Sjögren disease (SjD) is characterized by autoimmune lymphocytic infiltration of lacrimal and salivary glands, leading to dry eye and dry mouth. This study aimed to investigate the features and diagnostic value of lacrimal gland ultrasonography (LGUS) for distinguishing SjD from undifferentiated connective tissue diseases (UCTDs). This prospective cohort study enrolled 80 patients, including 46 with SjD and 34 with non-SjD UCTDs. All participants underwent LGUS, scored according to the OMERACT guidelines for greyscale and color Doppler systems, alongside salivary gland ultrasonography (SGUS) and objective dry eye tests. Diagnostic performance was assessed using receiver operating characteristic (ROC) analysis. The ocular surface evaluation including tear break-up time (BUT), Schirmer test (ST), ocular staining score (OSS), and LGUS greyscale score of patients with SjD showed significant differences as compared with non-SjD patients, while no difference was found in morphology and color Doppler ultrasound score between the two groups. The ROC of LGUS has an AUC of 0.70 (95% CI 0.579-0.810) compared to other CTD patients; the combined LGUS and SGUS model achieved an AUC of 0.76, while a multivariate nomogram incorporating LGUS, SGUS, Schirmer, and OSS yielded an AUC of 0.792 (95% CI 0.693-0.891). Besides, a significant correlation was found between the LGUS greyscale score and salivary gland involved, anti-SSA antibody, and the ocular surface parameters. LGUS is a non-invasive, cost-effective adjunct for early SjD diagnosis. It can be an additional tool integrated with SGUS and clinical tests, substantially improving diagnostic performance. Key Points • SjD patients showed significantly higher LGUS greyscale score than non-SjD UCTD patients. • LGUS may aid early SjD identification when used alongside ocular surface tests (Schirmer test and ocular staining score), with high specificity (82.4%). • LGUS greyscale score is significantly associated with anti-SSA antibody and parotid greyscale score on SGUS.

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.

In vivo biodistribution of mucoadhesive and ultrastable gold nanoparticles in ocular tissues after topical application.

Blue LED light induces dry eye disease via NCOA4-mediated ferritinophagy and iron-overload.

Correlative analysis between ocular surface features and carotid plaque : A multimodal machine learning framework.

Fate of intrastromal injected adipose-derived mesenchymal stem cell and its effects on corneal nerve regeneration: An in vivo confocal microscopy study.

Proanthocyanidins inhibit the inflammation response of dry eye by regulating IRAK4/JAK1/STAT1 signaling pathway.

To compare biomarker expression and proliferation rates of limbal epithelial stem cells (LESCs) cultured on Descemet membrane (DM) versus amniotic membrane (AM). To investigate the suitability of DM as a potential long-term scaffold for transplantation of cultivated limbal stem cells on the ocular surface. Donor limbal epithelial cells were pooled, reseeded, and expanded on decellularized DM and AM. LESC biomarker expression was assessed by In-Cell Western and immunocytochemical staining. Cell proliferation was evaluated by BrdU incorporation. Airlift organ cultures were performed on DM-limbal tissue constructs and analyzed with 3D immunofluorescence microscopy to determine if DM could support stratified epithelial growth. Suitability of DM as a potential long-term scaffold for cultured LESCs on the cornea was assessed by evaluating transparency and resistance to collagenase digestion versus AM. Cultured cells exhibited higher expression of putative LESC markers (ABCG2, ABCB5), lower expression of transient amplifying cell marker (p63α), and lower cell proliferation rates on DM versus AM, indicating DM maintained LESC stemness better than AM. Under airlifting conditions, cells on DM stratified with differentiation and expression of corneal epithelial cell biomarkers in superficial layers, while maintaining LESC biomarker expression in basal layers. DM was more transparent and resistant to collagenase digestion than AM. DM promotes LESC stemness better than AM in ex vivo culture and can support stratified corneal epithelium. DM is also a more transparent and potentially durable epithelial scaffold than AM. DM is a promising new alternative to AM for limbal stem cell therapy.

MicroRNAs (miRNAs) play critical roles in ocular surface diseases. In our recent study, through microarray analysis, miR-138-5p was identified as one of the most prominent miRNAs expressed in aniridia patients derived primary limbal epithelial cells (pLECs). Although miR-138-5p expression was significantly elevated in aniridia samples, its specific role in the pathogenesis of aniridia-associated keratopathy (AAK) remained unclear. Therefore, the present study focused on exploring the potential functional impact of upregulated miR-138-5p on limbal epithelial stem cell maintenance and function. Cultured pLECs of healthy human donors isolated from corneoscleral rims were transfected with miR-138-5p mimics. The gene and protein expression level of direct target genes of miR138-5p were evaluated. Additionally, cell proliferation, apoptosis, and cell cycle progression was assessed. Overexpression of miR-138-5p significantly downregulated the expression of several target genes, including Cyclin D (CCND1 and CCND3), Hypoxia-Inducible Factor 1-alpha (HIF1A), Forkhead Box C1 (FOXC1), Caspase 3 (CASP3), and Fos-like 1 (FOSL1). Protein levels of Cyclin D1 were also significantly reduced. Additionally, miR-138-5p transfection markedly inhibited cell proliferation and cell cycle progression. Our results demonstrate that miR138-5p can regulate CCND1 expression, and that its overexpression inhibits limbal epithelial cell proliferation and induces cell cycle arrest, suggesting that miR-138-5p acts as a negative regulator in limbal epithelial cells. Therefore, identifying strategies to suppress miR-138-5p expression at the ocular surface in congenital aniridia could have therapeutic potential for slowing the progression of AAK. Nonetheless, further in vivo studies are needed to fully elucidate the mechanistic link between miR-138-5p and AAK pathogenesis.

Exposure of human corneal epithelial cells to microplastic particles induces a phase-specific cytokine response.

Conjunctival Autograft Fixation in Primary Pterygium Surgery: A Network Meta-Analysis of Randomized Trials.

Animal-based experimental models in dry eye research: Current approaches and limitations.

Neurotrophin-4 as a promising therapy for corneal injuries: Enhancing epithelial repair and nerve regeneration in abrasion and alkali burn models.

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.

Ocular Surface Squamous Neoplasia Masquerading as Viral Keratitis.

The growing threat of antibiotic-resistant pathogens, particularly in ocular infections like bacterial keratitis, necessitates alternative therapeutic strategies. This review evaluates the potential therapeutic role of predatory bacteria as novel live antimicrobials, offering a timely exploration of their potential in overcoming resistance mechanisms such as biofilm formation and persister cell development. Predatory bacteria, including Bdellovibrio bacterovorus and Micavibrio aerguinosavorus selectively target Gram-negative bacteria, including Pseudomonas aeruginosa , while sparing Gram-positive ocular surface. They exhibit rapid bactericidal activity and efficacy against biofilms, persister cells, and antibiotic-resistant pathogens, but induce little inflammation. Advances in storage and delivery methods, such as lyophilization, cryomicroneedles, and thermoresponsive hydrogels, have potential to increase their therapeutic feasibility. However, in-vivo efficacy remains variable and their narrow spectrum limits effectiveness against Gram-positive pathogens. Predatory bacteria present a promising alternative to traditional antibiotics in ocular therapeutics, particularly for drug-resistant infections. Integration of predatory bacteria with bacteriophages or conventional antibiotics may further optimize their potential. Continued translational research is essential to address current limitation and to validate their safety and efficacy for human or veterinary applications.

The use of human amniotic membrane for treatment of ocular surface and corneal diseases gained enormous momentum in the late 1990s. Clinical observations already at that time indicated that amniotic membrane transplantation exerts both antiinflammatory and antiangiogenic properties. However, the precise molecular mechanisms of these beneficial effects were largely unknown. Hao and colleagues very elegantly demonstrated that both fresh and cryopreserved human amniotic membrane epithelial and mesenchymal cells contain numerous antiangiogenic and antiinflammatory factors.

Circadian rhythms are biological processes that occur in approximately 24-hour cycles in organisms. Disruption of circadian rhythms (CD) is thought to have adverse effects on many organs, including the eyes. The aim of this study was to evaluate the effects of circadian disruption on the cornea and conjunctiva, as well as the impact of two forms of omega-3 supplementation on the ocular surface, using a rat model of circadian disruption. This experimental study included 32 female Wistar albino rats, which were divided into four groups. The control group (Group 1) was maintained under normal feeding and sleeping conditions without any disruption. Circadian disruption was induced in the other three groups, which were administered saline (Group 2), fish oil (Group 3), or flaxseed oil (Group 4) via oral gavage. On the 31st day, all rats were euthanized, and corneal, conjunctival, and palpebral tissues were collected from both eyes through enucleation. Histological examination and immunohistochemical analysis of Caspase-3 (Cas-3), tumor necrosis factor-alpha (TNF-α), and PERIOD-2 (PER-2) were performed on the corneal and conjunctival tissues. Group 2 exhibited significantly thicker corneas compared to Group 1 (P < 0.001). Additionally, hyperemia, inflammatory cell infiltration in the conjunctiva, higher expression levels of Cas-3 and TNF-α, and decreased PER-2 expression were observed in the corneal and conjunctival tissues of Group 2. These pathological changes were minimal or absent in Groups 3 and 4. Notably, Group 3 showed better amelioration of these alterations compared to Group 4. Disruption of circadian rhythms can have a negative impact on the cornea and conjunctiva. Omega-3 supplementation demonstrated a significant protective effect against ocular tissue damage induced by circadian disruption. Fish oil was more effective than flaxseed oil in reducing corneal thickening, inflammation, and apoptotic marker expression, highlighting its potential as a therapeutic intervention for circadian rhythm-related ocular pathologies.

To evaluate whether hydroxypropyl-guar (HP-Guar) nano-emulsion artificial tears improve symptoms, quality of life, severity of meibomian gland dysfunction (MGD) and evaporative dry eye (EDE)-related parameters in mild-to-moderate EDE participants over 90 days. Fifty-one mild-to-moderate EDE participants were recruited for a single-masked, longitudinal clinical trial without a control group or placebo. Inclusion criteria comprised: Ocular Surface Disease Index (OSDI) between 13-32 points; at least one positive diagnostic sign (Non-Invasive Tear Break-Up Time [NIBUT] <10 s and/or corneal staining >1) and two classification signs (Tear Meniscus Height [TMH] ≥0.20 and ≤0.50 mm and MGD score ≥5 points). Participants applied 1-2 drops of HP-Guar nano-emulsion artificial tears per eye, four times daily for 90 days, with follow-up assessments at baseline, 30, 60 and 90 days. Three groups of tests were conducted each session: DED symptomatology and quality of life (OSDI, EuroQol 5-Dimension 5-Level [EQ-5D-5L]), MGD severity (MGD score, meibomian gland loss area [MGLA]) and EDE-related parameters (meibomian gland expression [MGE], Meibometry, lipid layer pattern (LLP), NIBUT, ocular redness and corneal staining). Significant differences in OSDI score, EQ-5D-5L in the 'Healthy today' scale, MGD score, lower eyelid MGLA and LLP were observed across sessions (all p ≤ 0.03). However, no significant differences were found in EQ-5D-5L score, upper eyelid MGLA, MGE, Meibometry, NIBUT-first, NIBUT-average, limbal or bulbar redness in any area or corneal staining (all p ≥ 0.09). This 90‑day single‑masked study without a control group found that HP‑Guar nano‑emulsion eye drops were associated with improvements in symptoms, perceived health and MGD‑related signs. These findings are exploratory and require confirmation in controlled trials.

PurposeTo evaluate the safety and efficacy of yellow laser photocoagulation for deep conjunctival nevi.MethodologyThis prospective interventional case series included patients with clinically stable conjunctival nevi for ≥6 months. Treatment was performed using the Iridex yellow laser (577 nm) under topical anesthesia, with a 200-micron spot, 80 ms exposure, and 300-600 mW power. The lesion was removed with sterile cotton buds post-laser, and topical steroids were prescribed for one week. Follow-up was at day 1, week 1, month 1, and month 3, assessing ocular surface health and lesion resolution. Examinations included Schirmer Test 1, Oxford corneal staining, Ocular Surface Disease Index (OSDI), tear meniscus height, and non-invasive keratograph break-up time (NIKBUT).ResultsThe study included 10 eyes from 9 patients. Mean age was 30 years (range: 6-63), with a 1:1 sex ratio. Anterior segment OCT confirmed subepithelial lesions in all, with intralesional cysts in 60%. Mean nevus diameter was 4.2 mm (range: 2-11), and 70% showed severe pigmentation. Laser treatment was completed in one session for 90% of eyes; one required a second due to large size. No significant changes were observed in ocular surface parameters. At a mean follow-up of 10.5 months (range: 3-17), 85% (6/7) of eyes had complete resolution when the laser was fully applied. No recurrence occurred. One patient developed conjunctival scarring from inadvertent Tenon's capsule application.ConclusionYellow laser photocoagulation is a safe, effective, minimally invasive outpatient treatment for conjunctival nevi, including deeply pigmented cases. It yields excellent cosmetic outcomes with minimal side effects, supporting its role as a potential standard of care.