Background/Aim. Vision and health problems associated with the use of computers and other digital devices are known as computer vision syndrome (CVS). Advances in technology have led to increased use of computers, so the prevalence of these symptoms is increasing. The aim of this study was to calculate the overall prevalence of CVS and CVS symptoms using meta-analysis. Methods. The study was developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. In July 2021, a systematic search of four electronic databases with article collections was performed: PubMed, Cochrane Library, Web of Science, and Google Scholar. The key search terms were: ?computer vision syndrome?, ?computer users?, ?digital eyestrain?, ?headache?, ?dry eyes?, ?red eyes?, ?eyestrain?, ?neck pain?, ?back pain?, and ?shoulder pain?. The articles included in the study had to be original articles written in English only, and the criterion that had to be met was that the research included computer users. As a result, the prevalence of CVS or the prevalence of any of the symptoms of CVS had to be measured. Results. A total of 43 articles were fully reviewed, of which 20 were included in the meta-analysis. The total calculated prevalence for all studies was 74.4%, while the prevalence for individual symptoms was: headache ? 43%, dry eyes ? 24.4%, eyestrain ? 29%, red eyes ? 20.7%, and neck, back, or shoulder pain ? 46.3%. Conclusion. The results obtained are worrying and point to the necessity of a multidisciplinary approach to solving CVS-related problems.

Backgrounds and Objectives: To analyze the influence of multiple anti-VEGF intravitreal injections for exudative age-related macular degeneration on the thickness of peripapillary retinal nerve fiber layer (RNFL) and macular ganglion cell-inner plexiform layer (GC + IPL) using spectral domain optical coherence tomography (SD-OCT). Materials and Methods: A prospective interventional study of consecutive patients treated with intravitreal bevacizumab (IVB) was performed. Average and sectorial values of RNFL and GC + IPL thickness were recorded using Cirrus SD-OCT at 0, 6, 12, and 24 months. Patients suffering from any ocular disease that could affect RNFL or GC + IPL thickness were excluded. Results: A total of 135 patients (70 women and 65 men, aged 65 ± 15 years) were included. The average number of injections per patient was 12.4 ± 2.4. Average RNFL and GC + IPL thickness prior to the first injection (87.6 ± 12.2 and 47.2 ± 15.5 respectively), and after 24-month follow-up (86.2 ± 12.6 and 46.7 ± 11.9 respectively) did not differ significantly (p > 0.05). There was a significant decrease in GC2, GC5 segments, and minimum GC + IPL thickness. Conclusion: Repeated anti-VEGF treatment did not cause significant changes in the thickness of RNFL and GC + IPL layers over a period of 24 months. The detected decrease in GC2 and GC5 sectors, as well as in minimum GC + IPL thickness, could be a sign of ganglion cell damage induced by the treatment or could occur during the natural course of the disease.

Introduction/Objective. Pseudoexfoliation (PEX) is an age-related systemic disorder, which can affect the whole body, as well as the eye. It is characterized by abnormal production and accumulation of pseudoexfoliative material. When present in the eye, it can cause different difficulties, but most common are PEX glaucoma (XFG) and intraoperative and postoperative complications of cataract surgeries. The aim of this study was to determine an incidence of patients with PEX in two different regions of Serbia. Methods. The study included 7451 patients scheduled for cataract surgery in two regions of Serbia. It was designed as a multicentric, retrospective study with evaluation of the medical records of all patients who underwent cataract surgery. The study evaluated: incidence of PEX syndrome and PEX glaucoma, age, and sex of patients, as well as preoperative antiglaucomatous therapy and intraoperative and postoperative cataract surgery complications. Results. PEX syndrome (XFS)was recorded in 676 patients (407 females and 269 males), while 243 patients had XFS. It represented 3.26% of patients included in the study. Mean age of XFG patients was 78.1 ?} 2.1 years with a statistically significant difference (p < 0.05) among incidence of XFG in females compared to males. Intraoperative and postoperative complications during cataract surgery were significantly common in patients with PEX (p < 0.05) Conclusion. PEX can complicate cataract surgery, while on the other hand XFG is more difficult to treat and control than most other glaucomas. Therefore, patients with PEX require special treatment during follow-up and treatment.

Introduction. Langerhans cell histiocytosis, as a hematopoietic neoplasm, is a clonal proliferation of Langerhans dendritic cells. Case study: A 43-year-old female patient first presented for an endocrinology consultation due to front neck pain and swelling accompanied by fatigue and malaise. Results.Physical examination revealed enlarged thyroid gland lobe of extremely firm consistency that was painfully tender on palpation. Echosonographic findings confirmed that the right thyroid gland lobe was enlarged and was not clearly demarcated from the surrounding tissue, while exhibiting pronounced parenchyma inhomogeneity characterized by reduced echogenicity of the anterior aspect and pronounced hypoechoicity of the posterior aspect, permeated with fibrous bands and calcifications. The structure of the left thyroid lobe was pseudonodose, with the characteristics of a chronic inflammatory process. Biohumoral findings indicated chronic autoimmune thyroiditis and primary hypothyroidism. Medical history, clinical findings, and personal and family predisposition to malignancy confirmed the need for accelerated additional diagnosis. Fine-needle aspiration biopsy (FNAB) was indicative of atypia of undetermined significance (AUS) involving Hurthle cells, nuclear overlaps, anisocytosis, anisonucleosis, and presence of nuclear incisions. Analyses performed after thyroidectomy pointed to the fibrous form of chronic thyroiditis, with suspected monoclonal proliferation of histiocytic and/or lymphoid cells. Immunohistochemical findings confirmed Hashimoto’s thyroiditis and Langerhans cell histiocytosis. As the postoperative course was favorable, the patient was prescribed L-thyroxine replacement therapy, along with continuous and systematic monitoring for histiocytosis.Conclusion.A comprehensive clinical examination is sometimes crucial for detecting rare adult diseases, such as Langerhans cell histiocytosis (LCH) with concomitant autoimmune thyroid disease, where timely LCH diagnosis largely determines the outcome. Histiocytosis should be suspected more often given the high incidence of autoimmune thyroid disease in adulthood.

Background/Aim. Center-involved diabetic macular edema (CI-DME) is a major cause of vision loss in diabetes mellitus, characterized by retinal thickening (1 mm) in the central foveal zone. Intravitreal anti-vascular endothelial growth factor (anti-VEGF) agents, such as aflibercept, are widely used to treat retinal edema and improve visual outcomes. The aim of the study was to evaluate anatomical and functional changes of the retina following intravitreal administration of aflibercept in patients with CI-DME. Methods. This retrospective longitudinal cohort study included 70 eyes in 50 patients with optical coherence tomography (OCT)-confirmed CI-DME [with central foveal thickness (CFT) ≥ 350 μm and best-corrected visual acuity (BCVA) ≥ 0.6 Snellen], treated with three monthly aflibercept injections. BCVA, CFT, and macular volume (MV) were measured using the Optovue RTVue XR OCT device at baseline and after 1, 3, and 6 months of treatment. Results. Mean patient age was 64.63 ± 7.79 years. Hypertension was the most prevalent comorbidity (72.0%). Over the six-month follow-up period, significant reductions were observed in mean CFT (459.00 μm to 379.92 μm, p < 0.001) and MV (9.05 mm³ to 8.44 mm³, p < 0.001) values. Although BCVA showed modest improvement, it did not reach statistical significance. Anatomical improvements align with aflibercept’s inhibition of VEGF-A and placental growth factor, which reduced vascular permeability. Conclusion. Intravitreal aflibercept significantly decreases retinal thickness and MV in patients with CI-DME, confirming its anatomical efficacy. Functional visual improvement was limited, possibly due to chronic retinal damage. In order to clarify the effect of intravitreal aflibercept on visual outcomes, longer-term studies with larger patient cohorts are required.

Background/Objectives: Retinal optical coherence tomography (OCT) has emerged as a sensitive biomarker of neurodegeneration in multiple sclerosis (MS), yet eyes without overt optic neuritis (ON) are routinely pooled as “clinically unaffected” despite their heterogeneous histories. We evaluated whether never-ON eyes and fellow eyes after unilateral ON differ structurally and microvascularly using swept-source OCT (SS-OCT) and OCT angiography (OCTA). Methods: In this cross-sectional, single-center study, 126 clinically unaffected MS eyes—96 never-ON eyes and 30 fellow eyes after unilateral ON—were compared with 118 healthy control eyes. SS-OCT quantified ganglion cell–inner plexiform layer (GCIPL), peripapillary retinal nerve fiber layer (pRNFL), and macular RNFL (mRNFL) thickness, while OCTA measured superficial vascular plexus (SVP) vessel density. Between-group differences were assessed using generalized estimating equations with participant-level clustering, empirical (sandwich) standard errors, adjustment for age and sex, and false discovery rate correction. Results: Despite preserved visual acuity, both never-ON and fellow eyes showed structural retinal thinning relative to controls. GCIPL thickness followed a stepwise gradient—66.14 ± 4.31, 62.08 ± 7.03, and 58.03 ± 7.71 µm in controls, never-ON eyes, and fellow eyes, respectively (FDR-adjusted q = 0.020 for fellow vs. never-ON eyes)—and pRNFL and mRNFL showed a similar overall pattern. After false discovery rate correction, OCTA parameters did not differ significantly between groups. Conclusions: Clinically unaffected eyes in MS are not structurally normal, and fellow eyes after unilateral ON carry a greater burden of silent retinal damage than never-ON eyes. These two phenotypes should be analyzed separately in MS imaging research. Structural OCT measures, particularly GCIPL thickness, appear more sensitive than microvascular indices for detecting subclinical retinal involvement.