Journal of Clinical Medicine

Background/Objectives: Multiple sclerosis (MS)-related optic neuritis (ON) results in thinning of the peripapillary nerve fiber layer (pRNFL) which tends to be temporal quadrant-predominant. Optical coherence tomography angiography (OCTA) enables visualization of the retinal vasculature. Prior studies have shown reduced peripapillary vessel density (VD) in MS but data on the quadrantic pattern of peripapillary VD loss are limited. Our objective was to investigate the pattern of OCTA-derived peripapillary VD reduction in MS. Methods: People with MS (PwMS) and healthy controls (HC) underwent optic disc OCTA scans (Solix, Optovue) and VD was derived for the peripapillary region and quadrants. Eyes with ON within six months were excluded. Analyses were performed with generalized estimating equations models and standardized coefficients are presented. Results: We included 50 eyes from 29 PwMS (12 ON, 38 non-ON) and 12 eyes from 6 HC. VD in the peripapillary region was lower in MS ON eyes compared to HC with the largest effect size observed in the temporal quadrant (average: −1.47, p < 0.001; superior: −1.08, p = 0.006; inferior: −0.94; p = 0.017; temporal: −1.55; p < 0.001; nasal: −1.06, p = 0.007). In MS non-ON eyes, only temporal VD was significantly lower compared to HC eyes (temporal: −0.77, p = 0.004). Moderate to strong correlations were observed between OCT and corresponding OCTA metrics from the same regions. Conclusions: Our findings suggest that vascular alterations in the peripapillary region may exhibit a temporal quadrant predominant pattern. Larger studies are needed to further characterize the patterns and temporal evolution of retinal peripapillary vascular injury in MS.

Background/Objectives: Macular Telangiectasia Type 2 (MacTel type 2) is a rare, progressive retinal disease that can lead to central vision loss. Optical coherence tomography (OCT) plays a crucial role in the early diagnosis, monitoring, and prognostic assessment of this condition. This narrative review aims to summarize the clinical features, OCT findings, and current management strategies for MacTel type 2. Methods: A literature search of PubMed, MEDLINE, and Google Scholar was performed for articles published from October 1993 to September 2025 using keywords related to MacTel type 2, OCT, clinical features, and treatment. All relevant clinical studies, including observational studies, clinical trials, and case series, were considered. The literature was screened independently by two authors, and a total of 69 articles were included. Results: Characteristic OCT findings include foveal cavitation, hyperreflective middle retinal layers, inner and outer retinal cavities, ellipsoid zone disruption, and retinal pigment clumps. Central macular thickness is consistently reduced, and structural biomarkers identified on OCT correlate with visual acuity decline. Treatment strategies vary by disease stage: non-proliferative MacTel type 2 currently has no universally effective therapy, although neuroprotective interventions such as ciliary neurotrophic factor (CNTF) show promising results. Proliferative MacTel type 2 is primarily managed with anti-vascular endothelial growth factor therapy (anti-VEGF), demonstrating functional and anatomical improvements. Conclusions: OCT provides essential structural evaluation for monitoring MacTel type 2, while treatment approaches remain stage-dependent. Emerging therapies, including CNTF implants and novel anti-VEGF agents, hold potential for improving outcomes.

Background: Silicone chin implants have been widely used is plastic and esthetic surgery of the face being considered as safe and efficient way for chin augmentation. However, complications such as bone resorption, displacement or ectopic bone formation may occur. Methods: The objective of this study was to evaluate complications associated with silicone chin implants and revision surgery protocols. Results: Among 98 patients who received silicone chin implants, 24 (11 males, 13 females) exhibited complications. The most commonly diagnosed issues were displacement (n = 3), bone resorption (n = 9), both conditions (n = 3), and patient dissatisfaction (n = 7). All patients were qualified for revision surgery, which included silicone implant removal followed by sliding genioplasty (n = 7), orthognathic surgery (n = 4), custom-made chin implant placement (n = 7), and repositioning and fixation (n = 1). After revision surgery, no complications occurred. Conclusions: Observations from this revision cohort suggest that careful patient selection and consideration of orthognathic or customized implant-based approaches may reduce the risk of dissatisfaction and revision surgery in patients with dentofacial deformities, or those seeking gender confirmation surgeries, compared to stock silicone implants.