The relationship between diabetes mellitus and ocular complications has been extensively studied by many authors. Diabetic keratopathy has already been well characterized and defined as a clinical entity. This review focuses on exploring corneal epithelial changes in diabetic patients, aiming to provide a pragmatic overview of the existing knowledge on this topic. The paper systematically examines alterations in corneal epithelial structure and their impact on diabetic patients. Advanced imaging techniques are also discussed for their role in precise characterization and improved diagnostics. Additionally, the paper explores the mechanisms behind corneal epithelial changes in diabetes, looking at factors such as hyperglycemia, oxidative stress, and Advanced Glycation End-Products. The impact of altered corneal epithelial integrity on barrier function and susceptibility to external issues is considered, addressing potential links to heightened proteolytic enzyme activities and delayed wound healing observed in diabetic individuals. The review also covers the practical implications of corneal epithelial changes, including the association with corneal erosions, persistent epithelial defects, and an increased risk of dry eye syndrome in diabetic patients.

Endometriosis is characterized by alterations of the action and control mechanisms that lead to the development of ectopic endometrial tissue. This study aimed to analyze the molecular profile of ectopic endometrium by evaluating the expression of several biomarkers [estrogen receptor (ER), progesterone receptor (PR), anti-apoptotic protein Bcl-2, and Ki-67 antigen] in relation to the stage of the disease and symptoms. A prospective study over a period of one year, consisting of 14 patients with endometriosis, was performed. All patients received laparoscopic surgical treatment for excision of the lesions and staging of the disease. The expression of the aforementioned biomarkers was assessed in the ectopic endometrial tissue from the excised lesions using immunohistochemistry to determine their expression in the glandular epithelium and stroma. The mean expression of biomarkers in the epithelial and stromal levels did not differ significantly based on disease stage. Epithelial ER expression was significantly positively correlated with stromal ER, epithelial PR, and stromal PR. Stromal ER was significantly positively correlated with epithelial PR and stromal Ki-67. Epithelial Bcl-2 was significantly positively correlated with stromal Bcl-2. Epithelial Ki-67 was significantly positively correlated with stromal Ki-67. Finally, epithelial Bcl-2 expression was significantly positively correlated with the intensity of dyspareunia. The correlation between epithelial Bcl-2 expression and the intensity of dyspareunia highlights a potential molecular link to the severity of symptoms in endometriosis. These results suggest that further exploration of these biomarkers could lead to improved understanding of their clinical implications and more personalized therapies for patients with endometriosis.

Background: In vivo confocal microscopy (IVCM) is a vital tool in studying dry eye disease (DED), providing insights into morphological changes at ocular surface unit levels. This review presents the main differences in corneal structure between aqueous-deficient dry eye disease (AD-DED) and normal eyes. Methods: A comprehensive search of PubMed, Web of Science, Embase, and MEDLINE databases from January 2000 to December 2023 was conducted. The study selection process, as well as data selection and examination, were independently performed by two members of the review team. Results: The review reveals a consistent decrease in corneal surface epithelial cell density in AD-DED cases compared to a control group, but conflicting data on basal epithelial cell density. Notably, the abnormal hyperreflectivity of keratocytes in patients with Sjogren’s syndrome was recorded, and there was a significant keratocyte density in AD-DED subjects compared to evaporative DED and control groups. Studies also found a decrease in sub-basal nerve density, increased tortuosity, and the fragmentation of nerve fibers. Dendritic cell density and dendritic cell dendrites increase in AD-DED patients compared to healthy subjects. Conclusions: IVCM is a powerful tool for enhancing our understanding of the pathophysiological mechanisms underlying DED. However, the review underscores the urgent need to standardize the terminology, analysis, and units used for accurate interpretation, a crucial step in advancing our knowledge of DED.

Background and Objectives: This research investigated the morphometric dimensions of the optic foramen (OF), superior orbital fissure (SOF) and inferior orbital fissure (IOF), using indirect measurement techniques such as laser scanning, making it likely the first study of its kind. This study aimed to identify the morphometric variability of the main orbit communications and to highlight the differences between genders. Materials and Methods: The anthropometric study was conducted on sixty dry skulls (120 orbits) of adults aged between 20 and 70 years. Measurements of orbital communications were made using the RS6 laser scanner. The orbital parameters that were investigated are as follows: length and width of the SOF and IOF, and height and width of the OF. Results: In males, the average height of the OF was 8.27 mm and 8.13 mm in females, while the average width of the OF was 6.34 mm in males and 5.83 mm in females. The SOF average length was 21.09 mm in males and 17.58 mm in females. The widths of the SOF in the three thirds (anterior, middle and posterior) in males were 5.14/4.77/7.11 mm and 2.28/3.48/5.80 mm in females. The average length of the IOF was 33.05 mm in males and 32.30 mm in females. The widths of the IOF in the three thirds (anterior, middle and posterior) were 5.61/3.92/4.70 mm in males and 7.24/4.68/4.08 mm in females. Conclusions: The OF height and width were higher in males compared to females. The SOF length and width were higher in males compared to females. The IOF length was higher in males for the right orbit and higher in females for the left orbit. The IOF width for both orbits was higher in females in the anterior and middle third, and higher for males in the posterior third. Evaluation of dry skulls using laser scanning is reliable and recommended for data accuracy. Laser scanning can become a usable method for all indented and hard-to-reach regions of the cranial skeleton.

This study aimed to review and describe isolated cotton wool spots (CWS) on retinal examination in patients with systemic or occult presentation of giant cell arteritis (GCA). Material and Methods: In this scoping review, following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) Extension for Scoping Reviews, PubMed, Scopus, and Web of Science were searched for peer-reviewed articles reporting an association between GCA and CWS from 1960 to 13 ^th of June 2026. Case reports and case series of confirmed GCA with CWS as the sole fundoscopic finding were included. Data were charted independently by two reviewers using a standardized Excel extraction form. Results: Sixteen articles, including fifteen case reports and one case series, were included in the study. 76.19% of patients had concurrent systemic symptoms, while the remaining 23.81% had an occult presentation. Patients with occult GCA tended to be younger at presentation compared with those with systemic disease. No difference in inflammatory markers was observed between the occult and the systemic presentation of the disease. Conclusion: This review summarizes the current evidence and characteristics of CWS as an isolated retinal manifestation of GCA. The included evidence suggests that this atypical presentation may occur even in the absence of systemic symptoms, highlighting the importance of early clinical recognition, as delayed diagnosis may lead to irreversible visual loss.

(1) Background: Diabetic retinopathy and peripheral arterial disease co-occur through shared endothelial pathophysiology. Ankle-brachial index (ABI), the standard peripheral screening tool, demonstrates poor sensitivity (35%) in diabetic cohorts due to medial arterial calcification. We comparatively assessed the association of peak-systolic velocity of posterior/anterior tibial artery ratio (PT:AT) versus that of traditional pressure-based (ABI) with foveal avascular zone (FAZ), a marker of retinal ischemia, and thus hypothesized that PT:AT would demonstrate stronger association with FAZ compared to ABI in our cohort. (2) Methods: Cross-sectional pilot study of 30 type 2 diabetes mellitus patients. We aimed to enhance the robustness of our results using five convergent statistical methods. (3) Results: PT:AT showed strong association with FAZ (r = 0.471, p = 0.0086, 95% CI [0.13, 0.71]), with convergent evidence across all five analytical methods. ABI showed no effect (r = −0.024, p = 0.901, 95% CI [−0.38, 0.34]). We showed that velocity-based metrics identify microvascular dysfunction, whereas the pressure-based ABI does not. The mediation analysis showed that the relation of PT:AT to FAZ is not significantly mediated by the resistivity index of ophthalmic artery. (4) Conclusions: In this pilot study, velocity-based tibial hemodynamics showed a stronger cross-sectional relationship with retinal microvascular damage compared to pressure-based ABI. These preliminary findings suggest PT:AT assessment may complement ABI screening in diabetic foot clinics to identify patients requiring intensive retinal surveillance. Multicenter validation is required before clinical implementation.