Objective: To investigate the effectiveness and prognosis of uveal melanoma treated with proton or heavy ion therapy. Methods: A retrospective analysis was performed. We enrolled patients diagnosed with uveal melanoma at the Department of Ophthalmology, Eye & ENT Hospital of Fudan University between 2015 and 2020 and receiving proton beam therapy overseas, as well as patients diagnosed with uveal melanoma and treated with heavy ion radiotherapy at the Department of Ophthalmology, Eye & ENT Hospital of Fudan University and the Department of Radiotherapy, Shanghai Proton and Heavy Ion Center from July 2020 to August 2025. Patients' information was collected, including the gender, age, best-corrected visual acuity and its changes, largest basal diameter and thickness of the tumor and their changes, tumor stage, radiotherapy type and complications, supplementary treatments after radiotherapy, and follow-up duration and modalities. The t-test was used to compare the changes in tumor diameter and thickness before and after radiotherapy. The local control rate of the tumor was summarized. Survival curves were drawn. The Kaplan-Meier product-limit method was used to calculate the cumulative metastasis-free survival rate and cumulative eye preservation rate at 3 and 5 years. Results: A total of 69 patients (69 eyes) were included. There were 31 males (44.9%) and 38 females (55.1%), with an average age of (46.5±12.2) years. The tumor stage (tumor-lymph node-distant metastasis staging system) was mainly T2 (33/69, 47.8%) and T3 stage (23/69, 33.3%). Twelve patients (17.4%) received proton radiotherapy, and 57 patients (82.6%) received heavy ion radiotherapy. The follow-up, which was conducted through outpatient visits and telephone interviews, lasted (40.2±31.8) months. The largest basal diameter of the tumor significantly decreased from (11.3±2.9) mm at baseline to (9.5±3.5) mm after radiotherapy, and the tumor thickness was reduced from (6.7±2.3) mm to (5.5±2.7) mm; both were statistically significant (both P<0.05). After treatment, 19 patients retained best-corrected visual acuity of≥0.1, and the major complications were radiation-induced retinopathy (29/69, 42.0%), macular edema (26/69, 37.7%), retinal detachment (24/69, 34.8%), and cataracts (23/69, 33.3%). Four patients (5.8%) ultimately underwent enucleation, including three cases due to neovascular glaucoma, and one case of anterior chamber seeding recurrence after local tumor resection. The local tumor control rate was 98.6% (68/69), and the 5-year cumulative eye preservation rate was 90.6%. In terms of survival prognosis, four patients had liver metastasis of the tumor, one patient had breast metastasis, and the 3-and 5-year cumulative metastasis-free survival rates were 93.7% and 90.3%, respectively. Conclusion: Both proton radiotherapy and heavy ion radiotherapy for uveal melanoma not only achieve high local tumor control and eye preservation rates with a favorable safety profile, but also help to preserve partial visual acuity, holding promising prospects.

To evaluate the feasibility, safety, and stability of a novel remote multimodal surgical platform that integrates a dual-arm robotic system with an intraoperative swept-source OCT surgical microscope system for subretinal injection in porcine eyes. Subretinal injection was performed in vivo in Bama miniature pigs (one eye per animal), with six animals assigned to robotic manipulation (RM) and six to manual manipulation (MM). Successful injection was defined as localized subretinal bleb formation confirmed by intraoperative OCT. Outcome measures included procedure time, injection time, first-attempt success rate, bleb morphology, intraoperative complications, postoperative OCT findings, needle-tip tremor amplitude, and histological changes. Subretinal injection was successful in all 12 eyes (100% success rate), with a first-attempt success rate of 5/6 in the RM group and 3/6 in the MM group. Total procedure time was longer in the RM group (901.5 vs. 489.8 s, P = 0.0093), whereas injection time did not differ significantly (median 8.00 vs. 8.50 s, P = 0.6842). Tremor amplitudes were numerically lower in the RM group but did not reach statistical significance (average: 4.48 ± 0.62 vs. 11.06 ± 3.65 μm, P = 0.087; peak: 23.19 ± 2.65 vs. 47.98 ± 18.66 μm, P = 0.146). No severe complications (extensive retinal detachment, uncontrolled bleeding, or lens injury) occurred in either group; minor localized hemorrhage showed a narrower distribution in the RM group than in the MM group. Postoperative OCT confirmed retinal reattachment in all eyes, and histology revealed only localized entry-site changes. This dual-arm robotic platform enabled successful bimanual subretinal injection in all porcine eyes, with comparable injection time, bleb morphology, and short-term tissue safety relative to manual surgery. Despite a longer total procedure time, the system showed a non-significant trend toward reduced needle-tip tremor. These results support the feasibility and preliminary safety of this platform for subretinal injection and warrant further evaluation for remote bimanual vitreoretinal microsurgery.

Posterior vitreous detachment (PVD) is considered a key event in the pathogenesis of rhegmatogenous retinal detachment (RRD), and horseshoe retinal tears are generally associated with vitreoretinal traction during PVD evolution. We report the longitudinal progression of horseshoe retinal tear-associated RRD without clinically evident complete PVD. A 64-year-old nonmyopic man presented to a general ophthalmology clinic with floaters and preserved visual acuity. Retrospective review of baseline ultrawidefield (UWF) imaging demonstrated a horseshoe retinal tear with localized macula-on temporal RRD extending to within approximately 2.5 disc diameters of the fovea, which had not been recognized initially. Posterior-pole optical coherence tomography (OCT) showed posterior hyaloid attachment at the macula and optic nerve head, without clinically evident complete PVD. However, posterior-pole OCT could not exclude localized peripheral vitreous separation or focal vitreoretinal adhesion adjacent to the tear. Approximately 6 months later, the patient presented with acute visual deterioration, and the detachment had progressed to a bullous macula-off RRD arising from the same tear. PVD was induced during pars plana vitrectomy. This case documents longitudinal progression of localized horseshoe retinal tear-associated RRD without clinically evident complete PVD. Although the underlying mechanism remains inferential, the clinical course is compatible with focal peripheral traction occurring before complete PVD becomes clinically evident. In symptomatic patients, preserved central visual acuity, unremarkable posterior-pole findings, and absence of clinically evident complete PVD should not lower concern for peripheral vitreoretinal traction, retinal breaks, or RRD. Meticulous peripheral retinal examination and intentional review of the temporal retina on UWF imaging remain essential.

A three-dimensional (3D) clinical simulation model was developed for ocular ultrasonography training, and its pedagogical potential was evaluated. Model design was based on computed tomography data of feline skulls, which were processed and segmented using specialized 3D modeling software. During this process, Standard Tessellation Language (STL) files were produced, corresponding to the three main model components: a feline skull and two eyeballs, one representing normal anatomy and the other simulating a total retinal detachment. All components were printed using a stereolithography printer. Rigid resin was used to print the skull and flexible resin for the eyeballs. Each eyeball was filled with a medical-grade gel with physical and acoustic properties like those of real feline eye. The printing and assembly stages resulted in reduced production costs and moderate reproducibility. Following initial fidelity validation by an experienced veterinary ultrasonographer, the model's pedagogical potential was assessed by veterinary students and practicing veterinarians during a structured training session, followed by the completion of a qualitative survey. Overall feedback was positive, with participants reporting acceptable fidelity, ease of use, and perceived improvements in manual dexterity and technical learning. Statistically significant associations were observed between academic degree and performance scores and between prior practical experience in ocular ultrasonography and perceived task ease. The feline ocular model represents a cost-effective, safe, and accessible educational tool with satisfactory sonographic fidelity.

Excessive oxidative stress and neuroinflammation caused by retinal detachment (RD) drive progressive photoreceptor degeneration, posing a major challenge to functional vision recovery even after successful anatomical reattachment. These limitations highlight the urgent need for alternative or adjunctive therapeutic strategies to protect photoreceptors. Here, smart supramolecular Cerium-Rutin nanoparticles (CRNPs) are developed for coordinated redox and immunomodulatory therapy in RD. CRNPs are constructed through the coordination assembly of cerium ions with the natural flavonoid Rutin, integrating the reversible Ce[3+]/Ce[4+] redox-switching capacity with the intrinsic anti-inflammatory activity of Rutin. This supramolecular nanozyme platform enables dynamic regulation of oxidative and inflammatory homeostasis within the injured retina. In vitro, CRNPs protect microglial and photoreceptor cells by scavenging reactive oxygen species (ROS) and suppressing inflammatory activation, demonstrating both anti-inflammatory and cytoprotective effects. In vivo, CRNPs effectively preserve photoreceptor morphology, protect outer nuclear layer integrity, enhance retinal electrophysiological responses and vision function in an RD model. Mechanistically, CRNPs first mitigate oxidative stress, which in turn suppresses activation of the NLRP3/ASC/caspase-1 signaling pathway, thereby reducing pro-inflammatory microglial activation and limiting the release of inflammatory mediators. Collectively, this study establishes a redox-active nanozyme platform capable of restoring retinal homeostasis and mitigating neuroinflammation, providing a promising nanotherapeutic approach for the treatment of RD and other oxidative stress-associated neurodegenerative diseases.