Background: Cytomegalovirus retinitis (CMVR) remains a sight-threatening complication after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Systemic antiviral, immunosuppressive, and anti-infective regimens are often modified because of transplant-related complications, but the association between these modifications and ocular relapse remains unclear. Methods: We analyzed a prospective cohort of 44 patients with CMVR after allo-HSCT (65 affected eyes) who were followed for three months after discontinuation of local antiviral therapy. The primary analysis used Cox proportional hazards regression at the eye level with robust standard errors clustered by patient. Exact dates of the first systemic medication adjustment were retrieved, and additional time-dependent Cox and patient-level time-to-first-relapse Cox analyses were performed. Results: During follow-up, 24 eyes from 19 patients relapsed, and 18 patients underwent systemic medication adjustment. The first adjustment occurred a median of 25.5 days after discontinuation of local therapy (range, 7 to 72 days). Among the 13 adjusted patients who relapsed, all first adjustments preceded relapse, with a median adjustment-to-relapse interval of 15 days (range, 3 to 52 days). In the primary model, medication adjustment was associated with relapse (HR, 8.254; 95% CI, 2.656 to 25.645; p < 0.001), as was baseline aqueous IL-8 (HR, 1.190 per 100 pg/mL; 95% CI, 1.088 to 1.301; p < 0.001). In the time-dependent eye-level analysis, medication adjustment remained associated with relapses (HR, 11.360; 95% CI, 4.330 to 29.803; p < 0.001). A patient-level time-to-first-relapse Cox analysis showed a similar association (HR, 4.477; 95% CI, 1.688 to 11.878; p = 0.003). Conclusions: Systemic medication adjustment was associated with short-term CMVR relapse after allo-HSCT. Because treatment changes were clinically indicated and heterogeneous, the findings remain associative, and confounding by indication cannot be excluded.

To compare oculomotor profiles among children wearing orthokeratology, defocus spectacle, and diffusion optics technology lenses in a routine pediatric myopia management setting. This real-world observational study included children who had worn one of the three lens types for approximately one year and had available eye tracking data. Lens type was selected during routine clinical care rather than assigned by the investigators. Oculomotor parameters were compared among lens groups using Kruskal–Wallis tests with false discovery rate correction. One-year spherical equivalent change was examined only in the defocus spectacle and diffusion optics technology groups. Adjusted and exploratory analyses included age, sex, baseline spherical equivalent, baseline axial length, axial elongation, and parental education categories. A total of 134 children were analyzed, including 46 in the orthokeratology group, 49 in the defocus spectacle group, and 39 in the diffusion optics technology group. Significant group differences were observed for microsaccade frequency (FDR adjusted p = 0.00099), peak velocity (FDR adjusted p = 0.00099), latency (FDR adjusted p = 0.00395), fixation disparity (FDR adjusted p = 0.00395), and conjugacy (FDR adjusted p = 0.0274). Saccade frequency and saccade amplitude did not differ significantly. One-year spherical equivalent change did not differ significantly between the defocus spectacle group and the diffusion optics technology group (−0.27 ± 0.43 D vs. −0.34 ± 0.36 D, p = 0.312). No statistically significant correlation was observed between spherical equivalent change and microsaccade frequency in the two spectacle lens groups (Spearman r = −0.231, p = 0.069). Parental education categories showed no consistent association with oculomotor parameters after correction for multiple comparisons. Children wearing different myopia control lenses showed selective differences in oculomotor profiles. Refractive change in the two spectacle lens groups was similar, and the observed oculomotor differences should not be interpreted as direct indicators of myopia control efficacy. Eye tracking may provide complementary information about visual behavior and lens adaptation, but prospective studies with age-balanced designs and longitudinal refractive and axial length outcomes are needed.

Objective: The objective of this study was to examine the association between parental smoking, a questionnaire-based proxy for secondhand smoke exposure, and incident right-eye corneal astigmatism (CA). Methods: This nested case–control reanalysis included 78 pairs matched on sex and follow-up duration. The primary endpoint, revised after peer review, was CA < 1.0 diopter (D) at cohort entry and ≥1.0 D at the index visit. Conditional logistic regression adjusted for entry age, entry CA, parental astigmatism, and afterschool outdoor time. Subsequent refractive astigmatism (RA) change was examined as an exploratory secondary outcome in the same selected sample. Results: Keratometry-based classification agreed with all original case–control labels. Parental smoking was reported for 61/78 cases and 48/78 controls. The adjusted odds ratio was 2.257 (95% profile-likelihood confidence interval, 1.016–5.434; likelihood-ratio p = 0.0456; Wald p = 0.0538). RA change was available for all 156 children after 19 blank cylinder entries were confirmed as measured zeros. The adjusted difference in RA change was 0.266 D (95% confidence interval, 0.181–0.351; p < 0.001). Conclusions: The CA estimate suggested higher odds with parental smoking, but wide intervals and inference sensitive to the statistical method indicate substantial uncertainty. The exploratory RA association is susceptible to selection bias because participants were sampled according to CA case status; adjustment for case status does not itself remove this bias. These findings do not establish causality or population-level astigmatism progression.