Background Some patients with dry eye disease (DED) respond sub-optimally to autologous serum (AS) therapy. Platelet-rich plasma (PRP), a blood-derived preparation with higher platelet-derived growth factor concentrations, may benefit patients refractory to AS. Objectives To evaluate the short-term efficacy and safety of topical autologous PRP eyedrops in patients with severe DED unresponsive to AS. Design Prospective single-arm interventional study with AS re-challenge. Methods Twenty eyes (10 patients) with severe DED unresponsive to 100% AS were enrolled. Participants applied 100% autologous PRP eyedrops six times daily for 6 weeks, then 100% AS eyedrops for 6 weeks. Ocular Surface Disease Index (OSDI) scores, conjunctival and corneal staining (NEI scores), tear film break-up time (TBUT), Schirmer test were evaluated at baseline, weeks 1, 4, 6, and 12. Subbasal nerve and dendritic cell density were assessed by in vivo confocal microscopy (IVCM) in the worse eye at baseline, week 6 and 12. Data were analyzed using a mixed-effects model with patient identity as a random effect and Bonferroni correction. Results OSDI scores improved significantly at weeks 1, 4, and 6 (adjusted P = 0.04, <0.01, <0.01). Conjunctival staining improved at weeks 4 and 6, corneal staining at week 1, and TBUT at weeks 1 and 6 (all P <0.05). After transitioning to AS, no statistically significant differences from baseline were observed for any parameter at week 12. Schirmer test, subbasal nerve density, and dendritic cell density showed no significant changes throughout. No adverse events were reported. Conclusions Autologous PRP eyedrops were associated with short-term improvements in symptoms and selected ocular surface signs in AS-refractory severe DED, which were not sustained after switching to AS.
Summary This summary explains the findings of the NEW DAY study, which examined two ways of starting treatment for diabetic macular edema (DME). DME is an eye condition that can affect people with diabetes and can cause blurred vision or vision loss if not treated. In the 18-month study, adults with DME who had little or no previous treatment started therapy with either a single fluocinolone acetonide (FAc) implant or a series of aflibercept injections. The FAc implant is a small device placed inside the eye and is designed to slowly release a corticosteroid up to 3 years. Aflibercept is a medicine given as a series of eye injections. After the planned starting treatment, people in both groups could receive extra (“rescue”) aflibercept injections if their vision worsened or if eye scans showed worsening DME (retina swelling). After the planned starting treatments, both groups needed a similar number of rescue injections. However, counting the planned starting treatments plus the rescue injections, people who received the FAc implant had fewer total injections and went longer before needing their first rescue injection. Vision and retina swelling improved similarly between groups. Side effects such as cataracts and increases in eye pressure were more common with the FAc implant. Such side effects are expected when steroids are given in the eye and manageable with regular checkups and treatment. Overall, compared with starting DME treatment with aflibercept, starting with the FAc implant reduced the total number of injections while providing similar vision and eye scan improvements. What is this summary about? This is a plain language summary of the results of the NEW DAY study published in Ophthalmology 2026 Jul;133(7):837-851. doi: 10.1016/j.ophtha.2026.03.019. NEW DAY compared ILUVIEN ® , a fluocinolone acetonide implant ( FAc ), with aflibercept in people with diabetic macular edema ( DME ) who had minimal or no prior treatment for that condition. DME is a complication of diabetes that affects the eye, causing blurred vision and potential vision loss if left untreated. DME happens when small blood vessels are damaged in the retina (an area at the back of the eye where specialized cells sense light and send signals to the brain so that we can see). These damaged blood vessels become leaky and cause swelling (edema) in a central area of the retina called the macula . Current treatments for DME include medicines that reduce inflammation (called corticosteroids ) and medicines that block a protein called vascular endothelial growth factor ( VEGF ) that causes blood vessels to leak (these are called anti-VEGFs ). The purpose of the NEW DAY study was to compare the FAc implant (a corticosteroid ) with aflibercept (an anti-VEGF ) injections as a treatment for people with DME who had either minimal or no prior treatment. Worsening DME may occur in some people despite treatment. During the study, extra aflibercept injections were given when needed after the initial planned treatment. The study compared how many extra, or “rescue”, aflibercept injections were needed after the planned treatment. The study also compared the effect of each treatment on vision and swelling of the macula. Side effects of the treatments were also recorded. What were the results? After the planned treatments (either one FAc implant or five aflibercept injections), the average number of extra aflibercept injections was similar between groups. However, when counting the planned treatments, the total number of injections over 18 months was lower in people who received FAc. Rescue injections were needed sooner after the last scheduled aflibercept injection than after receiving a FAc implant. Regardless of initial treatment, improvements in vision and swelling of the retina were similar. Side effects, such as cataracts and increases in eye pressure, were more frequent with FAc than aflibercept. What do the results mean? Starting DME treatment with the FAc implant had similar benefits to vision and swelling as starting with aflibercept. People who started with FAc needed fewer total injections overall than those who started with aflibercept and had a longer time to requiring rescue injections. Side effects of FAc were as expected and were manageable. Knowing the timing of when they happened can help eye-care teams better monitor patients with DME and manage their care.
Background: Retinitis pigmentosa (RP) comprises a group of genetically and clinically heterogeneous retinal dystrophies characterized by progressive retinal degeneration, leading to deterioration of vision. Optical coherence tomography angiography (OCTA) enables non-invasive assessment of retinal and choroidal microvasculature and has increasingly been used in the assessment of microvascular changes in PR. Objectives: To assess current evidence regarding the retinal and choroidal microvasculature using optical coherence tomography angiography in patients with RP. Design: Meta-analysis. Data sources and methods: A comprehensive literature search was performed in the PubMed database, including studies published up to July 2025. Eligible journal articles were quality and consistency assessed prior to inclusion. Mean difference (MD) and variances were calculated from reported means and standard deviations in patient and control groups. Heterogeneity was evaluated based on the values of I 2 and p -values. Group mean differences were reported with 95% confidence intervals (CIs) and 95% predicted intervals (PIs). Results: Nineteen eligible studies were included for this meta-analysis. The foveal perfusion density of RP patients was significantly lower than that of the control group for superficial capillary plexus, MD = −6.09% (95% CI: −9.75, −2.43), and deep capillary plexus, MD = −4.57% (95% CI: −7.22, −1.91). The parafoveal perfusion density of RP patients was significantly lower than that of the control group for superficial capillary plexus, MD = −8.72% (95% CI: −11.71, −5.74) and deep capillary plexus, MD = −6.55% (95% CI: −12.14, −0.96). The foveal avascular zone area of RP patients was significantly increased as compared to that of the control group for superficial capillary plexus, MD = 0.10 mm 2 (95% CI: 0.02, 0.17), and deep capillary plexus, MD = 0.12 mm 2 (95% CI: 0.02, 0.23). The perfusion density in the choriocapillaris of RP patients was not significantly lower than that of the control group in the foveal region, MD = −1.41% (95% CI: −6.73, 3.91), but was significantly lower in the parafoveal region, MD = −2.44% (95% CI: −3.85, −1.03). Significant heterogeneity was present across studies, resulting in PIs encompassing zero difference for all measures. Conclusion: The findings suggest an association between retinitis pigmentosa and reduced retinal and choroidal microvasculature parameters. However, substantial interstudy heterogeneity and wide PIs limit the certainty and generalizability of the results. Microvascular attenuation is likely occurring secondary to retinal degeneration and may share a similar mechanism to the peripheral large vessel attenuation, which is typically described peripherally in advanced RP.
Ocular colobomas are unusual congenital anomalies arising from abnormal ocular development and may involve different ocular structures, including the iris and lens. Typical ocular colobomas predominantly involve the inferonasal quadrant, in accordance with the inferonasal location and closure pattern of the fetal fissure. Atypical colobomas outside this region are unusual and may complicate clinical evaluation and surgical planning. We report the case of a 49-year-old male with congenital inferonasal iris coloboma associated with a superotemporal lens coloboma, sectorial cataract, superior posterior subcapsular cataract and localized zonular absence. Ultrasound biomicroscopy demonstrated localized lens thickening and increased sphericity corresponding to the area of zonular defect. Given the limited extent of zonular involvement and intraoperative capsular bag stability, phacoemulsification with in-the-bag intraocular lens implantation was performed without additional capsular support. Postoperatively, the intraocular lens remained well centered during two-year follow-up, and best-corrected visual acuity improved significantly.
Background: Corneal blindness remains a major global health burden, limited by donor shortage and graft-related complications. Tissue-engineered corneal substitutes have emerged as a promising alternative, aiming to restore corneal structure and function through bioengineered constructs. Objectives: To systematically review recent advances (2020–2025) in tissue-engineered corneal substitutes, classifying them according to the corneal layer replaced and evaluating their biological, optical, and functional performance, as well as their translational potential for clinical application. Design: A systematic review. Data sources and methods: A systematic review was conducted following Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) 2020 guidelines. Searches were performed in PubMed/MEDLINE, Scopus, and Web of Science using predefined keywords related to corneal tissue engineering. Eligible studies included experimental, preclinical, or clinical studies published between January 2020 and June 2025 describing cell-based corneal substitutes. Studies focused on keratoprostheses (KPros), acellular scaffolds, or non-cellular biomaterials were excluded. Results: Fourteen studies met the inclusion criteria: five endothelial, three stromal, one epithelial, and five epithelium–stroma substitutes. Endothelial models demonstrated cell viability, expression of tight junction proteins (ZO-1, Na + /K + -ATPase), and partial restoration of corneal transparency in animal and ex vivo systems. Stromal models incorporated advanced biofabrication techniques such as 3D bioprinting and neuronal co-culture, achieving > 80% optical transmittance and adequate biomechanical properties. The single epithelial model achieved complete re-epithelialization in a rabbit limbal deficiency model. Multilayered epithelium–stroma substitutes, including the NANOULCOR (Tissue Engineering Group, University of Granada, Granada, Spain) construct, exhibited safety and feasibility in preclinical and early clinical studies. Conclusion: Recent progress in corneal tissue engineering has yielded increasingly functional and biocompatible substitutes that replicate native corneal architecture. However, most studies remain limited by small sample sizes, short follow-up, and reliance on animal models. Further standardized clinical trials are required for clinical translation. Trial registration: Not applicable.
Charles Bonnet syndrome (CBS) is a condition that can cause people with vision loss to see things that are not actually present, such as patterns, objects, animals, or people. Although these experiences are usually not a sign of mental illness, many individuals feel worried, confused, or reluctant to discuss their symptoms with healthcare professionals. A recent study in Therapeutic Advances in Ophthalmology showed that an educational podcast helped people with CBS better understand their condition and reduced some of the emotional distress associated with hallucinations. This finding highlights the value of simple, accessible educational tools in supporting patients. In our letter, we suggest that educational podcasts should be viewed as the first step in a broader support strategy. Education can help patients feel reassured, but it should be combined with routine screening, opportunities to discuss symptoms with healthcare providers, and clear pathways for referral when additional support is needed. We also emphasize the importance of making educational resources available in different languages and formats so they can reach people with varying levels of digital access and health literacy. By combining patient education with structured clinical support, healthcare systems may improve awareness of CBS, reduce stigma, encourage earlier disclosure of symptoms, and enhance quality of life for people living with this often-overlooked condition. Our goal is to promote practical, equitable, and patient-centred approaches that can be adopted in eye care services worldwide.
Background: Trabeculectomy remains the standard surgical treatment for glaucoma, but is associated with postoperative complications. XEN gel stent implantation has emerged as a minimally invasive alternative, though comparative evidence regarding its efficacy and safety remains inconsistent. Objectives: To compare the efficacy and safety of ab-interno XEN 45 gel stent implantation versus trabeculectomy in patients with glaucoma. Design: Systematic review and meta-analysis. Data sources and methods: A comprehensive literature search was conducted across PubMed, Embase, Scopus, the Cochrane Library, and Web of Science to identify studies comparing the XEN Gel Stent with trabeculectomy. Random-effects meta-analyses were performed using odds ratios (ORs) and mean differences (MDs) with 95% confidence intervals (CIs). Results: Eleven studies comprising 1260 eyes (645 XEN, 615 trabeculectomy) were included. Trabeculectomy achieved significantly greater intraocular pressure (IOP) reduction (MD: −2.16 mmHg (95% CI: −2.88 to -1.44); I 2 = 43%) and higher qualified (OR: 1.59 (95% CI: 1.18 to 2.14); I 2 = 0%) and complete surgical success rates (OR: 1.72 (95% CI: 1.16 to 2.56); I 2 = 43%). No significant difference was observed in the number of antiglaucoma medications (MD: −0.03 (95% CI: −0.23 to 0.18); I 2 = 53%). Rates of hyphema, choroidal detachment, hypotony, flat anterior chamber, bleb revision, and reoperation showed no statistically significant differences between procedures, although substantial heterogeneity was observed for hyphema ( I 2 = 60%), hypotony ( I 2 = 76%), and reoperation ( I 2 = 53%). XEN demonstrated significantly lower risks of bleb leakage and endophthalmitis but higher rates of bleb needling. Conclusion: Trabeculectomy achieves greater intraocular pressure reduction and higher surgical success rates than ab-interno XEN45 gel stent implantation, whereas XEN is associated with lower rates of selected bleb-related complications. Procedure selection should be individualized according to target intraocular pressure, glaucoma severity, and postoperative management requirements. Trial registration: PROSPERO (CRD420251075034).
Keratoconus (KC) has traditionally been classified as a progressive anterior segment disorder, primarily affecting the cornea. However, emerging evidence from advanced imaging modalities—such as optical coherence tomography (OCT), OCT angiography, and enhanced depth imaging (EDI-OCT)—has revealed a broader spectrum of ocular involvement, including significant alterations in the posterior segment. This narrative review explores the structural and vascular changes observed in the retina, choroid, macula, and optic nerve head in KC patients, drawing on findings from more than 40 peer-reviewed studies. Retinal thickening, particularly in the central and parafoveal regions, has been consistently reported, with some studies suggesting a correlation between retinal morphology and disease severity. Vascular density reductions, especially in the superficial capillary plexus and radial peripapillary capillaries, have also been documented, suggesting microvascular compromise potentially associated with KC progression. Choroidal thickness appears to be increased in both pediatric and adult populations, with some evidence linking these changes to disease stage and systemic factors such as atopy. Although findings on macular thickness are more variable, patterns of thickening in early disease and thinning in advanced stages have been observed. Alterations in optic nerve head morphology and retinal nerve fiber layer parameters have also been noted, particularly in advanced or post-surgical cases. Taken together, these posterior segment changes challenge the traditional anterior-centric view of KC and suggest a more systemic ocular remodeling process. Understanding these alterations may enhance disease staging, prognostication, and personalized management strategies. While current evidence supports the clinical relevance of posterior segment evaluation in KC, further longitudinal studies with standardized imaging protocols are needed to clarify causality, functional implications, and potential therapeutic targets.
Background: Diabetic macular edema (DME) is a leading cause of vision loss in working-age adults. Subfoveal neuroretinal detachment (SND) is an OCT phenotype associated with prominent subretinal fluid and inflammatory signaling, and prospective routine-care data on faricimab in treatment-naïve SND-DME are limited. Objectives: To evaluate functional and anatomical outcomes of faricimab in a prospective routine-care, phenotype-defined cohort of treatment-naïve eyes with DME and SND, and to explore OCT biomarkers associated with visual improvement. Design: Prospective, single-center, routine-care observational study. Methods: Forty eyes received intravitreal faricimab with a loading phase followed by a treat-and-extend regimen. Best-corrected visual acuity (BCVA), central subfield thickness (CST), and OCT biomarkers—intraretinal fluid (IRF), subretinal fluid (SRF), hyperreflective retinal spots (HRS), disorganization of the retinal inner layers (DRIL), ellipsoid zone (EZ) disruption, epiretinal membrane (ERM), and vitreomacular adhesion (VMA)—were assessed at baseline and weeks 20, 48, and 64. Results: At week 64, mean BCVA improved from 47.5 ± 22.5 to 55.7 ± 24.8 ETDRS letters ( p = 0.01), and CST decreased from 460 ± 99.5 µm to 325.2 ± 116 µm ( p < 0.0001). Complete resolution of SND/SRF occurred in 37 eyes (92.5%) after loading and in all eyes by week 48, with sustained absence through week 64. Mean HRS decreased from 28.1 ± 12.2 to 15.8 ± 8.7 ( p = 0.01), while DRIL, EZ disruption, ERM, and VMA showed no significant changes. In exploratory logistic regression, SRF resolution and lower baseline HRS were associated with greater visual gain ( p = 0.01), whereas EZ disruption was associated with poorer visual outcomes ( p = 0.03). Conclusion: In this prospective routine-care cohort of treatment-naïve DME eyes with SND, faricimab was associated with sustained visual and anatomical improvements through 64 weeks. Reductions in OCT-derived fluid and HRS were observed, and exploratory biomarker analyses suggested associations with visual outcomes requiring confirmation in larger comparative studies. Trial registration: Not applicable.
Background: Cataract poses a significant burden in Ethiopia and was given priority in the WHO’s VISION 2020 program. However, there is limited pooled information on the extent of cataract and determinant factors in Ethiopia. Objective: The objective of the study is to provide updated data on the pooled prevalence of cataract and associated factors to develop effective intervention strategies, particularly for addressing modifiable risk factors. Design: The study utilized a systematic review and meta-analysis design. Data source and methods: The study was registered with the International Prospective Register of Systematic Reviews. Relevant published articles were searched in PubMed, EMBASE, Wiley Online Library, CINAHL/EBSCO, Wolters Kluwer, Cochrane Library, Science Direct, Google Scholar, and African Journal Online. Data were extracted using Microsoft Excel, and Meta-analysis was performed using STATA version 17. Results: In this study, the pooled prevalence of cataract in Ethiopia is estimated to be 32.30% (95% CI: 20.72−43.89, I ² = 99.2%). Age ⩾ 70 years old (Pooled odds ratio; POR = 9.03, 95% CI: 2.21–36.85), diabetes mellitus (POR = 3.31, 95% CI: 1.61–6.82), sunlight exposure (POR = 1.95, 95% CI: 1.53–2.47) and hypertension (POR = 4.09, 95% CI: 2.98–5.61) were associated with cataract. Conclusion: Despite progress in cataract control, the pooled prevalence of cataract in Ethiopia remains high. The pooled estimates for associated factors were based on a limited number of studies, including diabetes mellitus (two studies), hypertension (two studies), sunlight exposure (two studies), and age ⩾70 years (three studies); therefore, these findings should be interpreted cautiously. Trial registration: CRD42022377695.
Background:Dry age-related macular degeneration currently lacks effective treatments for geographic atrophy. Cord blood platelet-rich (CB-PRP) plasma intravitreal injections are a novel therapy under investigation with promising ad interim results. Objectives:To describe the safety profile of cord blood platelet-rich plasma intravitreal injections (IVIs) in dry age-related macular degeneration (AMD) patients. Design:This prospective, randomized, sham-controlled, open-label experimental trial evaluated the safety of repeated intravitreal CB-PRP injections. Methods:The study, conducted from January 2023 to January 2025, investigated the safety and efficacy of CB-PRP IVIs to slow down the progression of geographic atrophy (GA). One eye of each patient was randomly assigned to the monthly, every other month, or every 3 months arm and received 0.05 mL CB-PRP, while the other eye underwent only a sham injection. Complete ophthalmological evaluations were performed at baseline, 3-, 6-, 12-, 18-, and 24-month follow-ups. In addition, slit-lamp and fundus examinations were performed the day after the injection to exclude any adverse effect. Results:In a total of 328 intravitreal injections, vitreous opacities were observed in the absence of other signs of infection or inflammation only in three cases. All of them showed progressive improvement without treatment, and complete recovery was observed within 2 weeks. Conclusion:Although the pathogenesis of the detected vitreous thickening was not completely clear, the most likely hypothesis was the coexistence of a slightly lower temperature of the CB-PRP sample and individual factors. This mild adverse event occurred only once in each patient involved, with no recurrence during subsequent intravitreal injections. The occurrence of this self-limiting finding after CB-PRP IVIs has not invalidated the safety profile of the procedure.
What is this summary about? This is a summary of a publication about the 2-year (96-week) results from the PHOTON study, which was published in Ophthalmology. Diabetic macular edema (DME) is a leading cause of vision loss in people with diabetes. In people with diabetes, leaky blood vessels in the retina can lead to swelling (known as edema) in the macula, the area of the retina at the back of the eye that is responsible for sharp vision. Swelling of the macula can cause blurred vision and vision loss. The main cause of leakiness in blood vessels is over-production of a protein called vascular endothelial growth factor (VEGF). Anti-VEGF medicines can block VEGF to prevent the development of leaky blood vessels and edema. These medicines are injected into the eye and may need to be given regularly to maintain good vision. Some people find it difficult to attend all the injection appointments that may be necessary to maintain good vision. Aflibercept is an anti-VEGF medicine that has been approved for the treatment of people with DME. After 5 initial monthly injections of aflibercept 2 mg, the recommended injection schedule is every 4-8 weeks. The objective of the PHOTON study was to find out whether a higher dose of aflibercept (8 mg), injected every 12 or 16 weeks after 3 initial monthly injections, was as effective as aflibercept 2 mg injected every 8 weeks after 5 initial monthly injections. A previous report from the PHOTON study showed that aflibercept 8 mg provided a similar level of improvement in vision to aflibercept 2 mg after 1 year (48 weeks) in people with DME. People who received aflibercept 8 mg received fewer and less frequent eye injections than those who received aflibercept 2 mg. What were the results? After 96 weeks, study participants who received aflibercept 8 mg every 12 weeks or longer following 3 initial monthly injections maintained similar improvements in vision, with fewer injections, compared to those treated with aflibercept 2 mg every 8 weeks following 5 initial monthly injections. During the 96-week study, study participants could receive aflibercept 8-mg injections more or less frequently than the schedule they were assigned depending on whether DME was worsening or improving. More than 80% of participants who were given aflibercept 8 mg and completed the study through 96 weeks kept receiving injections at least every 12 weeks without needing more frequent injections.At Week 96, almost half of the participants receiving aflibercept 8-mg treatment qualified for dosing intervals of at least 20 weeks, and around one-quarter were able to have their aflibercept 8-mg dosing interval extended to every 24 weeks. Adverse events in participants who received aflibercept 8 mg were similar to those in participants who received aflibercept 2 mg through 96 weeks. What do the results mean? These findings show that aflibercept 8 mg provided a similar level of improvement in vision to aflibercept 2 mg in people with DME after 2 years, with fewer and less frequent eye injections. Thus, aflibercept 8 mg given at least every 12 weeks can provide long-term improvement in vision and reduce treatment burden. Where can I find the original article on which this summary is based? You can read the original article at: Do DV, Wykoff CC, Sivaprasad S, et al. Intravitreal Aflibercept 8 mg for Diabetic Macular Edema: 96-Week Results from the Randomized Phase 2/3 PHOTON Trial. Ophthalmology. 2026:133(5):577-588. doi: 10.1016/j.ophtha.2025.10.028 Who is this summary for? The authors developed this plain language summary to help people living with DME, care partners, patient advocates, healthcare professionals, insurance providers, and policy makers to better understand the results of the PHOTON study.
Summary What is this summary about? This paper describes the results of a clinical trial called HORNBILL that were published in a scientific journal called Ophthalmology Science. In HORNBILL, researchers looked at a new drug called BI 764524 in the treatment of diabetic macular ischemia (DMI). DMI is a condition that affects people living with diabetes. For people living with DMI, there is reduced blood flow in the center of the retina (an area at the back of the eye that changes light into signals to allow people to see). Reduced blood flow means that the retina does not function correctly and vision can get worse. There are no available treatments for people with DMI, so it is important that research is carried out to find possible new drugs. BI 764524 was injected into the eyes of 33 people with DMI. This paper describes whether there were any safety-related events that might stop BI 764524 being tested in more trials and if it helped people in the trial.
Background: Neurotrophic keratitis (NK) is a rare, degenerative disease of the cornea that arises from impaired trigeminal nerve innervation. The condition leads to progressive corneal anesthesia, epithelial breakdown, ulceration, and potential perforation. Cenegermin, a recombinant form of human nerve growth factor, is the first pharmacotherapy approved for this indication and operates through a disease-modifying mechanism that promotes corneal nerve regeneration. Objectives: To evaluate the therapeutic efficacy and safety profile of topical cenegermin (20 mcg/mL) compared with vehicle in adults with moderate to severe NK (Mackie classification stage 2 or 3) by quantitatively synthesizing evidence from randomized controlled trials (RCTs). Design: Systematic review and meta-analysis of RCTs, conducted in accordance with the PRISMA 2020 statement and the Cochrane Handbook for Systematic Reviews of Interventions. Data sources and methods: PubMed, Web of Science, and Cochrane CENTRAL were searched from inception through February 2026. Two double-masked, vehicle-controlled RCTs (the REPARO trial and the NGF0214 trial) enrolling 148 adults were included. Data were pooled using random-effects models (DerSimonian–Laird) and reported as risk ratios (RRs) with 95% confidence intervals (CI). Risk differences (RDs) and the number needed to treat (NNT) were also computed. Certainty of evidence was appraised using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. Results: Cenegermin substantially increased the probability of complete corneal healing at 8 weeks, with a pooled RR of 1.84 (95% CI 1.34–2.52; z = 3.8; p = 0.0001) and minimal between-study heterogeneity (I-squared = 0%; tau-squared = 0.00). The model-based pooled RD was 0.42 (95% CI 0.24–0.60), yielding an NNT of 3 (95% CI 2–5). The crude pooled event rates were 72.6% in the cenegermin group versus 38.7% in the vehicle group. Regarding safety, the pooled RR for any adverse event was 1.07 (95% CI 0.64–1.78; p = 0.80), showing no significant difference between groups. The overall certainty of evidence was rated as moderate for both outcomes under the GRADE framework. Conclusion: Cenegermin is an effective and well-tolerated, disease-modifying therapy for moderate to severe NK. It nearly doubles the likelihood of complete corneal healing and represents an important addition to the therapeutic options available for this debilitating condition. Larger, independently funded trials with longer follow-up are warranted to confirm these findings and to establish its position within the treatment algorithm. Trial registration: PROSPERO CRD420251103148.
Background: Charles Bonnet Syndrome (CBS) is characterised by visual hallucinations in individuals with visual impairment, which can negatively impact emotional wellbeing. Educational interventions may help improve understanding and coping. Objective: This study investigated whether an educational podcast on CBS could enhance emotional wellbeing and promote more positive attitudes toward hallucinations. Design: Pre–post exploratory study. Methods: Participants were recruited via charities and social media as part of a larger study on the psychosocial impact of CBS. A baseline survey collected data on CBS symptom characteristics, the perceived impact of hallucinations (rated on a 5-point Likert scale from very negative to very pleasant) and level of negative affect (negative emotional wellbeing), assessed by the Positive and Negative Affect Schedule (PANAS). Participants then engaged with an educational podcast about CBS over a 3-week period. A follow-up survey assessed changes in emotional wellbeing, attitudes toward hallucinations, and symptom perception. Results: Fifty-four individuals with CBS (76% female; 70% aged >65 years) received the podcast. After the podcast intervention, 22 participants (41%) reported a less negative impact of CBS on their lives. There was a statistically significant improvement in perceived CBS impact ( p < 0.01) and a statistically significant reduction in negative emotional wellbeing ( p = 0.02). Conclusion: The educational podcast intervention was associated with improved emotional wellbeing, reflected in statistically significantly reduced negative affect and a decreased perceived burden of CBS. These findings suggest that educational podcasts may serve as a valuable tool for supporting the emotional health of individuals with CBS.
Infectious keratitis (IK) is a serious vision-threatening ophthalmologic emergency that can lead to irreversible complications such as blindness or corneal scarring. IK can be caused by various types of microorganisms, including bacteria, fungi, protozoa, and viruses, which can cause an inflammatory response and penetrate deep into the cornea, leading to perforation in addition to scarring and ulceration. Given the need for thorough and rapid evaluation of patients with IK, effective ophthalmic imaging techniques that provide both quantitative and qualitative information are essential clinician tools. In this narrative review, we outline the benefits of anterior segment optical coherence tomography as a noninvasive, quantitative and qualitative modality for the supportive assessment of IK and for the longitudinal monitoring of corneal abnormalities that may result from infection.
Background: Submacular hemorrhage (SMH) is an uncommon complication of neovascular age-related macular degeneration (AMD). Objectives: The study aim was to evaluate the efficacy of combination therapy vitrectomy with subretinal recombinant tissue plasminogen activator (rtPA) given under the retina and anti-VEGF given into the vitreous cavity in patients with SMH based on duration of symptoms and to identify biomarkers to help predict potential visual acuity gain after the procedure. Design: Retrospective case series. Methods: Patients with SMH secondary to AMD were treated with quadruple therapy: (1) vitrectomy; (2) rtPA administration; (3) bevacizumab injection into the vitreous cavity; followed by (4) monthly intravitreal double-dose bevacizumab 2.5 mg. Results: Forty-eight patients were treated (68.8% women; mean age, 80 years). A median of 14 days elapsed between SMH onset and surgical intervention (range, 2–120 days), with vitrectomy performed after ⩾30 days in 39.6% of patients. A significant improvement from baseline in mean best-corrected visual acuity (BCVA) was observed 6 months after SMH treatment (1.6 (baseline) vs 0.9 (Month 6) logMAR; p < 0.001). Overall, 46 (95.8%) patients had improved BCVA and two (4.2%) had stable (unchanged) BCVA in the treated eye. Improvement in BCVA at Month 6 was similar between the cohort with only SMH and patients with coexisting subretinal pigment epithelium hemorrhage ( p = 0.11). The main biomarkers predicting surgical outcome were the state of the retina in the foveal center point and hemorrhage thickness. Treatment ⩾30 days after SMH onset resulted in poorer BCVA at Month 6 compared with treatment occurring <30 days after onset ( p < 0.05). Conclusion: A combination of vitrectomy, subretinal rtPA, and bevacizumab, performed in patients with submacular hemorrhage due to neovascular AMD, followed by monthly intravitreal double-dose bevacizumab for SMH, was an effective intervention to achieve visual acuity improvement.
Background: Dry eye disease (DED) is among the most common complications experienced after femtosecond laser-assisted in situ keratomileusis (Femto-LASIK), often affecting visual recovery, as well as patient satisfaction. Low-level light therapy (LLLT) has shown benefits in various ocular surface diseases, but its role in refractive surgery remains underexplored. This study aimed at evaluating the efficacy of perioperative LLLT in preserving tear film parameters and reducing ocular discomfort symptoms after Femto-LASIK. Methods: In this prospective multicentric, randomized, double-masked, sham-controlled clinical study, adult patients undergoing Femto-LASIK were randomized (1:1) to receive periocular LLLT (633 ± 10 nm, 15 min/session) or sham treatment 7 ± 2 days before and after surgery. Ocular surface evaluation was performed at baseline (T0), and 1 week (T1), 1 month (T2), and 3 months (T3) postoperatively. Outcomes were tear meniscus height (TMH), Schirmer test values, and Dry Eye Questionnaire-5 (DEQ-5) scores, noninvasive tear break-up time (NIBUT), and interferometry. Results: Forty eyes of 40 patients (mean age: 34.58 ± 5.67 years) were analyzed. In the LLLT group, tear film parameters and subjective symptoms remained stable throughout follow-up, with no statistically significant changes over time. Conversely, the control group showed a significant decline in TMH (0.27 ± 0.05 mm to 0.20 ± 0.05 mm; p < 0.001), Schirmer test (20.39 ± 10.84 mm/5’ to 15.65 ± 9.02 mm/5’; p = 0.022), and a significant worsening in DEQ-5 scores (3.53 ± 4.10 to 5.94 ± 2.79; p = 0.005). Between-group comparisons demonstrated in the LLLT group significantly higher TMH at T2 ( p = 0.034) and T3 ( p = 0.016), higher Schirmer values at T2 ( p = 0.048) and T3 ( p = 0.018), and lower DEQ-5 scores at T1 ( p = 0.041), T2 ( p = 0.029), and T3 ( p = 0.018). NIBUT and interferometry showed no significant between-group differences at any time point. No treatment-related adverse events were observed. Conclusion: Perioperative LLLT appears to be a safe and well-tolerated adjunctive treatment that may help preserve tear volume and support postoperative comfort after Femto-LASIK. These findings suggest a potential role for LLLT in perioperative refractive surgery care, although further studies are warranted to confirm its clinical benefit.
