Background and Objectives: Uveitis-masked syndromes or masquerade syndromes (UMSs) are a group of ocular conditions with several systemic underlying causes, malignant or nonmalignant, that mimic the inflammatory status of the uvea. They are often difficult to detect and diagnose with traditional techniques, such as ophthalmic exams. Ocular B (bidimensional)-ultrasound (OBU) is a non-invasive, repeatable, rapid ultrasound method effective in indirect signs that lead back to systemic diseases. It is comparable in effectiveness with other imaging tools. The cause of UMSs can often be serious, and therefore early diagnosis and prompt treatment are critical. This study aimed to identify the sonographic signs of these forms, which can help physicians discover the cause underlying UMS. Materials and Methods: This was a consecutive, retrospective, nonrandomized study. This study was conducted at the University Hospital Polyclinic of Bari, Italy, from January 2022 to December 2024. A total of 186 patients were included, from 10 to 85 years old. They all underwent B-scan ultrasonography (Quantel Medical ABSolu Ocular Ultrasound). Results: All patients reported blurred vision, which could be accompanied by visual reduction (<20/40, Snellen charts), photophobia, floaters, flashes, proptosis, and redness. In all cases, we noted peculiar ultrasonographic signs, which allowed us to discriminate the underlying systemic diagnosis, such as vitreous corpuscles, choroid thickening, and primitive or metastatic solid tumors. Finally, we identified different diseases, such as primary intraocular lymphoma (PIOL), other lymphoproliferative conditions, orbital plasmacytoma, uveal melanoma, metastasis, endogenous endophthalmitis, retinal detachment, central serous retinopathy, metallic foreign bodies, ocular amyloidosis, and drug-induced UMSs. The sensitivity and specificity of ocular ultrasound compared to multimodal ocular imaging in UMSs were as follows: for primary intraocular lymphoma (PIOL) and other lymphoproliferative conditions, 0.98 (95% CI, 0.80–1) and 0.68 (90% CI, 0.40–0.92), respectively; for orbital plasmacytoma, 0.64 (92% CI, 0.52–0.86) and 0.66 (93% CI, 0.48–0.89), respectively; uveal melanoma, 1.00 (98% CI, 0.88–1.00) and 0.98 (95% CI, 0.86–0.98), respectively; metastasis, 0.75 (95% CI, 0.53–0.85) and 0.85 (95% CI, 0.48–0.98), respectively; endogenous endophthalmitis, 1.00 (95% CI, 0.50–1.00) and 0.83 (95% CI, 0.48–0.98), respectively; retinal detachment, both were 1.00 (95% CI, 0.87–1.00 and 0.84–0.97, respectively); central serous retinopathy, 0.60 (80% CI, 0.41–0.88) and 0.85 (95% CI, 0.52–0.98), respectively; metallic foreign bodies, 1.00 (95% CI, 0.78–1.00) and 0.99 (95% CI, 0.99–1.00), respectively; ocular amyloidosis, 0.77 (82% CI, 0.52–0.90) and 0.83 (80% CI, 0.49–0.88), respectively; and drug-induced UMSs, 0.64 (95% CI, 0.49–0.88) and 0.85 (95% CI, 0.52–0.98), respectively. Conclusions: Diagnosing UMS accurately can be quite challenging, and many of its different types frequently go undetected. This complexity in identification often leads to underdiagnosis, meaning it is essential to improve awareness and understanding of the condition in order to achieve better recognition and treatment. Early detection of these forms is imperative. The use of OBU can help diagnose indirect signs of these forms early and treat them promptly. It compares well with other diagnostic imaging techniques, such as MRI, but this does not mean that it replaces them; it can offer added value in multimodal imaging.

Background and Objectives: Uveitis-masked syndromes or masquerade syndromes (UMSs) are a group of ocular conditions with several systemic underlying causes, malignant or nonmalignant, that mimic the inflammatory status of the uvea. They are often difficult to detect and diagnose with traditional techniques, such as ophthalmic exams. Ocular B (bidimensional)-ultrasound (OBU) is a non-invasive, repeatable, rapid ultrasound method effective in indirect signs that lead back to systemic diseases. It is comparable in effectiveness with other imaging tools. The cause of UMSs can often be serious, and therefore early diagnosis and prompt treatment are very critical. This study aims to identify the sonographic signs of these forms that can help physicians discover the cause underlying UMS. Materials and Methods: This is a consecutive, retrospective, nonrandomized study. This study is conducted at University Hospital Polyclinic of Bari, Italy, from January 2022 to December 2024. A total of 186 patients were included, from 10 to 85 years old. They all were undergone to B-scan ultrasonography (Quantel Medical ABSolu Ocular Ultrasound). Results: All patients reported blurred vision, that it can be accompanied by visual reduction (<20/40, Snellen charts), photophobia, floaters, flashes, proptosis, redness. In all cases we have noticed peculiar ultrasonographic signs which discriminate underlying systemic diagnosis, such as vitreous corpuscles, choroid thickening, solid tumors primitive or metastatic. Finally, they were identified different diseases, such as primary intraocular lymphoma (PIOL), and other lymphoproliferative conditions, orbital plasmacytoma, uveal melanoma, metastasis, endogenous endophthalmitis, retinal detachment, central serous retinopathy, metallic foreign bodies, ocular amyloidosis, toxoplasmosis, sarcoidosis, tuberculosis, syphilis, birdshot chorioretinitis, and drug-induced UMSs. lymphoma, other lymphoproliferative conditions, toxoplasmosis, sarcoidosis, tuberculosis, syphilis, UMSs caused by drugs, and others. Conclusion: Making a firm diagnosis of UMS is not easy, and the various forms are often underdiagnosed. Early detection of these forms is imperative. The use of OBU can help diagnose indirect signs of these forms early and treat them promptly. It compares well with other diagnostic imaging techniques, such as MRI, but this does not mean that it replaces them; it can be an added value in multimodal imaging.

Purpose: To evaluate the anatomical and functional outcomes of an epiretinal cryopreserved human amniotic membrane (hAM) overlay technique for the management of recurrent retinal detachment (RD) associated with peripapillary breaks in highly myopic eyes. Methods: Retrospective interventional case series including five eyes with recurrent RD (mean axial length 30.70 ± 2.03 mm). Two eyes presented with recurrence under silicone oil (SO) tamponade, and three after prior SO removal. All eyes underwent 25-gauge pars plana vitrectomy with SO removal when present. A customized 8–9 mm hAM patch was positioned epiretinally and unrolled bimanually under perfluorocarbon liquid (PFCL). Final tamponade was achieved with SO 1000 cSt, followed by scheduled SO removal. Results: Complete retinal reattachment was achieved in all cases (100%) after a single procedure and remained stable throughout follow-up. Mean best-corrected visual acuity (BCVA) improved from 1.00 ± 0.60 to 0.68 ± 0.58 logMAR at 2 months after SO removal (p = 0.068). Optical coherence tomography demonstrated stable integration of the hAM as a hyperreflective layer over the peripapillary defects. No cases of graft dislocation, proliferative vitreoretinopathy, or significant inflammatory complications were observed. Conclusions: The epiretinal hAM overlay technique appears to be a safe and effective approach for sealing complex peripapillary breaks in highly myopic eyes with chorioretinal atrophy. By providing both mechanical support and a biological scaffold for tissue repair, this technique may represent a valuable surgical option in cases where conventional retinopexy is not feasible or has failed.

Background: Epithelial ingrowth is an uncommon but potentially vision-threatening complication after keratorefractive lenticule extraction (KLEx). Although this complication is well described after flap-based refractive surgery, its occurrence after flapless lenticule extraction remains rare and is mainly reported in isolated cases. This narrative review summarizes the available literature on epithelial ingrowth after KLEx, with particular attention to proposed mechanisms, clinical presentation, imaging findings, and surgical management. An illustrative case of severe epithelial ingrowth managed with crocodile-forceps extraction is also presented. Methods: A literature search was performed to identify published reports describing epithelial ingrowth after SMILE/KLEx. Relevant articles were reviewed and compared with regard to onset, suspected mechanism, clinical severity, treatment strategy, anatomical outcome, visual recovery, and recurrence. Results: The affected eye developed extensive epithelial ingrowth associated with a postoperative tunnel laceration and marked visual deterioration during the first postoperative week. Surgical clearance through the original incision was performed using crocodile forceps followed by copious interface irrigation. Approximately one hour after treatment, AS-OCT demonstrated complete clearance of the hyperreflective interface material, corneal topography showed marked regularization, and wavefront aberrometry demonstrated a reduction in overall OPD RMS from 1.21 to 0.58 µm and higher-order RMS from 1.03 to 0.37 µm at a 4 mm pupil. Visual acuity subsequently improved over the following postoperative days, with no recurrence during 6-month follow-up. Conclusions: Severe epithelial ingrowth after KLEx may require prompt surgical intervention when rapid progression and visual deterioration occur. In this case, crocodile-forceps-assisted interface clearance through the original incision was feasible and was associated with rapid anatomical and optical recovery without cap-to-flap conversion or chemical adjuvants. Further cases are required to determine the reproducibility, safety, and long-term outcomes of this approach.