Age-related macular degeneration (AMD) significantly impacts central vision, fixation site and stability and reading abilities. This work aims to analyze the relationship between retinal fixation parameters measured using microperimetry and reading performance in patients with AMD. We identified the role of fixation stability measurement in the evaluation of reading abilities and discussed its implications both in clinical practice and in clinical trials. Our analysis highlights the importance of retinal fixation assessment as a precise surrogate for evaluating reading ability outcomes in AMD patients and as new clinical endpoint to demonstrate the functional effects of present and emerging target therapies.

Objectives: Myopia of prematurity (MOP) is a refractive error occurring in individuals born prematurely and is considered a distinct entity from pathologic and school-age myopia. Children affected by MOP are at risk of developing high myopia, with an increased lifelong cumulative risk of related complications. The aim of this study was to evaluate the progression of MOP in children previously affected by retinopathy of prematurity (ROP) who wore spectacles with Highly Aspherical Lenslet Target (HALT) technology compared to conventional single-vision lenses during childhood. Methods: Enrolled subjects were divided into two groups: subjects who used HALT lenses for at least 12 months and children who used standard single-vision lenses for the same period. The temporal evolution of spherical equivalent (SE) and axial length (AL) was evaluated in both groups. Results: Of the 252 preterm children screened, 58 were included in the study: 38 subjects (66%) in the standard lenses group and 20 subjects (34%) in the HALT lenses group. At 12 months SE progression and AL elongation in the HALT group (−0.32 ± 0.20 D and 0.12 ± 0.05 mm) were lower compared to the standard group (−0.93 ± 0.34 D and 0.46 ± 0.09 mm, p < 0.0001). Conclusions: The progression of MOP appears to be reduced in subjects corrected with HALT lenses compared to those wearing conventional lenses. These results suggest further investigation of HALT technology in selected subgroups of patients at high-risk of severe myopia to reduce its progression and the related lifelong cumulative risk of visual impairment.

Background: Radiation maculopathy (RM) is a common complication after radiotherapy for intraocular tumors, causing permanent visual loss. Intravitreal dexamethasone (IV DEX) is effective for macular edema (ME) resolution, but functional outcomes remain highly heterogeneous. This study aimed to assess the prognostic utility of CEA classification on visual outcomes following IV DEX based on three parameters: largest cyst diameter (C), ellipsoid zone (EZ) disruption (E) and retinal pigment epithelium (RPE) atrophy (A). Methods: A retrospective analysis of 50 patients with RM secondary to Iodine-125 brachytherapy treated with IV DEX was performed. Best-corrected visual acuity (BCVA) and CEA parameters were analyzed with OCT before and after treatment. Results: IV DEX induced significant anatomical improvement (mean Δcyst: −203.3 μm, p < 0.001), regardless of functional response. Visual outcomes were related to baseline CEA stratification: eyes with intact outer retina gained +6.4 ETDRS letters (p = 0.002); eyes with EZ disruption demonstrated stability (−2.8 letters; p = 0.183); eyes with RPE atrophy significantly worsened (−11.7 letters; p = 0.014). Baseline RPE atrophy was the strongest negative predictor (p = 0.007). Subgroup analysis of patients with intact outer retina identified a baseline BCVA cutpoint of ≤70 letters to predict clinically significant visual improvement (≥5 letters), demonstrating a functional ceiling effect. Conclusions: The CEA classification effectively stratifies functional response in RM. EZ disruption and RPE atrophy identify eyes unlikely to achieve visual improvement despite a reduction in ME, aiding clinical decision-making and establishing functional expectations while promoting a fundamental shift from an edema-driven management to a biomarker-centered approach.