Diabetic retinopathy (DR) is a leading cause of vision loss globally, with early detection and intervention critical to preventing severe outcomes. This narrative review examines the role of retinal biomarkers—molecular and imaging—in improving early diagnosis, tracking disease progression, and advancing personalized treatment for DR. Key biomarkers, such as inflammatory and metabolic markers, imaging findings from optical coherence tomography and fluorescence angiography and genetic markers, provide insights into disease mechanisms, help predict progression, and monitor responses to treatments, like anti-VEGF and corticosteroids. While challenges in standardization and clinical integration remain, these biomarkers hold promise for a precision medicine approach that could transform DR management through early, individualized care.

Intraoperative OCT (iOCT) is an innovative imaging modality that provides ophthalmic surgeons with real-time cross-sectional views of the surgical field. Recent advances in OCT technology, such as higher acquisition scanning rates, enable real-time video visualization. iOCT systems are widely used in both vitreoretinal and anterior segment surgeries. In corneal surgeries, iOCT imaging aims to optimize efficacy and safety by improving depth perception and enhancing visualization in cases of opaque optical media. iOCT is a valuable tool not only for experienced corneal surgeons, but also for training novice surgeons. This review summarizes the emerging applications of iOCT in corneal surgery, particularly in technically demanding lamellar keratoplasty procedures, as well as in various other corneal diseases and complications that require surgical intervention.

Corneal crosslinking (CXL) was first introduced in clinical practice in 2003. Since then, this procedure has been established as the first-line treatment in the management of progressive keratoconus. Over the last years, many different protocols have emerged, each one of them with variable clinical outcomes and safety profile. Progression of keratoconus after primary CXL is very rare, but it has been reported in the literature. This review summarises the existing data on repeated CXL after primary failure, emphasising on clinical efficacy and safety.

Orbital apex lesions represent a clinical challenge since they are difficult to remove surgically and may induce significant functional defects. The orbital apex is an area of convergence of neurovascular elements passing through the various local osseous foramina and the congestion of several critical anatomical structures in a confined space increases the risk of intraoperative complications. Radiotherapy is an alternative treatment option in such cases but may also induce radiation toxicity. We present a case of a vascular orbital apex lesion, which caused vision loss and was treated with stereotactic radiosurgery, resulting in significant visual restoration.