Background: Stevens–Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are rare, life-threatening mucocutaneous disorders often associated with severe ophthalmic complications. Ocular involvement occurs in 50–68% of cases and can result in permanent vision loss. Despite this, optimal management strategies remain unclear, and treatment practices vary widely. Methods: A systematic review was conducted in accordance with PRISMA guidelines and prospectively registered on PROSPERO (CRD420251022655). Medline, Embase, and CENTRAL were searched from 1998 to 2024 for English-language studies reporting treatment outcomes for ocular SJS/TEN. Results: A total of 194 studies encompassing 6698 treated eyes were included. Best-corrected visual acuity (BCVA) improved in 52.2% of eyes, epithelial regeneration occurred in 16.8%, and symptom relief was reported in 26.3%. Common treatments included topical therapy (n = 1424), mucosal grafts (n = 1220), contact lenses (n = 1134), amniotic membrane transplantation (AMT) (n = 889), systemic medical therapy (n = 524), and punctal occlusion (n = 456). Emerging therapies included TNF-alpha inhibitors, anti-VEGF agents, photodynamic therapy, and 5-fluorouracil. Conclusions: Disease-stage-specific therapy is crucial in ocular SJS/TEN. Acute interventions such as AMT may prevent long-term complications, while chronic care targets structural and tear-film abnormalities. Further prospective studies are needed to standardize care and optimize visual outcomes.

Objective: To evaluate the literature-pooled functional, anatomical and safety outcomes of aflibercept biosimilars compared with reference aflibercept for neovascular age-related macular degeneration (nAMD). Methods and analysis: Systematic review and meta-analysis. Medline, Embase and CENTRAL were searched from inception to 2 June 2025. Phase 3 randomised controlled trials (RCTs) comparing aflibercept biosimilars with the reference product in patients with nAMD were included. Two independent reviewers conducted screening, data extraction, risk of bias (RoB 2) assessment and certainty of evidence assessment (Grading of Recommendations, Assessment, Development and Evaluation), with a third reviewer resolving discrepancies. Primary outcomes included mean difference (MD) change in best-corrected visual acuity (BCVA) and retinal thickness over time, risk ratio (RR) for proportion of participants gaining >15 Early Treatment Diabetic Retinopathy Study (ETDRS) letters and RR for adverse events. Meta-regression was used to evaluate the temporal stability of continuous outcomes. Results: Six RCTs involving 2044 participants (1026 biosimilar, 1018 reference) were included. Five aflibercept biosimilars were evaluated, representing more than 50% of the eight biosimilars currently approved worldwide. Meta-regression revealed no significant difference in MD change in BCVA over time between biosimilar and reference aflibercept (slope: 0.0321 letters/week; p=0.1013). For MD change in retinal thickness, an initial anatomical advantage for reference aflibercept at week 0 (intercept: 9.58 µm; p=0.0449) was not sustained over time (slope: –0.1685 µm/week; p=0.2303). The pooled RR for gaining >15 ETDRS letters from baseline was 1.19 (95% CI 0.98 to 1.45; p=0.079). No statistically significant differences were observed across 15 safety outcomes. Conclusion: This systematic review and meta-analysis found no statistically significant differences in functional, anatomical or safety outcomes between aflibercept biosimilars and the reference product for nAMD, based on moderate to high certainty evidence. Functional and anatomical outcomes appeared stable across multiple timepoints. Further long-term pharmacovigilance studies and real-world data beyond 56 weeks are warranted. PROSPERO registration number: CRD420251048633.

Benzodiazepines and Z-drugs (e.g., zopiclone, zolpidem) (benzodiazepine receptor agonists or BZRAs), are prescribed for anxiety and insomnia disorders. However, they are not indicated as first line therapies for long-term management due to harms and efficacy limitations. BZRAs have also been associated with traffic accident risks. Patients taking BZRAs are told to consult with health care providers regarding motor vehicle operation safety. However, advice on driving is variable. The objective of this scoping review is to identify, map, and characterize the evidence for assessments that measure driving performance in people taking BZRAs. Embase (Elsevier), MEDLINE (Ovid), and PsycINFO (EBSCO) were searched. Covidence was used for screening. Each stage of screening included two independent reviewers. A REDCap database was used for data extraction by two independent reviewers. Results were tabulated and summarised as a narrative. Driving performance was assessed with 20 unique BZRAs across 183 studies (n = 92 experimental; n = 91 observational) in 178 publications. Zopiclone was the most studied. In experimental studies, the Standard Deviation of Lateral Position (SDLP) was used most often (n = 54, 62 %) and many studies (n = 35, 38 %) were conducted in the Netherlands. For observational studies, biological detection (e.g., urine, blood) (n = 73, 80 %) followed by prescription drug/dispensing records (n = 17, 19 %) were the most common impairment measures and Norway (n = 20) is where most studies took place. In experimental studies, most (n = 89, 97 %) were conducted using only one driving setting. Simulated driving in a car (n = 36) and road driving in traffic (n = 36) were common as compared to nontraffic driving course (n = 8) and simulated driving (n = 9). In experimental studies, seventy-eight of the 92 studies (85 %) had at least one measure that identified impairment. BZRA effects on motor vehicle driving performance have been studied using heterogenous protocols with multiple measures and settings, ranging from simulation to authentic traffic situations in experimental studies to biological detection and dispensing records in observational studies. Many BZRAs have been studied but study representation does not match prescribing pattern prevalence. The interpretation and contextualization of results for clinical practice is challenging due to the complexity (i.e., protocols, measures, settings). Future work in this area should work to improve knowledge translation of results so information is more readily accessible and applicable to health care providers and patients.