To estimate the incidence of complications after posterior chamber phakic intraocular lens implantation and to evaluate temporal and geographic variation in reported outcomes. PCPIOLs are widely used for refractive correction, yet uncertainty persists regarding the true frequency of mechanical, anterior-segment, and posterior-segment complications. Reliable incidence estimates are essential for patient counseling and postoperative management. This systematic review and meta-analysis included randomized and nonrandomized trials and observational studies involving adults undergoing posterior chamber phakic intraocular lens implantation. PubMed, Scopus, WANFANG Data, and China National Knowledge Infrastructure were searched through May 2024 without language or date restrictions. The primary outcome was the incidence of IOL explantation. Secondary outcomes included the onset of IOL rotation or displacement, anterior capsular opacification, cataract formation, iris atrophy, retinal detachment, macular oedema, pupillary block, glaucoma, pupil ovalisation, intraocular infection, endothelial failure, and iris cyst. Risk of bias was assessed using a modified Newcastle-Ottawa Scale. Incidence was modeled as events per 1,000 person-years using negative binomial regression with robust variance. The protocol was registered in PROSPERO (CRD42024527190). A total of 214 studies (45,027 eyes) were included, most involving the V4c model of the Implantable Collamer Lens (92.7%). Rotation or displacement occurred at 4.2 per 1,000 person-years and explantation at 3.1 per 1,000 person-years, corresponding to approximately about 2 rotated lenses and explantations per 100 eyes followed for 5 years, assuming constant hazards. Anterior segment events were less frequent, and posterior events were rare (retinal detachment, 0.4; macular edema, 0.3 per 1,000 person-years). Complication rates decreased in more recent studies and were lower in Asian cohorts. PCPIOL implantation is associated with a low incidence of complications, and vision-threatening events appear to be very rare. However, predominantly short follow-up and high risk of bias likely lead to underestimation of late events. These incidence estimates support early postoperative assessment of centration, axis alignment, and vault, and long-term endothelial and anterior segment monitoring.

Total limbal stem cell deficiency (LSCD), severe dry eye disease (DED), and ocular surface keratinization are severe ocular complications of Stevens-Johnson syndrome (SJS) that can be difficult to manage, resulting in poor visual outcomes. Several ocular surface reconstruction and visual rehabilitation techniques have been attempted with no satisfactory outcomes to date. Our purpose is to assess the functional and anatomical outcomes of Boston keratoprosthesis type I (Kpro-I) after minor salivary glands transplantation (mSG) and labial mucous membrane (MMG) grafting in patients with SJS suffering from total LSCD, DED, and ocular surface keratinization. This is a retrospective multicenter case series from 2 tertiary referral centers (New England Eye Center, Tufts Medical Center, Boston, Massachusetts and Federal University of Sao Paulo) assessing long-term outcomes of patients with SJS with severe ocular complications who received mSG/MMG grafting before Kpro-I implantation, including best-corrected visual acuity, Kpro-I device retention, and postoperative complications. Three patients with SJS with severe ocular complications (total LSCD, symblepharon, DED, and ocular surface keratinization) were treated with mSG/MMG grafting, followed by Kpro-I. Ocular surface keratinization was ameliorated in all patients after mSG. At the end of the long-term follow-up period, all patients retained the Kpro-I (33-63 months) and achieved improved visual acuity (20/40, 20/80, 20/100). Complications included glaucoma (n = 1), requiring a glaucoma drainage device; peripheral corneal thinning (n = 2), which was treated with a corneal patch graft; postoperative infectious keratitis (n = 1); cystoid macular edema (n = 1); and retroprosthetic membrane (n = 1), which was successfully treated. mSG/MMG grafting can optimize the ocular surface to allow for successful Kpro-I in patients with severe SJS, providing an alternative approach to Boston type II Kpro.

To compare anatomical and functional outcomes as well as postoperative complication rates between cryotherapy and illuminated endolaser retinopexy in chandelier-assisted scleral buckling (CASB) for rhegmatogenous retinal detachment. This retrospective study included 63 eyes from 63 patients treated with CASB between January 2021 and January 2024. Group 1 (n = 31) underwent retinopexy with cryotherapy, whereas Group 2 (n = 32) received illuminated endolaser through the same cannula as the chandelier light. All surgeries were performed using a noncontact wide-angle viewing system by a single experienced vitreoretinal surgeon. Outcome measures included best-corrected visual acuity (BCVA), intraocular pressure, swept-source OCT, and postoperative complications. Mean BCVA improved significantly in both groups. In Group 1, BCVA improved from 1.39 ± 0.74 logMAR (approx. Snellen 20/490) to 1.01 ± 0.63 (20/204), P < 0.001. In Group 2, BCVA improved from 1.50 ± 0.67 (20/632) to 1.14 ± 0.66 (20/276), P < 0.001. Final BCVA ( P = 0.21) and retinal reattachment rates ( P = 0.67) were similar. However, cystoid macular edema (CME) occurred significantly more in Group 1 (19.3%) than in Group 2 (3.1%) ( P = 0.04). Rates of epiretinal membrane, cataract, and intraocular pressure elevation did not differ significantly ( P > 0.05). No buckle exposure or infection was observed. Both techniques are effective for CASB. Endolaser provides a lower risk of CME and enhanced surgical precision, suggesting it may be a favorable option in selected cases.

The evidence remains contradictory regarding the optimal glycaemic targets needed to address the long-term effects of hyperglycaemia in people with diabetes mellitus (T2DM). We examined the association between HbA1c levels and the risk of individual microvascular complications among people with T2DM. We used the Clinical Practice Research Datalink (CPRD) GOLD database for a prospective cohort study, following patients ≥18years old from diagnosis of T2DM between January 2007 and December 2017. Neuropathy included foot ulcers, peripheral arterial disease, gangrene, and amputation. Nephropathy was classified by chronic kidney disease stages, and retinopathy included blindness and macular oedema. The risk of each complication in five HbA1c intervals [1.0%] intervals compared to 48.0-57.9mmol/mol (6.5-7.5%) was assessed using a multivariate time-varying Cox regression adjusted by various patients' characteristics. Subgroup analyses were performed according to age, hypertension, and the use of antihypertensive medications. Our study included 172,869 patients (mean age 62.6years and, 54.6% women). The risks were the highest in HbA1c levels >81.0mmol/mol (>9.6%) (HR 1.27, 95%CI 1.17-1.39 for nephropathy; 1.55, 1.27-1.47 for neuropathy; 1.66, 1.41-1.96 for retinopathy). The lowest risks observed in levels 48.0-57.9mmol/mol (6.5-7.5%) for nephropathy and in levels <48.0mmol/mol (<6.5%) for neuropathy (0.98, 0.88-1.09) and for retinopathy (0.89, 0.79-0.99). In the subgroup analysis, higher HbA1c levels were associated with an increased risk of nephropathy, particularly in individuals over 60, those with hypertension, and those using antihypertensive medications. For neuropathy, being over 60 was associated with an increased risk across all HbA1c levels. In retinopathy, hypertension and the use of antihypertensive medications were associated with lower risk across all HbA1c levels, while individuals under 60 were associated with higher risks at elevated HbA1c levels compared to those over 60. The risk of retinopathy and neuropathy was lowest in individuals with HbA1c levels within the non-diabetic range <48.0mmol/mol (<6.5%) and increased progressively with higher HbA1c levels. In contrast, the lowest risk of nephropathy was observed in individuals with HbA1c levels between 48.0 and 57.9mmol/mol (6.5-7.5%). These findings underscore the importance of a personalized approach to diabetes management that considers multiple risk factors and incorporates novel therapeutic strategies beyond glucose control.

Protective effects of Shabyar on endotoxin-induced uveitis in male rats: Involvement of the JAK2/STAT3 and VEGF pathways.

Intravitreal Aflibercept 8 mg for Diabetic Macular Edema: Ninety-Six-Week Results from the Randomized Phase 2/3 PHOTON Trial.

The RHONE-X study (ClinicalTrials.gov identifier, NCT04432831) evaluated long-term safety and tolerability (primary end points), and efficacy (exploratory end points) of faricimab, a dual angiopoietin-2 (Ang-2) and vascular endothelial growth factor A (VEGF-A) inhibitor, using a treat-and-extend (T&E) protocol in patients with diabetic macular edema (DME). Global phase 3, multicenter, nonrandomized, 2-year open-label extension study of the YOSEMITE and RHINE (ClinicalTrials.gov identifiers, NCT03622580 and NCT03622593, respectively) studies. Of 1622 patients who completed YOSEMITE and RHINE, 1474 patients (91%) were included in the RHONE-X trial. Patients transitioned from faricimab every 8 weeks (Q8W), faricimab T&E, or aflibercept 2.0 mg Q8W in YOSEMITE and RHINE to the RHONE-X study without requiring monthly initiation doses. All received faricimab T&E at up to 16-week intervals based on best-corrected visual acuity (BCVA) and central subfield thickness (CST), per YOSEMITE and RHINE criteria. Patients attended every month during the initial 4-month masked period, then only for T&E dosing visits (open-label arm). Analysis windows were defined for the RHONE-X study years 1, 1.5, and 2 to account for visit asynchronicity. The primary end point was incidence and severity of ocular and nonocular adverse events (AEs). Exploratory end points included change from baseline BCVA and CST, proportion of patients with absence of DME (CST < 325 μm), and treatment durability. Overall, 1204 patients (82%) completed the RHONE-X trial. The incidence of AEs leading to treatment discontinuation (1.5%) and rates of intraocular inflammation (1.3%) were low. Overall, faricimab T&E maintained visual and anatomic improvements achieved in YOSEMITE and RHINE. Adjusted mean BCVA improvements from YOSEMITE and RHINE baseline to the end of the RHONE-X trial were +10.1 letters (faricimab T&E), +11.4 letters (faricimab T&E [prior Q8W]), and +9.5 letters (faricimab T&E [prior aflibercept]); CST reductions were -198.3 μm, -202.5 μm, and -204.9 μm, respectively. At study end, more than 90% of patients achieved DME absence, regardless of prior treatment. Median number of injections over the RHONE-X trial (2 years) were 7 (faricimab T&E), 8 (faricimab T&E [prior Q8W]), and 8 (faricimab T&E [prior aflibercept]). By the RHONE-X trial completion, approximately 80% of patients received faricimab at ≥Q12W intervals. Faricimab, a dual Ang-2 and VEGF-A inhibitor, provided long-term safety, efficacy, and durability in patients with DME treated using a T&E regimen. Sustained visual and anatomic improvements were observed, with extended dosing intervals and reduced treatment burden. Faricimab was well tolerated, with a safety profile consistent with the YOSEMITE and RHINE trials. Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Opioid use disorder (OUD), cannabis use disorder (CUD) and cocaine use disorder have been associated with a range of adverse health outcomes, including certain ocular manifestations; however, their impact on diabetic retinopathy (DR) remains insufficiently explored. This study aimed to measure the association between OUD, CUD and cocaine use disorder and the risk of DR among patients with type 2 diabetes mellitus (T2DM). Propensity-score-matched retrospective cohort study. This study used the TriNetX US Collaborative Network to access electronic health records (EHRs), including data on demographics, diagnoses, medication use and laboratory results. A total of 131 088 adult patients with T2DM and comorbid OUD, CUD or cocaine use disorder, and 131 088 adult patients with T2DM without these conditions, were identified following propensity score matching. The primary outcome was the risk of DR evaluated over a 5-year follow-up period. The risks of various DR subtypes and diabetic macular edema (DME) were also assessed. Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated. Over a 5-year follow-up period, patients with T2DM comorbid with OUD, CUD or cocaine use disorder had a statistically significantly higher risk of developing DR [HR (95% CI) =2.90 (2.55-3.30), P < 0.00] compared with those without any drug use disorder. Drug use disorders were also associated with elevated risks of vision-threatening diabetic retinopathy (VTDR) [HR (95% CI) =2.78 (2.24-3.46), P < 0.00], non-proliferative diabetic retinopathy (NPDR) [HR (95% CI) =3.10 (2.61-3.68), P < 0.00], proliferative diabetic retinopathy (PDR) [HR (95% CI) =3.17 (2.26-4.45), P < 0.00] and DME [HR (95% CI) =2.64 (2.04-3.42), P < 0.00] among patients with T2DM. Opioid use disorder, cannabis use disorder and cocaine use disorder appear to be associated with an elevated risk of diabetic retinopathy among patients with type 2 diabetes mellitus.

Microaneurysm Reflectivity as a Prognostic Biomarker for Intravitreal Treatment Response in Diabetic Retinopathy.

Adalimumab, Anakinra, and Tocilizumab in Patients With Noninfectious Uveitis: A Multicenter Randomized Controlled Trial.

Yigan mingmu decoction treats diabetic retinopathy via Müller cell autophagy: A network pharmacology study.

Malignant hypertension is a medical emergency characterized by severe elevation in blood pressure with end-organ damage, including ocular involvement. Systemic lupus erythematosus (SLE) may result from lupus nephritis or vascular involvement in patients, and reports of severe hypertensive retinopathy in this setting are extremely limited. Herein, we report the case of a 30-year-old woman with SLE and poorly controlled chronic hypertension who presented with sudden bilateral vision loss. Ophthalmologic examination revealed grade IV hypertensive retinopathy with macular star exudates, a finding not previously described in similar reported cases. Optical coherence tomography demonstrated intraretinal hyperreflective deposits at the fovea without active macular edema, and fluorescein angiography showed areas of retinal ischemia. Intensive antihypertensive therapy and immunosuppressive treatment led to systemic stabilization but limited visual recovery. Only two similar cases have been reported, all presenting with hypertensive emergency, active SLE, and visual symptoms; however, the present case uniquely exhibited a macular star pattern. Early ophthalmologic recognition is essential for diagnosis, prognosis, and multidisciplinary management.

Fluocinolone acetonide implant in diabetic macular edema: sustained benefits and effects of following prior therapy.

BackgroundTo assess short-term clinical outcomes in patients with retinal vein occlusion (RVO)-related macular edema switched to Faricimab after a suboptimal response to previous intravitreal therapy.MethodsIn our retrospective single-center analysis, functional and anatomical changes of eyes affected by macular edema secondary to RVO were analyzed at baseline and four weeks after completing a three-injection Faricimab upload phase. Visual acuity (LogMAR) was analyzed as functional outcome measure, while central retinal thickness (CRT) and central retinal volume (CRV) were investigated as anatomical outcome measures. Further, a subgroup analysis compared treatment-related factors between patients exhibiting concurrent functional and anatomical improvements (full-responders) and those who did not (reduced-responders).ResultsA total of 21 eyes from 20 patients were included. Mean visual acuity improved modestly from 0.50 ± 0.52 to 0.40 ± 0.31 LogMAR, without reaching statistical significance (p = 0.257). Significant reductions in CRT (350.2 ± 124.5 to 302.6 ± 74.6 µm; p = 0.037) and CRV (2.53 ± 0.46 to 2.34 ± 0.29 mm3; p = 0.011) were noted. A positive correlation between CRT reduction and VA improvement was observed (r = 0.499; p = 0.021). In comparison, full-responders exhibited a significantly worse baseline LogMAR (p = 0.041) and CRT (p = 0.026).ConclusionIn our study assessing the short-term effect of switching to intravitreal Faricimab, significant anatomical improvements were observed. Although no significant functional improvements were observed, likely reflecting a ceiling effect, visual acuity remained stable. Further studies are necessary to evaluate especially sustained functional outcomes under long-term Faricimab therapy.

Patients with diabetic macular oedema (DMO) are susceptible to renal injury, raising the risks of acute kidney injury (AKI) and end-stage renal disease (ESRD) associated with anti-VEGF therapies. We aimed to compare the risks of AKI and ESRD between aflibercept and ranibizumab in DMO patients, focusing on AKI and ESRD in conjunction with all-cause mortality. A target trial emulation using the TriNetX Global Collaborative Network included adult patients with DMO who initiated treatment with aflibercept or ranibizumab in routine clinical practice. Ranibizumab exposure reflected real-world use and included both approved dosages. Patients with pre-existing ESRD or chronic kidney disease stage 5 were excluded. Propensity score matching was applied to balance demographics, comorbidities, medication use, and laboratory parameters. Time-to-event analyses were performed for AKI, ESRD, and all-cause mortality. Sensitivity analyses included application of a minimum 7-day latency window after treatment initiation to address potential temporality bias. After matching, 3411 patients were included in each treatment group (mean age, 64.0 ± 12.4 years; 51.5% male). During follow-up, aflibercept was not associated with an increased risk of AKI (hazard ratio [HR]: 0.97, 95% confidence interval [CI]: 0.89-1.06), ESRD (HR: 0.95, 95% CI: 0.83-1.09), or all-cause mortality (HR: 0.99, 95% CI: 0.89-1.10), when compared with ranibizumab. Results were consistent across subgroup and sensitivity analyses, including analyses incorporating a 7-day latency window with an HR of 1.08 (95% CI: 0.94-1.24) for AKI, and 0.89 (95% CI: 0.76-1.04) for ESRD. In this multinational, real-world study, aflibercept and ranibizumab demonstrated comparable risks of AKI, ESRD and mortality among patients with DMO after adjustment for measured confounders. Given the observational design, real-world dose heterogeneity, and limitations in detailed treatment-timing data, these findings should be interpreted with caution.

Purpose This study assessed retinal non-perfusion areas (RNPAs) and vascular density (VD) in the superficial (SCP) and deep (DCP) capillary plexuses of diabetic patients across three stages of diabetic retinopathy (DR): no DR (stage 0), non-proliferative DR (stage 1), and proliferative DR (stage 2). Methods Thirty-nine right eyes of 39 diabetic patients were included and underwent 3 × 3 mm and 15 × 15 mm Optical Coherence Tomography Angiography (OCTA) scans. A semiautomated software was utilized to quantify RNPAs and VD. Correlations with systemic and ocular factors were analyzed. Results Six eyes were in stage 0, 25 eyes were in stage 1 and 8 eyes were in stage 2. Mean RNPAs and VD from 15 × 15 mm OCTA scans differed significantly across the three DR stages. A positive correlation was found between DR stage and RNPA in both SCP (CC = 0.42; p = 0.04) and DCP (CC = 0.60; p = 0.004). Conversely, VD in DCP was negatively correlated with DR severity (CC = −0.51; p = 0.0018). Eyes with prior peripheral laser treatment showed significantly larger RNPAs and lower VD in wide-field scans. Macular edema was associated with increased RNPA and reduced VD in the SCP on 3 × 3 mm OCTA ( p 's &lt; 0.001). No significant associations were observed between OCTA parameters and systemic factors (e.g., hypertension, nephropathy). Conclusion Semiautomated OCTA analysis of retinal ischemia correlates positively with DR stage, peripheral laser treatment, and macular edema. The lack of association with systemic factors highlights the critical role of local ocular changes in DR progression.

Purpose: To determine whether preservation of the intact capsular bag allows safe iris fixation of a single‑piece acrylic intraocular lens (IOL) in cases of late, in‑the‑bag dislocation. Methods: We retrospectively reviewed 182 eyes from 172 patients who underwent fixation of dislocated IOL by a single retina surgeon between January 2018 and September 2024. Only eyes with ≥6 months of follow-up were included (140 eyes, 132 patients). Charts were reviewed for demographics, IOL type, capsular bag integrity, and etiology of dislocation. Main outcomes were postoperative ocular hypertension, uveitis, hyphema, vitreous hemorrhage, cystoid macular edema, retinal detachment, re-dislocation, and corneal edema at ≥6 weeks, ≥3 months, and ≥12 months. Results: Of 140 eyes, 80 (57%) had late dislocation of a single‑piece acrylic IOL within an intact capsular bag, and 60 (43%) had dislocation of a 3-piece IOL without an intact capsule. Postoperative complication rates did not differ significantly between single‑piece acrylic in-the-bag and 3-piece out-of-the-bag groups at ≥6 weeks (P = .71), ≥3 months (P = .84), or ≥12 months (P = .18). Conclusions: Preservation of an intact capsular bag allows refixation of a single‑piece acrylic IOL with a complication profile comparable to iris fixation of a 3-piece IOL lacking capsular support. This supports capsular bag preservation as a viable alternative to IOL explantation in late, in-the-bag dislocations.

Purpose: To report the long-term outcomes of patients undergoing epiretinal membrane (ERM) removal and validate the staging classification of the ectopic inner foveal layer as a prognostic factor for visual outcomes. Methods: A multicenter, retrospective, observational study was conducted of patients with an idiopathic ERM who underwent surgical removal and had follow-up of at least 60 months. Biomarkers from preoperative and postoperative spectral-domain optical coherence tomography scans were qualitatively and quantitatively analyzed. Results: Sixty-five eyes from 64 patients with a mean age of 68.1 years were included. Preoperative ERM staging found 9.2% of patients were stage 1, 15.3% stage 2, 50.7% stage 3, and 24.6% stage 4. At 5 years, the mean best-corrected visual acuity (BCVA) improved from 0.6131 logMAR (Snellen equivalent, 20/82) at baseline to 0.2723 logMAR (Snellen equivalent, 20/37) (unpaired t test; P < .001). The central macular thickness improved from 489 µm at baseline to 347 µm (unpaired t test; P = .001). A final BCVA ≥20/40 was attained by 84.6%, 86.2%, and 47.1% of patients with stage 2, 3, and 4 ERM, respectively. Preoperative ERM staging was associated with preoperative BCVA (1-way analysis of variance [ANOVA]; P = .04) and 5-year postoperative BCVA (1-way ANOVA; P < .001). Preoperative microcystoid macular edema was associated with 5-year postoperative BCVA (unpaired t test; P = .030). The preoperative and postoperative thickness of the ectopic inner foveal layer did not correlate with 5-year postoperative BCVA. Conclusions: Surgical removal of an idiopathic ERM results in long-standing improvement in BCVA, regardless of ERM stage. Preoperative ectopic inner foveal layer ERM staging assesses preoperative and postoperative BCVA. The preoperative presence of microcystoid macular edema was associated with a poorer postoperative BCVA.

To evaluate real-world, short-term anatomical and functional outcomes of faricimab versus aflibercept 2 mg in diabetic macular oedema (DMO). This retrospective, parallel-cohort comparative study included 300 consecutive patients with DMO from Moorfields Eye Hospital. Eligible eyes were treatment-naïve and treatment-experienced not receiving therapy for ≥6 months and subsequently initiated on loading phase of faricimab or aflibercept 2mg. Follow-up was 4 months. Data were collected from the Moorfields electronic medical records system. Changes in visual acuity (VA) and central subfield thickness (CST) from baseline to the fourth injection were analysed using multiple linear regression adjusted for baseline covariates (age, gender, ethnicity, diabetes type, baseline retinopathy status, baseline VA or CST and treatment interval). Of 300 eyes enrolled, 292 were ultimately analysed (191 aflibercept; 101 faricimab), with 246 eyes (84.2%) completing follow-up. Mean unadjusted VA gain was +3.9±10.4 letters with aflibercept and +5.2±11.8 letters with faricimab. Adjusted marginal mean VA gain was +4.2 letters for aflibercept and +4.7 letters for faricimab, with a non-significant difference of -0.5 letters (p=0.7). Baseline VA and treatment interval were significant predictors of functional response, with baseline VA exerting approximately 3.4 times the impact of treatment interval. Mean CST reduction was 87.3±106.1 µm with aflibercept and 113.1±136.7 µm with faricimab. Adjusted mean reductions were 95.4 µm and 99.8 µm, respectively (difference -4.4 µm, p=0.7). Baseline CST was the only independent predictor of anatomical response. Faricimab and aflibercept achieved comparable short-term anatomical and functional outcomes, with greater anatomical improvement associated with higher baseline CST and larger visual gains observed with lower baseline VA. Treatment interval influenced functional response, underscoring the importance of timely therapy. Baseline disease features and treatment adherence are key determinants of early outcomes, rather than drug selection.

Abstract Aims Diabetic macular edema (DME) is a leading cause of vision loss among individuals with diabetes. While anti‐VEGF therapy is a widely used and effective treatment, limited research has explored participants' lived experiences throughout the treatment process. Methods This qualitative study summarizes findings from longitudinal interviews conducted at 4 and 12 months after initiating intravitreal anti‐VEGF therapy. The analysis focused on participants' emotional, physical and psychosocial responses to treatment. Results An overarching theme, ‘health, hope, and worry’, captured the ambivalent experiences of participants. Two main categories were identified: ‘hope and anxiety during injection treatment’ and ‘uncertainty and variation in visual outcomes’. Participants described a spectrum of physical discomfort and emotional reactions, influenced by expectations, bodily sensitivity and clinical context. Trust in healthcare providers, consistent care and adequate information were crucial for emotional resilience. Perceived treatment effectiveness varied, with some experiencing significant visual improvement and regained independence, while others reported little or no change, leading to frustration and anxiety about future vision. Conclusions Anti‐VEGF treatment for DME is experienced not only as a clinical intervention but as an emotionally and physically complex journey. Participants' navigate fluctuating levels of hope and worry, shaped by their bodily experiences, emotional responses and expectations of outcomes. These findings highlight the need for empathetic communication, consistent care and individualized support to promote adherence and mitigate emotional distress. The insights from this study are especially relevant for multidisciplinary diabetes care teams.