Obstructive sleep apnea (OSA) is a common condition associated with intermittent hypoxia, systemic inflammation, and vascular dysfunction; mechanisms implicated in retinal disease pathogenesis. This real-world retrospective cohort study used data from the TriNetX Research Network to assess whether continuous positive airway pressure (CPAP) therapy reduces retinal disease incidence among adults with OSA and BMI between 25.0 and 30.0 kg/m². After 1:1 propensity score matching, 101,754 patients were included in the analysis. Retinal outcomes included diabetic retinopathy (DR), age-related macular degeneration (AMD), retinal vein occlusion (RVO), and central serous chorioretinopathy (CSC). CPAP use was associated with a modest but statistically significant reduction in DR (3.2% vs. 3.4%, RR: 0.922, p = 0.016) and AMD (2.1% vs. 2.3%, RR: 0.906, p = 0.018), while no significant differences were found for RVO or CSC. These findings support prior evidence linking CPAP to improved retinal microvascular health and suggest a protective effect against specific retinal complications. Limitations include a lack of data on CPAP adherence, OSA severity, and imaging confirmation. Still, this study highlights the importance of interdisciplinary care between sleep and eye health, and the need for further prospective studies to validate CPAP’s role in preventing retinal disease progression in OSA patients.

Purpose To synthesize method-dependent rates, time courses, risk factors, mechanisms, and management of strabismus/diplopia after glaucoma drainage device (GDD) surgery. Methods PRISMA-2020 systematic review (PROSPERO CRD420251110465) across seven databases to 21 July 2025, including randomized trials, cohorts, and case series. Outcomes were prespecified: incidence (early ≤3 months; late ≥12 months), visit-prevalence by standardized orthoptics or patient-reported outcome measures (PROMs), and chart-documented postoperative occurrence. Narrative synthesis followed SWiM guidance. Denominators were per patient for diplopia/strabismus and per eye for motility limitation. Results Ninety-one studies (11,681 patients; 12,068 eyes) met criteria. Onset clustered early (median ≈6 weeks), followed by two trajectories, many cases remitted with capsule remodeling; a minority persisted with restrictive tethering. Apparent rates varied by ascertainment and unit: persistent diplopia was 0–5% in contemporary chart-ascertained cohorts, ∼5% at 1 year and ∼4% at 5 years in standardized-orthoptic trials, and up to ∼23% at 1 year in PROM studies. Surgical anatomy and tissue planes outweighed device family or nominal plate size: inferior placement increased early strabismus (≈21% ≤3 months vs 0% with superior placement), and pars plana entry showed higher diplopia than anterior-chamber entry in matched cohorts. Mechanism was predominantly restrictive (posterior-fixation–like) from capsule–muscle coupling. Management mirrored the natural history: early symptoms often resolved with observation/prisms; persistent, clearly restrictive deviations benefited from capsule-aware adhesiolysis with limited, targeted rectus surgery; device revision/explant was uncommon. Conclusion Post-GDD motility morbidity is chiefly restrictive and measurement-dependent. Reports should separate incidence from visit-prevalence, distinguish any from persistent diplopia, and use per-patient denominators for diplopia/strabismus and per-eye for motility limitation. Future trials should standardize orthoptic endpoints, pair PROMs with imaging of the plate–muscle interface, and power for motility outcomes alongside IOP.

The aim of this study was to review and meta-analyze the efficacy and safety of topical insulin eye drops (TIED) in treating corneal epithelial defects (CED). We registered the protocol in PROSPERO (CRD420251051879). A systematic literature search on PubMed, Cochrane, ScienceDirect, Scopus, and Google Scholar until May 2025 was done to identify controlled comparative studies. Outcomes of interest include time to complete re-epithelialization, re-epithelialization rate, treatment failure, recurrence, and adverse events. We performed meta-analysis using a random-effects model and assessed the certainty of evidence for each result using Grading of Recommendations Assessment, Development, and Evaluation (GRADE) assessment. Seven studies involving 238 patients were included in the analysis. TIED significantly shortened re-epithelialization time (mean difference [MD] –1.20 days [−1.71–−0.69], p<0.0001) and accelerated the healing rate (MD +0.26 mm²/h [0.10–0.42], p=0.002). In addition, TIED significantly reduced the risk of treatment failure (risk ratio [RR] 0.30 [0.16–0.57], p=0.003) and recurrence (RR 0.25 [0.11–0.56], p=0.0007) compared to conventional treatments, with no adverse events reported. GRADE assessments indicated very low to low certainty of evidence. TIED may speed corneal healing, cut failures and recurrences, and is well-tolerated and inexpensive. Robust randomized controlled trials are still needed to nail down the optimal dosing, long-term safety, and its role in CED management.