Intravitreal injections (IVIs) of umbilical cord blood platelet-rich plasma (CB-PRP) were investigated to assess their safety and efficacy in slowing the progression of atrophy in eyes with late-stage dry age-related macular degeneration (AMD). Randomized, controlled, prospective study. Patients with AMD aged >65 years and diagnosed with bilateral geographic atrophy were enrolled. One eye of each subject received the treatment of intravitreal CB-PRP 0.05 ml, while the fellow eye received a sham injection. Atrophic areas were identified as large choroidal hypertransmission defects (hyperTDs) on en face subretinal pigment epithelium slabs (64-400 μm beneath Bruch's membrane) obtained 0.321 from swept-source OCT angiography scans. The main outcome was the mean annualized growth rate of the square root transformed area measurements in both treated and nontreated eyes. The mean ± standard deviation (SD) square root hyperTD area in the treated eyes was 3.30 ± 0.99 mm at baseline and 3.49 ± 0.98 mm after CB-PRP (IVI). In nontreated eyes, the mean square root hyperTD area was 2.96 ± 0.94 mm at baseline and 3.18 ± 0.94 mm after sham injections. Twenty-six eyes of 13 patients were included. In treated eyes, the mean ± SD best-corrected visual acuity (BCVA) was 48.92 ± 16.33 letters at baseline and 51.46 ± 12.27 letters at last follow-up. In untreated eyes, BCVA was 67.69 ± 10.89 letters at baseline and 65.38 ± 10.34 letters at last follow-up. The mean follow-up was 258.46 ± 97.54 days. In both groups, no statistically significant difference was observed between the baseline and final BCVA. For treated eyes, the mean annualized growth rate (square root) was 0.275 mm and for nontreated eyes it was 0.321 mm. The annualized growth rate of the hyperTDs in treated eyes was 14.5% lower than that in nontreated eyes (P = 0.007). No adverse events were recorded. These preliminary data suggest that intravitreal CB-PRP injections might be safe and effective in slowing the progression of atrophy in AMD. Extended follow-up and larger sample sizes are needed to confirm our findings and determine the optimal treatment regimen for this novel treatment option in late-stage dry AMD. Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Purpose: This review aims to consolidate current knowledge on the role of perforating scleral vessels (PSVs) in high myopia (HM), providing an updated overview of their clinical significance, imaging characteristics, and potential therapeutic implications. Methods: Literature review up to July 2025. Results: PSVs, originating from the short posterior ciliary arteries, penetrate the sclera and may contribute to biomechanical stress, ischemic alterations, and neovascular proliferation in highly myopic eyes. Increasing evidence suggests their complex role in the development and progression of myopic maculopathy, particularly in lacquer cracks, myopic choroidal neovascularizations, chorioretinal atrophy, and focal scleral ectasia. Advanced imaging techniques, such as enhanced depth imaging optical coherence tomography and swept-source OCT, have enabled better visualization of PSVs and their anatomical relationship with structural changes in highly myopic eyes. However, recent studies have revealed contradictory findings regarding PSVs' role in myopic choroidal neovascularization pathogenesis, with some studies suggesting a pathogenic association while others propose a protective effect. The relationship between PSVs and myopic choroidal neovascularization appears complex and context-dependent, potentially involving both mechanical stress mechanisms and hemodynamic factors. Conclusion: Despite their increasing recognition, the precise mechanisms by which PSVs influence myopic disease remain incompletely understood. Standardized quantification methods and prospective studies are needed to clarify their complex role in disease progression and to explore novel treatment strategies.

The aim of this narrative review was to provide a disease-oriented diagnostic framework for selecting and integrating multimodal imaging techniques according to the suspected optic disc disorder. A non-systematic PubMed search was performed to identify relevant literature on optic disc diseases and related imaging appearances. Searches included a combination of terms related to disease features and imaging modalities. The recent introduction of non-invasive imaging devices, such as optical coherence tomography (OCT) and OCT angiography (OCTA), has allowed a remarkable step forward in the knowledge of the optic disc. OCT has revolutionized the diagnosis and monitoring of glaucomatous eyes, providing useful quantitative biomarkers. Fundus examination and color fundus photography are the first step for evaluation of optic disc edema, which requires further exams, including fundus autofluorescence, to exclude the presence of optic disc drusen, ocular ultrasound and in certain cases, fluorescein angiography. Although still limited, OCTA could give a support in the evaluation of vascular diseases that involve the optic disc, such as anterior ischemic optic neuropathy, retinal vein occlusion and proliferative diabetic retinopathy. Analyzing the radial peripapillary capillary plexus, OCTA can also highlight early vascular changes in degenerative diseases (i.e., glaucoma, Alzheimer’s disease or multiple sclerosis). Multimodal imaging is a cornerstone in the neuro-ophthalmology field, offering unparalleled insight into optic nerve head architecture and vascular integrity in both normal and diseased states.

Aims: Myocardial bridge (MB) is the most common inborn coronary artery variant in which a segment of an epicardial coronary artery takes a tunneled course under a bridge of myocardium. MB has been documented from 1.5% to 16% of invasive angiographic series thus the true prevalence of MB is uncertain. The clinical relevance of MB is heterogeneous, being usually an asymptomatic bystander. However, a growing body of evidence suggests its association with myocardial ischaemia. In the present work, by setting up a database of patients affected by MB, we sought to assess their clinical characteristics and risk of major adverse cardiac events (MACE). Methods and results: This is a prospective/retrospective study and observational study in which we included 17 681 patients referred to undergo invasive coronary angiography (ICA) for suspected coronary artery disease. During the screening phase, we found that 338 cases (26 non-recruitable) were reported to have MB (1.9%). In-hospital clinical-instrumental data was acquired after ICA. The data obtained in the follow-up (FUP) visit is also included in the study. In particular, we recorded MACE and Seattle Angina Questionnaire (SAQ). The most frequent location of MB was the LAD coronary artery (96.8%). Other locations were the circumflex artery (1.3%), the right coronary artery (1%), the posterior interventricular artery (0.6%), and the first diagonal artery (0.3%). Chronic coronary syndrome (CCS) was the most frequent clinical presentation (47.5%). A big proportion (34.6%) of our patients were found to have MB during the occurrence of an acute coronary syndrome (ACS). In acute setting, unstable angina was the most frequent clinical presentation (17.6%). 47 patients (15%) underwent coronary angiography with provocative test (intracoronary acetylcholine) in order to search vasomotor disorders: according to COVADIS criteria, 17 procedures (5.5%) resulted positive for vasospastic angina (VSA). Invasive functional assessment with FFR/iFR was accomplished to assess the haemodynamic significance both of MBs and atherosclerotic plaques proximal to the MB segment in 35 patients (11.2%): in nine procedures (2.9%), functional tests resulted positive. β-Blockers (BBs) are suggested as first-line drugs as they increase diastolic filling time, by decreasing heart rate. Calcium channel blockers (CCBs) are useful, in VSA setting, to reduce epicardial spasm. In our court, 40% of patients toke BBs and 20% of patients toke CCBs at admission. The primary endpoint of the study is the incidence of MACE, defined as the composite of cardiac death, myocardial infarction and cardiac hospitalization. Considering patients who have already undergone FUP (114; 36.5%), we recorded 19 MACE (16.7% of patients with FUP). The secondary endpoint is the rate of patients with SAQ Angina Summary Score < 70: the rate of patients with SAQ < 70 is 23.7% at 6 months, 23.8% at 12 months and 23.2% at 24 months. Conclusions: MB has been typically considered benign and asymptomatic, but its clinical relevance is still matter of debate. A remarkable proportion of our patients were found to have a MB during the occurrence of ACS or CCS, highlighting that different mechanisms of ischaemia may coexist. Furthermore, invasive functional assessment shows a plausible correlation between MB and vasomotor disorders. Our study is still ongoing, and we hope to maximize the data in order to have a solid comprehension of MB and to propose the assessment that may indicate a tailored therapy.