Background: Pediatric gastrointestinal basidiobolomycosis is an unusual fungal infection caused by Basidiobolus ranarum, an environmental saprophyte found worldwide. Typically, basidiobolomycosis presents as a subcutaneous infection or soft tissue tumor-like lesion, and rarely involves the gastrointestinal tract. Gastrointestinal basidiobolomycosis is most common in young infants. It has no definitive clinical presentation, and almost all cases are misdiagnosed during the initial presentation. Case presentation: We report the case of a 4-year-old Saudi boy who presented to the emergency department with abdominal pain, nausea, vomiting, and weight loss. Ultrasonography revealed a target sign. Based on the ultrasonography findings, surgery was performed, which revealed the presence of intussusception. Eventually, the patient was diagnosed with intussusception secondary to intra-abdominal basidiobolomycosis based on the histological findings. The patient was readmitted and intravenous voriconazole therapy was initiated. One week after the second admission, the patient developed abdominal pain, nausea, vomiting, inability to hold down food, and constipation. Computed tomography of the abdomen was suggestive of small bowel obstruction, which was managed conservatively. The patient responded well and was subsequently discharged with a prescription of oral voriconazole. Conclusions: This case reveals that gastrointestinal basidiobolomycosis can cause intussusception. This report will inform clinicians of the importance of considering gastrointestinal basidiobolomycosis in the differential diagnosis of chronic abdominal pain in children, even in the absence of fever or a clinically obvious abdominal mass, especially in countries such as Saudi Arabia, where cases have been reported.

Purpose: To systematically review the evidence regarding the characteristics of Optical Coherence Tomography Angiography (OCTA) in acute retinal arterial occlusion (RAO), with a particular focus on vascular alterations across the superficial and deep capillary plexuses, choroid, and peripapillary regions. Methods: A comprehensive literature search was performed across PubMed, Web of Science, Scopus, EMBASE, Google Scholar, and the Cochrane Database up to April 2025. The search terms included “Optical coherence tomography angiography,” “OCTA,” “Retinal arterial occlusion,” “Central retinal artery occlusion,” and “Branch retinal artery occlusion.” Studies were included if they evaluated the role of OCTA in diagnosing or assessing acute RAO. Case reports, conference abstracts, and non-English articles were excluded. Two reviewers independently conducted the study selection and data extraction. The methodological quality of the included studies was assessed using the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool. Results: The initial search yielded 457 articles, from which 10 studies were ultimately included in the final analysis after a rigorous screening process excluding duplicates, non-English publications, and ineligible articles based on title, abstract, or full-text review. The included studies consistently demonstrated that OCTA is a valuable, noninvasive modality for evaluating microvascular changes in RAO. Key OCTA findings in acute RAO include significant perfusion deficits and reduced vessel density in both the superficial capillary plexus (SCP) and deep capillary plexus (DCP). Several studies noted more pronounced involvement of the SCP compared to the DCP. OCTA parameters, such as vessel density in the macular region, have been found to correlate with visual acuity, suggesting a prognostic value. While findings regarding the foveal avascular zone (FAZ) were mixed, the peripapillary area frequently showed reduced vessel density. Conclusion: Acute RAO is an ocular emergency that causes microvascular ischemic changes detectable by OCTA. This review establishes OCTA as a significant noninvasive tool for diagnosing, monitoring, and prognosticating RAO. It effectively visualizes perfusion deficits that correlate with clinical outcomes. However, limitations such as susceptibility to motion artifacts, segmentation errors, and the lack of standardized normative data must be considered. Future standardization of OCTA protocols and analysis is essential to enhance its clinical application in managing RAO.

Botulinum toxin A (BTA) injection is a well-established, minimally invasive treatment for strabismus, offering an alternative to traditional surgery. While generally safe, rare complications like globe penetration and inadvertent intraocular injection have been reported. These can lead to retinal detachment, vitreous hemorrhage, and retinal toxicity. Although most intraocular BTA injection complications are well-documented, endophthalmitis remains extremely rare, with only one previously reported case resulting in total vision loss. A 3-year-old boy with esotropia received a botulinum toxin A injection into the left medial rectus muscle. A globe penetration from the needle was suspected. The dilated fundus exam was unremarkable. However, one week later, he presented with eye pain, redness, and photophobia. Clinical examination confirmed the diagnosis of acute post-operative endophthalmitis. The patient underwent urgent vitreous tap, pars plana vitrectomy, Endolaser, intravitreal antibiotic injection, and silicone oil injection. Subsequently, the silicone oil with epiretinal membrane removal was performed, and the patient’s vision was maintained postoperatively, CUSNM in both eyes. This case emphasizes the rare yet serious complications of Inadvertent Intravitreal Injection of Botulinum Toxin. It underscores the importance of early detection of endophthalmitis and timely intervention for an optimal outcome and to prevent irreversible ocular damage.

Traumatic submacular haemorrhage is a vision-threatening ocular emergency that can result in permanent visual loss if not treated promptly. Following blunt ocular trauma, rapid accumulation of blood beneath the macula leads to photoreceptor damage through iron-mediated oxidative stress, mechanical disruption, and impaired metabolic exchange. Pneumatic displacement, with or without intravitreal tissue plasminogen activator (tPA), has emerged as a minimally invasive therapeutic option; however, standardized clinical guidelines for its use in traumatic cases remain lacking. A narrative literature search was conducted across Scopus, Web of Science, Medline, Embase, PubMed, OpenAlex, and Dimensions up to November 24, 2025, supplemented by citation tracking. After duplicate removal and title/abstract screening, full-text assessment was performed based on predefined inclusion criteria focusing on traumatic submacular haemorrhage managed with pneumatic displacement. Of 177 identified records, four studies met the final eligibility criteria. The available evidence suggests that pneumatic displacement using intravitreal gas alone, most commonly 100% perfluoropropane (C₃F₈), achieved anatomical displacement in some cases but showed lower functional success, particularly in thick or dense haemorrhages. In contrast, intravitreal tPA combined with expansile gas was the most frequently employed minimally invasive approach and resulted in high rates of complete subfoveal blood displacement and clinically meaningful visual improvement, especially in younger patients. Pars plana vitrectomy with subretinal tPA was reserved for large or complex haemorrhages and produced favorable outcomes, albeit with higher surgical risk. Although the current evidence is limited, largely retrospective, and derived from small-sample studies, early treatment appears to be associated with favorable anatomical and functional outcomes. Intravitreal tPA combined with pneumatic displacement appears to be the most effective first-line therapy, while gas-only displacement may be considered when tPA is unavailable. Well-designed prospective studies with standardized outcome measures are needed to define optimal management strategies.

Background: Occult macular pathology may limit visual recovery after cataract surgery but can remain undetected on routine clinical examination due to media opacity. Preoperative macular optical coherence tomography (OCT) improves detection of such abnormalities; however, its incremental prognostic value beyond routinely available clinical predictors remains uncertain. This study evaluated whether preoperative macular OCT provides additional predictive information for early (30– 120 day) postoperative visual acuity after phacoemulsification cataract surgery. Methods: This retrospective cohort study included consecutive eyes undergoing phacoemulsification for nuclear cataract at a tertiary eye hospital in Saudi Arabia between April 2023 and April 2025. Eligible eyes had documented preoperative and postoperative best-corrected visual acuity (BCVA) and a preoperative macular OCT scan of adequate quality. The primary outcome was postoperative BCVA measured within 30– 120 days after surgery. Multivariable analysis of covariance was used to identify predictors of postoperative BCVA. Incremental predictive value of OCT variables was assessed by comparing a base clinical model with an OCT-augmented model using changes in the coefficient of determination (R²), Akaike information criterion (AIC), and nested F-tests. Cluster-robust standard errors were applied to account for correlation between eyes from the same patient. Results: A total of 177 eyes were included, of which 57 (32%) demonstrated macular pathology on preoperative OCT. Eyes with macular pathology had worse preoperative BCVA but similar postoperative BCVA compared with eyes without pathology. In multivariable analysis, poorer preoperative BCVA (β = 0.224; P = 0.039) and older age (β = 0.090 per 10-year increase; P = 0.004) were independently associated with worse postoperative BCVA, whereas macular pathology was not. Adding OCT variables increased the model R² from 0.296 to 0.325 (ΔR² = 0.029; P = 0.029), indicating a statistically significant but modest improvement in predictive performance. Conclusion: Preoperative BCVA and age were the primary predictors of early postoperative visual acuity after phacoemulsification cataract surgery. Although macular OCT detected abnormalities in nearly one-third of eyes and provided a statistically significant improvement in predictive performance, the magnitude of this gain was modest, suggesting limited additional value for short-term visual outcome prediction beyond standard clinical factors.

Background: Choroideremia is an X-linked inherited chorioretinal dystrophy leading to blindness by late adulthood. Choroideremia is caused by mutations in the CHM gene, which encodes Rab escort protein 1 (REP1), a ubiquitously expressed protein involved in intracellular trafficking and prenylation activity. Case Report: We report a 48-year-old male with an 18-year history of progressive night vision impairment. Fundoscopic examination revealed sharply demarcated regions of chorioretinal atrophy, primarily around the optic nerve. Bone spicules were observed throughout the retina, particularly at the margins of the atrophic areas, with preservation of the macula. Electroretinography (ERG) demonstrated a diminished response. Genetic testing confirmed a hemizygous missense variant in the CHM gene (CHM: NM_000390:exon11:c.1413G>C:p.Q471H), establishing the diagnosis. Conclusion: This case, supported by clinical findings, multimodal retinal imaging, and genetic analysis, confirms that this CHM variant is pathogenic and contributes to choroideremia.