Mental health issues and insufficient physical activity (PA) among students pose significant public health concerns. This study aimed to examine the prevalence of depression, anxiety, and stress symptoms, alongside PA levels, among Croatian medical students, with a focus on sex-specific differences and associations between these variables. A cross-sectional study was carried out during May and June 2025 among medical students at the University of Osijek, Croatia. Participants completed a self-reported questionnaire consisting of three sections: sociodemographic characteristics, the Depression, Anxiety, and Stress Scale-21 (DASS-21), and the International Physical Activity Questionnaire-Short Form (IPAQ-SF). The study included 244 students (70 males, 174 females) with a median age of 21 years (IQR: 20–23). Symptoms of depression, anxiety, and stress were reported by 33.1%, 48.4%, and 42.6% of participants, respectively. According to IPAQ-SF, 39.7% of students reported PA levels below current recommendations. Female students reported significantly higher depression (p = 0.009), anxiety (p < 0.001), and stress scores (p < 0.001), lower levels of moderate (p = 0.009) and vigorous PA (p < 0.001), and more time spent sitting (p = 0.006) compared to their male counterparts. Furthermore, significant positive correlations were identified between sitting time and depression (ρ = 0.17, p = 0.01), anxiety (ρ = 0.18, p = 0.006), and stress (ρ = 0.26, p < 0.001). Conversely, higher PA—particularly vigorous activity—was associated with lower levels of depression (ρ = −0.21, p = 0.001) and anxiety (ρ = −0.15, p = 0.018). Croatian medical students demonstrated a substantial prevalence of depression, anxiety, and stress symptoms, combined with inadequate levels of PA. These findings highlight the importance of implementing strategies aimed at supporting mental health and fostering regular PA among future healthcare professionals.

Background: Retinal microvascular assessment has emerged as a promising non-invasive approach for evaluating vascular health. Recent advances in retinal imaging technologies have enabled detailed characterization of retinal vascular structure and function, raising interest in their potential role as biomarkers of exercise-related vascular adaptation. This systematic review with narrative synthesis aimed to summarize current evidence regarding the relationship between exercise, physical fitness, and retinal microvascular biomarkers. Methods: A systematic literature search was conducted in PubMed, Scopus, and Web of Science for studies published from January 2021 to June 2026, followed by a supplementary update search to identify eligible publications available through 31 July 2026. Search terms combined retinal microvascular assessment techniques with terms related to exercise, physical activity, physical fitness, and exercise training. Following screening and eligibility assessment, 42 publications were included in the final qualitative synthesis, comprising 20 publications identified through the initial search and 22 additional publications identified through the supplementary update search. Several publications represented complementary analyses of the same or overlapping study cohorts and were therefore not considered independent replications. Results: The included studies comprised observational studies and exercise intervention trials involving healthy individuals and clinical populations. Retinal biomarkers assessed included vessel diameters, arteriovenous ratio (AVR), vessel density, perfusion density, foveal avascular zone (FAZ), retinal oxygen extraction, wall-to-lumen ratio (WLR), and choriocapillaris perfusion parameters. Several studies reported measurable acute and chronic retinal vascular responses to exercise, although the direction, magnitude, and clinical meaning of these changes varied according to population, exercise modality, imaging technique, and biomarker. Observational studies generally reported associations between higher physical activity or cardiorespiratory fitness and a more favorable retinal vascular profile, but causal interpretation remains limited. Conclusions: Retinal microvascular biomarkers appear sensitive to acute physiological stress and may reflect selected adaptations associated with longer-term exercise exposure. However, retinal responses are heterogeneous and biomarker-specific, and their biological and clinical significance remains incompletely established. Methodological heterogeneity, overlapping study cohorts, and the limited number of adequately powered randomized and longitudinal studies constrain causal interpretation and generalizability. Retinal vascular measures should therefore currently be regarded as candidate biomarkers and research tools rather than validated surrogate outcomes or routine clinical measures.

Background and Objectives: Corneal ulcers in patients with lagophthalmos due to facial nerve palsy pose a significant therapeutic challenge. Topical insulin has emerged as a promising adjuvant therapy for enhancing corneal re-epithelialization. The aim of this study is to evaluate the efficacy of insulin drops compared with lipid-based artificial tears, and to compare the corneal healing rate in achieving complete epithelialization within 30 days in diabetic patients. Materials and Methods: This retrospective case–control study included 32 patients with facial nerve palsy and lagophthalmos who developed an exposed corneal ulcer, of whom 20 received topical insulin and 12 received lipid-based artificial tears. The primary outcome was complete epithelialization at day 30. Additional variables included age, sex, and baseline defect characteristics. Results: By day 30, complete epithelialization was achieved in 18 of 20 patients (90%) in the insulin group compared with 5 of 12 (41.7%) in the control group. Binary logistic regression analysis confirmed significantly higher odds of healing with insulin treatment (OR = 10.8; 95% CI 1.8–63.9). No systemic adverse events or signs of hypoglycemia were observed. Conclusions: Topical insulin significantly accelerates corneal epithelialization in patients with facial nerve palsy and exposed ulcers, offering safe and effective adjuvant therapy for a high-risk population. Despite promising results, the study’s limitations—including small sample size, single-center design, and retrospective nature—highlight the need for larger, multicenter prospective studies to confirm efficacy, optimize dosing, and further evaluate long-term safety.

Background/Objectives: Chronic topical antiglaucoma therapy may affect the ocular surface. We assessed documented dry eye disease (DED) and its associations with active-ingredient burden, treatment duration, and preservative exposure. Methods: This retrospective cross-sectional study included 357 adults receiving topical antiglaucoma therapy at a tertiary center who had complete treatment and ocular-surface data. Ocular-surface testing was prompted by symptoms or clinical judgment. The first eligible visit identified during chronological record review was analyzed for each patient. DED was based on the treating ophthalmologist’s documented diagnosis. Logistic regression evaluated treatment-related factors. Results: DED was documented in 171/357 patients within this selected sample (47.9%; 95% CI 42.8–53.1%). Prevalence was higher with at least two versus one active IOP-lowering ingredient (60.6% vs. 23.1%; p < 0.001). Each additional ingredient was associated with higher DED odds after adjustment for age, sex, and glaucoma subtype (adjusted odds ratio [aOR] 2.65, 95% confidence interval [CI] 1.88–3.74). Longer treatment duration was also associated with higher odds (aOR 1.12 per 12 months, 95% CI 1.05–1.20). In the linear extended model, active-ingredient count was not associated with documented DED (aOR 1.02, 95% CI 0.69–1.51), whereas an exclusively preservative-free regimen was associated with lower odds (aOR 0.011, 95% CI 0.001–0.084) and fixed-combination therapy with higher odds (aOR 3.23, 95% CI 1.74–5.98). However, categorical modeling of ingredient count significantly improved extended-model fit (likelihood-ratio p < 0.001), indicating sensitivity to functional form. Documented DED occurred in 1/91 (1.1%) exclusively preservative-free patients versus 170/266 (63.9%) preserved-exposure patients, with sparse PF events limiting interpretation. Conclusions: Documented DED was common in this selected cohort undergoing ocular-surface assessment. Active-ingredient count was associated with DED in the primary adjusted model, but its interpretation in the extended model depended on the functional form used. The marked inverse association with an exclusively preservative-free regimen requires prospective confirmation because sparse data, limited overlap between treatment groups, treatment selection, and residual confounding preclude causal inference.