To prove the role of high-tech investigation in monitoring corneal morphological changes in patients with neurotrophic keratopathy (NK) using Keratograph 5M (K5M) and anterior segment OCT (AS-OCT), corneal healing was monitored with Keratograph 5M (Oculus, Wetzlar, Germany) and AS-OCT (DRI, Triton, Topcon, Tokyo, Japan) in 13 patients (8F and 5M), aged from 24 to 93 years (67.8 ± 19) with severe NK, who were treated with Cenegermin 0.002% (20 μg/mL) (Oxervate^®, Dompè, Farmaceutici Spa, Milan, Italy). The surface defects were evaluated on Keratograph 5M with ImageJ software and the corneal thickness variations were measured using DRI-Triton OCT software. Instrumental procedures were performed at baseline, and after 4 and 8 weeks of the treatment, respectively. The main outcome measures were reduction of the ulcers’ area and corneal thickness recovery. The mean area of the corneal ulcers was reduced between baseline and 4 weeks examination in all patients, and at 8 weeks all ulcers were completely healed. An increase of the corneal thickness was evidenced between the baseline visit and after the 4- and 8-week follow-up, respectively. Additionally, only in collaborating subjects the In Vivo Confocal Microscopy (IVCM) was performed with HRT Rostock Cornea Module (Heidelberg Eng GmbH) to study the corneal nerves fibres. High-tech diagnostics with K5M, AS-OCT and IVCM proved useful in the assessment of corneal morphology and the healing process in patients with NK and could be extended to assess other corneal pathologies.

Introduction: The aim of this study was to evaluate the efficacy of sutureless amniotic membrane transplantation (SAMT) in patients with corneal perforation secondary to ocular surface inflammatory diseases. Methods: Twelve eyes of eleven patients with corneal perforation associated with Sjögren’s syndrome and ocular cicatricial pemphigoid were included. Surgical procedure consisted in the application of two layers of amniotic membrane covering the corneal perforation and a therapeutic contact lens placed above the two layers, followed by sutureless tarsorrhaphy with Steri-strip applied for 15 days to immobilize the eyelids. All patients underwent slit-lamp examination, fluorescein corneal staining, and anterior segment optical coherence tomography (AS-OCT), preoperatively and post-surgery, weekly for one month, and then every two weeks for three months. Results: All 12 eyes had complete resolution of corneal perforation. Pachymetry measurements improved in all eyes, and complete healing of the corneal ulcer was obtained following treatment and maintained up to 3 months follow-up in all patients. Conclusions: SAMT was proven to be a safe and effective option for the management of inflammatory corneal perforation. The procedure is non-traumatic and easy to perform since the surgical technique is sutureless and does not require topical therapy because it takes advantage of the intrinsic properties of the membrane itself.

Background: Evidence guiding secondary repair of persistent full-thickness macular holes (FTMHs) remains limited and heterogeneous. Temporal arcuate relaxing retinotomy has been described as a salvage maneuver intended to increase temporal retinal compliance, yet functional safety data are scarce. We report consecutive real-world outcomes of temporal arcuate relaxing retinotomy for persistent FTMHs after failed standard repair(s). Methods: Retrospective consecutive case series of patients with persistent FTMH after ≥1 pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling, treated with repeat PPV and temporal arcuate relaxing retinotomy. Outcomes included OCT (Optical Coherence Tomography)-confirmed closure after gas absorption and best-corrected visual acuity (BCVA, logMAR), ellipsoid zone (EZ) status, retinotomy-site morphology on OCT/fundus autofluorescence (FAF), and safety/functional outcomes (systematic scotoma symptom inquiry; Humphrey visual field testing when feasible). Exact binomial 95% confidence intervals (CI) were calculated for proportions. Results: Nine eyes (median age 70 years; range 55–76) underwent temporal arcuate relaxing retinotomy for persistent FTMH. Minimum linear diameter ranged 412–1037 µm (median 613 µm). OCT-confirmed closure was achieved in 7/9 eyes (77.8%; 95% CI 40.0–97.2) at a mean follow-up of 5.9 months (range 2–12). BCVA improved in 8/9 eyes (88.9%; 95% CI 51.8–99.7); mean BCVA improved from 1.26 ± 0.51 logMAR pre-operatively to 0.61 ± 0.18 logMAR at last follow-up (mean change −0.64 logMAR; Wilcoxon signed-rank test p = 0.011). As a sensitivity analysis, the paired t-test yielded p = 0.008. Humphrey visual fields were obtained in 6/9 eyes; one patient reported a new paracentral nasal scotoma, which was subjectively well tolerated. Conclusions: In this small consecutive series, temporal arcuate relaxing retinotomy was associated with a 78% closure rate and mean BCVA improvement in eyes with persistent FTMH after failed standard repair(s), with limited symptomatic scotoma reporting in those assessed. Given the retrospective design, small cohort, and incomplete standardized functional testing, larger comparative studies with uniform functional endpoints (microperimetry, RNFL/GCL metrics, and systematic perimetry) are needed to define patient selection, reproducibility, and relative performance versus contemporary salvage options.

Objectives: We propose a flow-signal-based classification of retinal artery macroaneurysms (RAMs) using Optical Coherence Tomography Angiography (OCTA) and compare the findings with fundus fluorescein angiography (FFA). Methods: A retrospective review of 49 RAM cases observed over 6 years (October 2017–March 2023) at a medical retina clinic at the University Hospital Southampton, UK. Electronic clinical records, FFA, and OCTA images (en face and B-scan) were reviewed to identify pathology and assess RAM flow profiles. Results: In total, 30 eyes from 30 patients were included. The mean age of the patients was 76 years (range 49–91), with 17 females and 13 males. All eyes underwent OCTA, enabling classification of RAMs into three flow signal types: high (9 eyes), low (10 eyes), and absent (9 eyes), while 2 eyes had haemorrhage-related artefacts. A subgroup of 13 eyes also underwent FFA, allowing direct comparison, which showed flow profiles similar to those of OCTA: high (4 eyes), low (6 eyes), and absent (2 eyes), with 1 ungradable case due to subretinal haemorrhage masking. A discrepancy in flow was observed in one case where FFA indicated flow, but OCTA did not. Despite this, FFA and OCTA generally agreed on the flow levels, with a Spearman correlation of r = 0.79 (p = 0.004). Conclusions: OCTA flow profiles were directly comparable to FFA. OCTA effectively identified different levels of blood flow signal behaviour in RAMs. The proposed flow-based RAM classification may aid in prognosis, treatment indications, follow-up, and safe repeat imaging in clinical practice without systemic risk to the patient.

Purpose: To evaluate the impact of pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment on corneal innervation and ocular surface integrity, and to assess the influence of intraoperative tamponade type (silicone oil vs. gas) on corneal sensitivity, tear film stability, epithelial damage, and subbasal nerve morphology. Methods: In this prospective multicenter study, 50 eyes of 50 patients undergoing primary PPV with 360-degree endolaser photocoagulation were enrolled. The patients were stratified based on tamponade type: silicone oil (n = 30) or C ₃ F ₈ gas (n = 20). Assessments performed at baseline and 1 month postoperatively included Cochet–Bonnet corneal sensitivity, tear break-up time, fluorescein staining, and in vivo confocal microscopy for subbasal nerve analysis (corneal nerve fibers density, corneal nerve fibers length, corneal nerve branch density). Corneal epithelial complications (persistent epithelial defects and neurotrophic ulcers) were also recorded. Results: Postoperatively, significant reductions were observed in corneal sensitivity (from 4.2 ± 1.1 cm to 2.5 ± 1.3 cm, P = 0.0006), tear break-up time (from 7.4 ± 2.1 to 3.6 ± 2.5 seconds, P = 0.0003), and subbasal nerve parameters (corneal nerve fibers density, corneal nerve fibers length, corneal nerve branch density, all P < 0.001). Corneal complications were reported in 8 patients (16%), 6 of whom were in the silicone oil group. Silicone oil was associated with significantly worse outcomes in all parameters compared with gas tamponade ( P < 0.001). Conclusions: PPV for rhegmatogenous retinal detachment significantly impairs corneal innervation and ocular surface integrity, with silicone oil tamponade associated with more severe reductions in corneal sensitivity, tear film stability, and subbasal nerve morphology. These findings highlight the importance of tamponade choice and warrant strategies to minimize postoperative ocular surface damage.