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ObjectiveMethodsResultsConclusionCiliary body medulloepithelioma (CBME), a pediatric intraocular tumor with potential for locally aggressive behavior and metastasis, may present with a diverse spectrum of clinical and histopathologic features leading to diagnostic and management challenges. Examination of unusual CBME cases highlights challenges and modern diagnostic techniques which facilitate accurate diagnosis and guide management.A retrospective clinicopathologic analysis of 6 patients with unusual clinical or pathologic features of CBME was performed.The mean duration of delay in accurate diagnosis was 5.7 years (SD: 8.2, median: 3, range: 0–22). All patients developed cataract, 4 (67%) were diagnosed with glaucoma, and 4 (67%) underwent surgery prior to accurate diagnosis. At initial presentation, only one patient with a known history of genetically confirmed DICER1 syndrome underwent appropriate imaging leading to a timely identification of a ciliary body mass and no delay in diagnosis. Following identification of intraocular mass, 4 (67%) patients underwent enucleation. Two patients (33%) underwent exenteration for extraocular extension of CBME. Initial histopathologic differential diagnosis included CBME, melanoma, adenoma or adenocarcinoma of the pigmented ciliary body epithelium, retinoblastoma, sarcoma, and malignant teratoma. Immunohistochemistry and genetic testing assisted in the diagnosis of CBME. Two patients (33%) had a germline DICER1 variant; this was known prior to CBME diagnosis in one patient and discovered after CBME diagnosis in the second patient.This series highlights the unusual clinical and histopathologic features of CBME that contribute to delays in diagnosis. Modern aids including genetic testing, ancillary imaging studies, and immunohistochemistry facilitate a timely accurate diagnosis of CBME and guide management. [ABSTRACT FROM AUTHOR]

Cilia assembly and function rely on the bidirectional transport of components between the cell body and ciliary tip via Intraflagellar Transport (IFT) trains. Anterograde and retrograde IFT trains travel along the B- and A-tubules of microtubule doublets, respectively, ensuring smooth traffic flow. However, the mechanism underlying this segregation remains unclear. Here, we test whether tubulin detyrosination (enriched on B-tubules) and tyrosination (enriched on A-tubules) have a role in IFT logistics. We report that knockout of tubulin detyrosinase VashL in Chlamydomonas reinhardtii causes frequent IFT train stoppages and impaired ciliary growth. By reconstituting IFT train motility on de-membranated axonemes and synthetic microtubules, we show that anterograde and retrograde trains preferentially associate with detyrosinated and tyrosinated microtubules, respectively. We propose that tubulin tyrosination/detyrosination is crucial for spatial segregation and collision-free IFT train motion, highlighting the significance of the tubulin code in ciliary transport. Cilia assembly relies on cargo trains that move bidirectionally on separate tubules of the ciliary microtubular structure, preventing traffic jams. Here, the authors demonstrate that train sorting is governed by tubulin tyrosination levels. [ABSTRACT FROM AUTHOR]

Pseudoexfoliation syndrome (PXS) is an age-related fibrillopathy where fibrillar exfoliation material accumulates and deposits in ocular and extra-ocular tissue. Within the eye, this substance accumulates on the ocular surface and in the anterior segment of the eye, impacting ocular structures such as the conjunctiva, Tenon's capsule, sclera, cornea, iris, ciliary body, trabecular meshwork, and lens. This review aims to collate the current literature on how each anatomical part of the eye is affected by PXS, with a strong focus on molecular changes. We also summarise the current understanding of the key genetic factors influencing the development of PXS. [ABSTRACT FROM AUTHOR]

Background: Cutaneous melanoma is the leading cause of death from cutaneous malignancy and tends to metastasize lymphatically and hematogenously to the lung, liver, brain, and bone; it is a rare source of metastatic disease to the eye. Herein we provide a case report of cutaneous melanoma metastatic to the ciliary body and choroid involving clinical examination, slit lamp photography, and B-scan ultrasonography. Result: A 55-year-old female with known metastatic cutaneous melanoma presented with pain, a large ciliochoroidal mass, visual decline, and diffuse intraocular inflammation. The examination and testing were consistent with intraocular metastasis from her primary cutaneous melanoma. Given the extent of intraocular disease, the patient elected for enucleation of the involved eye. The patient's intraocular disease demonstrated significant regression on combination immunotherapy with nivolumab and ipilimumab and surgery was subsequently deferred. The metastatic ciliochoroidal lesion ultimately regressed completely with systemic dual checkpoint inhibitor therapy. Conclusion: Combination therapy with ipilimumab and nivolumab immunotherapy may be effective in the treatment of aggressive intraocular metastatic cutaneous melanoma. [ABSTRACT FROM AUTHOR]

Purpose: To report the first case of uveitis-glaucoma-hyphema (UGH) syndrome post implantable collamer lens (ICL). Methods: Case report Results: A 41-year-old female presented to our clinic complaining of bilateral eye pain and redness for two weeks. Her past medical history was significant for ICL, in both eyes and multiple sclerosis controlled with treatment. She had a long-standing history of bilateral recurrent uveitis and glaucoma. Ultrasound biomicroscopy revealed several sulcus cysts displacing the ICLs haptic into the ciliary body, leading to iris abrasion and uveitis-glaucoma-hyphema syndrome. Conclusion: We present the first published case worldwide about UGH syndrome secondary to ICL. This is an unusual complication, and measures can be taken to avoid it. This provides evidence of the importance of postoperative follow-up by the surgeon and appropriate work-up when such cases are suspected. [ABSTRACT FROM AUTHOR]

Our study represents the first attempts to describe the ultrastructure features in addition to SEM‐EDX analysis of the pecten oculi of the nocturnal, visually active Eurasian stone‐curlew. The present study was carried out on 10 normal pecten oculi from the migrant Eurasian stone‐curlew (Burhinus oedicnemus) that was captured from the Northern Egyptian coast, Edku Lake, Edku, Behera, Egypt. The intraocular folded quadrilateral fan black pecten oculi was observed on the posteroinferior wall of the eyeball. The pecten oculi had 18–20 pleats, with narrow spaces in‐between. Our SEM findings showed a tortuous, coiled pecteneal surface due to numerous blood capillaries. The apical part was oriented toward the ciliary body, but the basal part was derived from the retina, just behind the optic nerve. The outer pleat surfaces are covered by the vitreopecteneal limiting membrane, which carries numerous hyalocyte cells on the outer pleat surface. The transverse sections revealed numerous blood capillaries surrounded by numerous melanin granules. Each basal part was surrounded by a thin, elevated ridge. Our SEM‐EDX analysis revealed that carbon is the highest (half percent), oxygen represents about one‐third, and nitrogen is one‐fifth percent of all elements. The lowest elements are sulfate at the apical part and phosphorus in the middle and basal parts. In conclusion, our findings reveal that the number of pecteneal pleats is related to the nocturnal active visual pattern and the lifestyle of this migratory bird. Summary: Our study focused on the ultrastructure features and SEM‐EDX analysis of the pecten oculi of the Eurasian stone‐curlew, a visually active nocturnal bird. The pecten oculi had 18–20 pleats and a tortuous, coiled pecteneal surface with numerous blood capillaries. The apical part was oriented toward the ciliary body, while the basal part was derived from the retina. The outer pleat surfaces were covered by the vitreopecteneal limiting membrane, which carried numerous hyalocyte cells. Transverse sections reveal numerous blood capillaries surrounded by melanin granules, and each basal part was surrounded by a thin, elevated ridge. SEM‐EDX analysis revealed carbon as the highest element, followed by oxygen and nitrogen. The lowest elements were sulfate at the apical part and phosphorus in the middle and basal parts. [ABSTRACT FROM AUTHOR]

Diabetes can involve several ocular structures -- including the cornea, lens, and retina -- and cause vascular and neural changes in these tissues. Although retinopathy is the most common ocular complication of diabetes, uveopathy can also be observed. This includes vascular, neural, muscular, and basement membrane changes. The main clinical manifestations of diabetic uveopathy are anterior uveitis and abnormal pupillary dynamics. Fluorescein angiography, optical coherence tomography, and optical coherence tomography angiography are ideal for the imaging of vascular changes of the iris and choroid, while dynamic pupillometry is a simple screening tool to detect neuropathy. Additionally, ultrasound biomicroscopy can provide clear images of the ciliary body. Iris abnormalities, primarily angiopathy and neuropathy, can appear as alterations in vascular diameter, neovascularization, and abnormal pupillary dynamics. Choroidal abnormalities primarily affect blood vessels, including alterations in vascular diameter, microaneurysm formation, and neovascularization. The abnormal manifestations in the ciliary body include a decrease in vessel count, alterations in their diameter, isolated angiomatous dilatation, and diffuse thickening of the basal membrane of the pigment epithelium. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to compare the safety and effectiveness of intraocular pressure reduction between micropulse transscleral cyclophotocoagulation and “slow cook” transscleral cyclophotocoagulation in patients with refractory primary open-angle glaucoma. Methods: We included patients with primary open angle glaucoma with at least 12 months of follow-up. We collected and analyzed data on the preoperative characteristics and postoperative outcomes. The primary outcomes were a reduction of ≥20% of the baseline value (criterion A) and/or intraocular pressure between 6 and 21 mmHg (criterion B). Results: We included 128 eyes with primary open-angle glaucoma. The preoperative mean intraocular pressure was 25.53 ± 6.40 and 35.02 ± 12.57 mmHg in the micropulse- and “slow cook” transscleral cyclophotocoagulation groups, respectively (p<0.001). The mean intraocular pressure was reduced significantly to 14.33 ± 3.40 and 15.37 ± 5.85 mmHg in the micropulse- and “slow cook” transscleral cyclophotocoagulation groups at the last follow-up, respectively (p=0.110). The mean intraocular pressure reduction at 12 months was 11.20 ± 11.46 and 19.65 ± 13.22 mmHg in the micropulse- and “slow cook” transscleral cyclophotocoagulation groups, respectively (p<0.001). The median preoperative logMAR visual acuity was 0.52 ± 0.69 and 1.75 ± 1.04 in the micropulse- and “slow cook” transscleral cyclophotocoagulation groups, respectively (p<0.001). The mean visual acuity variation was -0.10 ± 0.35 and -0.074 ± 0.16 in the micropulse- and “slow cook” transscleral cyclophotocoagulation, respectively (p=0.510). Preoperatively, the mean eye drops were 3.44 ± 1.38 and 2.89 ± 0.68 drugs in the micropulse- and “slow cook” transscleral cyclophotocoagulation groups, respectively (p=0.017), but those were 2.06 ± 1.42 and 1.02 ± 1.46 at the end of the study in the slow cook” and micropulse transscleral cyclophotocoagulation groups, respectively (p<0.001). The success of criterion A was not significant between both groups. Compared with 11 eyes (17.74%) in the slow cook” transscleral cyclophotocoagulation group, 19 eyes (28.78%) in the micropulse transscleral cyclophotocoagulation group showed complete success (p=0.171). For criterion B, 28 (42.42%) and 2 eyes (3.22%) showed complete success after micropulse- and slow cook” transscleral cyclophotocoagulation, respectively (p<0.001). Conclusion: Both techniques reduced intraocular pressure effectively. [ABSTRACT FROM AUTHOR]

Introduction: Choroidal metastases from systemic malignancies are the most common intraocular malignancies in adults. External beam radiation (EBR) has historically been first-line therapy for metastatic tumors to the choroid. However, good responses have been described with newer targeted biologics. The optimal management strategy for patients with choroidal metastatic tumors in the era of targeted cancer therapy is not known. We aim to describe management of these tumors in a "real-world" setting using both radiation and systemic therapy. Methods: We conducted a retrospective review of patients with choroidal/ciliary body metastases managed by the ocular oncology service at our institution over a five-year period. Demographic data, tumor type, treatment, visual outcomes, and mortality data were recorded. Results: 26 patients (33 eyes) with choroidal/ciliary body metastasis were identified. Primary malignancies included lung (8) breast (8), renal (3), esophageal (3), carcinoid (2), squamous cell carcinoma of the tonsil (1), and testicular cancer (1). Average time from diagnosis of ocular metastasis to death was 8 months (1-34). 20 eyes were treated with EBR and 13 eyes were treated with other modalities. Final logMAR visual acuity for eyes treated with radiation was 0.11 (0-3). Final visual acuity for eyes treated with other modalities was 0.18 (0-.70), with local tumor control in 20/23 eyes that had follow up after treatment. The difference between final visual acuity in these groups was not visually significant p=0.48. Conclusion: Patients with choroidal/ciliary body metastasis treated with either EBR or systemic therapy can have good visual outcomes. More work needs to be conducted to determine the optimal first-line treatment of ocular metastasis for specific tumor subtypes. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the 12-month rotational stability and outcomes of V4c toric Implantable Collamer Lenses (TICLs) (STAAR Surgical) located at two different lens orientations (horizontal or oblique). Methods: This retrospective study included a total of 403 eyes with TICL implantation, enrolled between January 2021 and December 2022, that were divided into two groups based on the minimum intended angle off the horizontal axis: horizontal with 263 eyes at an angle ±22.5 degrees or less and oblique with 140 eyes at a minimum intended angle of greater than ±22.5 degrees. A comparison was made of the preoperative characteristics, surgical outcomes, secondary surgical interventions, footplate positions, and adverse events at 1, 6, and 12 months postoperatively. The rotation-related factors were analyzed. Results: At 12 months, there were 243 eyes (92%) in the horizontal group and 130 eyes (93%) in the oblique group that were within ±0.50 diopters (D) of emmetropia. Their rotation proportion was 5.3 % and 5.7%, respectively, and their rotation angle was 9.11 ± 2.84 and 9.96 ± 2.42 degrees, respectively (P =.086). TICL footplates were mostly positioned on the ciliary body. No correlation was observed of lens placement axis, vault, or manifest refraction with rotation in both groups (P >.05). During the follow-up, no vision-threatening complications were observed in both groups. Rotation cases were successfully addressed via alignment or lens exchange. Conclusions: TICLs, when implanted across a range of lens orientations, demonstrated favorable rotational stability and postoperative outcomes. The postoperative rotational stability is independent of the placement angle of the TICL. [J Refract Surg. 2025;41(1):e29–e38.] [ABSTRACT FROM AUTHOR]

Background/Objectives: Micropulse laser trabeculoplasty (MLT) is gaining attention as a non-invasive treatment option for primary open-angle glaucoma (POAG), offering an alternative to traditional surgeries and medications. This systematic review evaluates the effectiveness, safety, and potential of MLT in glaucoma management. Methods: This review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The strength of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology, following the 2011 Oxford Centre for Evidence-Based Medicine (OCEBM) recommendations. Results: We identified 79 articles, and after removing duplicates and screening abstracts, 56 articles were eligible for further review. A detailed full-text analysis was conducted on 26 articles, of which 15 met the predefined inclusion criteria. Conclusions: MLT shows promise as a primary or adjunctive treatment for reducing intraocular pressure (IOP) in glaucoma and ocular hypertension patients. Current evidence supports its efficacy and safety; however, additional long-term studies are needed to confirm its durability and compare its effectiveness with traditional surgical and pharmacological approaches. Standardizing treatment protocols and refining patient selection criteria could enhance MLT's clinical value and support its broader adoption in glaucoma care. [ABSTRACT FROM AUTHOR]

In cataract surgery, post-surgical stability of the intraocular lens plays a major role. This study aims to explore how the size and decentration of the capsulorhexis affect intraocular lens decentration and tilt by using numerical methods. Finite element models included zonules, ciliary body, capsular bag, and an IOL with two open-loop haptics were built. Capsulorhexes were modeled with a 4.5- and 5.5-mm diameter. The capsulorhexis was shifted 0.5–1 mm in two in-plane directions normal to the optical axis. Three IOLs with different powers (5 D, 29 D, and 34 D) were compared. The results were also compared with currently published numerical and clinical studies. With different capsulorhexes sizes and locations, the decentration varied from 0.43 to 8.3 μm, and the tilt varied 0.02° − 0.09°. The 34 D lens had the largest tilt and decentration when capsulorhexis changed sizes or decentered. The simulation showed that capsulorhexis size and decentration have only a minor effect on IOL decentration or tilt that will in most cases not be noticeable to the patient. [ABSTRACT FROM AUTHOR]

Background: Recent studies have indicated that oxidative stress is a crucial pathophysiological process in glaucoma. We hypothesized that Posner-Schlossman syndrome (PSS) is a vascular inflammation in the ciliary body due to oxidative stress and endothelial dysfunction. Thus, we investigated serum uric acid (UA) and lipid levels in patients with refractory PSS with the aim of providing basic evidence for the mechanism of PSS. Methods: This is a retrospective, case-control study. A total of 81 refractory PSS and 409 control participants were included in this study. Clinical and laboratory characteristics were reviewed using an electronic medical system. Propensity score-matched (PSM) analysis was performed to reduce demographic differences. The t-test, Mann-Whitney U test, and χ2 test were used to assess the differences between the PSS and control groups. Logistic regression analysis was used to identify the predictors of PSS. Results: The higher serum UA (364.14 ± 98.72µmol/L vs. 322.38 ± 72.09µmol/L), higher low-density lipoprotein (LDL) / High-density lipoprotein (HDL) ratio (2.50 ± 0.97 vs. 1.95 ± 0.72) and lower HDL (1.29 ± 0.32 mmol/L vs. 1.59 ± 0.38 mmol/L) can be noticed in refractory PSS than control group. Logistics regression identified UA > 420 µmol/L (OR = 4.461) and the HDL < 1.03 mmol/L (OR = 3.896) were the independent risk factors for refractory PSS. Conclusions: Increasing serum UA and decreasing HDL levels were positively correlated with the incidence risk of refractory PSS. Further prospective longitudinal studies and animal models are needed. [ABSTRACT FROM AUTHOR]

OBJECTIVE To evaluate the long-term efficacy, prognostic factors, and complications of intravitreal cidofovir injection in dogs with end-stage glaucoma. ANIMALS 130 client-owned dogs. METHODS Medical records of dogs that underwent intravitreal cidofovir injections were reviewed. A minimum follow-up period of 6 months was required as the inclusion criterion. Signalment, type of glaucoma, preinjection intraocular pressure (IOP), types of applied glaucoma eye drop, coexisting ocular diseases, outcomes, and complications were recorded. Success was defined as lOP of g 25 mm Hg at the 2-week recheck that remained to the 6-month recheck. RESULTS The overall success rate of intravitreal cidofovir injection was 91.5% (140/153). The success rate of a single injection was 69.3% (106/153), of a second injection was 59.5% (25/42), of a third injection was 42.9% (6/14), of a fourth injection was 33.3% (2/6), and of a fifth injection was 50.0% (1/2). Intraocular pressures at 6 months after injection were relatively higher when the injection was repeated, fewer types of glaucoma eye drop were applied prior to the injection, and cataract stages were advanced at the time of injection (P < .05). The most common complications were phthisis bulbi (42.5%), cataract progression (30.1%), and intraocular hemorrhage (16.3%). Six eyes were enucleated, and 3 were enucleated due to corneal perforation. CLINICAL RELEVANCE Intravitreal cidofovir injection had a high long-term success rate in lowering lOP in dogs with end-stage glaucoma. [ABSTRACT FROM AUTHOR]

Objective: To report a case of bilateral diffuse uveal melanocytic proliferation (BDUMP) followed by massive unilateral uveal proliferation. Methods: Retrospective case report. Results: A 47-year-old female with history of metastatic ovarian carcinoma initially presented with bilateral vision loss and multifocal red patches on posterior poles consistent with BDUMP. Five years later, she presented with bilateral neovascular glaucoma and unilateral iris and ciliary body mass concerning for malignancy. Enucleation revealed diffuse uveal growth involving almost the entirety of the uveal tract. Conclusions: BDUMP can rarely be associated with uveal proliferation. Routine examinations are recommended to monitor for any changes concerning malignancy. [ABSTRACT FROM AUTHOR]

Adeno-associated virus (AAV)-based vectors are the most frequently used platform for retinal gene therapy. Initially explored for the treatment of loss-of-function mutations underpinning many inherited retinal diseases, AAV-based ocular gene therapies are increasingly used to transduce endogenous cells to produce therapeutic proteins, thus producing site-specific biofactories. Relatively invasive ocular routes of administration (ROA) mean prominent procedure-related in-life, and histopathological findings may be observed with some regularity. Test article-related findings may vary with the ROA and cell populations transduced, with retinal pigmented epithelium (RPE) changes prominent (ranging from pigment alteration through degeneration, with or without associated degeneration of the overlying retina) with subretinal ROA, and more anterior changes (iris, ciliary body) generally observed with the intravitreal ROA. Ocular inflammation is the most frequent finding that occurs nonclinically and in patients, and is particularly pronounced with intravitreal administration. Extraocular findings may be observed in extraocular muscles, regional ganglia, or central visual pathways with multiple ocular ROA. Work is still needed to understand the mechanisms underpinning many of these ocular and extraocular findings. Emerging patient data is helping to clarify both the potential for translating nonclinical findings to predict possible human responses and the applicability of nonclinical biomonitoring methods to the clinical setting. [ABSTRACT FROM AUTHOR]

Background: To establish a novel vault prediction formula after implantable collamer lens (ICL) implantation that considers both anterior and posterior chamber characteristics with multi‐modal parameters. Methods: A total of 103 and 65 eyes were included in the development and validation groups, respectively. Exploratory factor analysis was performed using data from optical coherence tomography and ultrasound biomicroscopy in the development group to synthesise summative factors with different clinical significance. Dominant original metrics with heavy loadings on significant factors (absolute value of the loading coefficient >0.5) were screened for multivariate linear regression models using a stepwise method. The newly derived formula was evaluated and compared to the NK and KS formulas in the validation group. Results: Six factors (anterior chamber angle, horizontal width, lens, iris, iridociliary complex and ciliary body) were generated after dimension reduction via factor analysis. Factors 2 (horizontal width), 3 (lens), and 5 (iridociliary complex) had a significant influence on the vault. When dominant metrics on these factors were screened for further model building, ICL size, anterior chamber width, crystalline lens rise, iris curvature, and iris‐ciliary process distance were retained in the final formula, with an adjusted R2 of 0.698, a median absolute error of 81.97 mm, and a root‐mean‐square error of 103.35 mm. Conclusions: Multiple intraocular components, including the lens, iris, and ciliary body, play important roles in vault determination. The new formula exhibits good accuracy for vault predictions and ICL size recommendations. [ABSTRACT FROM AUTHOR]

Objective Procedures Results Conclusion To describe the case of a 12‐year‐old male African lion (Panthera leo) presented with ocular discharge, corneal edema, and buphthalmos of the right eye.Ocular ultrasonography showed an intraocular mass involving the iris and ciliary body. Enucleation was performed.Subsequent histopathological analysis revealed a pleomorphic pigmented neoplastic cell population infiltrating, expanding and effacing the iris and ciliary body and occupying the ciliary cleft. The histopathological and immunohistochemical features were consistent with a diffuse iris melanoma (DIM).DIM is the most common primary intraocular neoplasm of domestic cats, but rarely reported in large felids. The prognosis in large felids is unknown and warrants identifying additional cases and careful monitoring of affected individuals. [ABSTRACT FROM AUTHOR]

Background/Objectives: Early stages of diabetic retinopathy are currently considered an unmet medical need due to the lack of effective treatments beyond proper monitoring and control of glycemia and blood pressure. Sitagliptin eye drops have emerged as a new therapeutic approach against early stages of the disease, as they can prevent its main hallmarks, including both neurodegeneration and microvascular impairment. Interestingly, all of these effects occur without any glycemic systemic improvement. In the present study, we aimed to investigate the pharmacokinetics and distribution of the drug within the eye and plasma. Methods: A total of 48 male New Zealand rabbits were treated with topical administration (eye drops) of sitagliptin at two concentrations: 5 mg/mL and 10 mg/mL. Blood, iris/ciliary body, retina/choroid, aqueous humor, and vitreous humor samples were collected at specific intervals post-administration (10 and 30 min and 1, 3, 6, 15, and 24 h), processed, and analyzed using an LC-MS/MS method. The pharmacokinetics of sitagliptin were then calculated, and statistical comparisons were performed. Results: Our findings indicate that sitagliptin reaches the retina prior to the aqueous and vitreous humors, suggesting that its absorption follows the transscleral route. Additionally, systemic absorption was minimal and below pharmacologically active concentrations. Conclusions: These results support the use of an eye drop formulation for the treatment of diabetic retinopathy and other retinal diseases. [ABSTRACT FROM AUTHOR]

Background: The ciliary muscle is known to play a part in presbyopia, but the mechanism has not received a comprehensive review, which this study aims to achieve. We examined relevant articles published from 1975 through 2022 that explored various properties of the muscle and related tissues in humans and rhesus monkeys. These properties include geometry, elasticity, rigidity, and composition, and were studied using a range of imaging technologies, computer models, and surgical methods. We identified a notable age-related displacement of the ciliary muscle apex that is characterized by anterior and medial shifts, and hypothesized to be primarily attributed to the accrual of connective tissue and tension exerted by the thickening lens. Other factors could also contribute to the movement, particularly the "inward bowing" of the sclera. Another noteworthy observation is that while the ciliary muscle experiences increasing constraint with advancing age due to adjacent anatomical structures, its contractile capacity remains unaltered, alongside the sustained constancy in both the concentration of muscarinic receptors and their binding affinity. Overall, more studies on human ciliary muscle are needed, as it ages differently from that of monkeys' ciliary muscle. These studies should explore other perspectives, including those regarding changes in the physical properties of the tissue and its relationship with other connected tissues. Methodology: This literature review utilized a systematic methodology to identify and analyze pertinent studies of the presbyopia and ciliary muscles. The approach encompassed a thorough examination of available literature across different academic databases, such as PubMed, Embase, and Cochrane Library. Results: Many studies have identified age-related thickening in the ciliary muscle and its potential causes, including the heightened deposition of connective tissues and traction exerted by the thickening lens. Notably, these inquiries culminated in the formulation of a geometric theory positing that the morphology of the ciliary muscle and its spatial relationship with adjacent structures exert pivotal influence over the tension exerted on zonular fibers. Conclusion: The decline in the accommodative response of the muscle is prevalent in advanced age, with reduced mobility likely attributable to the increased stiffness of the Bruch's Membrane-Choroid Complex (BMCC), where the tendons of the ciliary muscle insert, as well as the thickening and stiffening of the lens. Importantly, the ciliary muscle forces do not change with age. [ABSTRACT FROM AUTHOR]

Abstract Background Cutaneous melanoma is the leading cause of death from cutaneous malignancy and tends to metastasize lymphatically and hematogenously to the lung, liver, brain, and bone; it is a rare source of metastatic disease to the eye. Herein we provide a case report of cutaneous melanoma metastatic to the ciliary body and choroid involving clinical examination, slit lamp photography, and B-scan ultrasonography. Result A 55-year-old female with known metastatic cutaneous melanoma presented with pain, a large ciliochoroidal mass, visual decline, and diffuse intraocular inflammation. The examination and testing were consistent with intraocular metastasis from her primary cutaneous melanoma. Given the extent of intraocular disease, the patient elected for enucleation of the involved eye. The patient’s intraocular disease demonstrated significant regression on combination immunotherapy with nivolumab and ipilimumab and surgery was subsequently deferred. The metastatic ciliochoroidal lesion ultimately regressed completely with systemic dual checkpoint inhibitor therapy. Conclusion Combination therapy with ipilimumab and nivolumab immunotherapy may be effective in the treatment of aggressive intraocular metastatic cutaneous melanoma.

Background: Cyclodestructive procedures with high laser energy settings achieve their IOP reduction effect at the expense of damage to the secretory epithelium of the ciliary processes and adjacent structures, which may result in such complications as hypotony and ocular subatrophy. Purpose: To experimentally evaluate the histopathological features in the rabbit eye after exposure of the distal ciliary body to transscleral selective laser radiation at the 810 nm wavelength versus the 1064 nm wavelength, and to compare the histopathological effects of the diode and neodymium:yttrium-aluminum-garnet (Nd:YAG) lasers. Material and Methods: Four Chinchilla rabbits (8 eyes) were included in this experimental study. In four eyes, transscleral cyclophotocoagulation (TSCPC) of the ciliary body was performed with an 1064-nm Nd:YAG laser (energy, 1.0 J/ pulse; pulse duration, 3 ms) equipped with a 600-µm fused-silica fiber optic tip. In another four eyes, an 810-nm diode laser TSCPC of the ciliary body was performed using a Vitra 810 apparatus (Quantel Medical Instruments, France) with a laser power of 1W and exposure duration of 1.5 s (energy, 1.5 J/pulse). Results: Our experimental histopathological study of rabbit eyes demonstrated no significant difference in the development of ciliary stromal edema (р = 0.425) and focal necrosis of the non-pigmented ciliary epithelium (р = 0.764) between the eyes that received the transscleral contact cyclodestruction with an 810-nm diode laser at an energy of 1.5 J and the eyes that received transscleral contact-and-compression cyclodestruction with a 1064-nm Nd:YAG laser at en energy of 1.0 J. Conclusion: The use of 810-nm laser radiation at energy of 1.5 J in the transscleral contact cyclodestruction and the use of 1064-nm laser radiation at energy of 1.0 J in the transscleral contact-and-compression cyclodestruction were similar in enabling selective thermal effects on the ciliary epithelium with limited damage to adjacent structures in rabbits.

Background: Iridodialysis, the separation of the iris root from the ciliary body, typically results from trauma and can lead to significant visual impairment. This case report is novel as it demonstrates the successful management of iridodialysis using an extended depth of focus intraocular lens in a patient with a slightly irregular pupil. Case presentation: A 34-year-old Hispanic man presented with reduced vision and pain in his right eye following blunt trauma from a nail at work. Examination revealed a small temporal corneal stromal scar, traumatic posterior subcapsular cataract, two inferior iridodialysis defects, and a superiorly displaced dyscoric oval pupil. Snellen uncorrected distance visual acuity was 20/400. The patient opted for an extended depth of focus intraocular lens implantation to meet his visual demands for distance and intermediate vision without glasses. Cataract surgery with capsular tension ring, extended depth of focus intraocular lens implantation, iridodialysis repair, and suture pupilloplasty were performed uneventfully. At 1 month postoperatively, uncorrected distance visual acuity improved to 20/40, while uncorrected intermediate visual acuity and uncorrected near visual acuity were 20/20. A central, relatively round, and slightly inferiorly peaked pupil was achieved. A steroid response intraocular pressure rise at postoperative month 2 required intraocular pressure-lowering medications, and symptomatic posterior capsular opacity developed at 8 months postoperatively. At 11 months postoperatively, selective laser trabeculoplasty and laser capsulotomy were performed. At 4-year follow-up, visual acuity measurements remained stable, and intraocular pressure was normal without any medication. The patient was satisfied with the visual and cosmetic outcomes. Conclusion: This case demonstrates that extended depth of focus intraocular lenses can be a viable option for patients with slightly irregular pupils following suture repair of the iris and pupil. The successful visual and cosmetic outcomes in this patient suggest that extended depth of focus intraocular lenses may be considered in similar complex cases, providing a balance of near, intermediate, and distance vision without significant visual disturbances. [ABSTRACT FROM AUTHOR]

In this study, we conducted stress and strain analyses on the eyeball under pressure using the finite element simulation software Ansys. The eyeball model was constructed using SolidWorks, and additionally, it simulates a contact-type tonometer, applying pressure to the eyeball through probe force variations and calculating the pressure changes inside the eyeball. Initially, the cornea, sclera, ciliary body, suspensory ligaments, aqueous humor, and vitreous humor were combined using SolidWorks. Subsequently, the model was imported into Ansys for meshing, boundary setting, and simulation calculation. Finally, the analysis results were extracted using the Ansys postprocessor and the simulated data were validated against actual measurement data to ensure accuracy. Material properties necessary for the eyeball under pressure analyses were configured, with the Mooney-Rivlin hyperelastic material being selected. During compression, the cornea and sclera primarily absorbed the concentrated load after compression. Pressure was applied using a probe to observe variations in stress and strain concerning the applied force and intraocular pressure. Three probe materials (rubber, titanium alloy, and glass) were chosen for comparative simulation analyses. [ABSTRACT FROM AUTHOR]

Introduction: A cyclodialysis cleft, separating the ciliary body muscle from the scleral spur, can cause ocular hypotony by creating an abnormal aqueous humor drainage pathway. Though rare, this can occur post-intravitreal injection. Case Presentation: A 53-year-old man with diabetic retinopathy presented with persistent hypotony in his right eye after receiving an aflibercept intravitreal injection. On presentation, his visual acuity was 20/200, and intraocular pressure (IOP) was 2 mm Hg. Examination revealed a cyclodialysis cleft in the right eye. Despite initial treatment with steroids and atropine, the hypotony persisted, leading to surgical repair via ab-interno cyclopexy. Post-surgery, IOP normalized, and vision slightly improved. At 3 months post-operation, IOP was stable at 16 mm Hg without glaucoma medication, and no signs of hypotony were present, with vision improving to 20/150. Conclusion: Misplaced intravitreal injections can lead to cyclodialysis cleft formation. Ophthalmologists should be aware of this possible complication. Meticulous gonioscopy and the adjunctive use of ocular imaging are crucial for the proper diagnosis of these cases. Ab-interno direct cyclopexy is an effective surgical approach for cyclodialysis clefts non-responsive to medical or laser treatment. [ABSTRACT FROM AUTHOR]

Purpose: Uveitis-Glaucoma-Hyphema (UGH) syndrome results from contact between the intraocular lens (IOL) and the iris or ciliary body, leading to uveal structure erosion and blood-aqueous barrier breakdown. Treatment involves various drugs, with IOL removal often being necessary. Diagnosis relies on clinical signs, but imaging techniques like ultrasound biomicroscopy (UBM) or anterior segment optical coherence tomography (AS-OCT) are crucial. AS-OCT accurately depicts IOL position and potential contact, emerging as a primary alternative to UBM in the diagnosis. Our study aimed to correlate AS-OCT findings with clinically detectable iris atrophy in pseudophakic patients with IOL-iris chafing and UGH syndrome. Methods: The study retrospectively analyzed patients diagnosed with UGH syndrome presenting at the Ocular Immunology Unit of Reggio Emilia, Italy, from January 2019 to August 2023. Patients' data were collected. Ophthalmological exams and imaging were performed. The peephole sign in AS-OCT images was evaluated. Statistical analyses were conducted, with a significance level of p ≤ 0.05. Results: The study reviewed 22 eyes of 22 patients with UGH syndrome. Four eyes were excluded, leaving 18 patients (8 females, 10 males). Common misdiagnoses included idiopathic anterior uveitis (55.5%) and herpetic anterior uveitis (16.7%). All patients had iris transillumination defects, mostly focal (77.8%). AS-OCT revealed IOL chafing in all the eyes, with peephole sign correlation. More peephole signs occurred with IOL in the sulcus (p-value = 0.08). Conclusion: The study recommends AS-OCT for UGH syndrome confirmation and UBM when IOL-iris chafing is not observed on AS-OCT scans. [ABSTRACT FROM AUTHOR]

Background: At present, the severity and grade of anterior scleritis are judged mainly based on the area and location of involvement, whether there is necrosis, etc. Quantitative measurement of sclera and surrounding tissues will help to accurately assess the severity of scleritis and provide quantitative indicators for the choice of treatment. Methods: We retrospectively analyzed the thickness of sclera and ciliary bodies detected by ultrasound biological microscopy (UBM) in noninfectious anterior scleritis patients who subsequently were treated with topical or systemic treatment, and visited our hospital from March 2014 to March 2021. Age- and sex-matched normal individuals were used as controls. Results: A total of 185 patients (50 males and 135 females) with noninfectious anterior scleritis and 84 (31 males and 53 females) controls were included. In patients with noninfectious scleritis, the thickness of sclera and the ciliary body were significantly greater than those in the control group (p < 0.05). Before treatment, the thickness of sclera and the ciliary body in systemic treatment group was significantly higher than that in topical treatment group (p < 0.05). After treatment, both thicknesses of sclera and the ciliary body decreased significantly (p < 0.05). The ratio of ciliary body thickness from the site of inflammation to the normal position was significantly higher in the systemic treatment group than in the topical treatment group. Conclusions: UBM quantitatively shows a decrease in AST/CBT in patients with anterior scleritis after treatment. The ratio of ciliary body thickness at the site of information to that at the normal position may be a reference for the choice of treatment. [ABSTRACT FROM AUTHOR]

The document delves into various research studies and case reports in equine ophthalmology, covering topics like the impact of eye drops on horses, stable management practices, and ocular diseases. It discusses issues such as refractive errors, ocular toxicity, microbial flora, and treatments for corneal ulcers, including the use of platelet-rich fibrin. A case study of a 17-year-old Thoroughbred mare with a non-painful mass behind the left third eyelid is presented, revealing concerns of malignant transformation to T cell rich large B cell lymphoma. The mare underwent surgical resection of the mass, highlighting the challenges in diagnosing and treating conjunctival lymphoma in equine patients. [Extracted from the article]

Purpose: We report our experience of diagnosing and managing metastatic adenocarcinoma of the lungs with primary manifestation to the iris and the ciliary body with the purpose to raise clinical suspicion for systemic malignancy in the presence of undetected ocular mass along with other ocular manifestations. Observations: An 82‐year‐old male presented with a deterioration of vision and intense pain in the right eye since the day before. With his right eye, he suddenly discerned hand movements only. Intraocular pressure in the right eye was increased. Slit–lamp biomicroscopy revealed a ciliary injection and hemorrhagic mass overlying the temporal half of the iris. The L‐9 ultrasound biomicroscopy (UBM) scan documented the tumor completely infiltrating the iris and the ciliary body. We suspected a metastatic eye lesion. CT chest imaging showed a solid expansive formation of the right lung. At the Oncology Department, a fine needle aspiration biopsy was performed under the control of MSCT, which confirmed lung adenocarcinoma. Conclusions and Importance: Although very rarely, pathological changes in the uvea may indicate a metastatic occurrence that needs to be considered in the differential diagnosis. It is important to undergo a wide ophthalmological examination, which in this case included a standardized A‐scan echography and UBM, which confirmed the suspicion of a tumor lesion, followed by cooperation with other medical professionals in order to discover a primary diagnosis. [ABSTRACT FROM AUTHOR]

PurposeObservationsConclusionsUveal effusion syndrome (UES) is an exudative detachment of ciliary body, retina and choroid. Various underlying causes leads to UES-like drugs (topiramate), inflammation and hypotony. Wnt gene involvement has never been associated with UES. We report a case of bilateral UES being misdiagnosed as Vogt–Koyanagi–Harada syndrome (VKH), with Wnt gene dysfunction as the underlying trigger.A 32-year-old male presented with diminution of vision in his left eye. He was found to have choroidal detachment with retinal detachment in his left eye. Choroidal detachment was noted in the right eye. Various ocular imaging including fundus fluorescein angiography and ocular coherence tomography was done. He was misdiagnosed as a case of VKH syndrome, for which he was treated with systemic immunomodulatory therapy. However, a subclinical response was made to revisit the diagnosis. Ultrasound biomicroscopy showed supraciliary effusion. Systemic and genetic evaluation led to the detection of Wnt10A pathway mutation.UES is an entity of diagnostic challenge. Careful and thorough systemic evaluation is required to clinch the diagnosis. We reported the first case of bilateral UES recalcitrant to corticosteroids, with Wnt10A gene mutation. [ABSTRACT FROM AUTHOR]

Purpose: To describe features of a syphilitic vascularized iris mass on multimodal imaging and its resolution after penicillin treatment. Methods: Observational case report and literature review of syphilitic iris masses. Results: A 43-year-old woman presented with a unilateral vascularized tan iris mass in the setting of bilateral panuveitis that occurred along with bilateral papillitis, cystoid macular edema and retinal vasculitis. Laboratory work-up confirmed a diagnosis of syphilis. Ultrasound biomicroscopy (UBM) of the iris mass showed parapupillary hyperechoic full-thickness iris stromal thickening with small intrinsic circular lumens without cyst or ciliary body extension, while the anterior segment optical coherence tomography (AS-OCT) demonstrated a hyperreflective mass with deep iris extension and partial hyporeflective rim. Following treatment, the mass fully resolved without residual sequela. A review of literature identified 11 additional cases of syphilitic iris masses in the English literature from 1915 to present. Their presentations and clinical courses were reviewed herein. Conclusions: This report characterizes a syphilitic iris mass on slit-lamp photography, iris fluorescein angiography, UBM and AS-OCT; depicts key characteristics of syphilitic iris masses; and highlights the need for close inspection of the iris mass as an uncommon sign of ocular syphilis. [ABSTRACT FROM AUTHOR]

Simple Summary: This review serves as a comprehensive summary of how plaque radiotherapy, a specialized treatment for various eye tumors including uveal melanoma, is used to provide effective tumor control while preserving vision. The review discusses the radioisotopes available, explores various plaque designs, and describes clinical outcomes alongside possible complications. The review summarizes ongoing research and advancements that aim to enhance the effectiveness and safety of plaque brachytherapy, which is an important tool for the ocular oncologist. Plaque radiotherapy is an effective treatment modality for medium-sized ocular tumors such as uveal melanoma. The authors review the available literature and concisely summarize the current state of the art of ophthalmic plaque brachytherapy. The choice of radioisotope, which includes Ruthenium-106 and Iodine-125, depends on the intended treatment duration, tumor characteristics, and side effect profiles. Ophthalmic plaques may be customized to allow for the delivery of a precise radiation dose by adjusting seed placement and plaque shape to minimize collateral tissue radiation. High dose rate (HDR) brachytherapy, using beta (e.g., Yttrium-90) and photon-emitting sources (e.g., Ytterbium-169, Selenium-75), allows for rapid radiation dose delivery, which typically lasts minutes, compared to multiple days with low-dose plaque brachytherapy. The efficacy of Ruthenium-106 brachytherapy for uveal melanoma varies widely, with reported local control rates between 59.0% and 98.0%. Factors influencing outcomes include tumor size, thickness, anatomical location, and radiation dose at the tumor apex, with larger and thicker tumors potentially exhibiting poorer response and a higher rate of complications. Plaque brachytherapy is effective for selected tumors, particularly uveal melanoma, providing comparable survival rates to enucleation for medium-sized tumors. The complications of plaque brachytherapy are well described, and many of these are treatable. [ABSTRACT FROM AUTHOR]

Background: The majority of primary, intraocular tumors in cats originate from the uvea and include feline diffuse iris melanoma, lymphoma, and iridociliary epithelial adenoma or adenocarcinoma. In this case report, we describe for the first time the clinical, histological, and immunohistochemical findings of a rare myxoid intraocular neoplasm arising from the ciliary body in a cat. Case presentation: A 14-year-old, female, spayed domestic shorthaired cat was presented for evaluation of discolouration of the right eye. Upon examination, a clear to light whitish-tan, bubble-shaped intraocular mass adherent to the inferior ciliary body and extending into the anterior chamber was noted. Within five weeks, the tumor was significantly larger and the eye had developed secondary glaucoma so was enucleated. Light microscopic examination of the globe revealed a multinodular, hypocellular neoplasm arising from the ciliary body composed of interwoven spindle cells embedded in abundant amounts of a lightly basophilic myxoid matrix. Neoplastic cells exhibited strong immunoreactivity for cytokeratin while also showing moderate to strong immunoreactivity to vimentin. A diagnosis was therefore made of an unusual intraocular myxoid epithelioid sarcoma arising from the ciliary body. Conclusions: Although apparently exceedingly rare, epithelioid myxosarcoma should be included as a differential diagnosis for intraocular tumors in cats and they represent a clinical, histologic, and immunohistochemical diagnostic challenge. Early surgical intervention should be considered to prevent local invasion and ascension to the brain. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the factors affecting footplate position and its influence on vault characteristics after implantable collamer lens (ICL) implantation. Setting: Hunan Provincial People's Hospital, Changsha, China. Design: Retrospective case series. Methods: This study included 124 patients (124 eyes). Ultrasound biomicroscopy (UBM) was performed to assess the iris and ciliary body morphologies and observe the footplate position. Using multiple linear regression, the relationship between various ocular and ICL parameters and the vault as well as the factors affecting the footplate distance (FD) were analyzed. Based on the FD, 3 groups were formed: group 1 (<500 mm), group 2 (500 to 1000 mm), and group 3 (>1000 mm). The distribution of the vault range postoperatively was observed for the 3 groups. Results: Ciliary sulcus angle and FD significantly affected the vault (adjusted R² = 0.190, F = 6.763, P < .001), with FD being the most important factor influencing the vault (b = -0.383, P < .001). Postoperative UBM revealed that the footplate was located at different positions in the posterior chamber, with the majority (52%) being located on the ciliary body. The mean size of the 4 footplate orientations was 0.88 ± 0.24 mm. Multiple linear regression analysis revealed that ciliary body thickness (CBT), iris curvature (IC), and ICL iris contact length (IRCL) significantly influenced the FD (adjusted R² = 0.373, F = 11.432, P < .001). The vault range differed significantly among the 3 groups (X² = 32.33, P < .001). Conclusions: Different postoperative ICL footplate positions significantly affect the vault. CBT, IC, and IRCL can alter the position of the footplate from the expected position. This study provides reference for ICL size selection and vault prediction. [ABSTRACT FROM AUTHOR]

Background: Bilateral malignant glaucoma induced by a capsular tension ring associated with ring-shaped cysts of the ciliary body post-cataract surgery is rare. Herein, we present a case to highlight the possibility of capsular tension ring-induced malignant glaucoma. Case presentation: A 59-year-old woman underwent phacoemulsification combined with capsular tension ring implantation for cataracts and zonular fibre laxity in both eyes. Upon admission, annular ciliary masses were detected in both eyes using ultrasound biomicroscopy. Two months post-surgery, the patient experienced vision deterioration, high intraocular pressure, and an axial shallowing anterior chamber in the right eye, and responded poorly to traditional anti-glaucoma medication. Ten days later, similar symptoms appeared in the left eye. Ultrasound biomicroscopy detected contact between the ciliary body and the capsular tension ring. Subsequently, malignant glaucoma was diagnosed. Anterior and posterior capsulotomies performed peripheral to intraocular lens optics using neodymium: YAG laser restored communication and alleviated the symptoms. A one-year follow-up revealed stable intraocular pressure and anterior chamber in both eyes. Conclusions: This is the first case report of bilateral malignant glaucoma after cataract surgery induced by capsular tension ring, which is associated with bilateral ring-shaped cysts of the ciliary body. Blockage between the ciliary body and capsular tension ring was confirmed using ultrasound biomicroscopy. [ABSTRACT FROM AUTHOR]

Loeys-Dietz syndrome is a rare syndrome of genetically determined congenital defects characterized by specific dysmorphic features, vascular tortuosity, aneurysms, mitral valve disease, and bone abnormalities. Eye disorders include lens subluxation, myopia, retinal detachment, and the bluish colour of eye whites. We present a case of a child with ocular manifestations of Loeys-Dietz syndrome. A 6-year-old boy with Loeys-Dietz syndrome, confirmed by molecular genetic testing, presented with high myopia, subluxated lenses, dysmorphic features, and disorders of the osteoarticular and cardiovascular systems. The boy underwent a complete ophthalmic examination, ocular ultrasound (US), ultrasound biomicroscopy (UBM), electrophysiological assessment (flash VEP), and magnetic resonance imaging (MRI) of the orbits. The examinations revealed lens subluxation in both eyes resulting from congenital anomalies in the lenses, ligamentous apparatus, and ciliary body. Ultrasound demonstrated numerous linear preretinal echoes. Intraocular pressure was normal, i.e., 14 mmHg in the right and 15 mmHg in the left eye. The best-corrected visual acuity was 0.01 in the right and 0.3 in the left eye, respectively. Refractometry showed –23.0 D in the right and –21.75 D in the left eye. The patient had abnormal flash VEP. Due to a significant lens subluxation, a decision was made to perform pars plana lensectomy combined with anterior vitrectomy. Children with genetically determined congenital syndromes should be constantly monitored by an ophthalmologist for a thorough evaluation of the eyes and a prognosis of the development of visual function. [ABSTRACT FROM AUTHOR]

To investigate if the interval between diagnosis and treatment of posterior uveal melanoma (UM) is associated with metastatic death. Retrospective, single-center cohort study. A total of 1145 patients consecutively diagnosed with posterior UM at St. Erik Eye Hospital, Stockholm, Sweden, from 2012 to 2022, with recorded dates of diagnosis and primary treatment. This cohort represents 81% of all diagnosed patients in Sweden during this period. Data on the interval between diagnosis and treatment were collected for all patients. Its prognostic importance was examined with univariate and multivariate competing risks regressions, and cumulative incidence analyses. Incidence of metastatic death (UM mortality) for patients with prompt (< 1 month from diagnosis) versus delayed treatment (≥ 1 month) and subdistribution hazard ratios (exp(β j)) for every additional 10-day delay in treatment. The mean interval between diagnosis and treatment was 34 days (SD, 56, range, 0–932). Patients treated promptly had larger tumors at diagnosis, but there were no differences in patient age, tumor distance to the optic disc, rates of ciliary body involvement (CBI) or extraocular extension (EXE), or symptom duration before diagnosis. Those who were treated more than 1 month after diagnosis had greater UM mortality in American Joint Committee on Cancer (AJCC) stage II and III. In stage I, UM mortality for delayed treatment was lower for the first 10 years, followed by a marked spike in the 11th year. In multivariate competing risks regressions of all 1145 patients with tumor diameter, thickness, CBI, and EXE as covariates, the risk for UM mortality increased with 1% for every additional 10-day delay in treatment (exp(β j) 1.01). Among 355 patients treated with enucleation, this delay was associated with UM mortality, independent of AJCC stage, cytomorphology, and level of immunohistochemical BAP-1 expression. Increasing time between diagnosis and treatment of UM is associated with a higher risk of metastatic death. These results challenge a central concept in the understanding of metastatic progression and may indicate the existence of late metastatic seeding. They also underscore the importance of prompt treatment. Validation in independent cohorts is recommended. The author(s) have no proprietary or commercial interest in any materials discussed in this article. [ABSTRACT FROM AUTHOR]

Background: Chemical injuries of the eye may produce extensive damage to the ocular surface epithelium, cornea and anterior segment resulting in permanent unilateral or bilateral visual impairment. In addition to causing ocular surface injury, alkalis readily penetrate into the eye, damaging the corneal stroma and endothelium as well as other anterior segment structuressuch as iris, lens and ciliary body. Objective: To study the epidemiology Of Ocular Chemical Injuries. Methods: This prospective study was conducted among all patients who will presented with ocular chemical injuries to Government Rajaji Hospital between the period October 2012 to November 2013. Result: The mean age of the patient who sustained ocular chemical injuries was 29.05 years. Most of the people who sustained ocular chemical injuries are domestic workers (22.5%) and students (22.5%). Urban people (65%) are prone for chemical eye injuries. Semi urban people (31.7%) and rural people (3.3%) form the minority group in this study. Most literates (76.7%) [College education-36.7%, school education-40%]are prone for chemical injuries. The Right eye was relatively more commonly affected (50%) than the lefteye (30%). In our study, there were 12 cases with bilateral injury (20%). Most of the ocular chemical injuries are accidental (61.7%), work place (21.7%) eye injuries come under second category in our study. Conclusion: Most chemical eye burns are mild injuries with no lasting adverse effects. Immediate irrigation of the eye is the most important part of treatment. Prophylactic efforts should be increased in order to bring down the incidence of burns. Injuries caused by assault were more severe and people proportionately lost more eyes. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of anterior-segment structure on vault and position after implantable collamer lens (ICL) implantation using ultrasound biomicroscopy. Methods: The retrospective case-control study included insufficient vault eyes (<250 µm), ideal vault eyes (250–750 µm), and excessive vault eyes (>750 µm). The preoperative biometric parameters of the anterior-segment structure and basic data between the three groups were analyzed using one-way analysis of variance. Results: There were significant differences (P < 0.05) between the three groups in maximum ciliary body thickness (CBTmax), iris-zonule distance (IZD), and trabecular-ciliary angle (TCA). The vault gradually decreased as CBTmax decreased and TCA increased. In the pairwise comparison, the CBTmax comparison between the insufficient vault (<250 µm) group and the excessive vault (>750 µm) group was statistically significant (P = 0.024, 95% CI: −0.17–0.017 µm); the TCA comparison between the insufficient vault (<250 µm) group and the excessive vault (>750 µm) group was statistically significant (P = 0.005, 95% CI: 1.78°–12.15°); The IZD comparison between the insufficient vault (<250 µm) group and the excessive vault (>750 µm) group was statistically significant (P = 0.037, 95% CI: 0.0027–0.1119 µm). The analysis of 284 ICL haptics locations showed that there were 16.67%, 32.69%, and 70.83% haptics located in the ciliary sulcus in three groups, respectively. Conclusion: The vault and ICL haptics position are related to anterior-segment structure. A thinner and posteriorly positioned ciliary body would increase the risk of low vault and fewer ICL haptics located in the ciliary sulcus after ICL implantation. This provides guidance for the selection of the ICL size and placement position before surgery. [ABSTRACT FROM AUTHOR]

Background The ciliary muscle is known to play a part in presbyopia, but the mechanism has not received a comprehensive review, which this study aims to achieve. We examined relevant articles published from 1975 through 2022 that explored various properties of the muscle and related tissues in humans and rhesus monkeys. These properties include geometry, elasticity, rigidity, and composition, and were studied using a range of imaging technologies, computer models, and surgical methods. We identified a notable age-related displacement of the ciliary muscle apex that is characterized by anterior and medial shifts, and hypothesized to be primarily attributed to the accrual of connective tissue and tension exerted by the thickening lens. Other factors could also contribute to the movement, particularly the “inward bowing” of the sclera. Another noteworthy observation is that while the ciliary muscle experiences increasing constraint with advancing age due to adjacent anatomical structures, its contractile capacity remains unaltered, alongside the sustained constancy in both the concentration of muscarinic receptors and their binding affinity. Overall, more studies on human ciliary muscle are needed, as it ages differently from that of monkeys’ ciliary muscle. These studies should explore other perspectives, including those regarding changes in the physical properties of the tissue and its relationship with other connected tissues. Methodology This literature review utilized a systematic methodology to identify and analyze pertinent studies of the presbyopia and ciliary muscles. The approach encompassed a thorough examination of available literature across different academic databases, such as PubMed, Embase, and Cochrane Library. Results Many studies have identified age-related thickening in the ciliary muscle and its potential causes, including the heightened deposition of connective tissues and traction exerted by the thickening lens. Notably, these inquiries culminated in the formulation of a geometric theory positing that the morphology of the ciliary muscle and its spatial relationship with adjacent structures exert pivotal influence over the tension exerted on zonular fibers. Conclusion The decline in the accommodative response of the muscle is prevalent in advanced age, with reduced mobility likely attributable to the increased stiffness of the Bruch’s Membrane-Choroid Complex (BMCC), where the tendons of the ciliary muscle insert, as well as the thickening and stiffening of the lens. Importantly, the ciliary muscle forces do not change with age.

The article discusses a case of ocular mass in the anterior chamber of a 9-year-old male Golden Retriever, diagnosed as intraocular histiocytic sarcoma. The patient presented with symptoms such as edema, inflammation, and blindness, leading to enucleation and subsequent euthanasia due to hemoabdomen. The article highlights the challenges in diagnosing histiocytic sarcoma and differentiating it from ocular melanoma, emphasizing the importance of immunohistochemical stains for accurate diagnosis and prognosis. [Extracted from the article]

AIM: To determine the factors related to preoperative ocular characters that are predictive of insufficient vault (

To report a case of disseminated TB presenting as ciliary body and thyroid mass lesions. A 17-year-old male patient presented with a thyroid mass and blurring of vision in the left eye. A diagnosis of ciliary body granuloma was made. Although the Mantoux was negative, the HRCT chest showed evidence of miliary TB, and the fine needle aspiration cytology from the thyroid mass revealed AFB. On initiation of Antitubercular therapy(ATT), a paradoxical worsening of ciliary body granuloma was noted which resolved on starting steroids. Involvement of thyroid gland and ciliary body although rare in tuberculosis, may be the presenting feature of disseminated TB. Paradoxical reactions seen after initiation of ATT in these cases may respond well to oral steroids. [ABSTRACT FROM AUTHOR]

Intraocular tumors constitute a small subset of cases in ophthalmologic practice. Proper diagnosis of intraocular tumors is crucial because some pose threat to vision and life, while others may indicate underlying systemic disorders. Intraocular tumors comprise benign and malignant lesions affecting the retina, choroid, optic disc, iris, and ciliary body. Retinal tumors can be classified as vascular, neural, glial, and retinal pigment epithelial tumors. Optical coherence tomography angiography (OCTA) is a noninvasive imaging modality employed in diagnosis and management of retinal and choroidal vascular diseases, and has enhanced our knowledge in better understanding of the vascular physiology and pathology. Multiple case reports and small series evaluating the role of OCTA in retinal tumors are published in literature. OCTA helps in better understanding of the vascularity of intraocular tumors. In addition to this, OCTA has its role in clinical practice. It helps in identification of small retinal capillary hemangioblastoma (RCH), assessment of treatment response, and identification of tumor recurrence in RCH. It aids in identification of retinal astrocytic hamartoma missed on clinical examination and differentiating retinal astrocytic hamartoma and presumed solitary circumscribed retinal astrocytic proliferation. It helps in assessment of risk of tumor recurrence in retinoblastoma. It helps in differentiating tumors of retinal pigment epithelium (RPE) origin from pigmented tumors of the choroid. It also helps in detection of choroidal neovascular membrane in combined hamartoma of the retina and RPE. [ABSTRACT FROM AUTHOR]

Branched-chain amino acids (BCAAs) play vital roles in metabolic and physiological processes, with their catabolism initiated by two branched-chain aminotransferase isozymes: cytosolic (BCATc) and mitochondrial (BCATm). These enzymes have tissue and cell-specific compartmentalization and are believed to shuttle metabolites between cells and tissues. Although their expression and localization have been established in most tissues, ocular tissues remain unknown. In this study, we used immunohistochemical analyses to investigate the expression and localization of BCAT enzymes in the normal eye tissues. As expected, BCATc was highly expressed in the neuronal cells of the retina, particularly in the ganglion cell layers, inner nuclear layer, and plexiform layer, with little to no expression in Müller cells. BCATc was also present in the cornea, retinal pigment epithelium (RPE), choroid, ciliary body, and iris but not in the lens. In contrast, BCATm was expressed across all ocular tissues, with strong expression in the Muller cells of the retina, the endothelial and epithelial layers of the cornea, the choroid and iris, and the epithelial cells at the lens's front. The extensive expression and distribution of BCAT isozymes in the ocular tissue, suggests that BCAA transamination is widespread in the eye, potentially aiding in metabolite transport between ocular tissues. The findings provide new insights into the physiological role of BCATs in the eye, particularly within the neuronal retina. [ABSTRACT FROM AUTHOR]

Background: Uveitis, characterized by inflammation of the iris, ciliary body, and choroid, presents a significant global clinical challenge, contributing substantially to visual impairment. Risk factors include autoimmune diseases and immune cell dysfunctions, yet many remain unidentified. Immune cells, notably T cells, B cells, and monocytes, play pivotal roles in uveitis pathogenesis. While biologic agents show promise, comprehensive studies on immune cell types in ocular diseases are lacking. Genome-wide association studies (GWAS) and Mendelian randomization MR) present promising avenues to elucidate genetic susceptibilities and causal relationships between immune cell traits and uveitis risk. Methods: Two-sample MR analysis was used to evaluate the causal relationship between 731 immune cells and uveitis, and genome-wide significance analysis was performed for genetic variation in 731 immune cells traits (P < 5 x 10-8). Immune characteristics include median fluorescence intensity (MFI), relative cell counts (RC), absolute cell counts (AC), and morphological parameters (MP), which were determined by published GWAS, and public data from the IEU Open GWAS database. The main analysis method of MR is inverse variance weighting IVW). Heterogeneity and horizontal pleiotropy were also assessed. Results: 5 immunophenotypes, including CD62L-DC %DC, IgD+ CD38dim %B cell, CD3 on CM CD4+T cell, CD3 on CD45RA-CD4 +T cell, and CD3 on CD39+ CD4+ Treg may increase the risk of uveitis. 5 immunophenotypes, including CD11b on CD33dim HLA DR-Myeloid cell, HLA DR on CD33dim HLA DR+ CD11b-myeloid cell, CD14-CD16 + %monocyte, HLA DR on CD14-CD16 + monocyte and PDL-1 on CD14-CD16 + monocyte was negatively associated with the risk of uveitis. Among them, HLA DR on CD14-CD16 + monocyte (OR=0.921, 95%CI =0.875-0.970, P=0.001) and HLA DR on CD33dim HLA DR+ CD11b- (OR=0.879, 95%CI = 0.833- 0.927, P=0.00) were negatively associated with the risk of uveitis in bi-direction. Conclusion: These results indicate that 10 immune cells traits are significantly associated with the risk of developing uveitis and 2 of them were strongly associated with uveitis bi-directionally, after excluding the effects of confounding factors such as some immune diseases, which provided new ideas and therapeutic targets for the study of immune mechanism of uveitis. [ABSTRACT FROM AUTHOR]

Cisplatin (CP) is a chemotherapeutic agent employed as a therapy for different solid tumors. CP elicits many negative side effects including ocular toxicity. L-arginine able to increase the anti-inflammatory cytokine levels in the bloodstream. This study aimed to evaluate the possible protective impact of L-arginine against ocular toxicity of cisplatin through its anti-inflammatory action. Forty male rats were utilized in this experiment. The treatment protocol duration lasted for one week. The rats were divided randomly into four equal groups, as follows: the normal control group (G1) received a single intraperitoneal injection of normal saline, Cisplatin-administered group (G2) received single intraperitoneal injection of cisplatin in a dose (10 mg/kg body weight), Cisplatin + L-arginine-treated group (G3) received i.p. injection of cisplatin in a dose (10 mg/kg b.wt.) followed immediately by i.p. injection of L-arginine in a dose (10 mg/kg b.wt.), and L-arginine-treated group (G4) received intraperitoneal injection of 10 mg/kg b.wt. L-arginine. The protective effect of L-arginine was assessed through histopathology and immunohistochemical analysis of inducible nitric oxide synthase (iNOS) in ocular tissues. Cisplatin-administered group revealed corneal neovascularization, stromal inflammatory infiltration, corneal epithelial hyperplasia, and endothelial degeneration. Sclera revealed vascular congestion and inflammatory infiltrates. There were congested blood vessels, apoptosis, and a decrease the ganglionic cells number in the retinal tissue. Ciliary body had epithelial necrosis, congestion, and hemorrhage. These pathological changes were attenuated to be mild in the cisplatin + L-arginine-treated group. The intensity of the immunohistochemical expression of iNOS appeared weak and significantly decreased in G3 compared to G2. The obtained data validate that Co-treatment of cisplatin with L-arginine cause a reduction in histopathological ocular damage through its anti-inflammatory effect. [ABSTRACT FROM AUTHOR]

Background/Aim: Intraocular metastases of systemic cancer are most frequently located in the choroid, followed by the iris and ciliary body, while retinal metastases are extremely rare. Here we present a case of retinal metastasis and analyze multimodal imaging. Case Report: A 66-year-old woman with a medical history of breast cancer 5 years earlier was referred to our Department struggling with blurry vision in her right eye. At initial examination, her best-corrected visual acuity (BCVA) was 1.0 oculus dexter (OD). Fundus examination revealed a yellowish elevated lesion with irregular surface, measuring 2 papillary diameters, along with serous retinal detachment (SRD) on the temporal side of the optic disc. Optical coherence tomography showed SRD with an isointense nodule extending across all retinal layers. Fluorescein angiography showed hyper-fluorescence and vigorous fluorescence leakage inside the tumor in the early and late phases, respectively. Indocyanine green angiography depicted feeder and drainage vessels within the mass. Laser speckle flowgraphy (LSFG) showed a cold signal inside the tumor. Based on these clinical findings, the mass was diagnosed as a retinal metastasis. Eight days after the initial visit, the patient underwent external beam radiation to the right eye. One month after the initial diagnosis, her BCVA was 0.7 OD, the tumor was localized, and SRD had decreased. LSFG indicated vascular remodeling with marginally warmer signals in the tumor. Conclusion: LSFG of the retinal metastasis showed a cold signal, suggesting low tumor blood flow velocity and that the tumor may have grown slowly. LSFG findings are likely to play a supportive role in clinical diagnosis and contribute to better understanding of pathogenesis in juxtapapillary tumors. [ABSTRACT FROM AUTHOR]