To evaluate differences in clinical outcome, safety, and efficacy of photorefractive keratectomy (PRK) and laser-assisted in situ keratomileusis (LASIK) in the correction of hyperopic refractive errors. We have adhered to PRISMA criteria in this systematic review, which is registered with PROSPERO (CRD42023469543). Our search with studies comparing PRK and LASIK for hyperopia was conducted through the databases PubMed, EMBASE, Web of Science, and the Cochrane Library. We used the Cochrane method to assess bias and evaluated variables like uncorrected distance visual acuity and mean spherical equivalent. Using fixed- or random-effects models, a meta-analysis was performed using RevMan 5.4 for evaluating heterogeneity and significance. Sensitivity analysis addressed the causes of heterogeneity to assure stability. We included 6 articles (419 participants, 585 eyes) in this review five were retrospective and 1 case-series. The final mean refractive SE (WMD, -0.05; 95% confidence interval [CI], 0.42 to 0.31; P = 0.06). patients achieving uncorrected distance visual acuity (UDVA) of 20/20 or better (OR, 0.58; 95% CI, 0.39–0.78; P = 0.33). final UDVA of 20/40 or better (OR, 1.40; 95% CI, 0.65–3.02; P = 0.81) were analyzed. In this meta-analysis, LASIK had no significant benefits over PRK in relation to clinical outcomes. Less corneal haze was observed in LASIK-treated eyes at 1 to 3 months after surgery.

Purpose: To provide local data on the prevalence and risk factors of diabetic macular edema in the Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia. Method: A cross-sectional cohort study was conducted to screen the prevalence of diabetic macular edema among diabetic patients, with 906 patients randomly selected between May 2023 and September 2023 in a tele-screening program using OCT and fundus photos at the Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia. Results: In a sample of 906 diabetic patients who participated in a tele-screening program, 38 cases of diabetic macular edema (DME) were diagnosed, resulting in a prevalence of 4.19%. Males and females each composed 50% of the sample. The average age was 61.39 years (SD = 10.114), and 31.6% had diabetes for over 15 years. Most patients had comorbidities, including hypertension (86.8%) and dyslipidemia (89.5%). Diabetic complications were common: neuropathy was present in 23.6%, and nephropathy was present in 21%. Among the 48 eyes assessed, the mean central macular thickness was 315 ± 69 μm. The distribution of diabetic retinopathy severity in 48 eyes included 17 (35%) no retinopathy, 8 (17%) mild NPDR, 15 (31%) moderate NPDR, 7 (15%) severe NPDR, and 1 (2%) PDR. Center-involved DME was found in 45.8% of the eyes, whereas non-center-involved DME was observed in 54.2% of the eyes. Conclusion: This study in Riyadh, Saudi Arabia, revealed a 4.19% prevalence of diabetic macular edema (DME), emphasizing the importance of regular screening, especially for patients with longstanding diabetes, hypertension, and dyslipidemia.

Purpose: We are aimed at describing the clinical course and management of a rare case of phakomatosis pigmentovascularis (PPV Type IIb) presenting with bilateral glaucoma, complicated by bilateral Urrets‐Zavalia syndrome (UZS) following MicroPulse transscleral cyclophotocoagulation (MP‐TSCPC). Observations: A 6‐year‐old girl with PPV Type IIb and syndromic glaucoma underwent MP‐TSCPC as an initial surgical intervention for uncontrolled intraocular pressure (IOP). Postoperatively, the patient developed bilateral fixed dilated pupils consistent with UZS. Due to persistent IOP elevation and the complication of UZS, bilateral deep sclerectomy (DS) was performed, resulting in adequate IOP control. (10‐mmHg OD, 17‐mmHg OS) and gradual improvement in pupillary function. No further complications were observed. The case was classified under PPV Type II based on the coexistence of vascular and pigmentary anomalies. A review of the literature confirms the rarity of such a constellation of findings and the sparsity of reported bilateral UZS following MP‐TSCPC. Conclusion and Importance: This case highlights that PPV Type IIb requires careful examination because of the risk of associated glaucoma. UZS should be considered as a possible complication after MP‐TSCPC, especially when both eyes are treated. In complex cases with vascular involvement, DS can provide effective and safe IOP control.

Most glaucoma genetic data derive from European and East Asian cohorts, leaving high-consanguinity Middle Eastern populations under-characterized. This review synthesizes 33 Saudi-specific genetic studies (2014–2024, >9000 participants) to define a population-level glaucoma genetic architecture that diverges substantially from global models and carries direct precision medicine implications. Three findings distinguish the Saudi landscape. First, CYP1B1 functions as the dominant causal gene across both primary congenital glaucoma (PCG) and juvenile-onset open-angle glaucoma (JOAG), accounting for 76–86% of cases, with two founder alleles, p.G61E (penetrance 87.7%) and p.R469W (penetrance 93%), driving severe, early-onset phenotypes. Critically, MYOC and LTBP2, the primary JOAG genes in other populations, carry no pathogenic variants in Saudi cohorts, rendering standard multi-ethnic gene panels inadequate for this population. Second, adult-onset glaucoma follows a distinct polygenic architecture where APOE ε2 confers a near five-fold risk for primary angle-closure glaucoma (OR = 4.82), an effect absent or inconsistent in global datasets, and NOS3 variants associate with primary open-angle glaucoma specifically in men, a sex-stratified signal unreported outside Saudi cohorts. The MTHFR T/T genotype, common in European and Asian POAG patients, is entirely absent locally, indicating population-specific allelic distributions that alter folate-metabolism-related optic nerve susceptibility. Third, ACVR1 rs12997 associates across POAG, PACG, and pseudoexfoliation glaucoma (PXG), positioning BMP/TGF-β signaling as a shared mechanistic pathway spanning multiple subtypes. These findings argue for Saudi-specific genetic panels, CYP1B1-centered cascade testing in consanguineous families, and polygenic risk models incorporating local allele frequencies rather than globally derived weights.

Background/Objectives: Glaucoma is a leading cause of irreversible blindness globally and must be detected early to preserve vision. Standard methods, such as automated perimetry and optical coherence tomography (OCT), are limited in their ability to detect early changes. Therefore, this systematic review evaluates the diagnostic and predictive performance of artificial intelligence (AI)-driven OCT-based models, including those based on deep learning, machine learning, and transformer architectures, and contextualizes their performance against the recognized limitations of standard automated perimetry and conventional OCT trend analysis. Methods: The PubMed, Ovid, and Google Scholar databases were comprehensively searched to identify relevant published research in English. Screening of observational, cohort, prospective, retrospective and diagnostic accuracy studies, as well as clinical trials, identified 13 studies. Their key outcomes, including sensitivity, specificity, and area under the curve (AUC), were extracted for synthesis. Results: AI-driven OCT-based models generally reported high diagnostic performance, with mean sensitivities and specificities exceeding 80%, as well as AUC values generally above 0.85. AI-driven OCT-based models were reported to detect glaucoma progression as early as 9 months before standard methods. Conclusions: The findings suggest that AI-driven OCT-based models may improve glaucoma detection by identifying subtle structural and functional changes earlier, which may help inform earlier intervention decisions. However, the majority of included studies relied on internal validation only, and prospective multicenter studies with external validation are required before AI-driven OCT-based models can be reliably implemented in routine glaucoma care.