Introduction: Age-related macular degeneration (AMD) is a leading cause of vision impairment. A Mediterranean diet (MD) has been suggested to provide protective effects against AMD development and progression due to its antioxidant and anti-inflammatory properties. However, inconsistencies in findings across observational studies have been reported. This systematic review and meta-analysis aim to synthesize the existing evidence on the relationship between adherence to the MD and AMD development or progression. Methods: A systematic search was conducted using MEDLINE (via PubMed), Web of Science, and SCOPUS, following PRISMA guidelines. Observational studies assessing MD adherence in relation to AMD risk or progression were included. Meta-analyses were performed separately for each study design using odds ratios (ORs) for cross-sectional and case–control studies and hazard ratios (HRs) for prospective cohort studies. Heterogeneity was assessed using the I² statistic, and publication bias was evaluated via funnel plots. Results: Eight studies were included: two cross-sectional, three case–control, and three prospective cohort studies. The meta-analysis of cross-sectional studies (pooled OR = 0.96; 95% CI: 0.83–1.11; p = 0.6243; I² = 0%) found no significant association between MD adherence and AMD. However, the weight distribution was highly imbalanced, limiting interpretability. Meta-analyses of case–control and prospective cohort studies demonstrated a significant protective effect of MD adherence: case–control studies showed a 34% reduction in the odds of AMD progression (OR = 0.66; 95% CI: 0.54–0.81; p < 0.0001; I² = 41.5%), while prospective cohort studies indicated a 23% reduced risk of AMD progression (HR = 0.77; 95% CI: 0.67–0.88; p < 0.0001; I² = 0%). Conclusions: This systematic review and meta-analysis suggest an inverse association between adherence to the MD and AMD progression, particularly in case–control and prospective cohort studies. Despite the small number of included studies, these findings highlight the potential role of diet in AMD management. Future research should focus on larger, well-controlled prospective studies with standardized dietary assessments. Key Points: 1. Higher adherence to the MD is associated with a reduced risk of AMD progression, with meta-analyses of case–control and prospective cohort studies showing 34% lower odds (OR = 0.66) and 23% reduced risk (HR = 0.77) of disease progression, respectively. 2. No significant association was found in cross-sectional studies (OR = 0.96; 95% CI: 0.83–1.11), likely due to methodological limitations and the challenge of establishing a temporal relationship between diet and AMD progression. 3. Despite the limited number of studies, findings suggest a potential role of diet in AMD management. Future research should prioritize larger, well-controlled prospective studies with standardized dietary assessments.

Background/Objectives: The aim of this study was to review the therapeutic and prognostic factors influencing Acanthamoeba Keratitis (AK) management. Methods: A systematic search was performed across MEDLINE^® (via PubMed), Web of Science^®, and Scopus^®, following the PRISMA 2020 guidelines, and registered in PROSPERO (CRD420251010774). Studies reporting AK treatment regiments and prognostic factors were included. After extracting the data from the included articles, the relevant aspects of the treatment and the prognostic factors were compared and summarized. Results: Sixty-one articles were included: nine were prospective, including 3 randomized controlled trials (RCTs), and fifty-two were retrospective. The findings suggest that therapeutic epithelial debridement (TED), followed by an association with biguanides, diamidines, and an antibacterial agent, is a strong initial treatment option. An adjunctive medical treatment with topical voriconazole 1% or oral miltefosine may also be considered. Surgical approaches were also assessed when the pharmaceutical therapy failed, with Deep Anterior Lamellar Keratoplasty (DALK) playing an important role in the cases without a deep stroma involvement. Early Therapeutic Penetrating Keratoplasty (TPK) should be used as a salvage therapy and Optical Penetrating Keratoplasty (OPK) should be used for rehabilitation purposes. Key prognostic factors include older age, delayed diagnosis, corticosteroid use before prompt diagnosis, poor initial best corrected visual acuity (BCVA), and AK stage at presentation. Conclusions: The initial treatment with TED, biguanides, and diamidines remains the foundation of treatment. Surgical options can be considered in advanced cases. An early diagnosis, age, and initial BCVA are prognosis factors that should be considered. Future research may focus on improvement of protocols and searching for novel agents.

This study aims to characterize the clinical spectrum and genetic landscape of IRDs in Portugal. Multicentre, cross-sectional, cohort study comprising consecutive patients with a clinical diagnosis of IRD and available genetic results, enroled in the IRD-PT registry (retina.com.pt). Among the 1369 patients enroled from 1125 families, the most frequently observed phenotype was non-syndromic retinitis pigmentosa (40.8%). A genetically confirmed diagnosis was achieved in 72.3% of families. Consanguinity was observed in one-fifth of cases, contributing to a higher frequency of homozygous variants within this cohort. Disease-causing genotypes were distributed across 136 different genes, with ABCA4 (13.0%), EYS (10.0%) and USH2A (6.9%) being the most frequently mutated genes. Overall, these results from a nationwide cohort significantly advance our understanding of the clinical and genetic spectrum of IRDs in Portugal, laying the groundwork for future studies to identify patients eligible for targeted therapies and to describe the natural history of these diseases.

To assess intraocular pressure (IOP) changes and the development of ocular hypertension (OH) following pars plana vitrectomy (PPV), evaluating short- and long-term outcomes and risk factors. This is a retrospective study of 216 patients (432 eyes) who underwent primary unilateral PPV between April 2018 and July 2020, with ≥ 12 months of follow-up. IOP in vitrectomized and fellow eyes was analyzed preoperatively, at 3 months, and at final visit. OH was defined as the need for IOP-lowering medication; IOP was also analyzed as a continuous variable. Baseline and intraoperative factors were evaluated using cohort and matched case–control designs. Median follow-up was 28 months. Early and late OH occurred in 28.2% and 15.3% of vitrectomized eyes. Retinal detachment (RD) increased the risk of early OH fourfold (OR 4.16; p < 0.001). Higher preoperative IOP in the fellow eye predicted both early (OR 1.17; p = 0.003) and late OH (OR 1.18; p = 0.007). Postoperatively, vitrectomized eyes had higher IOP at all timepoints. Glaucoma developed in 6.5% of vitrectomized vs. 1.4% of fellow eyes (p = 0.008). PPV is associated with sustained IOP elevation and increased OH risk. RD and fellow eye IOP are relevant predictors. Long-term monitoring is essential to prevent glaucoma, especially in high-risk patients.