Background: Central retinal artery occlusion (CRAO) is an ophthalmic emergency attributed to a vessel occlusion with an embolus or a thrombus and may occur during the hypercoagulable state, inflammation, or vasculitis. CRAO may occur in children; however its incidence is very rare. Most pediatric cases have detectable etiologies. Case Presentation: We describe the case of an otherwise-healthy six-year-old female, who presented with the sudden and complete vision loss of the left eye lasting over twelve hours after a six-day chickenpox exanthema, followed by a high fever. All the ophthalmological, laboratory, and instrumental investigations led to the diagnosis of a left CRAO. Laboratory testing was unremarkable except for the transient elevation of D dimers (1363 µg/L), IgM anticardiolipin antibodies (238.5 CU), and IgG anti-beta-2 glycoprotein-1 antibodies (76.1 CU) on admission. Thrombolytic treatment was not exerted because of late presentation to the hospital. Treatment with steroids, antiviral medications, antibiotics, and anticoagulants was obtained, but the visual outcome was poor during the hospitalization and at the last follow-up. We could not ascribe features of this case to any etiological condition apart from the documented ongoing chickenpox infection. Conclusions: This is the first case report of CRAO in a child with transient aPL elevation and acute chickenpox infection.

Background: Psychological outcomes among patients receiving anti-vascular endothelial growth factor (anti-VEGF) therapy for diabetic macular edema (DME) remain insufficiently investigated. This study assessed symptoms of depression, anxiety, and stress, as well as life satisfaction, in patients undergoing intravitreal anti-VEGF therapy for DME. Methods: This cross-sectional study included patients receiving intravitreal anti-VEGF therapy for DME at Clinical Hospital Centre Osijek, Croatia, from 15 December 2025 to 15 February 2026. Depression, anxiety, and stress symptoms were assessed using the Depression Anxiety Stress Scale-21 (DASS-21), and life satisfaction using the Satisfaction with Life Scale (SWLS). Best-corrected visual acuity (BCVA) was categorized as ≥0.5, 0.1–0.49, or <0.1. Multivariable linear regression models were adjusted for age, sex, and diabetes duration. Results: A total of 156 patients were included; 51.3% were male, and the median age was 71 years (IQR 64.75–76.25). Mild-to-extremely severe symptoms of depression, anxiety, and stress were present in 39.7%, 48.7%, and 28.8% of participants, respectively, while 37.2% reported some degree of life dissatisfaction. In adjusted analyses (N = 155), worse-seeing eye BCVA < 0.1 was associated with higher stress scores compared with BCVA ≥ 0.5 (B = 2.667, 95% CI 0.526–4.808, p = 0.015; standardized effect size = 0.583). Associations with depression and anxiety were not significant, and no BCVA associations remained significant after Benjamini–Hochberg correction. The number of intravitreal anti-VEGF injections was not significantly associated with the assessed psychological outcomes and life satisfaction in univariable analyses. Conclusions: These findings highlight the importance of assessing psychological symptoms and life satisfaction in patients receiving anti-VEGF therapy for DME. Further research should examine the associations of visual acuity, the number of anti-VEGF injections, and other clinical and psychosocial factors with these outcomes.

Objective: To report a rare case of bilateral iris metastasis from small cell lung carcinoma (SCLC) and systematically review the literature on SCLC-associated iris metastases, with emphasis on clinical presentation, management, and outcomes. Materials and Methods: A systematic literature review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, ScienceDirect, Scopus, and Web of Science were comprehensively searched on 10 July 2025. Eligible studies included English-language reports of iris metastasis originating from SCLC in human subjects. Case report: A 58-year-old woman with previously treated SCLC developed bilateral iris metastases one year after complete remission of the primary tumor. Ophthalmic examination revealed whitish-gray, vascularized iris masses with iridocorneal angle involvement, associated with secondary angle-closure glaucoma and markedly elevated intraocular pressure (48 mm Hg) in the left eye. Cyclocryotherapy, preceded by systemic and topical antiglaucoma therapy, resulted in pain relief and a reduction in intraocular pressure; the patient died four months later due to pneumonia. Results (Systematic Review): Seventeen studies comprising 17 patients were included; the median age was 60 years, and 64.7% were male. The median interval from SCLC diagnosis to ocular presentation was 4 months, although iris metastasis was occasionally the initial or concurrent manifestation of disease. The most common presenting features were visual impairment (58.8%), ocular pain (41.2%), and elevated intraocular pressure (41.2%), while iris neovascularization (35.3%) and synechiae (29.4%) were also frequent. Bilateral involvement was reported in only one previous case. Treatment approaches were heterogeneous and included antiglaucoma therapy, systemic chemotherapy, local radiotherapy, anti-VEGF therapy, and enucleation. Among patients with available follow-up (n = 12), 58.3% died within a median follow-up of 7.5 months. Conclusions: Bilateral iris metastasis from SCLC is rare and may occur as a manifestation of recurrent disease after remission. It is an aggressive condition characterized by nonspecific ocular symptoms, variable management, and poor survival, underscoring the importance of early recognition and the need for evidence-based diagnostic and therapeutic strategies.