Background: To evaluate the morbidity frequency measures in terms of the cumulative incidence of sympathetic ophthalmia (SO) triggered by single or multiple vitreoretinal (VR) surgery procedures in eyes without an antecedent history of trauma and previous ocular surgery, except for previous or concomitant uneventful lens extraction, and to further investigate the relationship between VR surgery and SO. Methods: A literature search was conducted using PubMed, Embase, and Scopus from inception until 11 November 2022. The Joanna Briggs Institute (JBI) critical appraisal checklist for the case series and the Newcastle–Ottawa Scale were used to assess the risk of bias. The research was registered with the PROSPERO database (identifier, CRD42023397792). Meta-analyses were conducted using the measurement of risk and a 95% confidence interval (CI) for each study. Results: A random-effect meta-analysis demonstrated that the pooled cumulative incidence of SO triggered by single or multiple VR surgery procedures in eyes without an antecedent history of trauma and previous ocular surgery, except for previous or concomitant uneventful lens extraction among patients who developed SO regardless of the main trigger, was equal to 0.14 with a CI between 0.08 and 0.21 (I² = 78.25, z: 7.24, p < 0.01). The pooled cumulative incidence of SO triggered by single or multiple VR surgery procedures in eyes without an antecedent history of trauma and previous ocular surgery, except for previous or concomitant uneventful lens extraction among patients who underwent VR surgery, was equal to 0.03 for every 100 people, with a confidence interval (CI) between 0.02% and 0.004% (I² = 27.77, z: 9.11, p = 0.25). Conclusions: Despite postsurgical SO being a rare entity, it is a sight-threatening disease. VR surgery should be viewed as a possible inciting event for SO and considered when counseling patients undergoing VR surgery.

The main reasons why Amniotic Membrane (AM) is transplanted in Ophthalmology are: to provide a substrate for cellular growth and to provide tectonic support or as a biological bandage and barrier that protects the wound to facilitate an environment for wound healing. The application of AM is well-documented in corneal disorders of various aetiologies [1], however, research within the field has highlighted how it can be used in conjunctival disorders and most recently, in glaucoma and vitreoretinal procedures. This review explores the preservation modalities of AM and summarises the current literature regarding AM transplantation in Glaucoma and Vitreoretinal conditions. AM transplantation in conjunction with trabeculectomy was reported to be used in two different surgical techniques. They differ in relation to the position of the implant: below the scleral flap or over the entire exposed sclera. The results of these studies suggest that AM transplant is a safe procedure that helps in the improvement of the intraocular pressure when associated with trabeculectomies. Moreover, it enhances trabeculectomies success rates when used along with mitomycin C [2]. The use of AM is also described for managing leaking blebs. It is mentioned to be a suitable alternative to conjunctival advancement. Regarding AM transplantation in glaucoma shunt or valve surgeries, the current literature is relatively limited. However, AM has been described as a good tectonic support for shunt procedures [3]. Successful results are described in the literature for surgical treatments using AM plug for vitreoretinal procedures. In particular macular hole closure and rhegmatogenous retinal detachment. In conclusion, AM transplant is a very promising and versatile adjutant therapy. However, further studies are also required for a better understanding and refinement of surgical techniques.

Aim: Angioid streaks (ASs) are a rare retinal condition and compromise visual acuity when complicated with choroidal neovascularization (CNV). They represent crack-like dehiscences at the level of the Bruch’s membrane. This objective narrative review aims to provide an overview of pathophysiology, current treatment modalities, and future perspectives on this condition. Materials and Methods: A literature search was performed using “PubMed”, “Web of Science”, “Scopus”, “ScienceDirect”, “Google Scholar”, “medRxiv”, and “bioRxiv.” Results: ASs may be idiopathic, but they are also associated with systemic conditions, such as pseudoxanthoma elasticum, hereditary hemoglobinopathies, or Paget’s disease. Currently, the main treatment is the use of anti-vascular endothelial growth factors (anti-VEGF) to treat secondary CNV, which is the major complication observed in this condition. If CNV is detected and treated promptly, patients with ASs have a good chance of maintaining functional vision. Other treatment modalities have been tried but have shown limited benefit and, therefore, have not managed to be more widely accepted. Conclusion: In summary, although there is no definitive cure yet, the use of anti-VEGF treatment for secondary CNV has provided the opportunity to maintain functional vision in individuals with AS, provided that CNV is detected and treated early.

This narrative review examines the role of systemic (oral) therapies in diabetic retinopathy, summarizing their biological rationale, clinical evidence, and practical considerations. We framed mechanistic pathways across the retinal neurovascular unit, distinguishing direct effects on the endothelium, pericytes, Müller glia, retinal pigment epithelium, neurons, and immune cells from indirect downstream actions. We appraised the following key therapeutic oral classes: (a) peroxisome proliferator–activated receptor alpha agonists (fenofibrate), which consistently demonstrate prevention-of-worsening signals; (b) protein kinase C beta inhibitors (ruboxistaurin), showing mixed efficacy but reduced vision-threatening outcomes in specific subsets; (c) redox transcription modulators (APX3330/Ref-1), exhibiting binocular prevention-of-worsening signals; (d) vascular adhesion protein-1/ amine oxidase copper-3 inhibitors, with variable phase-2 results; and (e) rho kinase inhibitors (OPL-0401), which have shown neutral primary endpoints to date. We highlighted that upstream, pleiotropic agents may require longer treatment durations and progression-focused endpoints, whereas therapies targeting permeability/leukostasis targets may yield earlier but subtle signals. We discussed trial-design considerations, including binocular outcomes, prevention-focused endpoints, and patient selection, along with integration into clinical practice—addressing safety, comorbidities, and adherence advantages of oral delivery. Finally, we outlined current gaps—such as limited phase-3 data beyond fenofibrate, endpoint heterogeneity, and the need for robust prevention trials—and proposed a concise research agenda. As a narrative synthesis, this review emphasizes clinical interpretation rather than quantitative meta-analytic estimation.

Age-related macular degeneration (AΜD) remains a leading cause of irreversible vision loss. Ιn neovascular AΜD (nAΜD), frequent intravitreal anti-VΕGF injections create substantial treatment burden, while approved therapies for geographic atrophy (GA) provide modest slowing of progression. Ocular gene therapy aims to achieve sustained intraocular expression of therapeutic proteins after a single administration. Τhis review summarises the biological rationale, vector platforms, and delivery routes relevant to AΜD, with emphasis on adeno-associated virus (AAV) systems, capsid engineering, and compartment-specific administration (intravitreal, subretinal, and suprachoroidal). We synthesise the clinical landscape for sustained anti-VΕGF expression approaches in nAΜD and complement-modulating strategies for GA, and highlight how trials increasingly prioritise injection-burden reduction, anatomical endpoints, and biomarkers of target engagement. Κey challenges include intraocular inflammation and neutralising antibodies (particularly with intravitreal dosing), variability and durability of transgene expression, surgical risks associated with subretinal delivery, and practical constraints related to manufacturing scale, cost, and long-term safety surveillance for non-removable therapies. Overall, gene therapy offers a plausible route towards durable, mechanism-targeted AΜD management, but its clinical role will depend on robust controlled trials and multi-year follow-up.

Polypoidal choroidal vasculopathy (PCV) is a subtype of neovascular age-related macular degeneration (nAMD), characterised by polypoidal lesions. Prevalence data indicate that PCV is more common in people of Asian ethnicity, although it also occurs in non-Asian individuals. However, because of a lack of globally agreed diagnostic criteria and routine screening programmes, PCV is likely to be under-diagnosed in some populations. Recent consensus suggests that PCV is a form of type 1 macular neovascularisation and should be classified as a subtype of nAMD. Anti–vascular endothelial growth factor (VEGF) monotherapy has demonstrated short-term efficacy in terms of visual acuity in PCV, and outcomes may be further improved by combining anti-VEGF therapy with photodynamic therapy. However, data on the long-term (≥ 5 years) efficacy of these treatments are limited and often conflicting. Although some people with PCV can achieve long-term remission following initial treatment (21.7–51.5%), eventual lesion reactivation is reported for approximately four-fifths of patients (81.3%). The socioeconomic impact of long-term PCV management could be reduced by identifying and characterising the subpopulations least likely to require chronic treatment. Large, global, randomised, placebo-controlled studies with long-term follow-up periods are needed in addition to real-world evidence to allow clinicians to reliably stratify people with PCV and support the stopping of anti-VEGF therapy in people at low risk of disease reactivation.