King Khaled Eye Specialist Hospital

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[This corrects the article DOI: 10.3389/fmed.2026.1763735.].

To analyze trends in retinal imaging utilization and assess whether there is a correlation with anti-vascular endothelial growth factor (anti-VEGF) and panretinal photocoagulation (PRP) usage. We performed a cross-sectional study using the publicly available Medicare Physician & Other Practitioners-by Provider and Service database. Data were identified using procedural codes for ocular coherence tomography, fundus photography, fluorescein angiography (FA), indocyanine-green angiography, ophthalmic ultrasound, intravitreal anti-VEGF agents, and PRP from 2013 to 2021. Time-based analyses were also conducted for the individual periods 2013 to 2016 and 2017 to 2021 to account for changes in the billing of FA from unilateral to unilateral or bilateral after 2016. Although ocular coherence tomography increased in relative utilization ( P < 0.001 across 2013-2021, 2013-2016, and 2017-2021), there was a decline in relative utilization for FA, FA + indocyanine-green angiography, ultrasound, and fundus photography ( P < 0.001 for all modalities across 2013-2021, 2013-2016, and 2017-2021). For PRP, positive associations in annual volume were observed with FA ( P < 0.001, R 2 = 0.81) and FA + indocyanine-green angiography ( P < 0.001, R 2 = 0.87), whereas a negative association in annual volume was observed with ocular coherence tomography ( P = 0.028, R 2 = 0.52). For anti-VEGF injections, a positive association in annual volume was observed with ocular coherence tomography ( P < 0.001, R 2 = 0.84), whereas negative associations were observed with FA ( P < 0.001, R 2 = 0.89) and FA + indocyanine-green angiography ( P < 0.001, R 2 = 0.90). Although anti-VEGF use returned to 2019 levels by 2021, PRP use declined by 30% during the same period. Ocular coherence tomography continues to rise as a percentage of all retinal imaging ordered, whereas FA has declined. This trend corresponds to an increase in anti-VEGF injections and a decline in PRP in the treatment of retinal diseases.

Introduction: The aim of the study was to evaluate the safety and feasibility of a novel surgical technique for subconjunctival burial of 10-0 Prolene sutures without conjunctival peritomy. Methods: A retrospective case series of 12 patients who underwent trans-scleral suture fixation or silicone oil retention suture placement using 10-0 Prolene sutures was conducted between January 2024 and February 2025 at Sant’Anna University Hospital, University of Ferrara, Italy. Inclusion criteria included adults requiring scleral fixation with 10-0 Prolene. Exclusion criteria included prior conjunctival surgery at the site, active ocular surface disease, or inability to complete follow-up. Instead of conjunctival peritomy, a linear high-temperature cautery was applied along the intended suture path to create a fibrotic track. Sutures were passed trans-scleral and left exposed on the cauterized zone, allowing spontaneous re-epithelialization. Follow-up included slit-lamp examination, anterior segment photography, and optical coherence tomography at 1 day, 1 week, and 1, 3, and 6 months. Results: A total of 12 patients (12 eyes) were included. Successful suture burial was achieved in all 12 eyes (100%) without exposure, extrusion, or conjunctival dehiscence during the 6-month follow-up. Re-epithelialization was complete by day 7 in all cases (12/12, 100%). No patient reported foreign body sensation after day 7. There were no infections, granulomas, or surgery revisions. Conclusions: The “Burn and Bury” technique is a safe and minimally invasive alternative to conjunctival peritomy for burying trans-scleral Prolene sutures. It preserves conjunctival integrity, reduces surgical trauma, promotes rapid epithelial healing, and enhances patient comfort. This technique may be broadly applicable in anterior segment procedures requiring scleral suture fixation and warrants prospective validation.

Introduction: Choroidal osteoma is a rare, benign ossifying tumor of the choroid that can present with clinical features overlapping those of inflammatory choroidal lesions. In patients with a history of Vogt-Koyanagi-Harada (VKH) disease, distinguishing between inflammatory relapse and non-inflammatory choroidal pathology can be particularly challenging. This case report highlights the diagnostic pitfalls associated with choroidal osteoma in the setting of prior VKH and underscores the importance of comprehensive multimodal imaging to ensure accurate diagnosis and appropriate management. Case Presentation: A 39-year-old female with a 14-year history of VKH disease, who had been stable off immunosuppressive therapy since 2016, presented in early 2024 with a 7-week history of cloudy vision in the right eye. She was initially diagnosed with a recurrent posterior VKH relapse and treated with high-dose intravenous corticosteroids followed by an oral taper, resulting in symptomatic improvement. However, further multimodal imaging – including wide-field fundus photography, optical coherence tomography (OCT), fundus autofluorescence, OCT angiography, fluorescein angiography, enhanced depth imaging OCT (EDI-OCT), and B-scan ultrasonography – revealed a yellow-orange, minimally elevated subretinal lesion associated with focal choroidal excavation. These findings were consistent with choroidal osteoma and confirmed by EDI-OCT and B-scan ultrasonography. Conclusion: This case illustrates a rare instance of choroidal osteoma masquerading as a posterior relapse of VKH disease. It emphasizes the critical importance of differentiating inflammatory from non-inflammatory choroidal lesions in patients with a history of uveitis. Careful interpretation of multimodal imaging is essential to avoid misdiagnosis, prevent unnecessary immunosuppressive treatment, and reduce associated risks, ultimately leading to improved patient outcomes.

To report anatomical and functional outcomes of epiretinal proliferation (EP) embedding without internal limiting membrane peeling for lamellar macular holes (LMHs) with EP. This retrospective interventional case series involved patients with idiopathic LMHs and EP who underwent pars plana vitrectomy using the EP-embedding technique without internal limiting membrane peeling. The EP was peeled centripetally, left connected to the LMH edge, and embedded into the retinal cleavage plane. 20% sulfur hexafluoride gas tamponade was applied. After surgery, patients were recommended to avoid lying face-up. Fifteen eyes of 15 patients were included, and the mean follow-up was 12 ± 8 months. Lamellar macular hole closure was achieved in 100% of cases. Best-corrected visual acuity and central retinal thickness showed significant postoperative improvement, from 0.31 ± 0.20 logMAR (20/40 Snellen) and 156.5 ± 40.7 µ m preoperatively to 0.10 ± 0.12 logMAR (20/25 Snellen) ( P = 0.002) and 221.5 ± 46.5 µ m ( P < 0.001), respectively. Ellipsoid zone (EZ) and external limiting membrane restoration rates were 50% and 100%, respectively. No cases of full-thickness macular hole formation, LMH recurrence, or major complications were observed. EP-embedding without internal limiting membrane peeling yields favorable anatomical and functional outcomes in LMHs with EP and supports the nontractional pathophysiology of the condition.

BACKGROUND Micropulse cyclophotocoagulation (MPCPC) is a commonly used procedure to reduce intraocular pressure (IOP) in glaucoma patients. While it is generally considered safer than traditional transscleral cyclophotocoagulation (TSCPC), complications such as transient mydriasis and reduced accommodation due to short ciliary nerve damage have been reported. However, isolated loss of accommodation without pupillary involvement has not been previously documented. We report a case of reduced accommodation without pupil dilation in a young patient after MPCPC. CASE REPORT A 26-year-old woman with primary congenital glaucoma, previously treated with goniotomy and trabeculectomy, had uncontrolled intraocular pressure (IOP) despite maximum medical therapy. Her best-corrected visual acuity (BCVA) was 20/60 in the right eye and 20/300 in the left. Micropulse cyclophotocoagulation (MPCPC) was performed in the right eye, and an Ahmed glaucoma valve was placed in the left eye on the same day. The postoperative IOP was 22 mmHg in the right eye and 16 mmHg in the left eye. After 2 weeks, the patient reported blurry vision in the right eye with BCVA of 20/60 in the right eye, and the anterior segment examination was unremarkable. After 6 months, she continued to experience blurry vision at near distance in her right eye. Refraction revealed a need for glasses with a near vision add of +1.5. CONCLUSIONS This case illustrates isolated accommodative dysfunction without pupillary involvement following MPCPC in a patient with congenital glaucoma, showing the need for awareness of this potential outcome, especially in young, phakic patients with a history of ocular surgeries.

To compare the outcomes of scleral-fixated intraocular lenses (SFIOLs) in the paediatric population. We included sutureless scleral-fixated intraocular lenses (SLSFIOLs), glued scleral-fixated intraocular lenses (GSFIOLs) and sutured scleral-fixated intraocular lenses (SSFIOLs) using polypropylene and Gore-Tex sutures. A systematic review and meta-analysis were performed in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. An electronic search was performed to include studies from 1999 to 2023. We included 1-18-year-old studies. The analysis was based on fixed and random-effect models. Primary outcomes included visual acuity, refraction and intraocular pressure (IOP). Secondary outcomes were lens tilt and extrusion of suture material. 33 studies (1531 eyes) were included (GSFIOLs n=75, SLSFIOLs n=162, SSFIOLs n=1294 (Gore-Tex n=30 and polypropylene n=1264)). Vision improved from preoperative (mean 0.75±0.50 SD) to postoperative (mean 0.39±0.19 SD) logarithm of the minimal angle of resolution. The mean spherical equivalent was 0.59±0.91. Transient high IOP post-OP was highest among polypropylene SSFIOLs, 8.1%. Polypropylene SSFIOLs had glaucoma in 0.31% and corneal decompensation in 0.15%. A suture break or erosion was reported in 1.19%. None of the other groups developed glaucoma or corneal decompensation. Suture erosion was not reported in Gore-Tex SSFIOLs. GSFIOLs had a 5.3% reoperation rate, mostly for IOL repositioning. All types of scleral lens fixation showed improvement in initial outcomes. SLSFIOLs and Gore-Tex SSFIOLs have low complication rates.