Ocular neurodegeneration comprises a group of complex processes that severely affect visual function and is recognized as a key pathogenetic process in a variety of blinding ocular diseases, including glaucoma, diabetic retinopathy, age-related macular degeneration and retinitis pigmentosa. Although these diseases have different etiologies and mechanisms, apoptosis, metabolic disorders and oxidative damage are common features shared by all of them. Increasing evidence indicates that gut microbiota regulates distant organs by engaging in the host's neural, endocrine, immune regulation and even intercellular information. However，in ocular degenerative diseases, specific gut microbiota and their metabolites play an important role in ocular degenerative diseases. Therefore, in this review, we summarize the pathways through which the "gut-eye axis" functions and the mechanisms by which it interacts with ocular degenerative diseases, as well as the alterations in gut microbiota profiles observed in several common ocular degenerative diseases. Additionally, we provide an outlook on the clinical application of the "gut-eye axis", including its potential diagnostic, therapeutic, and adjunctive therapies.

Ocular neovascularization can impair vision and threaten patients’ quality of life. However, the underlying mechanism is far from transparent. In all mammals, macrophages are a population of cells playing pivotal roles in the innate immune system and the first line of defense against pathogens. Therefore, it has been speculated that the disfunction of macrophage homeostasis is involved in the development of ocular vascular diseases. Moreover, various studies have found that non-coding RNAs (ncRNAs) regulate macrophage homeostasis. This study reviewed past studies of the regulatory roles of ncRNAs in macrophage homeostasis in ocular vascular diseases.

Background: Autosomal recessive bestrophinopathy (ARB) arises from compound heterozygous BEST1 mutations. Beyond retinal pathology, it may be associated with short axial length, shallow anterior chamber, and refractory angle-closure glaucoma (ACG). Filtration surgery carries a high recurrence rate and may yield suboptimal outcomes in selected BEST1 -associated eyes, with the optimal surgical strategy remaining undefined. Case presentation: A 29-year-old female presented with refractory angle-closure glaucoma. Clinical examination revealed bilateral elevated intraocular pressure (IOP) and shallow anterior chambers. Retinal imaging demonstrated macular clefting and subretinal fluid. Ocular history was notable for repeated trabeculectomies, which provided transient IOP control. Genetic testing identified compound heterozygous BEST1 variants (c.922A > G and c.1740-1G > A). Familial segregation analysis demonstrated that the two BEST1 variants were inherited from different parents and were present in trans, supporting the molecular diagnosis of ARB. Given the patient's short axial length and history of failed filtration surgeries, ultrasound cycloplasty (UCP) was performed on the left eye. Postoperatively, IOP in the left eye remained stable. At the 7-month follow-up, OCT showed a concurrent reduction in macular schisis-like changes and subretinal fluid in the UCP-treated eye, whereas these retinal abnormalities progressed in the medically managed fellow eye. Conclusion: This case represents a rare report of ARB presenting with refractory ACG in a patient harboring compound heterozygous BEST1 variants, including c.922A > G, classified as likely pathogenic, and c.1740-1G > A, classified as a variant of uncertain significance. Young patients with ACG accompanied by short axial length, a shallow anterior chamber, and unexplained retinal abnormalities may benefit from early evaluation for ARB, including genetic testing. UCP may offer a potential alternative to conventional filtration surgery for IOP control in selected patients with ARB and refractory ACG. However, the theory requires confirmation in larger studies with longer follow-up.

Ocular diseases, including corneal disease, glaucoma, age-related macular degeneration (AMD), diabetic retinopathy, and retinopathy of prematurity, can significantly impair vision and reduce the quality of life. Due to the fact that degenerated cells in these diseases are unable to regenerate, treatments for them have limited efficacy. Stem cell therapies are revolutionizing the treatment of degenerative eye conditions, enabling tissue and functional recovery through mechanisms such as cell replacement and paracrine signaling. This review examines the advancements in stem cell therapy for ocular diseases, from preclinical studies to early clinical trials, focusing on various types of stem cells, including embryonic stem cells, induced pluripotent stem cells (iPSCs), and mesenchymal stem cells. Significant progress has been made with iPSC-derived retinal pigment epithelium cell transplantation in AMD treatment, showing cell survival in trials as well as with mesenchymal stem cells for corneal repair through anti-inflammatory effects. Challenges remain, such as controlling differentiation to prevent tumorigenesis, managing immune rejection, and ensuring production that complies with Good Manufacturing Practice (GMP) standards. By integrating mechanistic insights with translational strategies, this review outlines pathways to optimize stem cell therapies for previously intractable ocular diseases.

Nanophthalmos is a rare developmental ocular disorder of congenital origin, manifesting as a notably reduced globe volume, shortened axial length, shallow anterior chamber, thickened sclera, and significant hyperopia. These anatomical features predispose affected individuals to angle-closure glaucoma as a result of anterior segment crowding. Traditional treatments for nanophthalmos-related angle-closure glaucoma often involve complex combined surgeries, which are not only technically demanding but also easily cause postoperative complications, such as malignant glaucoma and choroidal leakage. This case series presents three middle-aged and elderly female patients (a total of four eyes) with nanophthalmos-related angle-closure glaucoma. Common clinical findings included an axial length ≤ 20.5 mm, high intraocular pressure (IOP > 21 mmHg; 1 mmHg = 0.133 kPa), shallow anterior chamber, and diminished visual acuity. Based on the pathogenesis of postoperative malignant glaucoma, we implemented a modified surgical technique termed pars plana filtration (PPF). This procedure involves partial excision of the ciliary body to establish an alternative aqueous drainage route, thereby reducing anterior vitreous and posterior segment pressure. Compared to traditional combined surgeries, the PPF approach offers technical simplicity, minimized tissue invasiveness, and a shorter learning curve for ophthalmic surgeons. Our study describes successful implementation of this surgery without postoperative complications observed. These findings suggest that PPF may represent a safe and effective surgical alternative for managing nanophthalmos-related angle-closure glaucoma. Nevertheless, further larger-scale studies are needed to validate its long-term effectiveness and generalizability.

Purpose: This study aimed to assess the long-term motor, sensory, and safety outcomes following botulinum toxin type A (Botox®) injection for cyclic esotropia in children. Methods: We retrospectively enrolled children with cyclic esotropia receiving botulinum toxin type A injections between May 2023 and February 2025 who had a minimum 12-month postoperative follow-up. All subjects received complete ophthalmologic assessments comprising best-corrected visual acuity (BCVA), spherical equivalent (SE), and fundus photography, alongside dedicated strabismus evaluations for deviation angle, ocular motility, and binocular function. Ocular deviation and binocular function (distance and near stereopsis) were measured at baseline and scheduled follow-up visits at 1 week, 1, 2, 3, 4, 6 and 12 months postinjection. All adverse events emerging throughout follow-up were prospectively recorded. Treatment success was defined as no recurrence of cyclic esotropia with residual manifest deviation ≤ 5 prism diopters (PD). Results: Seven pediatric patients (2 males, 5 females; aged 3–5 years) were enrolled in this cohort. At 3 months postinjection, six subjects achieved orthotropia within ± 5 PD, while one developed transient recurrent deviation. Notably, none demonstrated persistent cyclic esotropia. Adverse events were identified in all patients at the 1-week follow-up: upper eyelid ptosis in 6 of 7 patients (85.7%), consecutive exotropia in 6 of 7 (85.7%), and vertical strabismus in 2 of 7 (28.6%). Two new-onset vertical strabismus cases were detected at the 1-month visit, raising the overall prevalence to four patients. Partial recovery was observed in 4/6 (66.7%) ptosis cases, 4/6 (66.7%) consecutive exotropia cases, and none of the four vertical strabismus cases; meanwhile, binocular function improved in 2/7 (28.6%) children. By the 3-month follow-up, complete resolution was seen in all ptosis (6/6, 100%) and consecutive exotropia (6/6, 100%) cases, alongside improvement in 3/4 (75%) vertical strabismus and 6/7 (85.7%) binocular function. At the 12-month endpoint, all seven patients, including the single case with transient early recurrence at 3 months, maintained ocular alignment within ± 5 PD with no recurrent cyclic deviation, and binocular function recovered to near-normal levels across the entire cohort. Conclusion: Botulinum toxin type A injection effectively interrupts the cyclic deviation pattern and yields durable ocular alignment in this small cohort of children with cyclic esotropia. The majority of injection-related adverse events resolved by 3 months, with complete resolution of all complications by 4 months. Accordingly, botulinum toxin type A injection represents a viable nonsurgical alternative for the management of pediatric cyclic esotropia.