Background: Retinal microvascular anomalies have been identified in patients with cardiovascular conditions such as arterial hypertension, diabetes mellitus, and carotid artery disease. We conducted a systematic review and meta-analysis (PROSPERO registration number CRD42024506589) to explore the potential of retinal vasculature as a biomarker for diagnosis and monitoring of patients with coronary artery disease (CAD) through optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA). Methods: We systematically examined original articles in the Pubmed, Embase, and Web of Science databases from their inception up to November 2023, comparing retinal microvascular features between patients with CAD and control groups. Studies were included if they reported sample mean with standard deviation or median with range and/or interquartile range (which were computed into mean and standard deviation). Review Manager 5.4 (The Cochrane Collaboration, 2020) software was used to calculate the pooled effect size with weighted mean difference and 95% confidence intervals (CI) by random-effects inverse variance method. Results: Eleven studies meeting the inclusion criteria were incorporated into the meta-analysis. The findings indicated a significant decrease in the retinal nerve fiber layer (WMD −3.11 [−6.06, −0.16]), subfoveal choroid (WMD −58.79 [−64.65, −52.93]), and overall retinal thickness (WMD −4.61 [−7.05, −2.17]) among patients with CAD compared to controls (p < 0.05). Furthermore, vascular macular density was notably lower in CAD patients, particularly in the superficial capillary plexus (foveal vessel density WMD −2.19 [−3.02, −1.135], p < 0.0001). Additionally, the foveal avascular zone area was statistically larger in CAD patients compared to the control group (WMD 52.73 [8.79, 96.67], p = 0.02). Heterogeneity was significant (I² > 50%) for most features except for subfoveal choroid thickness, retina thickness, and superficial foveal vessel density. Conclusion: The current meta-analysis suggests that retinal vascularization could function as a noninvasive biomarker, providing additional insights beyond standard routine examinations for assessing dysfunction in coronary arteries.

Background and Objectives: Screening, primary prevention, and the early identification of high-risk individuals are crucial for minimising the burden of cardiovascular diseases (CVDs). In this study, we aimed to evaluate the association of retinal microvascular features with myocardial dysfunction and CVD risk factors in a group of patients with significant coronary artery disease (CAD) compared to patients with newly diagnosed isolated arterial hypertension and healthy controls. Materials and Methods: We performed a single-centre cross-sectional study on 214 individuals divided into three groups: a group of 99 cases diagnosed with significant CAD, a group of 61 cases with newly diagnosed isolated arterial hypertension, and a control group of 54 cases with no confirmed cardiovascular pathology. Colour optic disc-centred retinal photographs were taken in all cases, and the following parameters were quantified using MONA REVA 3.0.0 software (VITO Health, Mol, Belgium): central retinal arteriolar equivalent, central retinal venular equivalent, arteriovenous ratio, fractal dimension, tortuosity index, and lacunarity. Univariable and multivariable statistical analyses were performed to assess changes in retinal microvascular features in CVD. Results: Dyslipidaemia (p = 0.009), systolic blood pressure (p = 0.008), and LDL cholesterol (p = 0.003) were negatively associated while left ventricular (LV) strain (0.043) was positively associated with the CRAE. In the case of the CRVE, the coronary Agatston score (p = 0.016) proved a positive and HDL cholesterol (p = 0.018) a negative association. A lower fractal dimension was associated with the presence of diabetes mellitus (p = 0.006), dyslipidaemia (p = 0.011), and a history of acute myocardial infarction (p = 0.018), while a higher fractal dimension was associated with increased left ventricular ejection fraction (LVEF) (p = 0.006) and medical treatment (p = 0.005). Lacunarity was higher in patients of female gender (p = 0.005), with decreased HDL (p = 0.014) and LVEF (0.005), and with increased age (p < 0.001) and Agatston score (p = 0.001). The vessel tortuosity index increased with LV strain (p = 0.05), medical treatment (p = 0.043), and male gender (p = 0.006). Conclusions: Retinal microvascular features may serve as additional risk stratification tools in patients with CVD, particularly CAD, pending prospective validation.

Aim: Our study aimed to evaluate serum oxidative stress-related biomarkers (three pro-oxidants: total oxidant status (TOS), indirect assessment of nitric oxide synthesis (NOx), and malondialdehyde (MDA), and three anti-oxidants: total anti-oxidant capacity (TAC), catalase (CAT), and thiols) in patients with keratoconus (KCN). Methods: We conducted a single-center, cross-sectional study with the prospective enrollment of adult patients attending an outpatient ophthalmology clinic between 1 January 2024, and 1 September 2025. The diagnosis of KCN was established based on the clinical signs and two or more aberrant Pentacam parameters. Results: We evaluated 44 subjects with KCN (median age, 26 years) and 38 without KCN (median age, 28 years), with similar age and sex distributions (p-values > 0.09). All evaluated biomarkers showed statistically significant differences between subjects with KCN and those without KCN (p-values < 0.001), with higher serum TOS, NOx, MDA, CAT, and oxidative stress index levels and lower levels of TACs and thiols in subjects with KCN than in those without KCN. Conclusions: Our findings indicate a systemic imbalance between pro-oxidant and anti-oxidant biomarkers in subjects with keratoconus.

This prospective, experimental study aims to evaluate the association between administration of α-blocker, 5α-reductase inhibitor, or anxiolytic medications and intraoperative floppy iris syndrome (IFIS) using a rabbit animal model. A total of 31 Metis rabbits were distributed into four groups as follows: 10 rabbits given tamsulosin, 10 rabbits given finasteride, 5 rabbits who received lorazepam, and 6 treatment-naive animals in the control group. Dosing was calculated according to body surface area ratio of man to rabbit, with a dosing duration of 43 days for all groups. Phacoemulsification maneuvers were performed by a single surgeon, who was blinded to group allocation. Any intraoperative billowing of the iris was noted and subsequently graded from 0 to 3. Higher incidences of iris billowing were found in the tamsulosin-dosed animals [OR = 8.33 (CI 95% 0.63–110.09)], (p = 0.13), the finasteride group [OR = 11.6 (CI 95% 0.92–147.6)], (p = 0.11), and the lorazepam group [OR = 7.5 (CI 95% 0.45–122.8)], (p = 0.24), as opposed to the control. Administration of α-blocker tamsulosin, 5α-reductase inhibitor finasteride, or anxiolytic medication lorazepam induces altered intraoperative iris behavior. These results correspond with previous studies and further solidify the hypothesis that systemic medication, administered both long and short-term, influences surgical parameters in cataract surgery. The present study can become the basis for further clinical or experimental research.

Background/Objectives: Intraocular pressure measurements are influenced by corneal biomechanical properties, but their contribution to discrepancies between different tonometric methods remains poorly understood. This study evaluated the influence of corneal hysteresis (CH) on differences between corneal-compensated IOP (IOPcc), non-contact (NCT), and rebound tonometry, while adjusting for age and central corneal thickness (CCT). Methods: This cross-sectional study included 134 eyes. IOP was measured using NCT, iCare Pro rebound tonometry, and the Ocular Response Analyzer, which provided IOPcc and CH. Central corneal thickness was measured by spectral-domain optical coherence tomography. Agreement was assessed using regression-based Bland–Altman analysis. Multivariable linear regression evaluated CH, CCT, and age as determinants of the tonometric differences. Inter-method differences were also compared across CH tertiles. Results: Mean biases were +0.15 mmHg for IOPcc–NCT, +1.68 mmHg for IOPcc–iCare, and +1.18 mmHg for NCT–iCare. After adjustment for CCT and age, each 1-mmHg decrease in CH was associated with a 1.56-mmHg increase in the IOPcc–NCT difference and a 2.23-mmHg increase in the IOPcc–iCare difference (both p<0.001). Differences involving IOPcc progressively increased across decreasing CH tertiles. In the lowest CH tertile, the mean IOPcc–NCT difference was 2.50 ± 2.05 mmHg, whereas the mean IOPcc–iCare difference reached 5.51 ± 3.11 mmHg, indicating clinically relevant discrepancies in eyes with low CH. Conclusions: Lower corneal hysteresis was associated with greater discrepancies between biomechanically compensated and the other tonometric methods. While mean differences were small in the overall cohort, they became clinically relevant in eyes with low CH. These findings suggest that considering CH in addition to CCT may support a more accurate interpretation of IOP measurements in biomechanically vulnerable eyes.

Background/Objectives: Early corneal changes after phacoemulsification reflect both surgery-related stress and individual tissue susceptibility. The contribution of preoperative corneal hysteresis (CH) to this variability remains uncertain. To test the interaction between preoperative CH and cumulative dissipated energy (CDE) in relation to early postoperative central corneal thickness (CCT), and to characterize postoperative pachymetric and biomechanical changes. Methods: This prospective study included 89 eyes of 80 patients undergoing uncomplicated phacoemulsification. CH and CCT were measured preoperatively, on postoperative day 1, and at 1 month; CDE was recorded intraoperatively. Early change in CCT (ΔCCT) was the primary outcome. Multivariable regression assessed the CH×CDE interaction adjusted for baseline CCT and age, IOPcc and IOPg. Longitudinal and biometric associations were also evaluated. Results: CCT increased by 149.0 ± 112.2 µm and CH decreased by 1.60 ± 1.98 mmHg on postoperative day one. CH significantly modified the CDE–ΔCCT association (β=1.99, 95% CI: 0.08–3.90; p=0.041): higher CH was associated with less predicted thickening at low-to-moderate CDE, with attenuation as CDE increased. CDE was strongly associated with ΔCCT but only weakly with CH reduction. At late follow-up, CCT was no longer significantly different from baseline, whereas CH remained reduced (MD=−0.68 mmHg, 95% CI:−1.30, −0.06; p=0.025). Eyes with ACD ≤2.5 mm showed a greater CCT response to CDE (β=7.70; p=0.028). Conclusions: Preoperative CH showed a moderating effect on the relationship between phacoemulsification energy and early corneal thickening, supporting a contribution of baseline biomechanics to individual corneal susceptibility.