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        <title>Frontiers in Ophthalmology | New and Recent Articles</title>
        <link>https://www.frontiersin.org/journals/ophthalmology</link>
        <description>RSS Feed for Frontiers in Ophthalmology | New and Recent Articles</description>
        <language>en-us</language>
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        <pubDate>2026-05-11T23:25:08.814+00:00</pubDate>
        <ttl>60</ttl>
        <item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fopht.2026.1799892</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fopht.2026.1799892</link>
        <title><![CDATA[Injectable corneal endothelial cell therapy: recent progress, translational barriers, and future directions]]></title>
        <pubdate>2026-05-08T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Ghadeer Mohammed</author><author>Muhammad Abbas Tayyab</author><author>Jaffer Hussain</author><author>Renad AlDhib</author><author>Mifrah Rahat Khan Sherwani</author><author>Johar Abbas</author><author>Zahra Arsalan</author><author>Carolina Mercado</author>
        <description><![CDATA[IntroductionCorneal endothelial dysfunction, most commonly caused by Fuchs endothelial corneal dystrophy (FECD) or pseudophakic bullous keratopathy (PBK), leads to stromal edema and corneal decompensation when endothelial cell density (ECD) falls below 500–700cells/mm². Standard treatment via corneal transplantation, including Descemet stripping automated endothelial keratoplasty (DSAEK) and Descemet membrane endothelial keratoplasty (DMEK), is limited by the need to standardize corneal endothelial cell culture, donor shortages, immune rejection, and technical complications.This review aims to summarize recent advances in injectable corneal endothelial cell (CEC) therapy, critically appraise translational challenges, and discuss future directions for establishing this regenerative approach as a global treatment.DesignNarrative review of pre-clinical and clinical studies examining CEC injection therapy.MethodsRelevant literature was analyzed to evaluate innovations in Human corneal endothelial cells (HCEC) preparation, culture techniques, delivery methods, and strategies to enhance cell adhesion and survival. Studies reporting preclinical models and human clinical trials were included to assess safety, efficacy, and translational feasibility.ResultsCorneal endothelial cells (CEC) injections have achieved significant advancement since their development. Simple cultured CEC injections showed poor efficacy due to limited cell adhesion and survival, but the introduction of ROCK inhibitors along with cultured CECs demonstrated improvement in corneal transparency up to 5 years. Advancements in cell delivery techniques like hydrogel, carrier-assisted injections, magnetically guided injections, as well as alternative cell sources have shown promising results in pre-clinical studies, but human studies are still ongoing. Despite advancements, persisting challenges include phenotypic stability, and longterm safety and efficacy.DiscussionInjectable CEC therapy is a promising minimally invasive alternative to corneal transplantation. While early clinical outcomes are encouraging, further work is required to optimize cell preparation, delivery, and long-term safety, and to establish the therapy as a scalable, globally applicable treatment for endothelial failure.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fopht.2026.1811004</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fopht.2026.1811004</link>
        <title><![CDATA[Clinical evaluation of corneal elasticity and true IOP using a dual-applanation tonometer]]></title>
        <pubdate>2026-05-08T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>C. Caruso</author><author>G. Barbaro</author><author>M. Troisi</author><author>F. Matarazzo</author><author>C. Costagliola</author>
        <description><![CDATA[PurposeTo evaluate the clinical feasibility of a modified Goldmann applanation system capable of estimating true intraocular pressure and corneal elasticity in vivo.MethodsA dual-applanation prism was developed, allowing two sequential IOP readings under identical optical conditions. A mathematical model was applied to compute true intraocular pressure and the corneal Young’s modulus measured applanation forces, corneal thickness and curvature. Fifty-three healthy eyes were examined. Model-derived true intraocular pressure values were compared with standard GAT, Pascal dynamic contour tonometry and corneal Young’s modulus.ResultsMean IOPT was 15.72 ± 2.44 mmHg, significantly higher than GAT measurements (14.86 ± 2.71 mmHg; mean difference +0.86 ± 1.82 mmHg, p = 0.0012). IOPT showed strong agreement with Pascal DCT (15.60 ± 2.35 mmHg), with minimal bias (+0.15 ± 1.63 mmHg, p = 0.499) and high correlation (r = 0.93, p < 0.0001). Measurement variance was lower for IOPT than for GAT, indicating improved precision. The mean in vivo corneal Young’s modulus was 0.18 ± 0.04 MPa (range 0.057 MPa to 0.296 MPa.), consistent with physiological values. Young’s modulus showed significant age-related variation (p < 0.001) and a moderate inverse correlation with IOPT (r = −0.53, p < 0.001), while no significant sex-related differences were observed.ConclusionThis dual-applanation system enables real-time in vivo estimation of both true intraocular pressure and corneal elasticity. The model provides a physically grounded correction to Goldmann tonometry and introduces a new clinically accessible method to assess corneal biomechanics.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fopht.2026.1813018</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fopht.2026.1813018</link>
        <title><![CDATA[Bag-in-the-lens technique]]></title>
        <pubdate>2026-05-08T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Shervine Ameli</author><author>Iva Krolo</author><author>Silke Oellerich</author><author>Luc Van Os</author><author>Marie-José Tassignon</author><author>Sorcha Ní Dhubhghaill</author>
        <description><![CDATA[Optimal centration of an intraocular lens (IOL) is important for obtaining its intended visual properties. The bag-in-the-lens (BIL) approach is a surgical technique that optimizes centration by centring the lens using both an anterior and a posterior capsulorhexis. The BIL is a monofocal hydrophilic IOL with a biconvex optic and two elliptical plane haptics. The space between the haptics creates an equatorial groove. The IOL is then suspended by placing both anterior and posterior capsular bag rhexis openings into this equatorial IOL groove. As a result, the BIL IOL captures residual lens epithelial cells and therefore additionally seals its position avoiding opacification of the visual axis. In this review, we offer an overview of current literature on the BIL technique.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fopht.2026.1806872</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fopht.2026.1806872</link>
        <title><![CDATA[Poroid hidradenoma of the eyelid: a case report]]></title>
        <pubdate>2026-05-07T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Christian Nieves-Rios</author><author>José J. López-Fontanet</author><author>Juan Serrano-Olmo</author><author>Joseph Campbell</author>
        <description><![CDATA[BackgroundPoroid hidradenoma (PH) is a rare, benign tumor arising from eccrine sweat glands. It typically presents as a painless and slow-growing subcutaneous lesion in individuals in their sixth to seventh decades of life. Histologically, PH demonstrates neoplastic poroid cells with solid and cystic structures confined to the dermal layer, distinguishing it from other types of eccrine tumors such as eccrine poroma, hidroacanthoma simplex, and dermal duct tumor. It predominantly involves regions abundant in eccrine glands, yet reports involving the eyelids are scarce.Case presentationWe report a case of an 88-year-old woman with a 2-year history of a non-painful, enlarging mass on her left upper eyelid, associated with irritation and itchiness. Examination revealed a skin-colored, cystic lesion with associated madarosis and minimal telangiectasia. The patient underwent excisional biopsy of the lesion. Histopathological analysis confirmed the diagnosis of PH, characterized by well-circumscribed solid and cystic components with a pseudocapsule. There was no evidence of recurrence at the 3-month follow-up visit.ConclusionThis case highlights the rare occurrence of PH in the eyelids, emphasizing the diagnostic challenges associated with adnexal tumors in atypical locations. Surgical excision remains the standard treatment, and awareness of ocular manifestations of PH is essential for accurate diagnosis and management by ophthalmologists.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fopht.2026.1677323</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fopht.2026.1677323</link>
        <title><![CDATA[Advanced bilateral glaucoma decades after first-generation Fyodorov ‘collar-button’ anterior–posterior phakic intraocular lens implantation: a case report and clinical management considerations]]></title>
        <pubdate>2026-05-04T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Monika Sarnat-Kucharczyk</author><author>Anna Hitnarowicz</author><author>Aleksandra Ziemba</author><author>Dorota Pojda-Wilczek</author><author>Ewa Mrukwa-Kominek</author><author>Sudi Patel</author>
        <description><![CDATA[BackgroundPhakic intraocular lenses (pIOLs), used to correct high refractive errors, have since been associated with long-term complications including glaucoma and cataract formation. Elevated intraocular pressure (IOP) in these patients can be challenging to manage, often requiring surgical intervention. Micropulse trans-scleral cyclophotocoagulation (MP-TSCPC) offers a less invasive option for IOP control in refractory cases. This report describes a patient with advanced glaucomatous optic neuropathy decades after undergoing pIOL implantation and the successful use of MP-TSCPC.Case presentationA 45-year-old male presented in June 2023 with advanced glaucomatous optic neuropathy following bilateral implantation of a first-generation Fyodorov “collar-button” phakic intraocular lens (pIOL) performed 25 years earlier. The patient experienced worsening vision in both eyes. Visual acuity testing, slit-lamp examination, static visual field (VF) assessment, anterior and posterior segment optical coherence tomography (AS-OCT, PS-OCT), pattern and flash visual evoked potentials (PVEP/FVEP) were performed. Corrected distance visual acuity (CDVA) was 0.9 in the RE and 1.0 in the left eye LE on the Snellen chart. Corrected near visual acuity (CNVA) was 0.5 on the Jaeger chart in both eyes. IOP was 26 mmHg in the RE and 24 mmHg in the LE. Slit-lamp examination revealed the presence of pIOLs with anterior capsular cataracts in both eyes. Fundoscopy showed severe glaucomatous optic neuropathy. Gonioscopy indicated a 30-degree angle width with grade 3 trabecular pigmentation. Visual field testing revealed advanced scotomata. PS-OCT confirmed severe ganglion cell and retinal nerve fiber loss. Performed examinations confirmed bilateral glaucomatous optic nerve atrophy. Despite the use of antiglaucoma medications, IOP remained elevated 3 weeks later measuring 23 mmHg in the RE and 21 mmHg in the LE. Due to persistently elevated intraocular pressure (IOP) despite pharmacological treatment, micropulse transscleral cyclophotocoagulation (MP-TSCPC) was performed in the right eye (RE). Following MP-TSCPC in the RE, the IOP decreased to 16 mmHg. The LE was managed pharmacologically, achieving favorable outcomes.ConclusionLong-term follow-up is essential in patients with anterior chamber phakic IOLs due to the risk of progressive complications such as cataract formation and secondary glaucoma. Early diagnosis of glaucoma could have prevented advanced optic nerve damage in the presented patient. In complex cases with multiple potential causes of visual impairment, electrophysiological examinations may serve as a supportive tool in the differential diagnosis of optic neuropathies.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fopht.2026.1822331</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fopht.2026.1822331</link>
        <title><![CDATA[Application of imaging studies for orbital tumors: a practical review and representative cases]]></title>
        <pubdate>2026-04-30T00:00:00Z</pubdate>
        <category>Review</category>
        <author>César Fernández</author><author>J. Matthew Debnam</author><author>Bita Esmaeli</author>
        <description><![CDATA[Orbital imaging has undergone a significant transformation over the past few decades, evolving from basic radiographic techniques to sophisticated cross-sectional imaging modalities. Historically, conventional radiography was limited to visualizing only the bony structures of the orbit or radiodense foreign bodies, making it inadequate for detecting soft tissue pathology. Advances in imaging over the last several decades—first with computed tomography (CT) in the 1970s and later with magnetic resonance imaging (MRI) in the 1980s—have revolutionized orbital diagnostics by enabling detailed visualization of both osseous and soft tissue structures. Magnetic resonance imaging (MRI) has emerged as the preferred modality for evaluating orbital tumors and other soft tissue lesions. Its superior soft tissue resolution, multiplanar imaging capability, and ability to characterize lesion morphology and extent make it crucial in clinical practice. MRI is especially valuable in differentiating benign from malignant lesions, evaluating involvement of critical structures such as the globe, optic nerve, extraocular muscles, and vascular components, and assessing disease at the orbital apex or with suspected intracranial extension. Advanced MRI techniques, including diffusion-weighted imaging (DWI) and dynamic contrast-enhanced (DCE) MRI, further enhance diagnostic accuracy. In pediatric populations, MRI holds particular importance due to its lack of ionizing radiation and its effectiveness. In contrast, while CT offers superior resolution of bony anatomy and is useful for detecting calcifications and fractures, it is somewhat limited in soft tissue differentiation and involves exposure to ionizing radiation. While CT examination can be tailored to evaluate bone or soft tissues, orbital CT is typically reserved for cases requiring detailed osseous assessment, acute trauma settings, or for patients who cannot undergo an MRI. MRI creates high-resolution images by detecting signals emitted by hydrogen nuclei when exposed to a strong magnetic field and radiofrequency pulses. Differences in signal based on tissue composition and water content are captured and converted into high-resolution images. Interpreting orbital lesions requires standardized terminology.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fopht.2026.1839194</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fopht.2026.1839194</link>
        <title><![CDATA[Artificial intelligence in ophthalmology: from innovation to clinical integration]]></title>
        <pubdate>2026-04-30T00:00:00Z</pubdate>
        <category>Perspective</category>
        <author>Bharat Gurnani</author><author>Kirandeep Kaur</author>
        <description><![CDATA[Artificial intelligence (AI) has emerged as a transformative force in modern ophthalmology, enabling rapid advances in disease detection, clinical decision support, workflow optimization, and tele-ophthalmology. Ophthalmology is particularly suited for AI integration because of its reliance on imaging modalities such as fundus photography, optical coherence tomography (OCT), and visual field testing. Over the past decade, deep learning algorithms have demonstrated high diagnostic accuracy in identifying retinal diseases including diabetic retinopathy, age-related macular degeneration, and glaucoma. The approval of autonomous AI diagnostic systems for diabetic retinopathy screening marked a significant milestone in clinical adoption. Beyond diagnostics, AI is increasingly influencing surgical planning, predictive analytics, education, and patient engagement. Despite these promising advances, significant challenges remain regarding algorithm generalizability, ethical considerations, regulatory approval, data privacy, and integration into routine clinical practice. This perspective article reviews current innovations in AI applications within ophthalmology and discusses their clinical impact while outlining future directions for research and implementation. We argue that the next phase of AI in ophthalmology will involve multimodal learning systems, integration with large language models, and deployment in global eye-care networks to address disparities in access to care. A collaborative approach involving clinicians, data scientists, regulators, and industry will be essential to ensure safe, ethical, and effective adoption of AI technologies in ophthalmic practice.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fopht.2026.1779060</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fopht.2026.1779060</link>
        <title><![CDATA[Ocular manifestations of vitamin A deficiency in gastrointestinal and hepatobiliary disease]]></title>
        <pubdate>2026-04-29T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Eric W. Lai</author><author>Timothy Lee</author><author>George Chen</author><author>Shih-Chung Lai</author><author>Paul Kang</author><author>Sidney A. Schechet</author>
        <description><![CDATA[PurposeTo characterize clinical features, risk factors, and outcomes of vitamin A deficiency (VAD) among patients with gastrointestinal (GI) and/or hepatobiliary comorbidities.MethodsThis retrospective study examined patients with GI or hepatobiliary disease who presented with ocular manifestations of VAD. Extracted data included patient demographics, underlying GI or hepatobiliary diagnoses, serum vitamin A levels, ophthalmic symptoms and examination findings, imaging features, and response to vitamin A repletion.Results26 eyes from 13 patients were included. The most common systemic comorbidities were fatty liver disease (38.5%), prior gastric bypass surgery (23.1%), and cirrhosis (23.1%). Median serum vitamin A level at diagnosis was 19.1 mcg/dL (range, 2.5–36.1 mcg/dL, reference range 38–72 mcg/dL). Median presenting best visual corrected acuity (BCVA) was 20/50 (logmar 0.44, range, 20/20-light perception). Twenty-two eyes (84.6%) demonstrated anterior segment manifestations of VAD, including four eyes (15.4%) who presented with bilateral corneal ulceration and perforation. Posterior segment findings were present in 16 eyes (61.5%), including subretinal drusenoid deposits, RPE mottling, placoid macular changes, optic neuropathy, and a full-thickness macular hole. All patients reported bilateral vision loss, with 63.6% endorsing nyctalopia. All patients who underwent vitamin A repletion experienced subjective visual improvement and partial or complete resolution of ophthalmic findings, including regression of anterior and posterior segment pathology.ConclusionsVitamin A deficiency occurs across a wide spectrum of GI and hepatobiliary diseases and is associated with diverse anterior and posterior segment ocular findings, ranging from subtle surface disease to severe, vision-threatening pathology. Visual symptoms and ocular findings improved following vitamin A repletion, highlighting the preventable and reversible nature of this condition when identified early. Given the risk of irreversible ocular sequelae with delayed diagnosis, serum vitamin A assessment with timely repletion should be considered in patients with at-risk gastrointestinal and hepatobiliary conditions. Early identification through multidisciplinary care may prevent avoidable, vision-threatening ocular complications.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fopht.2026.1812914</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fopht.2026.1812914</link>
        <title><![CDATA[Efficacy of Manuka honey eye drops in managing dry eye disease after cataract surgery: a prospective controlled study]]></title>
        <pubdate>2026-04-28T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Javier García-Bardera</author><author>Javier García-Bella</author><author>Fiorella K. Cuba-Sulluchuco</author><author>Bárbara Burgos-Blasco</author><author>Pedro Arriola-Villalobos</author><author>Jose Manuel Benítez-Del-Castillo</author>
        <description><![CDATA[BackgroundTo evaluate the efficacy of Leptospermum spp (Manuka) honey eye drops in improving dry eye symptoms and reducing ocular inflammation after cataract surgery, compared to sodium hyaluronate eye drops.MethodsA prospective controlled study including 53 eyes undergoing cataract surgery was conducted. Patients were consecutively allocated to Manuka eye drops (n = 25) or sodium hyaluronate (n = 28). Subjective symptoms were assessed using the Ocular Surface Disease Index (OSDI) and CATQUEST-SF9 questionnaires. Objective parameters included non-invasive tear break-up time (NIBUT) and conjunctival redness measured with the Keratograph® 5M. Assessments were performed preoperatively and at 1 day, 1 week, and 1 month.ResultsA total of 53 eyes from 53 patients (18 males and 35 females) were analyzed, with a mean age of 72.1 ± 7.6 years. At 1 month, the Manuka group showed a greater reduction in OSDI score compared to the control group (-27.3 ± 20.3 vs -4.3 ± 17.4). After adjustment for baseline OSDI and sex, OSDI remained significantly lower in the Manuka group (adjusted mean difference: -18.7; 95% CI: -28.8 to -8.7; p = 0.007). Conjunctival redness was also lower in the Manuka group at 1 month (adjusted mean difference: -0.56; 95% CI: -0.91 to -0.21; p = 0.014). No significant differences were observed in NIBUT between groups.ConclusionManuka eye drops were associated with greater improvement in postoperative dry eye symptoms and reducing ocular surface inflammation compared to sodium hyaluronate. These findings should be interpreted with caution and considered hypothesis-generating.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fopht.2026.1777608</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fopht.2026.1777608</link>
        <title><![CDATA[A 5-year retrospective review of post-Mohs reconstruction outcomes for periocular cutaneous malignancies at an academic medical center]]></title>
        <pubdate>2026-04-28T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Amanda K. Hertel</author><author>Aaron Veenis</author><author>Rachel Chu</author><author>Nathaniel Cameron</author><author>Nikki Gill</author><author>Irfan Ansari</author><author>Maggie Malmberg</author><author>Emilee Wells</author><author>Geethanjalee Mudunkotuwa</author><author>Isuru Ratnayake</author><author>Jason A. Sokol</author>
        <description><![CDATA[PurposeThis project examines outcomes of post-Mohs reconstruction for periocular cutaneous malignancies. These results highlight reconstructive surgery challenges and their solutions, a topic with limited peer-reviewed literature.MethodsA retrospective chart review on post-Mohs reconstruction outcomes for adults seen at a tertiary referral center between August 2018 and March 2023 was performed. Information on demographics, past medical history, and surgical outcomes was collected. Descriptive statistics and correlations where applied were applicable. The Institutional Review Board (IRB) approved this study.ResultsA total of 194 patients met the inclusion criteria (mean age, 67.7 years). Past medical history and skin cancer risk factors were evaluated. The most common periocular malignancy was basal cell carcinoma (70.6%), the location was lower lid (56.7%), and the reconstruction type was Modified Hughes tarsoconjunctival flap (24.7%). There were no intraoperative complications. The most common post-operative complications were healing issues (6.7%) or ectropion (6.2%). Patients reported post-operative symptoms such as eye irritation (23.2%) or pain (20.1%). Most patients had full eyelid function after surgery (93.3%) and acceptable cosmetic appearance (94.8%). Some correlations were found. For example, post-Mohs defect size was associated with variables such as cure rate (p = 0.01834) and general eyelid reconstruction (p = 0.0230). Adjuvant chemotherapy was associated with decreased cure rates (p = 0.0010) and recurrence (p = 0.0174).ConclusionsThis study found associations between health history, periocular cutaneous malignancy features, and post-Mohs reconstruction outcomes. Features such as location, defect size, and staged reconstruction techniques in particular had an association with numerous outcomes.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fopht.2026.1804194</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fopht.2026.1804194</link>
        <title><![CDATA[Retinal vascular occlusions during COVID-19: an epidemiological survey]]></title>
        <pubdate>2026-04-27T00:00:00Z</pubdate>
        <category>Brief Research Report</category>
        <author>Andrea Montesel</author><author>Yan Guex-Crosier</author><author>Chiara M. Eandi</author>
        <description><![CDATA[PurposeTo evaluate whether the COVID-19 pandemic was associated with changes in the incidence of retinal vascular occlusions. MethodsWe performed a retrospective cohort study at the Jules-Gonin Eye Hospital (Lausanne). All new diagnoses of central retinal vein occlusion (CRVO), branch retinal vein occlusion (BRVO), central retinal artery occlusion (CRAO), and branch retinal artery occlusion (BRAO) between January 1, 2019 and December 31, 2020 were included. Regional COVID-19 case counts were obtained from public health records. Incidence rate ratios (IRR) comparing 2019 cases versus 2020 were calculated using official population data. Pearson correlation was used to explore temporal associations between monthly COVID-19 cases and retinal vascular events. The study period largely reflects natural infection exposure, as COVID-19 vaccination in Switzerland began on December 23, 2020.ResultsIn 2019, 66 retinal vein occlusions (38 CRVO, 28 BRVO) and 20 arterial occlusions (9 CRAO, 11 BRAO) were recorded. In 2020, 49 retinal vein occlusions (34 CRVO, 15 BRVO) and 21 arterial occlusions (14 CRAO, 7 BRAO) were recorded. The IRR for 2020 versus 2019 was 0.73 for vein occlusions (95% CI 0.51–1.05; p=.093) and 1.04 for arterial occlusions (95% CI 0.57–1.90; p=.896). Monthly analysis showed no significant temporal association between COVID-19 incidence and retinal vascular events (p=.08).ConclusionsIn this regional study, we did not observe an increase in retinal vascular occlusive events during the early phase of the COVID-19 pandemic. While biologically plausible mechanisms have been proposed, these population-level trends do not support a strong association.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fopht.2026.1772378</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fopht.2026.1772378</link>
        <title><![CDATA[Artificial intelligence-assisted diagnosis of ocular caruncle oncocytoma: a proof- of-concept case report of two cases]]></title>
        <pubdate>2026-04-24T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Matteo Sacchi</author><author>Clara Ellecosta</author><author>Sara Sechi</author><author>Stefano Dore</author><author>Antonio Pinna</author>
        <description><![CDATA[BackgroundOncocytomas of the ocular caruncle are rare benign epithelial tumors. Their clinical diagnosis is challenging, as they can mimic other benign or malignant lesions such as papilloma, nevus, squamous cell carcinoma, melanoma, or oncocytic carcinoma. For this reason, histopathological confirmation remains indispensable. The aim of this study was to test the ability of a multimodal large language model (ChatGPT, GPT-5, 2025 version) to generate diagnostic hypotheses directly from slit-lamp images, supported by brief clinical summaries.Case presentationWe retrospectively analyzed two cases of caruncular oncocytoma that had undergone surgical excision with subsequent histopathological confirmation. For each case, ChatGPT was provided only with slit-lamp photographs of the lesion and a concise clinical summary including age, sex, and the site of the lesion (caruncle). No histopathological data or additional clinical details were supplied. In both cases, ChatGPT proposed oncocytoma as the primary diagnostic hypothesis. The model also generated differential diagnoses including papilloma, nevus, as well as the possibility of a malignant lesion such as squamous cell carcinoma or melanoma.ConclusionsThis proof-of-concept demonstrates, for the first time to our knowledge, that a general- purpose multimodal AI system can correctly recognize a rare ocular surface tumor from slit-lamp images. While preliminary and limited by the very small sample size, these findings suggest that large language models may assist clinicians in considering rare adnexal tumors during differential diagnosis. Further research on larger datasets is required, and histopathology will remain the gold standard for definitive diagnosis.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fopht.2026.1812277</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fopht.2026.1812277</link>
        <title><![CDATA[Workforce challenges to implementation of myopia management in Europe: an electronic/telephone expert survey]]></title>
        <pubdate>2026-04-22T00:00:00Z</pubdate>
        <category>Perspective</category>
        <author>Annegret Dahlmann-Noor</author><author>Line Kessel</author><author>Wolf A. Lagrèze</author><author>Susana Noval</author><author>Jan Roelof Polling</author><author>Edoardo Villani</author><author>Dominique Brémond-Gignac</author>
        <description><![CDATA[The European Medicines Agency and the UK Medicines and Healthcare products Regulatory Agency recently approved the first commercial preparation of low-concentration atropine, Ryjunea, for use in children aged 3 years and older to slow the progression of myopia. Whilst optical approaches have been available for several years, the addition of a pharmacological option will increase the involvement of ophthalmologists in paediatric myopia management. However, little information is available about implementation strategies in different European countries. We conducted an electronic/telephone survey with key opinion leaders in myopia management in Germany, the Netherlands, Denmark, the UK, France, Italy, and Spain. We complemented the survey with figures on population size reported by the World Bank and UNICEF, and workforce numbers reported by the International Council of Ophthalmology, the International Orthoptic Association, and national associations, where available. We collated data in categories reflecting the current provision of eye care for children and workforce availability. Prescribing rights for medicines, spectacles, and contact lenses for children, as well as workforce numbers, including paediatric ophthalmologists, optometrists, and orthoptists, vary significantly across European countries. In general, workforce numbers appear low compared with the number of children and young people in each country. Policies and implementation pathways for myopia management in children are required to ensure equitable access. European guidelines for training in myopia management and national pathways and standards of care should be developed and endorsed by professional organisations to enable children and young people at risk of myopia progression to access appropriate interventions in a timely and economical fashion.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fopht.2026.1763171</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fopht.2026.1763171</link>
        <title><![CDATA[Laser doppler holography for choroidal blood flow assessment: a systematic review of technical capabilities, validation studies, and clinical applications]]></title>
        <pubdate>2026-04-20T00:00:00Z</pubdate>
        <category>Systematic Review</category>
        <author>Manfredi Marco Giammanco</author><author>Ginevra Genziana Bazan Russo</author><author>Marco Giammanco</author>
        <description><![CDATA[IntroductionQuantitative choroidal blood flow assessment is important for understanding chorioretinal diseases. Laser Doppler Holography (LDH) is a new non-invasive imaging technique that provides full-field, high-temporal-resolution assessments of ocular hemodynamics. This systematic review synthesizes evidence on LDH’s technical capabilities, clinical applications, and provides normative reference values for choroidal vascular anatomy.MethodsA systematic search of the literature was undertaken in accordance with PRISMA guidelines. Studies that evaluated choroidal blood flow in humans using LDH were identified. Data on technical specifications, hemodynamic parameters, and vascular anatomy were extracted for narrative synthesis.ResultsThe comprehensive literature search resulted in 347 records, with 8 studies that met the inclusion criteria for qualitative synthesis, as well as 2 studies that could be included in the meta-analysis. The pooled mean diameter of the choroidal arteries was derived to be 134.2 μm (95% CI: 128.3 to 140.1 μm) based on the meta-analysis and demonstrated low levels of heterogeneity (I2 = 0).DiscussionThe narrative synthesis found that LDH could assess choroidal vasculature, differentiate arteries from veins using both flow waveforms and spectral data, deliver quantitative data for hemodynamic parameters, and assess blood flow directionality. LDH is a promising and versatile technique to study choroidal blood flow quickly and non-invasively.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fopht.2026.1804578</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fopht.2026.1804578</link>
        <title><![CDATA[TREM2 in age-related macular degeneration: a microglia-centered perspective in the retinal myeloid landscape]]></title>
        <pubdate>2026-04-17T00:00:00Z</pubdate>
        <category>Mini Review</category>
        <author>Shengyu Zhu</author><author>Taoshuo Yang</author><author>Limei Sheng</author><author>Lei Shi</author>
        <description><![CDATA[Age-related macular degeneration (AMD) is a leading cause of irreversible central vision loss in older adults. Advanced AMD comprises an atrophic (“dry”) form characterized by retinal pigment epithelium (RPE) and photoreceptor degeneration and a neovascular (“wet”) form driven by choroidal neovascularization (CNV). Beyond genetic predisposition and environmental stressors, chronic dysregulation of innate immunity is increasingly recognized as a convergent mechanism linking drusen/Bruch’s membrane alterations to outer retinal cell death and pathological angiogenesis. Retinal myeloid cells—including resident microglia and, in specific disease contexts, recruited monocyte-derived macrophages—can support homeostasis by clearing lipids and cellular debris, yet may also exacerbate inflammation, matrix remodeling, and neovascularization. Triggering receptor expressed on myeloid cells 2 (TREM2) is an innate immune receptor expressed by microglia and other myeloid cells that regulates phagocytosis, lipid handling, migration, survival, immunometabolism, and inflammatory tone. Recent retinal studies suggest that TREM2-associated programs can restrain lesion expansion in outer retinal degeneration models and modulate CNV severity in experimental neovascularization; however, interpretation remains limited by disease stage, anatomical niche, and the difficulty of cleanly separating microglia from infiltrating macrophages in vivo. Here, we synthesize current evidence on retinal myeloid contributions to dry and neovascular AMD, provide an updated mechanistic framework for TREM2 signaling, and discuss therapeutic strategies and translational challenges for targeting TREM2 in AMD.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fopht.2026.1795898</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fopht.2026.1795898</link>
        <title><![CDATA[Four-dimensional ultrasound versus torsional ultrasound phacoemulsification in cataracta nigra: a single-nucleus ex vivo bench pilot]]></title>
        <pubdate>2026-04-16T00:00:00Z</pubdate>
        <category>Brief Research Report</category>
        <author>Rosa Giglio</author><author>Daniele Tognetto</author>
        <description><![CDATA[Cataracta nigra, an extremely dense nuclear cataract, often requires prolonged ultrasound use during phacoemulsification, increasing the risk of corneal endothelial injury and incision-site thermal damage. We compared the Alcon UNITY Cataract System using 4-dimensional (4D) ultrasound with the Alcon CENTURION Vision System with torsional ultrasound in an ex vivo cataracta nigra bench model. A single human cataracta nigra nucleus was divided into four fragments; two fragments were emulsified with UNITY and two with CENTURION under identical user-selected console settings (35% power; IOP 36 mmHg; vacuum 450 mmHg; aspiration flow 30 mL/min). Endpoints included emulsification time, effective phaco time (EPT), cumulative dissipated energy (CDE), and qualitative video assessment of fragments behavior. In this single-specimen model, compared with CENTURION, UNITY showed shorter emulsification time (mean 12.0 s vs 43.5 s) and lower console-reported energy indices (mean EPT 4.2 s vs 15.2 s; mean CDE 1.12 percent-seconds vs 15.01 percent-seconds). Video review suggested more continuous fragment engagement with minimal chatter using UNITY, whereas CENTURION more often showed initial fragment repulsion and turbulence. Because EPT and CDE are console-derived, these findings should be interpreted as relative performance under matched user-selected settings rather than equivalent physical energy delivery. These preliminary findings suggest that the 4D ultrasound mode might be associated with improved emulsification efficiency compared to torsional mode in ultra-dense nuclear material. Further studies using additional specimens and clinical cohorts are needed to determine whether these bench findings translate into meaningful surgical benefit.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fopht.2026.1824816</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fopht.2026.1824816</link>
        <title><![CDATA[Understanding perceptions of ophthalmology residents on pursuing a uveitis fellowship]]></title>
        <pubdate>2026-04-16T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Lorenzo Bosque</author><author>John Gonzales</author><author>Shilpa Kodati</author><author>Meghan Berkenstock</author>
        <description><![CDATA[PurposeTo investigate factors influencing the decision of ophthalmology residents in the United States to pursue a uveitis fellowship.MethodsA cross-sectional survey, with prospective data collection, study. From December 2023 to July 2024, an anonymous survey was distributed via the Association of University Professors of Ophthalmology (AUPO) to all United States ophthalmology residents. The survey was distributed a second time, between May 2024 and July 2024, through the American Uveitis Society listserv to distribute to residents. The primary outcome was to determine factors influencing ophthalmology residents’ decisions to pursue or forgo a uveitis fellowship.ResultsOf 115 ophthalmology resident respondents, 14 (12.2%) chose to pursue a uveitis fellowship. Key factors influencing the decision to pursue a uveitis fellowship included the perceived complexity of the field (21.6%), job market perceptions (19.6%), and mentor influence (15.7%). Conversely, the main reasons for not choosing a uveitis fellowship were perceptions regarding surgical opportunities (17.6%), beliefs about the field’s complexity (15.1%), and salary expectations (13.2%). Residents not pursuing uveitis subspecialization were more likely to decide before their PGY3 year (26.7% vs. 14.3%, P = 0.041) and 43.6% indicated they would reconsider if the fellowship were combined with another subspecialty. Additionally, 75% (N = 87) felt their uveitis rotation time was inferior compared to other subspecialties. Residents pursuing uveitis subspecialization had more surgical exposure with uveitis-trained faculty than those who did not (64.3% vs. 56.4%, P = 0.018). Residents not pursuing a uveitis fellowship had a higher number of uveitis-trained faculty at their program compared to residents who pursued a fellowship in uveitis (1.90 vs. 1.14, P = 0.002).ConclusionsImproving recruitment into uveitis fellowship may require residency curriculum adjustments that emphasize earlier rotations and increased surgical exposure with uveitis faculty. While didactic and research opportunities are valuable, other factors may play a more determinative role in a resident’s decision to pursue a uveitis fellowship. Strengthening mentorship programs can address concerns compensation along with surgical and research opportunities to foster an interest in current residents.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fopht.2026.1787176</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fopht.2026.1787176</link>
        <title><![CDATA[Comparative clinical outcomes of SMILE, femtosecond LASIK, and transepithelial PRK: a multicenter Iraqi study]]></title>
        <pubdate>2026-04-14T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Hassan A. Aljaberi</author><author>Saeed Rahmani</author><author>Humam H. Alrikabi</author>
        <description><![CDATA[PurposeTo compare refractive predictability, long-term stability, visual quality, ocular surface outcomes, and safety of small incision lenticule extraction (SMILE), femtosecond laser–assisted laser in situ keratomileusis (FS-LASIK), and transepithelial photorefractive keratectomy (Trans-PRK) for myopia correction in an Iraqi population.MethodsThis retrospective multicenter comparative cohort study included 919 eyes of 919 patients who underwent SMILE (388 eyes), FS-LASIK (344 eyes), or Trans-PRK (187 eyes) between January 2023 and December 2025. Postoperative outcomes were evaluated at 6 months, 1 year, and 1.5 years. Primary outcome measures included refractive predictability and stability of spherical equivalent (SE). Secondary outcomes included uncorrected and corrected distance visual acuity (UDVA and CDVA), absolute refractive error, induced corneal higher-order aberrations (HOAs) at 6 months, Ocular Surface Disease Index (OSDI) scores, and safety outcomes. Multivariable linear regression analysis was performed to identify factors associated with residual SE at 1.5 years.ResultsSMILE demonstrated the highest refractive predictability and long-term stability, with postoperative SE values closest to emmetropia and the narrowest distribution of residual refractive error at all follow-up intervals. FS-LASIK showed intermediate outcomes, whereas Trans-PRK was associated with greater residual myopia and increased refractive regression over time. Induced corneal HOAs were lowest following SMILE and highest following Trans-PRK. OSDI scores were consistently lower after SMILE, intermediate after FS-LASIK, and highest after Trans-PRK throughout follow-up. Multivariable analysis identified surgical technique as the primary independent predictor of residual SE at 1.5 years, with FS-LASIK and Trans-PRK associated with significantly greater myopic residual error than SMILE. All three procedures demonstrated a high safety profile, with low rates of CDVA loss and infrequent enhancement procedures.ConclusionsIn this large multicenter Iraqi cohort, SMILE provided superior refractive predictability, long-term stability, visual quality, and ocular surface outcomes compared with FS-LASIK and Trans-PRK. FS-LASIK remained an effective and safe alternative, while Trans-PRK was associated with greater refractive regression and higher enhancement rates, particularly in eyes with higher degrees of myopia. These findings support procedure-specific patient selection to optimize refractive outcomes and postoperative comfort.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fopht.2026.1730495</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fopht.2026.1730495</link>
        <title><![CDATA[Optimizing imaging in orbital vascular anomalies: a review on matching modality to pathology for effective diagnosis and treatment planning]]></title>
        <pubdate>2026-04-13T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Arshia Arjomandi</author><author>Katherine M. Lucarelli</author><author>Robert A. Goldberg</author><author>Daniel B. Rootman</author>
        <description><![CDATA[IntroductionOrbital vascular anomalies (OVAs) encompass a heterogeneous group of lesions requiring precise imaging to guide diagnosis and treatment. Multiple imaging modalities offer distinct strengths and limitations, with the choice guided by the balance between spatial and temporal resolution. This review aligns imaging modalities with specific OVM subtypes to optimize diagnostic accuracy and procedural planning, while highlighting advanced and evolving imaging techniques that may further enhance clinical decision-making.MethodsA narrative review was conducted on studies describing imaging characteristics, diagnostic performance, and clinical utility in OVAs, supplemented with imaging from patients presenting with a wide range of lesions. All patient data were collected and reviewed in compliance with HIPAA regulations and international ethical standards.ResultsAlthough ultrasound provides dynamic assessment of vascular flow and superficial morphology, its role is limited in modern practice due to poor spatial resolution and depth penetration. CT offers superior spatial resolution for osseous and calcified lesions, while MRI provides excellent soft tissue characterization and evaluation of complex low-flow malformations. MR and CT angiography deliver detailed vascular mapping critical for pre-embolization planning, yet their static nature limits evaluation of dynamic changes. Dynamic techniques, such as Time-Resolved Imaging of Contrast KineticS (TRICKS) MRI angiography and dynamic CT angiography, enable real-time assessment of flow and venous distensibility, improving procedural planning. Conventional digital subtraction angiography remains the standard for complex lesions in critical locations, combining high-temporal-resolution diagnosis with therapeutic intervention. Given the heterogeneity of OVAs, a multimodal approach is often necessary to address diagnostic, planning, and treatment needs comprehensively.ConclusionOptimal imaging of OVAs requires tailoring modality selection to lesion type and clinical context. Incorporating advanced and emerging imaging approaches into clinical practice may further improve diagnostic precision, procedural planning, and patient outcomes.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fopht.2026.1688660</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fopht.2026.1688660</link>
        <title><![CDATA[Use of preoperative swept-source optical coherence tomography in vitrectomy for advanced diabetic eye disease: a pilot study]]></title>
        <pubdate>2026-04-13T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Arshad Mehmood</author><author>Altamash Shahriyar Ghazanfar</author><author>M. A. Rehman Siddiqui</author>
        <description><![CDATA[BackgroundSwept-source optical coherence tomography (SS-OCT) is an OCT variant with longer wavelengths than other commonly used OCT devices. Our aim was to determine the benefit of pre-operative SS-OCT to detect occult retinal pathologies in patients with advanced diabetic eye disease (ADED).MethodsFundus photos and SS-OCT were performed pre-operatively in all patients scheduled for vitrectomy for ADED. These were reviewed by two retina specialists. A modified BIO-score based on the Nussenblatt scale of vitreous haze was used to evaluate fundus clarity on fundus photos. Findings on fundus photos were compared with the findings on SS-OCT. Any disagreement between the retina specialists was resolved upon discussion.ResultsWe included 38 consecutive eyes of 35 patients. Various degrees of cataract was present in 22 eyes. In our sample, 84.2% of cases had a BIO score of 3 or more and 31.6% had a BIO score of 4 or 5. The most common diagnosis on fundus photos was vitreous haemorrhage (n = 23). Tractional retinal detachment (n = 20) was the most common diagnosis on SS-OCT. Only 3 cases had no view on SS-OCT. There was almost perfect (κ = 0.933, 95% CI: 0.887-0.979), substantial (κ = 0.734, 95% CI: 0.632-0.836) and moderate (κ = 0.593, 95% CI: 0.494-0.692) intergrader agreement for fundus photo diagnosis, SS-OCT diagnosis and BIO scores respectively.ConclusionSS-OCT showed potential as an adjunct to clinical examinations, especially when hazy media opacities did not allow for a clear view of the fundus. However, it is important to recognise that OCT only serves as an adjunct and cannot be used as a definitive argument for assessing surgical feasibility.]]></description>
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