Background: Dry eye is a multifactorial disease defined less than 30 years ago. It is a relatively common disorder, affected by a number of well-known risk factors. Dry eye can be challenging to diagnose because of the possible discrepancy between patients’ symptoms and clinical signs, and its overlap with other ocular surface diseases. Literature-wise, dry eye is usually associated with age and therefore investigated within older populations. Recently, studies focusing on young adult and student populations have demonstrated a higher prevalence of dry eye than previously expected. Aim: The study aims to determine the frequency of dry eye symptoms in the student population, and the impact of students’ activities and habits as potential risk factors. Methodology: Our study involved 397 students from the medical school at the University of Belgrade, Serbia. Students were asked to complete an online survey that addressed general information, health, habits, and routine in everyday use of electronic devices. In addition, students completed a standard Ocular Surface Disease Index questionnaire. Results: The prevalence of dry eye was 60.5% (240/397) in our study population. Contact lens wear (p<0.001), allergies (p = 0.049) and increased number of hours per day using VD devices for studying purposes (p = 0.014) were associtated with a higher risk of dry eye disease. Risk factors that did not significantly impact dry eye were the use of oral contraceptives, smoking, systemic diseases, year of study and sex. Conclusion: In our study, the prevalence of dry eye disease was similar or slightly higher than in previous studies among young adults. In addition, contact lenses, allergies and visual display devices were associated with the development of the dry eye.

(1) Background: This study aims to evaluate retinal perfusion by optical coherence tomography angiography (OCTA) in pediatric patients with type 1 diabetes mellitus (T1D) without diabetic retinopathy (DR). (2) Methods: Thirty-one patients affected by T1D were enrolled. All participants were evaluated using OCTA. The foveal avascular zone (FAZ) and superficial and deep macular vessel density (VD) were analyzed. The correlation of these parameters with metabolic factors such as body mass index (BMI), glycated hemoglobin (HbA1c), and the type of insulin therapy (multiple daily injections, MDI vs. continuous subcutaneous insulin infusion, CSII) was determined. (3) Results: None of the OCTA parameters were significantly different between the groups. The patients’ HbA1C level did not influence any of the OCTA parameters. The use of MDI tended to reduce the parafoveal and perifoveal deep VD (p = 0.048 and p = 0.021, respectively) compared to CSII. An elevated BMI tended to increase the deep macular (p = 0.005) and perifoveal VD (p = 0.006). (4) Conclusion: VD and FAZ are normal in pubescent children with T1D without signs of DR. Treatment with CSII may be a better choice compared to MDI, as CSII may be protective against retinal microvascular damage. Our results indicate the need for new clinical parameters of glycemic control in addition to HbA1c which could assess the risk of DR.

Introduction: Herpesviridae is a large family of double-stranded DNA viruses with eight types known to infect humans: Herpes simplex virus (HSV) type 1 and 2, Varicella zoster virus (VZV), Cytomegalovirus (CMV), Epstein Barr virus (EBV), Human herpesvirus (HHV) 6, 7 and 8. Herpetic eye disease can affect the anterior and/or posterior segment of the eye. In this article we focused on the anterior segment manifestations. Methods: A review of research articles with key words scleritis, keratitis, anterior uveitis, herpetic, HSV, VZV, CMV, and EBV published in PubMed database until April 30th, 2024 was done. Results: HSV1, VZV, and CMV are well known to cause inflammation in the anterior segment of the eye, which includes episcleritis, scleritis, keratitis, and anterior uveitis or their combination. However, there are reports of anterior segment inflammation caused by EBV, HSV2, or HHV6. The disease usually has a recurrent or chronic course and persistent inflammation can cause severe damage to the ocular tissues, which can significantly impair vision. Although some types of ocular inflammation can be effectively treated with antiviral agents during active phase of the disease (HSV1, HSV2, VZV, CMV), so far there is no final treatment which would permanently prevent the recurrences. The main complications include corneal scarring, scleral thinning, glaucoma, synechiae, iris atrophy, and cataract. Conclusion: Due to its recurrent or chronic course, the herpetic inflammation of the anterior segment of the eye remains a challenge for clinicians. While typical clinical clues may sometimes lead an ophthalmologist to suspect a herpetic cause of the inflammation, a definitive diagnosis-especially in atypical cases-can only be confirmed by PCR verification of the viral genome from ocular tissues or, in cases of uveitis, by detecting local specific antibody production in the aqueous humor using the Goldmann-Witmer coefficient.

Purpose: To evaluate the clinical efficacy and safety of eye drops containing lyophilized amniotic membrane (AM) in the treatment of dry eye disease (DED), with a focus on tear film stabilization and epithelial–immune balance. Methods: In this prospective cohort study, 40 patients (80 eyes) with DED were followed over six visits. The primary outcome was tear break-up time (TBUT). Secondary outcomes included corneal and conjunctival staining graded by the Oxford scale, meibomian gland parameters, corneal sensitivity (Cochet–Bonnet esthesiometry), best-corrected visual acuity, intraocular pressure (IOP), and Schirmer I test. Continuous variables were analyzed using repeated-measures ANOVA with Greenhouse–Geisser correction and Bonferroni post hoc testing; ordinal outcomes were analyzed using the Friedman test with Dunn–Bonferroni correction. Results: TBUT increased significantly in both eyes (OD: +5.3 s; OS: +4.9 s; both p < 0.001; ηp² ≈ 0.33). Corneal and conjunctival staining scores decreased (p < 0.001), meibomian gland quality and expressibility improved (p < 0.001), and corneal sensitivity increased (p < 0.001), while visual acuity and IOP remained stable. Schirmer I values showed no significant change. The combined pattern of changes (TBUT ↑, staining ↓, meibum/expressibility ↑, sensitivity ↑) indicates tear film stabilization and ocular surface improvement with a preserved safety profile. Conclusions: Lyophilized AM eye drops significantly prolong TBUT and improve clinical signs of DED, presumably by restoring the extracellular matrix (ECM) niche and the heavy-chain hyaluronan/pentraxin 3 (HC-HA/PTX3) complex, reducing proteolytic burden, and promoting a pro-resolving immune balance, with potential neurotrophic effects. These findings support the adjunctive use of AM-derived eye drops within contemporary TFOS DEWS II-based management algorithms for dry eye disease.

(1) Introduction: The main way of spreading the herpes simplex virus 1 (HSV-1) is through direct contact, as the virus enters the host via mucous membranes. Ocular infection can occur as a primary infection or as a recurrent one. The movement of HSV-1 along the ophthalmic branch of the fifth cranial nerve from its latency phase in the trigeminal ganglion and its activation represent a process influenced by various symbiotic factors, such as environmental conditions and the host’s genetic characteristics. The aim of this study was to assess the frequency of IL28 (rs12980275) and (rs8099917) in recurrent ocular HSV infections. (2) Materials and methods: The study included 60 patients aged over 18, of both sexes, all of whom had a history of herpes simplex labialis (HSL). Patients were tested for HSV-1-specific IgG antibodies, and seropositive individuals were genotyped for single nucleotide polymorphisms (SNPs) rs12980275 and rs8099917. A total of 57 seropositive patients were included in the study. (3) Results: A statistically significant association was found between recurrent HSV keratitis (HSK) and heterozygous GT rs8099917 and homozygous TT rs8099917, as well as heterozygous AG rs12980275 and homozygous AA rs12980275 (p < 0.01). Interestingly, patients with homozygous GG polymorphism for both genotypes GG rs8099917 and GG rs12980275 did not develop recurrent HSV keratitis. (4) Conclusion: The most frequent SNP variations in patients with recurrent HSV disease were heterozygous AG rs12980275 (61.40%) and heterozygous GT rs8099917 (52.63%). Patients with recurrent HSV keratitis lacked the homozygous GG polymorphism in both GG rs8099917 and GG rs12980275 genotypes, suggesting that HSV-seropositive individuals expressing these genotypes may have lower predisposition to develop recurrent stromal HSV keratitis.

Introduction: Dry Eye Syndrome (DES) is a multifactorial disorder of the ocular surface, characterized by complex interactions between environmental factors, immune dysregulation, and potential genetic predispositions. Vitamin D deficiency, known for its immunomodulatory properties, has increasingly been implicated in the pathogenesis of DES; however, the underlying mechanisms remain insufficiently elucidated. Of particular interest is the vitamin D receptor (VDR) gene, whose polymorphisms may influence the bioavailability and biological activity of vitamin D. Objective: The aim of this study was to investigate the association between serum 25-hydroxyvitamin D [25(OH)D₃] levels and selected polymorphisms in the VDR gene (Taq, Fok, Apa, and Bsm) in patients with DES and to analyze their potential clinical and genetic interactions. Methods: This prospective observational study included 60 patients with a confirmed diagnosis of DES. Serum 25(OH)D₃ levels were measured, and genotyping of four VDR single-nucleotide polymorphisms (SNPs) was performed using PCR followed by restriction fragment length polymorphism analysis. Genotype distributions were assessed in relation to vitamin D status using appropriate statistical tests and Hardy–Weinberg equilibrium analysis. Results: Over 85% of patients exhibited insufficient or deficient vitamin D levels. Among the analyzed SNPs, only the ApaI polymorphism (rs7975232) showed a statistically significant association with vitamin D status (p = 0.0384), with the homozygous AA genotype being more prevalent among patients with hypovitaminosis. The remaining polymorphisms (TaqI, FokI, BsmI) did not reach statistical significance; however, potential trends were observed that may warrant further investigation in larger cohorts. Conclusion: The findings suggest a potential role for VDR gene variability in the regulation of systemic vitamin D levels in patients with DES. Identification of specific genotypes may contribute to the development of personalized diagnostic and therapeutic strategies, particularly for patients with treatment-resistant forms of the disease. These results support the integration of genetic biomarkers and nutritional parameters into modern ophthalmologic practice.