Search Results (1,142)

Purpose: This study aimed to comprehensively map the structural impacts of ROP on all ocular structures, including and extending beyond the inner retina and the associated long-term sequelae that manifest into adulthood. Methods: This scoping review identified studies on animal oxygen-induced retinopathy and clinical retinopathy of prematurity using a multi-database search. Study selection and data extraction were performed independently by multiple reviewers using Covidence software. Results: ROP results in lasting ocular complications. Posterior segment findings include choroidal insufficiency, photoreceptor dysfunction, and retinal detachment. Anterior segment complications involve a higher incidence of angle-closure glaucoma, strabismus, and significant myopia. Conclusions: This scoping review was conducted and reported in accordance with the PRISMA-ScR guidelines, though it is limited by the exclusion of non-English studies. Lifelong ophthalmic monitoring is essential for ROP patients due to persistent anterior and posterior segment complications. This study also identifies key future research priorities, including elucidating mechanisms of foveal development and conducting longitudinal studies. Furthermore, as neonatal intensive care expands in low and middle-income regions, international collaboration is vital to guide screening and treatment and prevent a debilitating surge of ROP. Full article

Background/Objectives: To comprehensively evaluate longitudinal retinal and choroidal vascular changes after phacoemulsification using automated optical coherence tomography angiography (OCTA) analysis and to investigate clinical factors influencing these changes. Methods: This retrospective study included 26 subjects (31 eyes) who underwent uncomplicated phacoemulsification. OCTA was performed at baseline and at 1 day, 1 week, 1 month, and 2 months postoperatively. Automated quantitative analysis was applied to assess vessel density- and structure-related parameters in the superficial capillary plexus (SCP), deep capillary plexus (DCP), choriocapillaris, and Haller layer. Longitudinal changes were analyzed using repeated-measures analysis of variance, with time × clinical factor interactions evaluated for diabetes mellitus, anesthesia method, and sex. Inter-layer associations were assessed using Spearman correlation analysis. Results: Significant longitudinal changes were observed in retinal layers. In the SCP, vessel density increased from 42.59 ± 1.46 at baseline to 44.10 ± 1.44 at 2 months (p = 0.002), accompanied by increases in vessel length and node counts (all p < 0.001). In the DCP, vessel density increased from 34.66 ± 5.98 to 38.65 ± 4.83 (p < 0.001). In contrast, choriocapillaris-related parameters showed no significant overall time effect. In the Haller layer, mean vessel diameter decreased significantly over time (p < 0.001), while density-related metrics remained unchanged. ΔVAD demonstrated positive correlations between adjacent layers (SCP–DCP and DCP–choriocapillaris) and a negative correlation between choriocapillaris and Haller layers. Diabetes mellitus showed no significant longitudinal effect, whereas retrobulbar anesthesia and sex significantly modified selected choroidal trajectories. Conclusions: Automated and integrated OCTA analysis revealed layer-dependent retinal and choroidal vascular responses after phacoemulsification, with coordinated changes confined mainly to anatomically adjacent layers and selective modulation by clinical factors. Full article

To compare the respiratory lesions and nervous system damage in cotton rats and BALB/c mice following respiratory syncytial virus (RSV) infection, and to evaluate their suitability as models for RSV-related respiratory and nervous system diseases, cotton rats and BALB/c mice were infected with RSV via intranasal instillation, monitored daily for weight and temperature. At 3, 5, and 7 days post-infection (dpi), viral loads in the nasal turbinates, lungs, and brain tissues were quantified. Pathological changes and neuroinflammatory responses in the lungs and brain were assessed using hematoxylin and eosin (H&E) staining, Nissl staining, immunofluorescence, and Western blotting analysis, while the mRNA expression levels of inflammatory factors were specifically analyzed at 5 dpi. The results showed that viral loads in the nasal turbinates and lungs of cotton rats were significantly higher than those in BALB/c mice, accompanied by more extensive pulmonary inflammatory factor gene upregulation at 5 dpi and more pronounced lung histopathological alterations. In contrast, RSV RNA and antigens were detected in the brain tissues of BALB/c mice, at levels markedly lower than those in respiratory tissues, along with viral antigens primarily localized to the choroid plexus epithelium. No significant pathological or neuroinflammatory changes were observed in the brains of cotton rats at any examined time point. In conclusion, cotton rats provide advantages for modeling RSV-associated respiratory tract infection and pulmonary pathology, whereas under the experimental conditions of this study, BALB/c mice may be more appropriate for investigating RSV-associated CNS inflammatory responses, although the clinical relevance of these findings remains to be further validated. Full article

Background: Diabetic retinopathy (DR) is a leading cause of vision loss worldwide. Microvascular changes precede clinically detectable DR, creating an opportunity for early diagnosis and intervention. Optical coherence tomography angiography (OCTA) enables noninvasive, quantitative assessments of retinal and choroidal microcirculation and has emerged as a promising tool for identifying early biomarkers of DR. The goal of this study was to review the literature on OCTA-derived biomarkers associated with preclinical diabetic retinopathy in patients with type 1 and type 2 diabetes mellitus. Methods: This descriptive literature review summarizes current evidence regarding OCTA-derived biomarkers associated with preclinical diabetic retinopathy in patients with type 1 and type 2 diabetes mellitus. A search of the PubMed/MEDLINE database was performed to identify original studies published between 2015 and 2025 evaluating OCTA parameters in diabetic patients without clinically detectable diabetic retinopathy. The findings were synthesized qualitatively due to methodological heterogeneity among studies in terms of OCTA devices, imaging protocols, and analyzed parameters. Results: The reviewed studies consistently reported early microvascular abnormalities detectable by OCTA prior to the development of clinically visible diabetic retinopathy. The most frequently described changes included reduced vessel density (VD) and perfusion parameters, enlargement and increased irregularity of the foveal avascular zone (FAZ), areas of capillary non-perfusion, and alterations in vascular network geometry and complexity. These changes were most consistently observed in the deep capillary plexus (DCP), suggesting that this vascular layer may be particularly susceptible to early diabetic microvascular damage. Conclusions: This review provides a comprehensive synthesis of OCTA-derived biomarkers associated with early retinal microvascular alterations in diabetic patients without clinically detectable diabetic retinopathy. By integrating findings from recent studies, the review highlights the potential role of OCTA in identifying preclinical microvascular changes and discusses current methodological challenges and future research directions. Full article

Non-arteritic ischemic optic neuropathy (NAION) results from vascular insufficiency within the optic nerve head. The precise pathogenesis of NAION remains unclear; however, insufficient blood supply from the short posterior ciliary arteries and the choroidal circulation has been associated with its development. Although major risk factors include diabetes, hypertension, and hyperlipidemia, coronavirus disease 2019 (COVID-19) may also contribute to the development of NAION. This literature review presents our case of NAION associated with COVID-19 infection and summarizes previously reported cases of NAION following COVID-19 infection published in the English-language literature worldwide. Because direct infection of ocular tissues, including ocular vessels, via the angiotensin-converting enzyme 2 receptor is thought to contribute to the development of NAION, cases of NAION associated with COVID-19 vaccination were excluded from this review. Furthermore, we discuss the possible molecular mechanisms underlying the development of NAION after COVID-19 infection and highlight the potential risks of COVID-19 for clinical ophthalmologists. Full article

Background: Multiple evanescent white dot syndrome (MEWDS) is usually acute and self-limited, whereas multifocal choroiditis (MFC)/punctate inner choroidopathy (PIC) is relapsing; overlap can obscure early diagnosis and requires longitudinal multimodal imaging. Methods: We report a 4-year follow-up of a 31-year-old woman with fundus autofluorescence (FAF), fluorescein angiography (FA), indocyanine green angiography (ICGA), and spectral-domain optical coherence tomography (SD-OCT), plus a systemic/neurologic/rheumatologic work-up. Treatment included intravenous methylprednisolone for presumed optic neuritis, followed by topical, periocular, intravitreal, and systemic corticosteroids, later escalated to adalimumab and an intravitreal dexamethasone implant. Because foveal granularity could not be documented, baseline was termed “MEWDS-like”. Diagnostic labelling was benchmarked against Standardization of Uveitis Nomenclature (SUN) criteria, and choroidal neovascularization (CNV) was assessed at each relapse by OCT and FA. Results: The right eye initially showed a MEWDS-like pattern with wreath-like FA lesions and disc leakage, hyperautofluorescent FAF lesions, focal ellipsoid zone disruption on SD-OCT, and multifocal ICGA hypofluorescent spots. A relapse at 6 months with peripapillary inflammatory foci and recurrent cystoid macular edema supported reclassification to a unilateral MFC/PIC-spectrum phenotype. At 2 years, the fellow eye developed mild vitritis, peripapillary hyperautofluorescence, peripapillary/arcade leakage on FA, delayed peripapillary filling on ICGA, and cystoid macular edema, establishing sequential bilateral MFC; no CNV developed and anti-vascular endothelial growth factor (anti-VEGF) therapy was not required. Complications included steroid-induced ocular hypertension and cataract surgery. Conclusions: The purpose of this report is to highlight longitudinal imaging “red flags” that supported reclassification from a MEWDS-like phenotype to a sequential bilateral MFC/PIC-spectrum disease. Full article

Background and Objectives: In many neurodegenerative diseases, the pathological changes occurring in the central nervous system may be reflected in the periphery. The aim of this study was to examine the possible relationship between the retina, choroid, and nerve fibre layer thicknesses measured on optic coherence tomography (OCT) and the serum microbiota metabolite levels of trimethyl amine-N-oxide (TMAO), S-equol, Indoxyl sulphate (IS), and Maresin 1 (MaR1). Materials and Methods: This study included a total of 60 subjects, comprising 30 patients diagnosed with schizophrenia and a control group of 30 healthy individuals. A sociodemographic form was given to all the subjects and the Positive and Negative Syndrome Scale (PANSS) to the schizophrenia patients. The eye fundus was evaluated with OCT. A 5 mL blood sample was taken from the arm of each subject, and the microbiota metabolite levels of TMAO, S-equol, IS, and MaR1 were examined. Results: The retina nerve fibre layer (RNFL) analysis results showed that the RNFL superior (p = 0.016), inferior (p = 0.002), central choroid (p = 0.033), nasal choroid (p = 0.004), temporal choroid (p = 0.038), and TMAO (p = 0.001) values were significantly lower in the schizophrenia patients than in the control group. In the patient group, a significant negative correlation was determined between the RNFL temporal measurements and IS, as well as a significant positive correlation between the central choroid measurement and the nasal choroid and temporal choroid measurements and between the nasal choroid and temporal choroid measurements. A statistically significant positive correlation was seen between S-equol and TMAO. A significant negative correlation was seen between the MaR1 level and age and disease duration. Conclusions: The study results showed that fundus changes are associated with serum microbiota metabolite levels in schizophrenia patients. Therefore, these parameters may be considered potential exploratory biomarkers; however, their clinical applicability requires validation in larger longitudinal studies. Full article

Background: Pachychoroid pigment epitheliopathy (PPE) is a non-exudative entity within the pachychoroid disease spectrum characterized by increased choroidal thickness and isolated serous pigment epithelial detachment (PED) without subretinal fluid. Although photodynamic therapy (PDT) is established for chronic central serous chorioretinopathy (CSC), its efficacy in isolated pachychoroid-related PED remains insufficiently defined, with available evidence limited to small case series. Purpose: This study aims to characterize symptomatic pachychoroid-related PED and evaluate anatomical and functional outcomes following half-dose PDT (hd-PDT), with additional analysis according to lesion localization and CSC history. Methods: This retrospective study included 34 eyes of 27 patients treated with hd-PDT between June 2022 and December 2024. PEDs were categorized as central (fovea-involving) or paramacular. Best-corrected visual acuity (BCVA) and spectral-domain optical coherence tomography parameters—central subfield thickness (CST), mean subfield thickness (MST), macular volume (MV), subfoveal choroidal thickness (SFCT), and PED height—were assessed at baseline, 1 month, and 6 months. Treatment planning was based on indocyanine green angiography (ICGA) and spectral-domain optical coherence tomography (SD-OCT) findings. Statistical analyses employed non-parametric tests and generalized estimating equations. Results: Central lesions were associated with longer disease duration, worse baseline BCVA, and greater retinal thickness and PED height (p < 0.05). Complete PED resorption occurred in 79.4% of eyes at 1 month and 73.5% at 6 months (central: 86.3% and 81.8%; paramacular: 66.6% and 58.3%). Mean BCVA improved significantly from 0.22 ± 0.24 to 0.10 ± 0.16 logMAR at 6 months (p < 0.0001), with greater functional gain in central lesions. Significant reductions were observed in CST, MST, MV, and PED height, whereas SFCT remained stable. Better final BCVA correlated with younger age, shorter disease duration, smaller baseline retinal volume, smaller PDT spot size, and absence of CSC history. Non-responders had worse baseline BCVA, higher PED height, and larger treatment areas. No treatment-related complications were detected. Conclusions: Half-dose PDT was associated with favorable anatomical and functional outcomes in symptomatic pachychoroid-related PED, particularly in centrally located lesions. Baseline disease severity appeared to influence treatment response. Prospective studies with longer follow-up are warranted to confirm long-term efficacy and safety. Full article

An 87-year-old woman was referred to our ophthalmology ward due to decreased visual acuity and intense right orbital pain, which had been present for four weeks. The anamnesis was not contributory, except that she had been vaccinated against severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) four weeks prior to symptom onset. Her best-corrected visual acuity was hand movements in the right eye and 20/20 in the left eye. Intra-ocular pressure was 34 mmHg and 16 mmHg, respectively. Right eye slit lamp examination revealed palpebral oedema, chemosis, and temporal scleral thickening with conjunctival injection. The cornea was edematous with endothelial precipitates. The anterior chamber was shallow with a closed angle, associated with grade 1+ cells and 1+ flare, according to the SUN grading system. Mild vitreous inflammation was present (grade 0.5+ vitreous cells), and a total choroidal detachment was visible. In the absence of any other plausible cause, unilateral choroidal effusion with secondary angle-closure due to severe panuveitis was considered a possible adverse event following vaccination against SARS-CoV2. Full article

Background: Mixed connective tissue disease (MCTD) is a rare systemic autoimmune disease which presents with clinical features that overlap with at least two connective tissue disorders, including systemic lupus erythematosus (SLE), systemic sclerosis (SSc), polymyositis (PM), dermatomyositis (DM), and rheumatoid arthritis (RA). It is characterized by the presence of anti-ribonucleoprotein (anti-U1RNP) antibodies. The mechanism of the vasculopathy associated with MCTD remains largely unknown. Optical coherence tomography angiography (OCTA) is a non-invasive imaging method of the microvasculature of the retina and choroid, providing the assessment of retinal perfusion. Objectives: The aim of the study was to evaluate the optical coherence tomography angiography (OCTA) parameters in patients with mixed connective tissue disease compared to healthy individuals. Methods: In this study, we compared the following parameters between patients with MCTD and healthy subjects: foveal avascular zone (FAZ), FAZ perimeter (PERIM), flow density (FD), choriocapillaris flow area (CCFA), outer retina flow area (ORFA), and foveal and parafoveal mean superficial and deep vessel density. Results: Parafoveal mean superficial vessel density and parafoveal mean deep vessel density were significantly lower in the MCTD group than in controls. The FAZ, FAZ PERIM, and FD values in the patients with MCTD were lower than in the control group and statistically significant for all parameters. Conclusions: The present study’s findings suggest the presence of ocular vascular abnormalities in patients suffering from MCTD. These abnormalities are characterized by decreased retinal vessel density and lower choriocapillaris flow. The results of the study demonstrate the significant role of OCTA in the diagnosis and monitoring of microvascular changes in patients with MCTD. Full article

Background/Objectives: This study aimed to evaluate macular choroidal blood flow dynamics and structural alterations in children with hyperopic anisometropic amblyopia and compare these findings with those of the fellow eyes. Methods: This retrospective observational study included 36 eyes from 18 children (mean age: 4.9 years) with unilateral hyperopic anisometropic amblyopia. Central choroidal thickness (CCT) was measured using enhanced depth imaging optical coherence tomography. Macular choroidal hemodynamics were assessed using laser speckle flowgraphy. Mean blur rate (MBR) was used as an index of blood flow, whereas beat strength (BS) was used as a measure of pulsatility. Ocular perfusion pressure (OPP) was also calculated. All parameters were compared between amblyopic and fellow eyes. Results: Amblyopic eyes demonstrated significantly greater CCT compared with fellow eyes (407.6 ± 84.9 µm vs. 326.4 ± 79.1 µm). Conversely, macular MBR was significantly lower in amblyopic eyes (9.28 ± 3.60 AU vs. 10.94 ± 4.68 AU), as was BS (5.73 ± 3.07 AU vs. 7.28 ± 3.59 AU). No significant differences were observed in central retinal thickness or OPP between amblyopic and fellow eyes. In amblyopic eyes, CCT was not significantly correlated with macular MBR or BS. Conclusions: Amblyopic eyes exhibited significant central choroidal thickening accompanied by reduced macular blood flow and pulsatility. These findings suggest that localized macular hemodynamic dysregulation may contribute to the pathophysiology of hyperopic anisometropic amblyopia. Full article

The choroid plexus (CP) has traditionally been regarded as a cerebrospinal fluid-producing structure; however, increasing evidence indicates that it functions as a dynamic regulatory interface involved in immune surveillance, metabolic homeostasis, and brain clearance. Neuroimaging studies consistently report CP enlargement across aging and diverse neurological and neuropsychiatric disorders, yet the underlying cellular mechanisms remain poorly integrated. In this review, we synthesize morphological, molecular, and imaging evidence to propose a sequential degenerative model of the CP epithelium. This model comprises: (1) regulated epithelial cell loss via apical extrusion, (2) compensatory hypertrophy of residual cells, (3) mitochondrial remodeling with oncocytic-like change, and (4) progressive blood–cerebrospinal fluid barrier dysfunction. At the molecular level, alterations in epithelial adhesion systems—particularly SPINT1-mediated protease regulation and E-cadherin–based adherens junction stability—may initiate epithelial instability. Hypertrophic epithelial cells exhibit increased mitochondrial burden, reflected by Tom20 expression, which may initially support metabolic adaptation but ultimately contribute to oxidative stress and functional decline. At the macroscopic level, the cumulative effects of cell loss, hypertrophy, and mitochondrial remodeling likely underlie CP enlargement detectable by magnetic resonance imaging. This framework positions CP enlargement as an imaging-visible manifestation of epithelial stress and provides a structural–molecular basis for interpreting CP alterations in brain aging and neurodegenerative disorders. Full article

Background: Senior–Loken syndrome (SLS) is a rare autosomal recessive ciliopathy classically defined by the concurrence of nephronophthisis, frequently progressing to end-stage renal disease (ESRD), and retinal dystrophy, most commonly presenting as retinitis pigmentosa (RP). Given its phenotypic overlap with other renal–retinal syndromes, establishing a definitive diagnosis necessitates integrated clinical evaluation and molecular confirmation. Case Presentation: A 28-year-old Chinese female presented with a two-month history of binocular floaters. Her medical history was significant for ESRD of five years’ duration, managed with maintenance hemodialysis. Ophthalmic assessment revealed retinal pigment mottling along the inferior temporal arcades and generalized arterial attenuation. Spectral-domain optical coherence tomography demonstrated outer retinal thinning with loss of the ellipsoid zone at corresponding locations. Perimetry confirmed visual field constriction, and full-field electroretinography showed severely reduced rod- and cone-mediated responses. Genetic testing was performed and a pathogenic variant in the NPHP1 gene was identified. Segregation studies confirmed both parents as heterozygous carriers, consistent with autosomal recessive inheritance. Collectively, these findings established a diagnosis of SLS. Conclusions: This case reinforces that SLS should be considered in the differential diagnosis of any young patient exhibiting RP alongside chronic kidney disease, particularly in the setting of early-onset ESRD. It also illustrates the essential role of a coordinated, multidisciplinary approach—encompassing nephrology, ophthalmology, and genetics—in diagnosing complex ciliopathies. Genetic confirmation not only validates the clinical diagnosis but also provides a foundation for family counseling, prognostic stratification, and future eligibility for gene-specific therapeutic trials. Full article

Objectives: The objective of this study was to investigate choroidal structural alterations and evaluate the outcomes of switching to faricimab in patients with neovascular age-related macular degeneration (nAMD) previously treated with other anti-vascular endothelial growth factor (anti-VEGF) therapies after 12 months of follow-up. Methods: We performed a retrospective study of 30 eyes from 30 patients with nAMD who were switched to faricimab. The choroidal vascularity index (CVI), best-corrected visual acuity (BCVA), central macular thickness (CMT), subfoveal choroidal thickness (CST), and the presence of subretinal fluid, intraretinal fluid, and wet macula were assessed at baseline and after 6 and 12 months. Results: CVI remained stable during follow-up (p > 0.05). BCVA improved significantly after 6 months (p = 0.041), but not at 12 months (p = 0.075). A significant reduction in CMT was observed (p < 0.05). Additionally, wet macula improved after 12 months (p < 0.05). Moreover, treatment intervals increased from 7.53 ± 2.39 to 12.47 ± 4.51 weeks. Conclusions: Switching to faricimab in patients with nAMD previously treated with other anti-VEGF therapies was associated with anatomical improvement, extended treatment intervals, and short-term visual gains, while choroidal vascular structure was maintained. Nonetheless, additional studies are warranted to more comprehensively evaluate the effectiveness of switching to faricimab, as well as the associated changes in choroidal vascular structure. Full article

Background: Early identification of small choroidal melanomas is important, as metastatic risk increases with tumor size. However, distinguishing small melanomas from benign choroidal nevi is challenging and may lead to unnecessary referrals and overtreatment. Both the MOLES scoring system and the deep learning algorithm MelAInoma have been developed to support assessment of pigmented choroidal lesions in non-expert settings. This study aims to compare the association between MOLES and MelAInoma scores and to assess their relative association with expert melanoma versus nevus diagnosis. Methods: In this retrospective cohort study, 86 patients with small pigmented choroidal lesions (29 melanomas and 57 nevi) diagnosed at a national ocular oncology referral center were included. MOLES scores were assigned by ocular oncologists based on multimodal examination, whereas MelAInoma scores were generated solely from color fundus photographs. Associations between scores were assessed using linear regression and the Jonckheere–Terpstra test. Univariable and multivariable binary logistic regression was used to evaluate associations with melanoma diagnosis. Results: MelAInoma scores increased monotonically with higher MOLES categories (p = 0.0001). Linear regression showed a statistically significant association between MOLES and MelAInoma scores, but with substantial dispersion (R² = 0.16). In univariable logistic regression, both MOLES and MelAInoma scores were associated with increased odds of melanoma diagnosis. MelAInoma showed a stronger association with diagnosis than MOLES (R² = 0.38 vs. 0.27). In multivariable analysis including both scores, each remained independently associated with melanoma diagnosis. Conclusions: Both MOLES and MelAInoma are effective for differentiating small choroidal melanomas from nevi. Although the scores are statistically associated, they capture partly distinct information. MelAInoma demonstrates slightly stronger association with melanoma diagnosis and provides fully reproducible output, supporting its role as a complementary aid in lesion triage. Full article