Introduction: Macular holes are breaks in the retinal tissue at the center of the macula, affecting central vision. The standard treatment involves vitrectomy with membrane peeling and gas tamponade. However, for larger or chronic holes, alternative techniques like autologous retinal graft have emerged. This meta-analysis evaluates the efficacy and safety of retinal transplantation in managing large macular holes. Methods: We conducted a systematic review and meta-analysis following PRISMA guidelines. The study was prospectively registered in PROSPERO (CRD42024504801). We searched PubMed, Web of Science, Cochrane, and Embase databases for observational studies including individuals with large macular holes with or without retinal detachments and retinal transplantation as the main therapy. We used a random-effects model to compute the mean difference with 95% confidence intervals and performed statistical analysis using R software. Results: We conducted a comprehensive analysis of 19 studies involving 322 patients diagnosed with various types of macular holes (MHs). These included cohorts with refractory MH, high myopia associated with MH, primary MH, and MH with retinal detachment (RD). The findings were promising, revealing an overall closure rate of 94% of cases (95% CI 88–98, I² = 20%). Moreover, there was a significant improvement in postoperative visual acuity across all subgroups, averaging 0.45 (95% CI 0.33–0.58 ; I² = 72%; p < 0.01) overall. However, complications occurred with an overall incidence rate of 15% (95% CI 7–25; I² = 59%). Conclusion: ART for large MH shows promising results, including significant improvements in visual acuity and a high rate of MH closure with low complication risks overall and for subgroups.

Autologous platelet concentrates are rich in growth factors and have shown potential for high anatomical success rates in macular hole treatment. However, no systematic review has yet assessed its impact. Therefore, this study aimed to conduct a comprehensive review and metaanalysis on the comparative efficacy and safety of autologous platelet concentrates in treating macular hole. A systematic review of the literature on autologous platelet concentrate therapy for macular hole was conducted in accordance with Preferred Reporting Items for Systematic

Obstructive sleep apnea (OSA) is a common condition associated with intermittent hypoxia, systemic inflammation, and vascular dysfunction; mechanisms implicated in retinal disease pathogenesis. This real-world retrospective cohort study used data from the TriNetX Research Network to assess whether continuous positive airway pressure (CPAP) therapy reduces retinal disease incidence among adults with OSA and BMI between 25.0 and 30.0 kg/m². After 1:1 propensity score matching, 101,754 patients were included in the analysis. Retinal outcomes included diabetic retinopathy (DR), age-related macular degeneration (AMD), retinal vein occlusion (RVO), and central serous chorioretinopathy (CSC). CPAP use was associated with a modest but statistically significant reduction in DR (3.2% vs. 3.4%, RR: 0.922, p = 0.016) and AMD (2.1% vs. 2.3%, RR: 0.906, p = 0.018), while no significant differences were found for RVO or CSC. These findings support prior evidence linking CPAP to improved retinal microvascular health and suggest a protective effect against specific retinal complications. Limitations include a lack of data on CPAP adherence, OSA severity, and imaging confirmation. Still, this study highlights the importance of interdisciplinary care between sleep and eye health, and the need for further prospective studies to validate CPAP’s role in preventing retinal disease progression in OSA patients.

This systematic review and meta-analysis evaluated the efficacy and safety of autologous human serum as an adjuvant agent in pars plana vitrectomy (PPV) for macular holes (MH). Thus, a comprehensive search was conducted across PubMed, Web of Science, Embase, and the Cochrane Library databases up to August 20th, 2023. The inclusion criteria targeted randomized clinical trials (RCTs) or non-RCTs that compared the use of autologous serum in vitrectomy for MH with the same procedure without the serum. The outcomes were MH closure rates and postoperative complications such as retinal detachment and cataracts. Odds ratios (OR) and mean differences (MDs) were calculated using a random-effects model. Review Manager 5.3 (The Cochrane Collaboration, Oxford, UK) was used for statistical analysis. Four studies, comprising two RCTs and two non-randomized cohort studies with 373 eyes of 372 patients, were included. The pooled analysis showed no significant difference in MH closure rates (OR 1.28; 95% confidence interval (CI): 0.48 to 3.43; P=0.62) and no difference concerning the incidence of adverse events (OR 0.97; 95% CI: 0.30-3.09; P=0.96). Leave-one-out sensitivity analysis excluding the study by Lauritzen et al. revealed a significant difference in anatomical closure, favoring the serum arm, and demonstrated a reduction in the level of heterogeneity. Our meta-analysis demonstrated no difference between groups in the pooled analysis of all studies. However, considering the quality assessment of one of the included studies, and observing the divergent result in sensitivity analysis following its exclusion, there are indications that might suggest the superiority of the serum in terms of the analyzed endpoints. This finding highlights the existing research gaps and the imperative need for additional high-quality randomized trials to further investigate this treatment.

Objective: To compare the effectiveness and safety of phacoviscocanalostomy and phacotrabeculectomy in treating combined glaucoma and cataracts. Methods: A systematic review and meta-analysis were conducted following the PRISMA guidelines. The PubMed, Web of Science, Cochrane, and Embase databases were searched for randomized controlled trials or observational studies comparing phacotrabeculectomy to phacoviscocanalostomy in patients with glaucoma and cataracts. Statistical analysis was used to compare the efficacy (intraocular pressure reduction, mean deviation of the visual field, and failure rates) and safety

Purpose: This systematic review and meta-analysis aimed to comprehensively assess the acute effects of caffeine and caffeinated beverages on ocular microvasculature measured by optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) parameters, explicitly focusing on subfoveal choroidal thickness (SFCT) and superficial capillary vessel density (SVD), and deep capillary vessel density (DVD). Methods: A systematic search was conducted across PubMed, the Cochrane Database, and Embase for trials evaluating the acute effects of caffeine or caffeinated beverages on SFCT, SVD, and DVD, as measured by OCTA. Pooled mean differences (MD) were calculated using random-effects models, with heterogeneity assessed by I² statistics. Subgroup analyses were performed by study design, intervention type, and refractive status. The protocol was prospectively registered in PROSPERO (CRD420251091123). Statistical analyses were performed using RStudio 2025.05.1+513. Results: 18 studies comprising 630 patients were included. Pooled analysis demonstrated a significant reduction in SFCT after caffeine intake (– 23.79 μm; 95% CI: – 31.43 to – 16.15; p < 0.001), particularly with coffee and caffeine capsules, whereas no effect was observed with energy drinks or in highly myopic eyes. Regarding SVD, caffeine was associated with significant reductions across foveal, parafoveal, and perifoveal regions, mainly driven by coffee and capsule interventions. In DVD analyses, no overall significant effect was found; however, subgroup analyses indicated significant reductions with caffeine capsules and coffee, while energy drinks showed opposite trends. Conclusion: Acute caffeine intake, primarily from capsules or coffee, induces significant SFCT reduction and modest reductions in SVD, while changes in DVD were confined mainly to the caffeine-capsule subgroup, suggesting that energy drink ingredients may counteract caffeine-induced vasoconstriction. These findings offer valuable insights into the acute effects of caffeine on ocular microvasculature; however, the modest effect sizes necessitate caution regarding inherent physiological, measurement, and bioactive components variability. This study establishes a foundation for future investigations into the clinical significance of acute ocular microvascular fluctuations following caffeine intake.