Background: Retinitis pigmentosa (RP) is a group of hereditary retinal dystrophies characterized by progressive degeneration of photoreceptor cells, which results in debilitating visual impairment. This systematic review aims to evaluate the efficacy and safety of emerging treatment modalities for RP, including gene therapy, mesenchymal-cell-based approaches, and supplementary interventions. Methods: A comprehensive search of electronic databases was conducted to identify relevant studies published up to February 2024. Studies reporting outcomes of treatment interventions for RP, including randomized controlled trials, non-randomized studies, and case series, were included. Data extraction and synthesis were performed according to predefined criteria, focusing on assessing the quality of evidence and summarizing key findings. Results: The search yielded 13 studies meeting inclusion criteria, encompassing diverse treatment modalities and study designs. Gene therapy emerged as a promising therapeutic approach, with several studies reporting favorable outcomes regarding visual function preservation and disease stabilization. Mesenchymal-cell-based therapies also demonstrated potential benefits, although evidence remains limited and heterogeneous. Supplementary interventions, including nutritional supplements and neuroprotective agents, exhibited variable efficacy, with conflicting findings across studies. Conclusions: Despite the lack of definitive curative treatments, emerging therapeutic modalities promise to slow disease progression and preserve visual function in individuals with RP. However, substantial gaps in evidence and heterogeneity in study methodologies underscore the need for further research to elucidate optimal treatment strategies, refine patient selection criteria, and enhance long-term outcomes. This systematic review provides a comprehensive synthesis of current evidence and highlights directions for future research to advance the care and management of individuals with RP.

Background: Incomplete eyelid closure and lagophthalmos due to facial nerve palsy are significant functional and aesthetic concerns often requiring surgical correction. The aim of this systematic review is to quantitatively assess the efficacy, safety, and patient satisfaction associated with gold or platinum weight implantation, autologous fat grafting (lipofilling), and müllerectomy. Methods: A systematic review was performed following PRISMA guidelines, searching PubMed, Embase, Cochrane Library, Web of Science, and Scopus up to March 2025. Studies included clinical data on surgical correction for incomplete eyelid closure in facial palsy, reporting functional, anatomical, and satisfaction outcomes. Quality was assessed using the Newcastle–Ottawa Scale (NOS) and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. Results: Twenty-six studies including a total of 1205 patients were included. Gold/platinum weight implantation achieved complete or near-complete eyelid closure in 83–92% of cases, with a reduction in lagophthalmos to <1 mm. Complication rates ranged from 5–15% (mainly extrusion/migration), and patient satisfaction averaged 7.9/10. Lipofilling showed persistent benefit in 77% of cases, with 9–20% requiring repeat procedures and 10–12% experiencing minor complications. Müllerectomy yielded symptomatic improvement or resolution in 92% of cases, with a mean lagophthalmos reduction of 1.18 mm. Conclusions: Gold or platinum weight implantation provides the most reliable improvement for severe upper eyelid dysfunction in facial palsy. Lipofilling is a viable autologous alternative, while müllerectomy is effective in selected cases. Further prospective comparative trials are needed to refine surgical selection and optimize outcomes.

Background/Objectives: Accurate intraocular lens (IOL) power calculation is vital for achieving the desired postoperative spherical equivalent (SE) in cataract surgery. Generative Artificial-Intelligence (AI) systems are increasingly being used in ophthalmology to refine diagnostic and surgical planning. However, it is still unknown whether a low-cost, easily accessible generative AI model like DeepSeek can match the accuracy of conventional biometric formulas. To evaluate the accuracy of DeepSeek, an open-source generative artificial intelligence (AI), in predicting postoperative refractive spherical equivalent compared to the Barrett Universal II formula in uncomplicated cataract surgeries. Methods: This study analyzed biometric data from 50 eyes of 50 patients who underwent cataract surgery between July 2024 and January 2025 at Humanitas Research Hospital in Milan, Italy. Only uncomplicated cases of emmetropia with Alcon AcrySof^® SA60WF IOL implantation were included. 30–40 days postoperative subjective refraction was measured with a calibrated trial-frame and 6 m logMAR chart by an experienced optometrist. Prediction error (PE), median absolute error (MedAE), standard deviation (SD), and cumulative frequency of PE diopters range were calculated. A Wilcoxon signed-rank test was performed to assess statistical significance. Results: Barrett showed MedAE 0.36 D [0.16–0.64] and MAE 0.43 D (95% CI, 0.34–0.52) while DeepSeek-R1 showed MedAE 0.76 D [0.52–1.01] and MAE 0.77 D (95% CI, 0.67–0.87). Cumulative accuracy (AE threshold) at ±0.25/±0.50/±0.75/±1.00/±1.25/±1.50/±1.75 D was 37.7/71.7/81.1/92.5/100.0/100.0/100.0% for Barrett Universal II and 11.1/25.9/50.0/74.1/88.9/96.3/100.0% for DeepSeek-R1 (McNemar p < 0.01 at each threshold). The paired comparison of per-eye absolute errors favored Barrett (Wilcoxon signed-rank test, p < 0.0001). Conclusions: In this cohort, Barrett Universal II outperformed DeepSeek-R1 across MedAE/MAE and cumulative accuracy thresholds, with a significant paired difference. A general-purpose generative model used off-the-shelf (fixed A-constant, no ophthalmology-specific tuning) did not match the accuracy of a validated vergence-based formula; established formulas remain the reference standard for clinical IOL power calculation.

Purpose: To describe the clinical and optical coherence tomography (OCT) changes of prechoroidal cleft in treatment-naïve and non-naïve neovascular age-related macular degeneration (nAMD) treated with Faricimab intravitreal injections. Methods: A case series (4 eyes from 4 patients). Results: Cases 1 and 2 were diagnosed with treatment-naïve nAMD. Case 1 showed minimal prechoroidal cleft persistence after treatment with visual acuity stabilization. Case 2 showed prechoroidal cleft resolution, followed by its recurrence with neovascular reactivation. Cases 3 and 4 had a history of nAMD unresponsive to Aflibercept therapy. In Case 3, prechoroidal cleft reappearance occurred simultaneously to neovascular reactivation. In Case 4 prechoroidal cleft resolved rapidly after switching to Faricimab, but this was complicated by the development of a retinal pigment epithelium (RPE) tear. Conclusion: In this report, we highlight the importance of prechoroidal cleft as a negative prognostic OCT biomarker despite the increasingly proved efficacy of Faricimab. Pigment epithelium detachment height may correlate with the size of prechoroidal cleft and macular neovascularization (MNV) activity. Further studies are needed to better elucidate the prognostic significance of prechoroidal cleft after Faricimab therapy.

Purpose: This review consolidates current evidence on how chronic kidney disease (CKD)-especially end-stage kidney disease (ESKD) and its treatments-alters choroidal and retinal vascular permeability, leading to changes in intraocular fluid homeostasis. Methods: A literature search of Medical Literature Analysis and Retrieval System Online (MEDLINE), reference lists, and key ophthalmology-nephrology texts was performed for studies published between 1980 and 2025. One-hundred-forty-four articles (clinical trials, observational cohorts, and case reports) met the inclusion criteria. Data were abstracted on choroidal thickness changes, blood-retinal barrier integrity, incidence of Central Serous Chororioretinopathy (CSCR) and Serous Retinal Detachment (SRD) in dialysis and transplant populations, and systemic variables such as oncotic pressure, hypertension, and corticosteroid exposure, with special attention to retinal pigment epithelium (RPE) pump function. Findings were synthesized qualitatively and tabulated where appropriate. Results: ESKD induces a triad of lowered plasma oncotic pressure, fluctuating hydrostatic forces, and impaired RPE pump function that collectively drive subretinal fluid accumulation. Hemodialysis acutely reduces sub-foveal choroidal thickness by a mean of ≈15–25 µm yet shows inconsistent effects on retinal thickness. Large population data demonstrate a three- to four-fold higher SRD risk and ~1.5-fold higher CSCR risk in dialysis patients versus controls, with peritoneal dialysis conferring the greatest hazard. After kidney transplantation, CSCR prevalence approaches 6%, driven by combined stresses of surgery, hypertension, and long-term corticosteroid or calcineurin-inhibitor therapy. Most reported SRDs resolve as systemic parameters normalize, underscoring the importance of promptly identifying systemic drivers. Conclusions: Systemic fluid-pressure imbalances and treatment-related factors in CKD significantly perturb the outer blood-retinal barrier. Regular ophthalmic surveillance, early visual-symptom screening (e.g., Amsler grid), and close nephrologist-ophthalmologist collaboration are essential for timely detection and management. Future research should quantify the relative contribution of hypoalbuminemia, hypertension, and immunosuppression to ocular permeability changes, and evaluate preventive strategies tailored to high-risk CKD subgroups.

Purpose: To identify and harmonize preoperative inclusion and exclusion criteria for corneal neurotization (CN) in neurotrophic keratopathy (NK), describe how consistently they are reported, and summarize practical, clinic-ready guidance for selection and follow-up. Methods: Systematic review (PRISMA-2020; PROSPERO CRD420251117787) of human studies on CN for NK (databases searched July 18, 2025). Study-level eligibility criteria, disease stage, esthesiometry, chronicity thresholds, donor-nerve requirements, and stated exclusions were evaluated; risk of bias (ROBINS-I) and certainty (GRADE) were recorded. Results: Thirty-six studies (380 patients) were included; of these, 26 (72.2%) explicitly reported eligibility criteria. Most common inclusion criteria were refractory NK (92.3%), severe/objective corneal anaesthesia or Mackie III severity stage (69.2%), NK with intact donor territory (50.0%), and corneal epithelial instability (46.2%). Exclusion criteria were often not stated (76.9%); when present, they most often listed active infection/non-NK disease (38.5%), systemic unsuitability (34.6%), absent/abnormal donor nerve(s) (15.4%), and severe limbal stem cell deficiency (15.4%). Across studies, CN improved corneal protection and surface stability with sensory recovery over ~6– 18 months and in vivo confocal microscopy evidence of nerve regrowth; visual acuity changes were variable. No randomized clinical trials were found; ROBINS-I was commonly moderate to serious, and overall certainty by GRADE was low. Conclusions: This systematic review defined and harmonized preoperative inclusion and exclusion criteria for CN in NK. A minimum preoperative dataset, including disease stage, mapped corneal sensitivity, denervation timeline and etiology, donor-dermatome integrity, feasibility of tension-free coaptation, and ocular surface status, may guide referral timing, donor-feasibility–driven technique selection, and structured follow-up.