Background: Anti-vascular endothelial growth factor (anti-VEGF) therapy has revolutionized the management of various ocular conditions, including diabetic macular edema (DME), retinal vein occlusion (RVO)-related macular edema (ME), and neovascular age-related macular degeneration (nAMD). However, there remains a need to systematically assess its effectiveness across these distinct conditions. Methodology: A systematic review was conducted to identify studies evaluating the efficacy of anti-VEGF therapy in improving ocular outcomes in patients with DME, RVO-related ME, and nAMD. PubMed, Embase, and Cochrane Library databases were searched for relevant articles published up to 2024. Studies meeting the inclusion criteria were critically appraised, and data on the proportion of patients gaining ≥ 15 Early Treatment Diabetic Retinopathy Study (ETDRS) letters in best-corrected visual acuity (BCVA), mean change in BCVA (ETDRS letters), and reduction in central macular thickness (CMT) (μm) were extracted and synthesized. Results: The systematic review identified 18 studies comprising randomized controlled trials, prospective studies, retrospective analyses, and observational studies. Anti-VEGF therapy demonstrated efficacy across all three conditions, with varying proportions of patients experiencing improvements in BCVA and reductions in CMT. Notably, the proportion of patients gaining ≥ 15 ETDRS letters ranged from 18.1% to 44.8% in DME, while mean changes in BCVA ranged from +4.2 letters to +21.4 letters in RVO-related ME and nAMD. Reductions in CMT ranged from 183.1 μm to 294 μm in DME and RVO-related ME. Conclusion: Anti-VEGF therapy represents a cornerstone in the management of DME, RVO-related ME, and nAMD, with significant improvements observed in BCVA and reductions in CMT across diverse patient populations. While our findings support the effectiveness of anti-VEGF therapy in improving ocular outcomes, further research is warranted to compare its efficacy with alternative treatment modalities and to elucidate its long-term safety profile.

Background: Laryngopharyngeal reflux (LPR), allergic rhinitis (AR), and asthma are common airway disorders that often coexist, suggesting shared inflammatory mechanisms. LPR involves gastric reflux into the laryngopharynx, while AR and asthma are linked by the “united airway” hypothesis. Evidence indicates LPR may contribute to AR and asthma exacerbation, yet their interactions remain unclear. Understanding their interaction may enhance clinical outcomes. Objective: This systematic review aimed to evaluate the associations between LPR, AR, and asthma by analyzing studies that examined these conditions in various patient populations. Methodology: A comprehensive search of electronic databases, including PubMed, Scopus, and Google Scholar, was conducted for studies published up until 2024. Eligible studies were selected based on predefined inclusion criteria, and data on the prevalence, diagnostic methods, and associations between LPR, AR, and asthma were extracted. This systematic review was conducted and registered in PROSPERO (CRD42024588367). Statistical analysis was performed to determine the strength of the associations between these conditions. Results: The review identified significant associations between LPR and both AR and asthma. Multiple studies confirmed a positive correlation between LPR and AR, with worse AR symptoms observed in patients with more severe LPR. Additionally, a strong association between LPR and asthma was observed, particularly in patients with poorly-controlled asthma. The analysis also revealed a robust relationship between AR and asthma, consistent with the “united airway” hypothesis, which posits that the upper and lower airways share common inflammatory pathways. These findings suggest that the coexistence of these conditions may exacerbate symptoms and complicate management. Conclusion: This systematic review highlights the significant associations between LPR, AR, and asthma, emphasizing the importance of recognizing and addressing these comorbidities in clinical practice. The findings suggest that managing 1 condition may have a beneficial effect on the others, supporting a multidisciplinary approach to diagnosis and treatment.

Background: Rhinoplasty is a widely performed cosmetic and functional procedure. Despite its popularity, postoperative dissatisfaction remains a common concern. This study aims to assess patient satisfaction and quality of life using the rhinoplasty outcome evaluation (ROE) survey, to help improve preoperative planning and postoperative care. Patients and Methods: A systematic literature review was conducted in PubMed, Cochrane, Google Scholar, EBSCO, and Web of Science using the terms “Rhinoplasty OR Septorhinoplasty,” “Satisfaction OR Prognosis OR Outcome,” “Quality of Life OR QoL,” and “ROE OR Rhinoplasty Outcome Evaluation.” All studies published between 2018 and 2024 were selected, and nonrelevant studies were excluded after full text review. Results: Twenty-four studies were included in a meta-analysis comparing ROE scores pre- and postoperative. The results demonstrated a significant improvement in satisfaction and quality of life postoperatively. The subgroup analysis revealed a notable variation in the outcome according to the country of origin. Although the study heterogeneity was high (I ² = 99.8%), a random-effects model was used for the analysis. Conclusions: Gender was not a major determinant of satisfaction. However, the country of origin significantly influenced ROE scores. These findings emphasize the need for culturally sensitive counseling, individualized surgical planning, and management of patient expectations to enhance satisfaction.

BACKGROUND: Dry eye disease (DED) is a multifactorial condition characterized by discomfort and visual disturbances, often linked to prolonged screen time and other environmental or lifestyle factors. In Saudi Arabia, DED prevalence is increasing, especially among younger populations. AIM: This study aimed to assess the prevalence of DED, its associated risk factors, and awareness among Saudi youth. METHODOLOGY: A cross-sectional questionnaire-based study was conducted targeting 366 Saudi youth. The sample was recruited randomly, with the majority (89.3%) from the central region. Participants ranged in age from 19 to over 55 years, with a mean age of 28.6 ± 11.7 years. Data were collected via a self-administered electronic questionnaire covering demographics, screen time, awareness, and risk factors related to DED. The Ocular Surface Disease Index (OSDI) was used to assess the severity of DED. Statistical analysis was performed using SPSS, with significance set at p < 0.05. RESULTS: The prevalence of DED was 67.8%, with 19.9% of cases being mild, 18% moderate, and 29.8% severe. Long use of computer screens (77%), fatigue (69.7%), and air pollution (68.9%) were the most commonly reported risk factors for DED. Significant associations were found between DED and factors such as female gender (p = 0.003), older age (p = 0.049), and prolonged TV screen time (p = 0.030). Awareness of DED was high, with 83.1% of participants reporting knowledge of the condition, primarily from internet sources and healthcare professionals. However, only 19.9% reported regular eye doctor visits, and 50.5% used cooling eye drops for symptom relief instead of artificial tears. CONCLUSION: DED is highly prevalent among Saudi youth, with prolonged screen time, fatigue, and environmental factors contributing to the risk. Awareness is widespread, but healthcare- seeking behavior remains low. Strategies to promote early diagnosis, proper treatment, and preventive measures are needed to reduce the burden of DED in this population.

Patulous Eustachian Tube (PET) is a rare otologic disorder, which is caused by abnormal patency of the Eustachian tube. Rapid weight loss is a recognized predisposing factor for PET potentially because of the reduction in peritubal adipose tissue that contributes to normal tubal closure. Although there is increasing awareness of this association, the best treatment of PET is still debated with several conservative, medical and surgical operations reported in the literature. This narrative review summarizes the available evidence regarding conservative, medical, minimally invasive, and surgical management of PET, with particular consideration of PET associated with rapid weight loss. Relevant literature was identified through searches of PubMed/MEDLINE, Embase, Web of Science, and the Cochrane Library, with attention to studies using standardized diagnostic criteria and outcome measures. Conservative approaches, including hydration, nasal saline instillation, and behavioral modifications such as cessation of habitual sniffing, have been associated with symptomatic improvement and considered as initial options because of their accessibility and low procedural burden. Medical therapies, such as topical irritants, estrogen-based preparations, and mucosal-thickening agents, may provide temporary symptom relief, although their long-term effects require further evaluation. Among interventional strategies, silicone (Kobayashi) plug insertion has demonstrated encouraging symptom improvement and reductions in symptom scores in selected patients with refractory PET. Minimally invasive techniques, including autologous fat injection, cartilage augmentation, and soft tissue bulking procedures, have also demonstrated encouraging outcomes. Trans-tympanic interventions, including ventilation-tube insertion and catheter-based techniques, provided additional options with variable reported outcomes. Management of PET remains heterogeneous and largely individualized. Conservative and medical therapies are considered reasonable first-line options, while surgical and minimally invasive approaches may be considered for selected patients with persistent symptoms.

Background: Ear piercing is one of the most commonly performed forms of body modification worldwide. While generally considered a simple procedure, it may be associated with a range of local and cosmetic complications. Objective: To evaluate current ear-piercing trends, determine the prevalence of ear-piercing complications, and identify factors independently associated with the development of these complications among females residing in Riyadh. Methods: A cross-sectional survey was conducted among females residing in Riyadh, Saudi Arabia. Participants were recruited through an online self-administered questionnaire distributed via social media platforms. Multivariable logistic regression was used to identify independent predictors of complications. Results: A total of 1018 participants were included. Ear piercing for aesthetic purposes was reported by 52.8% of respondents. Most participants (87.8%) reported not receiving information regarding procedural risks or aftercare instructions. Complications were reported by 26.5% of participants, with infection (57.0%) and ear pain (54.1%) being the most frequent. Independent predictors of complications included having multiple piercings, cartilage piercing, student status, and the use of piercing guns. Undergoing the first ear piercing before one year of age was associated with a lower risk of complications. Conclusions: Our findings indicate that nearly one-quarter of females reported experiencing complications from ear piercings and are associated with several potentially modifiable factors. This emphasizes the importance of informed consent before the procedure, along with proper education on associated risks.