Purpose: Macular telangiectasia type 2 (MacTel2) is a rare disorder, affecting retina's vascular structure, and MacTel2-associated full-thickness macular holes (MHs) are extremely rare in general population. Since their management is still controversial, this literature review was aimed to gather evidences on the surgical management of MacTel2-associated MHs. Methods: A retrospective review on the Cochrane Central, PubMed, Web of Science, and ClinicalTrials.gov databases for articles regarding MacTel2 and MHs. The search period was set from January 2000 to February 2024, and any kind of article was taken into account. Results: We took into account 10 studies analyzing surgical outcomes of MacTel2-associated MHs, with a total number of 95 treated eyes. Different surgical techniques were used, with a better anatomical outcome after internal limiting membrane inverted flap surgery but with very controversial functional outcomes. In a comparative report, internal limiting membrane peeling alone (34 eyes) was associated with a 47% anatomical success rate, internal limiting membrane inverted flap (22 eyes) with 90% successful closure, and autologous retinal transplantation (five eyes) with a 100% success rate but without visual improvement. Conclusion: Since the exact pathophysiology of MacTel2 macular holes is not clear yet, even if the internal limiting membrane inverted flap technique could be an effective treatment for these patients, visual outcomes are poor. This underlines the necessity of a deeper comprehension of the pathophysiology of the disease and the development of new surgical approaches.

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.

Background: Dry age-related macular degeneration currently lacks effective treatments for geographic atrophy. Cord blood platelet–rich (CB-PRP) plasma intravitreal injections are a novel therapy under investigation with promising ad interim results. Objectives: To describe the safety profile of cord blood platelet–rich plasma intravitreal injections (IVIs) in dry age-related macular degeneration (AMD) patients. Design: This prospective, randomized, sham-controlled, open-label experimental trial evaluated the safety of repeated intravitreal CB-PRP injections. Methods: The study, conducted from January 2023 to January 2025, investigated the safety and efficacy of CB-PRP IVIs to slow down the progression of geographic atrophy (GA). One eye of each patient was randomly assigned to the monthly, every other month, or every 3 months arm and received 0.05 mL CB-PRP, while the other eye underwent only a sham injection. Complete ophthalmological evaluations were performed at baseline, 3-, 6-, 12-, 18-, and 24-month follow-ups. In addition, slit-lamp and fundus examinations were performed the day after the injection to exclude any adverse effect. Results: In a total of 328 intravitreal injections, vitreous opacities were observed in the absence of other signs of infection or inflammation only in three cases. All of them showed progressive improvement without treatment, and complete recovery was observed within 2 weeks. Conclusion: Although the pathogenesis of the detected vitreous thickening was not completely clear, the most likely hypothesis was the coexistence of a slightly lower temperature of the CB-PRP sample and individual factors. This mild adverse event occurred only once in each patient involved, with no recurrence during subsequent intravitreal injections. The occurrence of this self-limiting finding after CB-PRP IVIs has not invalidated the safety profile of the procedure.

Objectives: This study aims to compare the imaging performance of spectral-domain optical coherence tomography (SD-OCT) and swept-source OCT (SS-OCT) in the early postoperative assessment of patients undergoing vitreoretinal surgery with intraocular gas or air tamponade. Methods: Seventeen eyes of 17 patients who underwent pars plana vitrectomy with either sulfur hexafluoride (SF₆, 20%) or air tamponade were prospectively enrolled. All patients underwent OCT imaging on postoperative day 1 using both the SD-OCT system and the SS-OCT platform, without pharmacological mydriasis. Images were independently evaluated by two experienced ophthalmologists based on the ability to delineate four prespecified anatomical layers: inner retinal layers, ellipsoid zone (EZ), retinal pigment epithelium (RPE) and choroid. Images were classified as adequate quality if two or more of these structures were identifiable. Results: SS-OCT provided adequate-quality images in all 17 eyes (100%), with complete visualization of the inner retinal layers, EZ, RPE, and choroid in 15 eyes (88.2%). In contrast, SD-OCT yielded adequate-quality images in only three of 17 eyes (17.6%), demonstrating marked signal attenuation, interface artifacts, and inability to resolve deeper retinal structures in most cases. No difference in imaging performance was observed between SF₆ and air tamponade subgroups. Conclusions: SS-OCT demonstrates markedly superior imaging performance in gas-filled eyes on postoperative day 1 compared to SD-OCT, primarily attributable to its longer wavelength, reduced sensitivity roll-off, and superior penetration through optically challenging media. These findings suggest that SS-OCT may offer meaningful advantages for early postoperative monitoring following vitreoretinal surgery with tamponade; confirmation in larger prospective cohorts with clinical-outcome correlation is warranted before it can be recommended as the preferred modality.