Comorbidity of uveitis and multiple sclerosis.

Ocular complications of Mpox are relatively rare but can be devastating, particularly in immunocompromised individuals. We report a case of severe keratitis resulting in significant visual impairment in a 26-year-old male living with advanced HIV. The patient presented with a 2-month history of disseminated ulcerative lesions and a 1-month history of progressive vision loss in the right eye. He was newly diagnosed with HIV, and laboratory testing revealed a positive Mpox virus polymerase chain reaction (PCR) result alongside severe immunosuppression (CD4 + T-lymphocyte count: 35cells/μL). Ophthalmologic examination revealed corneal opacity, stromal edema, and neovascularization. Despite systemic antiviral and topical antibiotic/anti-inflammatory treatment, visual acuity remained poor due to permanent corneal scarring. This case highlights the potential for sight-threatening ocular complications in individuals with Mpox and severe immunodeficiency, underscoring the critical importance of early ophthalmologic assessment in this vulnerable population.

To report a rare and challenging case of an atypical and bilateral ischemic retinal vasculopathy in a young patient following haploidentical bone marrow transplantation (BMT). Case report and literature review on ocular complications after hematopoietic stem cell transplantation (HSCT). A 29-year-old woman presented with an atypical and bilateral ischemic retinal vasculopathy after haploidentical BMT, with a partial response to corticosteroids and anti-vascular endothelial growth factor therapy. Serial changes were documented using optical coherence tomography. Ocular complications unrelated to graft-versus-host disease are generally uncommon after HSCT but can lead to significant and prolonged visual impairment. Retinal ischemic vasculopathy post-HSCT may present with typical and atypical features, each carrying distinct clinical manifestations and prognostic implications. While the typical form is well characterized in the literature, bilateral ischemic retinal vasculopathy following haploidentical HSCT remains unreported. Potential contributing factors include endothelial injury, microvascular occlusion, and immune-mediated mechanisms associated with HSCT. Moreover, medications used during and after transplantation-such as corticosteroids and immunosuppressants-may have ocular side effects that contribute to retinal complications. This case underscores the importance of early ophthalmologic evaluation in post-HSCT patients with visual symptoms, even in the absence of graft-versus-host disease.

Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in children. Uveitis is the most frequent extra-articular manifestation of JIA and a major cause of visual morbidity. Despite advances in immunomodulatory therapy, many patients reach adulthood with active ocular inflammation or vision-threatening complications. The transition from pediatric to adult care represents a vulnerable period. The primary objective of our study is to describe ophthalmologic and rheumatologic disease characteristics at the time of transition from pediatric to adult care. We conducted a retrospective cohort study of patients with JIA and past or present uveitis who transitioned to adult rheumatology at Cochin Hospital between 2016 and 2024. Clinical, ophthalmologic, and therapeutic data were collected from electronic medical records. Descriptive statistics were performed. Comparative analyses were exploratory and intended to describe differences between subgroups rather than to test predefined hypotheses. A total of 46 patients were included. Median age at JIA diagnosis was 7.5 years [IQR 2.0-16.0] and median age at first uveitis was 6.0 years [IQR 3.0-12.2]. Median follow-up after transition was 2.44 years [IQR 1.17-3.94]. Most patients were female (80%, n = 37) and had oligoarticular JIA (59%, n = 27). Chronic uveitis predominated (83%, n = 38). Ocular complications occurred in 46% (n = 17), including cataract (24%, n = 11), glaucoma (20%, n = 9), and keratitis (7%, n = 3). Over half (57%, n = 13/23) experienced ≥ 5 flares since diagnosis. Biologic DMARDs were prescribed in 53% (n = 23/43), predominantly anti-TNF agents. This study highlights the substantial burden of JIA-associated uveitis at the time of transition to adult care, characterized by frequent complications, persistent disease activity, and a high need for biologic therapy. Our findings emphasize the necessity of structured and continuous ophthalmologic follow-up across all JIA subtypes, alongside close multidisciplinary collaboration, to prevent long-term ocular damage and preserve visual function.

To evaluate the short-term clinical outcomes of CKD-701, a ranibizumab biosimilar, in treating vitreous hemorrhage (VH) secondary to proliferative diabetic retinopathy (PDR). This retrospective study included 64 eyes of 64 patients with VH secondary to PDR who received intravitreal CKD-701 injections and were followed for at least four months. Visual acuity (VA) was assessed at baseline, at the first follow-up (mean 3.8 weeks), and at 2- and 4-months post-treatment. The incidences of recurrent VH and vitrectomy were recorded. The factors associated with the degree of visual improvement were analyzed. The patients received a mean of 1.8 ± 0.9 injections. VA significantly improved over time (mean logMAR VA: 1.29 ± 0.82 at baseline, 1.11 ± 0.84 at first follow-up, 0.94 ± 0.81 at 2 months, and 0.73 ± 0.68 at 4 months; P < 0.001). The proportions of patients achieving 20/40 or better VA at each time point were 18.8%, 25.0%, 29.7%, and 40.6%, respectively. Recurrent VH occurred in 17.2% of patients, and vitrectomy was performed in 12.5%. There was no significant difference in 4-month VA between patients who did and did not undergo vitrectomy (P > 0.999). Baseline VA was significantly associated with the degree of visual improvement (P = 0.010). No severe ocular complications were observed. In this short-term study, VH secondary to PDR decreased following CKD-701 treatment and was accompanied by visual improvement. Further well-controlled long-term studies are needed to definitively assess the efficacy of CKD-701.

Mucopolysaccharidosis type VI (MPS VI) is a rare autosomal recessive lysosomal storage disorder caused by pathogenic variants in ARSB, leading to deficiency of N-acetylgalactosamine 4-sulfatase and accumulation of glycosaminoglycans. Although enzyme replacement therapy (ERT) alleviates systemic symptoms, its efficacy for ocular complications is limited. Because ocular manifestations may require distinct therapeutic approaches, a precise understanding of the underlying retinal pathology is essential. This study aimed to characterize ocular and retinal involvement in MPS VI through clinical and experimental analyses. Comprehensive ophthalmic examinations were performed in siblings with MPS VI, and histological and electrophysiological assessments were conducted in an MPS VI rat model. Retinal morphology, retinal pigment epithelium (RPE) integrity, and electroretinographic responses were evaluated. In patients, no apparent photoreceptor degeneration was detected, although subtle functional impairment could not be excluded. Consistently, MPS VI rats exhibited preserved photoreceptor structures but reduced electroretinogram amplitudes. Although RPE abnormalities were not evident in patients, rats showed pronounced RPE alterations, suggesting RPE involvement as a potential origin of retinal dysfunction. Our findings suggest that retinal dysfunction in MPS VI may primarily arise from RPE pathology rather than photoreceptor loss. Detailed retinal evaluations in aging patients are warranted, and therapeutic approaches targeting the RPE, such as localized ERT or RPE cell transplantation may provide future benefits.

Evidence and Consensus Based Imaging Guidelines in Cytomegalovirus retinitis. Multimodal imaging in Uveitis (MUV) Taskforce Report 15.

Scleritis is a rare and severe ocular inflammatory disease that is often associated with potentially sight-threatening ocular complications. The aim of the present study was to characterize ocular complications in non-infectious scleritis and identify predictive variables for their development. Data for this registry-based study were extracted from the AutoInflammatory Disease Alliance Network for Scleritis Registry. Univariate analysis was performed to examine potential associations of demographic and clinical variables with the development of ocular complications. Uveitis and peripheral ulcerative keratitis were considered to be extensions of the inflammatory process and not to be true structural complications. Predictive factors of ocular complications were assessed using regression analysis. The impact of ocular complications on visual acuity-measured by best-corrected visual acuity (BCVA)-was also analyzed. A total of 154 patients (218 eyes) with non-infectious scleritis were enrolled. In 58 of these patients (87 eyes), 102 ocular complications were recorded, with cataract, scleral and corneal thinning, and glaucoma and/or increased ocular pressure being the most frequently recorded complications. Ocular complications were found to be significantly more frequent among patients affected by granulomatosis with polyangiitis (GPA) (p < 0.0001) and concomitant uveitis (p = 0.023). The mean severity score was significantly higher among eyes experiencing ocular complications (p < 0.0001). Regression analysis identified three variables capable of predicting the development of ocular complications: a diagnosis of GPA [odds ratio (OR) 7.747, p < 0.0001]; the presence of concomitant uveitis (OR 3.648, p = 0.019); and a high severity score (OR 1.138, p = 0.044). Mean (± standard deviation) BCVA converted to logMAR was found to be significantly higher among eyes without ocular complications (0.12 ± 0.24 vs 0.27 ± 0.49; p = 0.005). Scleritis was accompanied by irreversible ocular complications in a considerable proportion of the patients enrolled in this study. Patients with a diagnosis of GPA, concomitant uveitis, and a higher severity score are more likely to develop ocular complications, and thus warrant a tighter follow-up schedule and early treatment in order to minimize the risk of poor visual prognosis.

Oculodermal melanocytosis (ODM) is an uncommon congenital melanocytic disorder infrequently reported in dogs. It is characterized by dermal and ocular hyperpigmentation involving neural crest-derived tissues and may predispose affected dogs to secondary ocular complications such as glaucoma or, in exceptional cases, malignant transformation. A 4-year-old neutered male Great Dane was presented with unilateral facial and ocular hyperpigmentation. Ophthalmic examination revealed marked pigmentation and thickening of the right iris, perilimbal and peripheral corneal pigmentation, and diffuse uveal involvement. Bilateral uveal cysts were identified. Intraocular pressure was within reference intervals but asymmetric between eyes. Fundus examination demonstrated focal tapetal hyperreflectivity and vascular attenuation in the right eye, and electroretinography confirmed reduced retinal function. Six months later, secondary glaucoma developed, necessitating enucleation. Histopathology revealed diffuse infiltration of heavily pigmented cells without cytologic atypia or mitotic activity within the sclera, uveal tract, perioptic connective tissue, and cornea. Marked goniodysgenesis was also identified, providing a structural basis for impaired aqueous outflow. This case expands the clinicopathologic characterization of canine oculodermal melanocytosis by documenting concurrent breed-associated uveal cysts and histologically confirmed goniodysgenesis in addition to retinal dysfunction and secondary glaucoma. The findings highlight the multifactorial nature of ocular disease in affected dog and emphasize that pigmentary disorders may coexist with independent structural abnormalities influencing intraocular pressure and retinal function. Comprehensive and repeated evaluation of both anterior and posterior segment structures is therefore essential when managing complex unilateral ocular pigmentation.

Diabetes is a significant disease that affects individuals of all ages and may lead to the development of systemic and ocular complications, ultimately resulting in a poor quality of life (QoL). The use of health-related quality of life (HRQoL) measures is important for identifying disparities and those at risk, thereby promoting early intervention. This study aimed to examine the HRQoL and associated factors in Ghanaian children and adolescents with type 1 diabetes mellitus (T1DM). A cross-sectional study involving children and adolescents with T1DM aged 5-19 years was conducted. Demographic and clinical data of participants were recorded. Participants completed the PedsQL Generic Scales questionnaires. SPSS Version 25.0 was used in analyzing the data. Logistic regression was used in analyzing risk factors associated with poor QoL. p-values < 0.05 were considered statistically significant. Data from 46 children and adolescents with T1DM were analyzed. A female preponderance of 35/46 (76.1%) was observed. The overall mean HRQoL score for participants was 73.9 ± 18.7. Sex was the only risk factor associated with poor self-reported HRQoL in children and adolescents with T1DM. Female children and adolescents with T1DM were 13 times more likely to have poor self-reported HRQoL compared with their male counterparts (OR = 13.2; 95% CI = 1.9-91.0; p = 0.009). There were no significant associations with age, duration of diabetes, glycemic control, number of hypoglycemic and diabetic ketoacidosis episodes, hypertension, or nephropathy. Self-reported QoL of children and adolescents with T1DM was poor. Female children and adolescents with T1DM are more likely to have poor self-reported QoL.

Ocular Complications among Noma Survivors: A Cross-Sectional Study.

To evaluate the association between retinal vein occlusion and leukemia. A comprehensive literature search was conducted across PubMed, Google Scholar, ScienceDirect, Scopus, and Cochrane Library from inception to October 20, 2025, following PRISMA guidelines and a registered PROSPERO protocol (CRD420251134924). Observational studies reporting ocular findings in leukemia were included. Data extraction and risk of bias assessment were performed independently using the JBI and ROBINS-I tools. Pooled effect sizes were calculated using Comprehensive Meta-Analysis (CMA v4.0), expressed as logit event rates with 95% confidence intervals. Case reports were narratively summarized but excluded from quantitative synthesis. Eight studies encompassing 1,016 participants were included in the meta-analysis. The pooled logit event rate for overall ocular manifestations was -0.3307 (95% CI: -0.456 to -0.206; P < 0.0001), corresponding to a prevalence of 42%. Retinal hemorrhage was the most frequent finding (logit = -1.90; 13%-15%), followed by retinal infiltration (logit = -3.55; 3%) and retinal vein occlusion (logit = -4.41; 1.2%). Heterogeneity was low for infiltration (I 2 = 10.2%) and retinal vein occlusion (I 2 = 0%). Ocular involvement occurs in nearly half of patients with leukemia, with retinal hemorrhages and microvascular compromise as dominant manifestations. Although retinal vein occlusion is rare, it signifies advanced hematologic derangement. These findings highlight the importance of routine ophthalmic screening including fundus examination, OCT, and OCTA-as integral components of leukemia management for early detection, systemic correlation, and vision preservation.

Significant complications are uncommon with aesthetic hyaluronic acid (HA) dermal fillers, but inadvertent injection of dermal filler into an artery can result in tissue damage, scarring, visual loss, and even stroke. Practitioners must therefore reduce this risk through proactive, preventative techniques. Early recognition of vascular occlusion (VO) is also crucial to minimize subsequent tissue injury. To review and summarize evidence-based preventative measures and first aid management strategies for HA-associated peripheral cutaneous VO, explicitly excluding ocular and neurological complications. A comprehensive literature search was conducted using the BestBETs methodology to review the preventative measures available for reducing the risks of HA-associated peripheral VO, with ocular and neurological side effects considered beyond this review's scope. We then examined the pathophysiology of VO and the evidence for its management to establish an HA dermal filler VO "first aid" protocol. Our review underscored the importance of preventative strategies (practitioner skill and knowledge; cannula usage; microboluses of small filler volumes, low plunger pressure, and constant needle tip movement), along with the liberal usage of hyaluronidase, heat, and massage, and supports the addition of antiplatelet agents for acute management. Aspiration is controversial and cannot reliably exclude intravascular needle placement. Prompt recognition and management of VO are critical to prevent skin necrosis, scarring, and long-term morbidity. Preventative practice, immediate treatment protocols, and further research are essential to enhance clinician confidence and improve patient safety in aesthetic HA filler procedures.

To assess the clinical characteristics and surgical outcomes of retinal detachment (RD) associated with presumed trematode-induced granulomatous intermediate uveitis (PTIGIU). A review of the medical records of patients diagnosed with RD secondary to PTIGIU over a 3-year period was conducted. Main outcome measures were the type and morphology of RD, final functional and anatomical outcomes. Out of 98 eyes with PTIGIU, 41 eyes (41.8%) were diagnosed with RD secondary to PTIGIU and were operated upon and completed 6-month follow-up period. Mean age was 12.6 years and logMAR corrected distance visual acuity 1.76. All eyes had vitritis of variable grades. Thirty-five eyes (85.4%) had tractional retinal detachment (TRD) and four eyes (9.8%) had combined tractional-rhegmatogenous retinal detachment. According to the extent of retinal detachment, the eyes were grouped into Group 1: 28 eyes, with subtotal peripheral RD, and Group 2: 13 eyes, with total RD or subtotal RD reaching posterior pole. The former group showed better functional and anatomical outcomes ( P = 0.019 and 0.028, respectively). Approximately 80.5% of all eyes showed final anatomical success and visual improvement (median corrected distance visual acuity 0.40, P < 0.001) at the final follow-up. Tractional retinal detachment is a common complication to PTIGIU, and early intervention is essential to avoid devastating ocular complications.

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.

Marfan syndrome is a connective tissue disorder with several vision-threatening ocular manifestations. This study synthesizes recent advances in the surgical approach to ocular complication of Marfan syndrome including ectopia lentis, early cataract, glaucoma, and retinal detachment. Recent literature highlights advances in capsular support devices and alternative fixation methods for ectopia lentis, including long-term outcomes with modified capsular tension rings, suture-less scleral fixation, and iris-claw intraocular lenses. Pediatric cohorts underscore elevated risks of retinal detachment following lens removal, particularly when capsular remnants persist, emphasizing the importance of complete removal and vigilant follow-up. In highly myopic Marfan eyes, modern intraocular lens power calculation formulas demonstrate improved refractive predictability, though pediatric patients remain prone to progressive myopic shift. For glaucoma, tailored modifications to trabeculectomy and tube shunt techniques address the challenges of thin sclera and ocular surface fragility. Contemporary retinal detachment series reveal high lifetime risk, with surgical success often requiring multiple procedures, and outcomes closely tied to macular status and presence of proliferative vitreoretinopathy. Advances across anterior and posterior segment surgery have improved visual outcomes for Marfan patients, but long-term risks remain substantial. Individualized surgical planning, early detection of complications, and long-term surveillance are essential to optimize outcomes in this high-risk population.

Stromal Keratitis in the Zoster Eye Disease Study: Lessons Learned.

Retinopathy of prematurity (ROP) remains a leading cause of childhood vision loss, often resulting in long-term complications such as strabismus, amblyopia, and glaucoma. Despite advances in screening, limited data exist on which infants are at highest risk and when these complications typically emerge-an important gap given the nationwide shortage of pediatric ophthalmologists. This study aimed to identify predictors of post-ROP ocular complications and determine the optimal timing and frequency of pediatric ophthalmology follow-up visits. We retrospectively reviewed 223 infants who underwent ROP screening between 2018 and 2021 and subsequently followed up with pediatric ophthalmology. The primary outcome was the development of ocular complications following ROP resolution, including their type and timing of detection. Univariate and multivariate logistic regression were used to identify independent risk factors, and Kaplan-Meier analysis assessed time to complication onset. Of 223 infants, 54 (24.2%) developed at least one ocular complication. The most common were refractive error (17.0%), strabismus (13.9%), and amblyopia (4.5%). Most complications occurred within two years after ROP clearance. Strabismus was diagnosed earliest, followed by refractive error and amblyopia. Longer NICU stay was an independent predictor of ocular complications (OR 1.30, 95% CI 1.04-1.63; p = 0.022). Nearly one in four infants developed ocular complications after ROP screening, typically within the first two years. NICU length of stay independently predicted risk, supporting the need for risk-stratified surveillance to ensure timely detection, optimize resource allocation, and reduce preventable vision loss in infants screened for ROP.

HighlightsWhat are the main findings?Zika virus (ZIKV) reprograms trabecular meshwork cell metabolism by activating AMPK signaling and promoting lipid droplet (LD) biogenesis.Fatty acid (FA) metabolism regulates infection, where saturated FAs enhance and unsaturated FAs suppress ZIKV replication by affecting viral entry.What are the implications of the main findings?Host metabolic pathways (AMPK, LD, and FA metabolism) are key regulators of ZIKV ocular infection and pathogenesis.These pathways represent potential therapeutic targets for preventing or treating ZIKV-associated ocular complications.Zika virus (ZIKV) remains a significant global public health threat due to its association with severe neurological and ocular abnormalities, including microcephaly and congenital glaucoma in infants. Viruses often exploit host metabolic programs, such as energy and lipid metabolism, to support their replication. However, how ZIKV-driven metabolic reprogramming affects the anterior segment of the eye, especially trabecular meshwork (TM) cells, remains poorly defined. In this study, we investigated the roles of AMP-activated protein kinase (AMPK) signaling, fatty acid (FA) metabolism, and lipid droplet (LD) biogenesis in ZIKV-induced ocular pathogenesis using primary human TM cells and an IFNAR1-deficient mouse model. ZIKV infection triggered time-dependent activation of the LKB1-AMPK-ACC signaling axis and significantly increased LD accumulation. Pharmacological activation of AMPK suppressed viral replication, whereas its inhibition enhanced infection, highlighting an antiviral role for AMPK signaling. In contrast, ZIKV promoted LD biogenesis, and inhibition of DGAT1 reduced both LD formation and viral replication, indicating a proviral role for LDs. Modulation of FA metabolism further revealed differential effects on ZIKV infection: saturated FA (palmitate) enhanced viral replication, whereas inhibition of FA oxidation with etomoxir reduced infection. Conversely, unsaturated FAs (oleate and linoleate) suppressed viral replication, in part by impairing viral binding and entry. Collectively, these findings show that ZIKV reshapes host metabolic pathways in TM by differentially engaging AMPK signaling, FA metabolism, and LD biogenesis to promote viral replication and spread in ocular tissue. Targeting these metabolic pathways may offer promising therapeutic avenues for preventing and/or treating ZIKV-associated ocular complications.

To evaluate the clinical manifestations and visual outcomes of patients with syphilitic uveitis, and to compare these features based on human immunodeficiency virus (HIV) infection status. The records of patients diagnosed with syphilitic uveitis between 2014 and 2024 were analyzed retrospectively. Demographics, history, ocular examination findings, syphilis and HIV serology, lumbar puncture test, treatment approaches, and best-corrected visual acuity (BCVA) results of all patients were documented. A total of 51 eyes of 33 patients were included in the study. Twenty-seven patients (82%) were male, with a mean age of 44 years (range, 21-69). HIV co-infection was present in 39% of the patients (all male). Prior to presentation, 9 patients (27%) had received an incorrect diagnosis or inappropriate treatment. The most common form of syphilitic uveitis was panuveitis (63%), followed by posterior uveitis (31%). Anterior segment inflammation and optic nerve involvement were observed at higher rates in patients with HIV co-infection (p<0.05). All patients received systemic penicillin therapy, and 51% received systemic corticosteroids. Visual acuity improved significantly after treatment in all patients (p<0.01). HIV co-infection status was not associated with age, laterality, lumbar puncture findings, the development of ocular complications, or baseline and final BCVA outcomes (p>0.05). Syphilitic uveitis is an important clinical entity due to its broad spectrum of ocular manifestations. In this study, severe intraocular inflammatory findings, including panuveitis and optic nerve involvement, were more frequently observed in patients with HIV co-infection. However, HIV co-infection did not influence final visual acuity or the rate of ocular complication development.