We investigated the association between the SDF-1-3′ (c801G > A) variant and the development of diabetic macular edema (DME) or proliferative diabetic retinopathy (PDR) in a Hungarian cohort. SDF-1-3′ (c801G > A) was genotyped in 103 patients with diabetic retinopathy and 31 age- and sex-matched non-diabetic controls. Central retinal and choroidal thickness was measured by swept-source optical coherence tomography. The distribution of heterozygous and homozygous SDF-1-3′ (c801G > A) genotypes was similar in diabetic and control subjects. The SDF-3′(c801AA) genotype was associated with DME (n = 94 eyes, allele distribution p = 0.006, genotype distribution p = 0.01 OR: 2.48, 95% CL: 1.21–5.08) in both univariable and multivariable modelling, independent of duration and type of diabetes, HbA1C, hypertension and microalbuminuria (p = 0.03). DME occurred earlier in patients carrying the SDF-1 (c801A) allele (Kaplan–Meier analysis, log-rank test p = 0.02). A marginally significant association was found between the presence of the SDF-1 (c801A) allele and the development of PDR (n = 89 eyes, p = 0.06). The SDF-1-3′ (c801A) allele also showed a correlation with central retinal (p = 0.006) and choroidal (p = 0.08) thickness. SDF-1-3′ (c801G > A) is involved in the development of macular complications in DM independent of critical clinical factors, suggesting that SDF-1 may be a future therapeutic target for high-risk patients, especially those carrying the SDF-1 (c801A) allele.

Purpose: To evaluate prognostic factors for visual outcome in patients with diabetes who have undergone vitrectomy (PPV) for severe proliferative diabetic vitreoretinopathy (PDVR) in at least one eye in the past 15 years. Methods: Medical records of 132 eyes of 66 patients were analyzed (median age 52 years 21–80; patients with type 1/2 diabetes 40/26; median follow-up 38 months 9–125). Correlations between final favorable visual outcome defined as 0.5≤ best-corrected visual acuity (BCVA) and prognostic factors (age, sex, type and duration of diabetes, metabolic status, BCVA, diabetic retinopathy status, data of preoperative management, data of vitrectomy, and postoperative complications) were analyzed. Results: BCVA improved significantly in the entire study cohort (from median 0.05 min–max 0.001–1 to 0.32, 0.001–1, p < 0.001). Visual stabilization was achieved in the majority of patients, and good visual acuity (0.5 ≤ BCVA) was maintained in more than one-third of the eyes. Multivariable GEE statistics showed that in addition to the duration of diabetes and stable HbA1c values, only preoperative tractional macular detachment proved to be an independent significant predictor of visual outcome. Conclusions: Pars plana vitrectomy is a useful tool when performed early before tractional macular detachment. However, long-term visual stability can only be achieved with good metabolic control.

Endophthalmitis is a serious ophthalmologic condition involving purulent inflammation of the intraocular spaces. Fungal endophthalmitis is a highly sight-threatening condition that can be complicated by difficulties in diagnosis and therapeutic delay. We report herein a rare case of bilateral endogenous Candida albicans endophthalmitis with favorable outcome. High suspicion of fungal origin is essential since the diagnosis for fungal endophthalmitis is usually based on the ophthalmological exhibition in combination with the presence of fungemia or predisposing factors. Only prompt initiation of systemic, intravitreal and surgical treatment may reduce ocular morbidity or even mortality.

The aim of this study was to analyse data from a clinical database using a novel visual acuity parameter to determine whether anti-VEGF molecules that target multiple domains involved in neovascularisation are more likely to achieve good visual acuity than agents that solely inhibit VEGF. This retrospective study analysed data from patients treated with anti-VEGF injections between 2015 and 2023. We set an ETDRS score threshold of 70 (equivalent to 20/40 Snellen acuity) to calculate ‘time in range’ (TIR). TIR is defined as ‘time spent with best-corrected visual acuity (BCVA) better than 20/40’ and can highlight significant variations in the time individuals spend above the threshold during their AMD treatment. Over nine years, 30,209 aflibercept and 10,876 ranibizumab injections were administered to 6043 patients. Patients received an average of 6.8 injections. The mean BCVA at the first injection was 57.00 ± 16.15 ETDRS letters for ranibizumab patients and 58.75 ± 15.82 for aflibercept patients, with a statistically significant difference (p < 0.001). Both groups showed significant improvement in visual acuity at follow-up (aflibercept: 60.21 ± 15.53; ranibizumab: 59.43 ± 15.81; both p < 0.001). The mean time between the two consecutive injections, including both the initial loading phase and the subsequent maintenance phase, was 67.22 ± 34.08 days for ranibizumab and 72.15 ± 31.00 days for aflibercept; the difference was statistically significant (p < 0.001). After controlling for the effect of initial BCVA and time between injections, patients who received aflibercept had a significantly higher average TIR (60.90 ± 36.27 days vs. 56.55 ± 38.78 days, p < 0.001), and significantly more likely to achieve >70 letters at the next visit (OR: 1.10; 95% CI: 1.05–1.15; p < 0.001) compared to patients receiving ranibizumab. Aflibercept treatment improves the likelihood of maintaining good BCVA by 10% compared to ranibizumab in patients receiving intravitreal anti-VEGF treatment for nAMD. Furthermore, the beneficial effects of aflibercept treatment are observed with less frequent dosing. Our results suggest that using anti-VEGF compounds that target multiple domains provides a detectable advantage in treating age-related macular degeneration, particularly when these agents have a longer duration of action.

Geographic atrophy (GA) is a progressive cause of central vision loss with limited rehabilitation options. This prospective case series aimed to evaluate the effects of biofeedback fixation training (BFT) on visual function and vision-related quality of life (QoL) in patients with GA. Eighteen patients with total central vision loss in one eye underwent BFT on the fellow eye (study eye) using the Macular Integrity Assessment (MAIA) system, which was used to select a new, previously chosen preferred retinal locus (PRL) to stabilize fixation or adopt a new fixation locus. Patients were followed for an average of 13.2 months (range 3–26 months). Functional outcomes included best corrected visual acuity (ETDRS chart), reading performance (Radner test), and contrast sensitivity (Spot Checks test). MAIA parameters comprised average retinal sensitivity, fixation distance and stability (P1, P2), and changes in the bivariate contour ellipse area (BCEA). Vision-related quality of life was assessed using the National Eye Institute Visual Functioning Questionnaire-25 (NEI-VFQ-25). Following BFT, visual acuity, reading ability and contrast sensitivity improved significantly (p value: p < 0.02), and fixation stability and NEI-VFQ-25 scores showed a positive trend. These findings indicate that BFT is a feasible and promising rehabilitation approach for patients with GA.

Geographic atrophy (GA) is a progressive cause of central vision loss with limited re-habilitation options. This prospective case series aimed to evaluate the effects of bio-feedback fixation training (BFT) on visual function and vision-related quality of life (QoL) in patients with GA. Eighteen patients with total central vision loss in one eye and partial involvement of the fellow eye (study eye) underwent BFT using the Macular Integrity Assessment (MAIA) system, which was used to select a new, previously chosen preferred retinal locus (PRL) on the study eye to stabilize fixation or adopt a new fixation locus. Patients were followed for an average of 13.2 months (range 3-26 months). Functional outcomes included best corrected visual acuity (BCVA, ETDRS), reading performance (Radner test), and contrast sensitivity (CS Spot Checks test). MAIA parameters comprised average retinal sensitivity, fixation distance and stability (P1, P2), and changes in the bivariate contour ellipse area (BCEA). Vision-related quality of life was assessed using the National Eye Institute Visual Functioning Questionnaire-25 (NEI-VFQ-25). Following BFT, BCVA, reading ability and contrast sensitivity improved significantly (p< 0.02), and fixation stability and NEI-VFQ-25 scores showed a positive trend. These findings indicate that BFT is a feasible and promising rehabilitation approach for patients with GA.