Purpose:To evaluate the effect of caffeine intake on intraocular pressure (IOP). Methods:The PubMed, Cochrane, Scopus, and ProQuest databases were searched for publications of randomized trials investigating the effect of caffeine consumption on IOP in healthy and glaucomatous populations until February 1, 2025. Outcomes at 30 min, 1, 1.5, 2, and 3 h were analyzed using a random-effects model. Subgroup analysis was done for different types of caffeine-containing beverages and different amounts of caffeine. Results:Sixteen studies, including 599 healthy participants and 63 glaucomatous patients (with primary open-angle glaucoma, ocular hypertension, and normotensive glaucoma), were included in this meta-analysis. The weighted mean difference (WMD) with 95% confidence intervals of IOP in the healthy population at 30 min, 1 h, 1.5 h, and 2 h were significant at 0.61 (0.07; 1.16), 0.87 (0.40; 1.33), 1.60 (0.40; 2.80), and 0.63 (0.03; 1.22), respectively. In glaucomatous patients, WMD at 1 and 1.5 h time points were significant at 1.51 (0.83; 2.18) and 1.39 (0.99; 1.78), respectively. Ingestion of >100 mg of caffeine significantly increased IOP at 30 min, 1, and 1.5 h, whereas ingestion of ≤100 mg did not significantly increase IOP in healthy populations. All included studies with glaucomatous populations used >100 mg of caffeine. Conclusion:Caffeine ingestion, especially of >100 mg, acutely elevates IOP in both healthy and glaucomatous populations.
Purpose:To report a case of progressive anatomical improvement documented over 3 years after epiretinal membrane (ERM) peeling and to describe how fundus autofluorescence (FAF) imaging contributed to the documentation and evaluation of this long-term recovery. Methods:A retrospective case report was conducted. Results:This case report describes a 70-year-old male patient with decreased visual acuity due to idiopathic ERM. Preoperative FAF demonstrated vessel displacement, and optical coherence tomography showed Grade 3 tractional changes. The patient underwent pars plana vitrectomy with ERM and internal limiting membrane peeling. Visual acuity improved rapidly, while FAF follow-up over 3 years demonstrated progressive centrifugal repositioning of retinal vessels toward their predisplacement locations. Conclusions:This finding illustrates the utility of FAF in documenting long-term anatomical recovery beyond macular thickness normalization. FAF may serve as a valuable complementary tool to monitor retinal remodeling and vessel realignment following membrane peeling, supporting its role in postoperative assessment of ERM surgery outcomes.
Purpose:To investigate the prevalence, clinical course, and prognostic significance of hyporeflective micro-elevations and irregularity of the ellipsoid zone (MEEZ) in blunt ocular trauma. Methods:Patients with blunt ocular trauma underwent standard ophthalmological examination and optical coherence tomography angiography. MEEZ was defined as small hyporeflective foci at the level of the ellipsoid and interdigitation zone, with disappearance of the thin hyporeflective band between these layers. The prevalence and spatial distribution of MEEZ, choriocapillaris perfusion, and associated findings were evaluated. Results:MEEZ was identified in 62 (40.3%) out of 154 eyes with blunt trauma, including nine eyes with MEEZ as the only form of posterior segment injury, and 53 eyes where MEEZ was found with other posterior segment injuries. Mean best-corrected visual acuity in eyes with MEEZ only was 0.0 logMAR (20/20 of Snellen equivalent). In eyes where MEEZ was associated with other posterior segment injuries, mean best-corrected visual acuity was 0.9 ± 0.64 logMAR (approximately 20/160 of Snellen equivalent). Choriocapillaris perfusion area in eyes with MEEZ only and healthy fellow eyes was 21.1 ± 1.3 and 20.4 ± 1.2 mm2 (P > 0.05), respectively. During the follow-up, MEEZ showed complete resolution in all cases with available follow-up data (n = 15) after a median period of 34.0 days. Conclusions:MEEZ is an important part of the spectrum of traumatic retinal changes frequently observed in blunt ocular trauma. As the only manifestation of blunt ocular trauma, MEEZ is associated with a favorable prognosis.
Purpose:To evaluate the differences in intraocular pressure (IOP) response to the water drinking test (WDT) in advanced glaucoma patients following trabeculectomy or Preserflo MicroShunt implantation. Methods:This prospective study included 30 eyes from 29 advanced glaucoma patients: 15 underwent trabeculectomy, and 15 received the Preserflo MicroShunt. Baseline IOP was measured using Goldmann applanation tonometry, followed by WDT involving the consumption of 10 mL of water per kilogram of body weight over 5 min. IOP was measured at 15-min intervals until it returned to baseline. Outcomes included peak IOP, time to peak IOP, IOP fluctuation, and time to return to baseline. Results:Baseline IOP was comparable between groups (trabeculectomy: 14.83 ± 2.28 mmHg; Preserflo: 15 ± 1.23 mmHg, P = 0.515). The peak IOP and IOP fluctuation were also similar (P = 0.978 and P = 0.614, respectively). However, trabeculectomy patients exhibited a shorter time to peak IOP (27 ± 5.6 min vs. 36.25 ± 9.8 min, P = 0.017) and faster return to baseline (55 ± 4.8 min vs. 57.25 ± 9.8 min, P = 0.03). Conclusions:Both trabeculectomy and the Preserflo MicroShunt effectively controlled IOP during WDT, with the Preserflo MicroShunt demonstrating noninferiority in overall IOP control. Trabeculectomy exhibited superior dynamic outflow capacity, making it suitable for patients requiring aggressive IOP reduction.
Purpose:To evaluate long-term outcomes of bilateral medial rectus recession in infantile esotropia (IET) using survival analysis of real-world data to identify predictors of surgical failure. Methods:This retrospective study included 121 IET patients with ≥12 months of follow-up. Motor success was defined as alignment within ±10 prism diopters at 6 months (early) and final visit (late). Sensory success was defined as binocular single vision (BSV), including fusion with or without stereopsis. Long-term motor stability was evaluated using survival analysis and Cox regression, while sensory outcomes were analyzed using multivariable regression. Results:Median surgical age was 24 months; the mean follow-up was 77.8 ± 59.6 months. Motor success was 56.2% at 6 months and 52.9% at the final follow-up. Cumulative success declined from 95.9% at 1 year to 54.9% at 10 years (median survival: 130 months). Male sex (P = 0.009), larger initial deviation (P = 0.035), and recession ≥6 mm (P = 0.022) were independently associated with failure, whereas surgical timing within the age range represented in this cohort was not. At the last follow-up, 33.1% of patients were undercorrected and 14.0% overcorrected, with overcorrection more frequent in longer follow-up (P = 0.001). Stereopsis was achieved in 9.3% of patients, and 70.9% of patients demonstrated BSV. Amblyopia independently reduced the likelihood of achieving BSV (odds ratio = 0.26, P = 0.015). Conclusions:Long-term motor alignment is maintained in about half of IET patients, though stability declines over time. Male sex, larger deviation, and higher surgical dose predict failure. Peripheral fusion is frequent, fine stereopsis remains rare, and amblyopia adversely affects sensory outcome.
