vision-threatening tumors. SEGA was explicitly reported in approximately one-third of cases, although retinal severity did not consistently correlate with SEGA status. This study provides the most comprehensive patient-level synthesis to date of concurrent retinal and CNS involvement in TSC and highlights the rarity of histopathologic confirmation in published reports. The inclusion of a biopsy-proven SEGA case with direct clinicopathological correlation strengthens the evidence base and underscores the importance of integrated ophthalmic and neurologic evaluation in TSC.
Abstract Introduction: Adnexal tumors, including sebaceous adenoma, pilomatrixoma, and syringoma, are tumors arising from the folliculosebaceous units or associated sweat glands. They can mimic malignancies such as basal and sebaceous cell carcinoma and signal genetic syndromes like Muir–Torre syndrome. They can cause cosmetic and functional issues, with risk of malignant transformation. This study examines their clinical and pathological features to enhance diagnosis. Subjects and Methods: A retrospective review of 47 patients diagnosed with adnexal tumors at MUHC-McGill University Ocular Pathology and Translational Research (2007–2022) analyzed data on age, sex, tumor location, and clinical-pathological correlations. Results: Among 47 cases, the mean age was 57 years, and 53% ( n = 25) were female. Syringoma (40%, n = 19), sebaceous adenoma (15%, n = 7), and pilomatrixoma (13%, n = 6) were the most common diagnoses, with 77% ( n = 36) not clinically identified. Tumor locations included the eyelid (81%, n = 38), upper eyelid (21%, n = 10), lower eyelid (55%, n = 26), unspecified (4%, n = 2), medial canthus (9%, n = 4), and eyebrow (4%, n = 2). Conclusion: Accurate clinicopathological correlation is key, as adnexal tumors may mimic malignancy or signal genetic syndromes despite being mostly benign. Comprehensive assessment improves outcomes by avoiding overtreatment and addressing cosmetic or functional concerns, as highlighted by the high misdiagnosis rate.
Abstract The reporting of high-order aberrations (HOAs) stemming from the internal optics has garnered increased attention in recent years. This is attributed to evidence, suggesting their significant role as an optical factor affecting image quality in the retina, particularly notable in patients who have undergone postcorneal or crystalline lens surgery. However, most studies focus on total or high-order corneal aberrations of the eye, and little is known about HOA from the internal optics. We conducted a systematic review of articles referenced in three databases published until December 31, 2024. Among the 24 articles included, 14 comprised experimental studies. The majority of them concluded that lenticular aberrations compensate for corneal aberrations in young patients. From the age of 45 years onward, this compensation is lost, coinciding with the onset of cataract development. Internal optics HOAs increase with age due to increased refraction of the lens nucleus, especially with the formation of nuclear and cortical cataracts that induce different HOAs. Relying solely on corneal topography for refractive procedures is inadequate as a preoperative assessment. We propose that keratorefractive or refractive lens exchange procedures should be tailored to incorporate an aberration profile, taking into account the compensation of optical structures that diminishes with age.
Abstract Objectives: To compare the anatomical and functional outcomes during follow-up in eyes with uveal effusion syndrome (UES) treated with scleral window surgery versus medical/observational management, defining response as optical coherence tomography (OCT) resolution of serous retinal detachment (SRD) and/or serous choroidal detachment (SCD) and change in best-corrected visual acuity (BCVA, logMAR). Materials and Methods: Retrospective analytical case series at a tertiary referral center in Santiago, Chile. Retina specialists established UES by multimodal imaging and exclusion of secondary causes. Complete anatomical response was full SRD/SCD resolution on OCT. Functional response was BCVA change; clinically relevant improvement was ≥0.2 logMAR. Paired comparisons used Wilcoxon; between-group analyses were exploratory. Results: Eight eyes from six patients were included (62.5 ± 10.8 years; 66.7% women). UES subtypes were type 1 (25.0%), type 2 (50.0%), and type 3 (25.0%). Complete anatomical resolution occurred in all eyes (8/8, 100%). Mean BCVA improved from 0.60 ± 0.29 to 0.33 ± 0.20 logMAR at last follow-up (ΔlogMAR −0.27 ± 0.19; P = 0.0078). Clinically relevant improvement was achieved in 5/8 eyes (62.5%) and no eye worsened. The mean follow-up was 58.3 ± 40.0 months. Scleral window surgery was performed in 6/8 eyes (75.0%) and observation in 2/8 (25.0%); one eye crossed over from systemic corticosteroids to surgery. No intraoperative or postoperative complications were recorded. Conclusions: In this Latin American series, UES treated predominantly with scleral windows achieved complete anatomical resolution and significant visual improvement without recorded complications. Multimodal evaluation and a subtype-oriented approach may favor timely diagnosis and individualized treatment over a long-term, real-world follow-up in Chile.
Abstract Aim: The aim of this study was to evaluate the outcome and safety of slow-coagulation transscleral cyclophotocoagulation (TSCPC) in patients with uncontrolled glaucoma. Materials and Methods: This was a retrospective study of 58 eyes that underwent TSCPC using slow-coagulation settings at a tertiary hospital. Results: The mean age was 53.86 years; 62.1% were males. The indications for the laser included neovascular glaucoma (34.5%), advanced primary open/angle closure glaucoma (19%), glaucoma secondary to vitreoretinal surgery (23.8%), or penetrating keratoplasty (23.8%). Statistically significant reduction in intraocular pressure (IOP) from 40.19 to 15.33 mmHg was noted at 6 months. Surgical success was achieved in 82.5% at 6 months. The mean antiglaucoma medications reduced from 3.72 to 2.35 ( P < 0.001). No drop in visual acuity was seen in any patient. Majority of the patients (78.9%) did not develop any complication. Some of the complications were hyphema, anterior chamber inflammation, and scleritis that were transient and conservatively managed. Hypotony was recorded in one patient, and repeat laser was advised in five patients. Conclusion: Encouraging safety and efficacy were demonstrated by a noteworthy decrease in IOP and antiglaucoma medications, with insignificant serious complications.
Abstract Introduction: With the increasing use of artificial intelligence in medicine and patients’ growing need to obtain information about conditions such as age-related macular degeneration (AMD), ensuring the quality of responses generated by large language models (LLMs) has become a major challenge. Objective: To evaluate retina specialists’ perceptions of the quality of LLM-generated responses to patient-oriented questions about AMD. Methods: An observational, comparative study was conducted in 2025. Nine retina specialists evaluated responses generated by ChatGPT-5, ChatGPT-4, Gemini, and Grok to eleven frequently asked questions about AMD. Three dimensions – accuracy, clarity, and satisfaction – were assessed using 7-point Likert scales, along with intention to use (yes/no). Statistical analyses included the Friedman test, paired Wilcoxon tests with Holm adjustment, Cochran’s Q test, and McNemar tests ( P < 0.05). Results: Significant global differences were observed across the three evaluated dimensions ( P < 0.001). ChatGPT-5 consistently achieved the highest scores. In terms of accuracy, ChatGPT-5 outperformed Grok and ChatGPT-4 (Holm-adjusted P < 0.001). Regarding clarity, ChatGPT-5 scored higher than Grok, ChatGPT-4, and Gemini (Holm-adjusted P < 0.005). For satisfaction, ChatGPT-5 outperformed ChatGPT-4 and Grok (Holm-adjusted P < 0.001). Item-level analysis showed that model performance varied according to the specific question. Intention to use did not differ significantly among platforms after adjustment for multiple comparisons (Holm-adjusted P ≥ 0.375). Conclusions: ChatGPT-5 demonstrated the most consistent performance across all evaluated dimensions. The variability observed based on question type underscores the importance of clinical oversight before implementing these tools in patient education for retinal pathology.
Abstract Objectives: To describe the clinical, structural, and functional characteristics of autoimmune retinopathy (AIR) in a cohort of Chilean patients, applying the six diagnostic domains proposed by the American Academy of Ophthalmology (AAO) 2025, and to evaluate the visual and anatomical outcomes at 12 months. Design and Setting: Retrospective case series, performed at Fundación Oftalmológica Los Andes, in Santiago, Chile, between 2005 and 2025. Materials and Methods: 25 eyes of 16 patients with a diagnosis of “probable or possible” AIR were included. Clinical variables and multimodal images were analyzed, evaluating best corrected visual acuity, wide field electroretinogram, Goldmann visual field, ellipsoid zone integrity, and medical treatment. Statistical analyses used: Nonparametric tests (Wilcoxon and Mann–Whitney U), Kaplan–Meier curves, and multivariate logistic regression models were used to explore predictors of relapse. Results: Sixty-eight percent of the patients were women, with a mean age of 54 ± 17 years. The majority had nonparaneoplastic AIR (96%) and seropositivity for antiretinal antibodies (75%). At 12 months, median acute viral myocarditis showed a slight but significant decrease (from 0.15 to 0.10 logarithm of the minimum angle of resolution; P = 0.015). Most eyes maintained functional stability, although progressive thinning of the outer nuclear layer (ONL) was observed. Relapse-free survival was 70%, with no differences according to immunosuppression. Conclusions: Early diagnosis and treatment with immunosuppressants seem to stabilize functional and structural parameters in AIR. Loss of ONL could precede visual changes. The usefulness of the AAO 2025 diagnostic model and the need for prospective studies with biomarkers and long-term imaging follow-up are highlighted.
