This study evaluates the long-term effects of selective retina therapy (SRT) on the retinal pigment epithelium (RPE) and neuroretina in patients with central serous chorioretinopathy. SRT was performed on 36 patients using a Nd:YLF-Laser at 527 nm (R:GEN^®, Lutronic, Goyang-Si, Republic of Korea). A total of 994 titration spots were examined using up to three years’ multimodal imaging. Leakage in fluorescein angiography (FA) was observed after SRT in 523 lesions and resolved after one month. SRT lesions were not visible clinically, but appeared as brightly reflective areas in infrared and multicolor images. Normal morphology was observed in optical coherence tomography (OCT) immediately after SRT. After one month, thickening of the RPE and interdigitation zone changes were seen and disappeared after 539 ± 308 days. No RPE atrophies occurred during the observation period. Decreased fundus autofluorescence (FAF) was mostly observed directly after SRT followed by increased FAF at one month, which faded over time. A significant decrease in the number of visible lesions in the FA and FAF was observed within the three-year follow-up. OCT findings are consistent with animal studies showing SRT-related defect closure by hypertrophy and migration of neighboring cells without RPE atrophy or photoreceptor damage. This suggests that SRT is a safe treatment option for macular diseases and does not lead to retinal atrophy.

Introduction In this work, we provide a detailed characterization of a rare complication—subconjunctival cyst formation after strabismus surgery—in a large German cohort. Methods We conducted a retrospective analysis of 822 consecutive patients who underwent strabismus surgery between 2015 and 2022. The patients received comprehensive eye and orthoptic examinations preoperatively, at 1 day, and at 3 months postoperatively. Cysts were analyzed with slit-lamp examination, anterior segment optical coherence tomography (AS-OCT), and histopathological subsumption. Results Nineteen cases of postoperative cysts were observed (2.3%), 12 of which underwent surgical revision. Clinical evaluation including slit-lamp and AS-OCT as well as histological analysis resulted in a classification of three types of cysts: type 1, which is a single hyporeflective cyst, type 2, which is a multilobular hyporeflective cyst, and type 3, a dense hyperreflective granulomatous-like cyst. Eta (η) correlation ratio analysis could show a correlation between time of clinical appearance and type of cyst (Eta = 0.63). Most cysts developed within 20 days after surgery. Not only did cysts more frequently affect the medial rectus muscle, which in most cases underwent a shortening procedure (11/19 tucks, 4/19 resections) for intermittent exotropia (X(T)), but the cyst also formed earlier than in the lateral rectus muscle (Eta = 0.45). No correlation could be shown between the type of surgical procedure and time of cyst occurrence (Eta = 0.1). Patient age and cyst type correlated strongly (Eta = 0.47). The underlying type of strabismus did not correlate with the type of cyst observed. Conclusions Our cases showed a strong positive correlation to the type of strabismus (X(T)), age (young patients), and the procedure (tuck/resection). We introduce a grading system for postoperative cysts after strabismus surgery, complementing histopathology and slit-lamp aspects with AS-OCT information.

This article describes the development of decreased intraocular pressure (IOP) under general anesthesia with medetomidine, midazolam, and fentanyl in mice with normal and elevated IOP. IOP was measured using the iCare Tonolab rebound tonometer. Twelve 3–4 months-old male and female C57BL/6J mice were randomized to a control group with physiological IOP and a high IOP group with experimentally induced ocular hypertension using tarsal injections of dexamethasone-21-acetate. For anesthesia, medetomidine and midazolam were used, subgroups additionally received fentanyl. IOP was measured every 2.5 min for 30 min. Control group differed with 14.89 mmHg (SEM: 0.58) significantly (p = 0.0002) from the high IOP group with initial 20.44 mmHg (SEM: 0.75). All groups showed a significant (p < 0.05) decrease in IOP under general anesthesia. There was no significant difference in IOP development and decrease between the group additionally receiving fentanyl and the group without fentanyl. The decrease in IOP was highly dependent on the initial value, with the high IOP group showing a greater decrease. After 10 min, no significant difference in IOP could be detected between the high IOP and control group. In mice, general anesthesia with medetomidine and midazolam leads to a declining IOP over time. Adding fentanyl to the anesthesia did not alter these effects. The decline is time-dependent and IOP-dependent

Proliferative vitreoretinopathy (PVR) is a vision-threatening fibrotic retinal disorder characterized by the epithelial-mesenchymal transition (EMT) of retinal pigment epithelial (RPE) cells. In this study, we established a pathophysiologically relevant in vitro model by co-stimulating ARPE-19 cells with transforming growth factor beta 2 (TGFB2) and tumor necrosis factor-alpha (TNF), referred to as ‘TNT’, and evaluated the anti-fibrotic and anti-angiogenic effects of Nicotinamide (NAM), a vitamin B3 derivative previously reported to counteract fibrosis in various disease models. Confluent ARPE-19 cells were treated with TGFB2, TNF, or TNT for up to six days. EMT progression was assessed via immunocytochemistry, Western blotting, and collagen gel contraction assays. Live-cell imaging (LCI) combined with Hoechst 33342 nuclear staining and automated tracking using Fiji/TrackMate enabled real-time analysis of cell migration and multicellular aggregation. VEGFA secretion was quantified by ELISA. TNT stimulation induced synergistic EMT-like features, including cell elongation, directional migration, extracellular matrix (ECM) remodeling, gel contraction, and formation of multicellular aggregates. TrackMate-based analysis revealed coordinated nuclear migration under TNT conditions. VEGFA secretion was significantly elevated at early time points. NAM co-treatment reduced ECM protein expression (FN1, COL1A1), attenuated migration and contraction, and significantly lowered VEGFA release. This TNT-based ARPE-19 model represents a robust, live-cell-compatible in vitro system that mimics both fibrotic and pro-angiogenic aspects of PVR. It allows real-time assessment of EMT progression and is suitable for screening anti-fibrotic compounds. Our findings suggest that Nicotinamide mitigates both fibrotic and angiogenic responses in this model and may hold therapeutic potential for fibrotic retinal diseases.

Objectives: This retrospective study aimed to evaluate the effect of titration-guided focal selective retina therapy (SRT) for chronic central serous chorioretinopathy (cCSCR) and determine the need and effectiveness of re-treatment. Methods: SRT was performed in 60 eyes of 57 patients with cCSCR, targeting focal leakage points (FLP) using a Nd:YLF-Laser at 527 nm (R:GEN®, Lutronic, South Korea) titration-guided at 80% threshold, with 140 ms irradiation time, 100 Hz frequency, 1.7 µs pulse duration, 200 µm spot size. Best documented visual acuity (BDVA), peak height of subretinal fluid (SRF), height of SRF at the fovea, central retinal thickness (cRT) and total macular retinal volume (tRV) were measured. Results: A significant improvement in BDVA was observed up to 1 year compared to baseline ( p < 0.02). A limited analysis due to the small sample size showed no significant difference between the BDVA at baseline and 2-year ( n = 15) and 3-year ( n = 10) follow-ups. A significant decrease in the height of the SRF at the highest point and fovea and total retinal volume up to the 3-year follow-up was observed compared to the baseline ( p < 0.03). Thirty (50%) eyes of 30 patients required re-treatment, on average 9.2 ± 9.6 months after the initial SRT. This study found no predictors for the need of re-treatment. Conclusions: The study concludes that SRT is safe and shows anatomical and functional benefits for treating cCSCR. We recommend performing regular check-ups every three months and following a zero-fluid tolerance policy for re-treatment. Trial registration: German Clinical Trials Register ID: DRKS00031038, registration date: 2023-01-16