PurposeTo compare the clinical outcomes of conventional photorefractive keratectomy (PRK) and transepithelial PRK (TransPRK) for the correction of myopic refractive errors.MethodsThis prospective, paired-eye comparative study included 48 eyes of 24 patients. Each patient underwent conventional PRK in the right eye and TransPRK in the left eye. Both patient and outcome assessors were blinded to treatment allocation. Preoperative and postoperative parameters including uncorrected distance visual acuity (UDVA), spherical equivalent (SE), postoperative pain, epithelial healing time, and complications were evaluated. Paired statistical analyses were used to compare outcomes between the two procedures.ResultsThere were no significant differences in baseline characteristics between the groups. Postoperatively, there were no statistically significant differences in UDVA (p = 0.084) or final SE (p = 0.512). Epithelial healing was faster in the TransPRK group but failed to show statistical significance (p = 0.371). However, postoperative pain was significantly higher in the TransPRK group, with a median pain score of 8 (IQR 8-10) compared to 6 (IQR 6-8) in the PRK group (p = 0.014). Clinically significant postoperative haze was observed in 3 (12.5%) of patients, with an identical pattern in both eyes of every affected patient.ConclusionBoth conventional PRK and TransPRK are safe and effective procedures for myopic correction, providing comparable visual and refractive outcomes. In this cohort, TransPRK was associated with significantly greater early postoperative pain, a finding that contrasts with much of the existing literature and warrants further investigation. The contralateral study design highlights the consistency of other outcomes while isolating this key difference.

Slow-wave activity (SWA), a key indicator of sleep homeostasis, is often diminished in individuals with treatment-resistant depression (TRD). Ketamine, a rapid-acting antidepressant, increases SWA during the first period of non-rapid eye movement (NREM1) sleep. However, research into how ketamine affects sleep and its connection to treatment outcomes in TRD has been limited by small sample sizes and a lack of comparison with healthy volunteers (HVs). This placebo-controlled study compared the effects of ketamine on NREM1 SWA in a large sample of unmedicated TRD patients (n = 91; 51 F/40 M) and HVs (n = 42; 23 F/19 M). Linear mixed-effects models and regression analyses, with post-hoc testing (paired ttests and Wilcoxon matched-pairs signed rank tests), were used to assess condition-related effects across baseline, ketamine, and placebo in TRD and HV participants. Age-related moderation of ketamine-associated NREM1 SWA changes and condition-related changes in sleep variables were also examined. At baseline, TRD patients had lower NREM1 SWA than HVs. Ketamine, but not placebo, increased NREM1 SWA in TRD patients, particularly in responders. In contrast, ketamine had no effect on NREM1 SWA in HVs. Following ketamine, TRD patients also showed significant increases in total sleep time and sleep efficiency and a reduction in sleep latency. In TRD patients, the ketamine-related increase in NREM1 SWA diminished with increasing age. Together, the results indicate that ketamine's antidepressant effects appear closely associated with its ability to modulate early SWA. These effects may also be linked to ketamine's ability to improve sleep architecture in TRD. Clinical Trials Identifier: www.clinicaltrials.gov , NCT00088699, NCT01204918.

ObjectiveThis study aims to identify signals of disproportionate reporting (SDR) associated with donanemab by analyzing data from the Food and Drug Administration's Adverse Event Reporting System (FAERS) database.MethodsA retrospective analysis was conducted on reports related to donanemab in the FAERS database from the third quarter of 2024 to the second quarter of 2025. Four signal detection methods were employed: reporting odds ratio (ROR), proportional reporting ratio (PRR), Multi-item gamma poisson shrinkage (MGPS), and Bayesian confidence propagation neural network (BCPNN). Additionally, descriptive analysis was performed on the time to onset of reports associated with donanemab.ResultsA total of 646 reports identified donanemab as the primary suspect drug. We identified common SDRs listed on the drug label, including amyloid related imaging abnormality-oedema/effusion, amyloid related imaging abnormality-microhaemorrhages and haemosiderin deposits, headache, and infusion-related reactions. In addition, some SDRs not previously listed on the drug label, such as back pain, feeling hot, and influenza like illness, were also detected. The median time to onset for donanemab-related adverse events was 31.5 days (interquartile range: 25-58 days).ConclusionThis study provides a comprehensive analysis of SDRs associated with donanemab. These results are merely statistical indicators and require further validation through clinical trials.

Castleman disease constitutes a rare spectrum of conditions with rheumatologic, hematologic, and oncologic features. Orbital involvement is extremely rare with only several cases involving the lacrimal gland. This report describes Castleman disease in a 15-year-old patient who presented with progressive left eye bulging and intermittent periorbital pain. Neuroimaging demonstrated a well-defined, enhancing, homogeneous left lacrimal gland mass with decreased diffusivity, smooth bone remodeling, and anteromedial globe displacement, and no other systemic findings. The lesion was excised in toto and histopathology revealed features of hyaline vascular-type Castleman disease. This is the first reported case of Castleman disease in a pediatric patient with an isolated lacrimal gland lesion. It emphasizes the importance of considering Castleman disease among other lymphoproliferative diseases in the differential diagnosis for patients presenting with a well-circumscribed, homogeneous orbital mass associated with decreased diffusivity and bone remodeling.

Corneal innervation research has faced long-standing clinical challenges that only recent technological breakthroughs now make tractable. Advances in single-cell analysis, viral vectors, clinical imaging, and artificial intelligence provide integrated approaches for uncovering molecular mechanisms underlying functional outcomes and facilitating clinical applications. The National Eye Institute's U01-funded consortium on ocular surface innervation addresses major knowledge gaps in characterizing corneal-projecting neurons, understanding neuroimmune and epithelial interactions in the cornea, and translating animal model findings to human pathology. The unique properties of the cornea (transparent, avascular, and densely innervated) make it ideal for neurobiology research on peripheral and central sensory processing. Through a multi-institutional collaboration, the consortium roadmap systematically integrates four complementary pillars: retrograde labeling, omics technologies, animal models, and research models and human clinical imaging. The roadmap progresses through three phases: standardizing methodological foundations, achieving technological convergence through multimodal synthesis, and advancing clinical translation via cross-species harmonization, therapeutic target identification, and patient characterization strategies. This coordinated approach transforms isolated findings into mechanistic frameworks, demonstrating how technological convergence combined with collaborative science accelerates discovery and establishes foundations for understanding ocular surface circuitry in physiological and pathophysiological contexts, including pain.

Aureobasidium pullulans is a dematiaceous fungus and a rare causative agent of fungal keratitis. We report a case of Aureobasidium pullulans keratitis that did not respond to conventional therapy despite two months of treatment for a corneal ulcer. A 52-year-old male patient presented with complaints of pain and redness of the right eye (OD) for two months. There was no history of any ocular trauma or surgery, or any other significant ocular and systemic illness. In the left eye (OS), a laser peripheral iridotomy was done 15 days ago. The patient was under treatment for a OD fungal corneal ulcer without any significant improvement after two months. Fungal culture isolated Aureobasidium pullulans as the causative infectious organism. The patient was treated successfully with topical natamycin and systemic itraconazole.

Nitrous oxide (N2O) has both MAC (Minimum Anaesthetic Concentration) sparing and rapid pharmacokinetic washout properties. We hypothesised that adding N2O at the end of surgery would hasten emergence from anaesthesia, decrease variability in emergence duration and reduce the number of prolonged emergences. Adult patients, American Society of Anesthesiologists Physical Status I-III, undergoing general anaesthesia for surgery with duration of over 120 min were randomised into two groups according to carrier gas: air/30% oxygen, and the same mixture until the last 30 min of surgery when 70% N2O in 30% oxygen was used. Anaesthesia was maintained at ~1 MAC with sevoflurane in both groups. Early and late recovery, postoperative nausea and vomiting, and pain scores and analgesic use were assessed. Time to extubation time was deemed prolonged if it lasted more than 15 min. Fifty-one patients in N2O/O2 and 50 in air/O2 were enrolled. N2O administration lasted (mean ± standard deviation) 24.8 ± 9.4 min. Time to extubation was faster with N2O/O2 (5.5 ± 2.6 min) than with air/O2 (9.1 ± 4.0 min), mean difference 3.6 min; 95% confidence interval 2.3 to 4.9, p < 0.001. Ability to open eyes, follow commands and being oriented were similarly significantly faster (mean differences 3.6, 3.4 and 3.7 min, respectively, p < 0.001 in all). None of the patients with N2O/O2, but 6% of patients with air/O2, had prolonged time to extubation, p < 0.001. There were no differences between the groups in postoperative pain scores, or in early and late postoperative recovery. Patients administered N2O/O2 received significantly less analgesics: tramadol (medians 0 vs 100 mg, p = 0.037), paracetamol (33% vs 62%, p = 0.004) and ketoprofen (16% vs 32%, p = 0.054). Adding N2O at the end of sevoflurane-based anaesthesia hastened extubation, eye opening, following commands and orientation, and eliminated prolonged time to extubation without increasing early or late complications.

Chronic red eye is a prevalent presentation in both primary care and emergency settings. While most cases are self-limiting, recurrent or treatment-resistant episodes warrant systematic evaluation to exclude underlying chronic inflammatory conditions. We report the case of a 19-year-old female patient with a longstanding history of bilateral red eye associated with pain, photophobia, and epiphora, initially and repeatedly managed as infectious conjunctivitis in the emergency department (ED). Despite multiple antibiotic courses, symptoms persisted. Ophthalmologic evaluation ultimately revealed chronic anterior and posterior blepharitis with meibomian gland dysfunction, peripheral corneal infiltrates, and neovascularization (NV) - findings consistent with ocular rosacea. Notably, subtle cutaneous signs of rosacea were also identified on clinical examination, further supporting the diagnosis. Following targeted therapy with oral doxycycline 100 mg twice daily, topical corticosteroids (CSs), and ocular lubricants, the patient achieved significant clinical improvement. This case highlights the diagnostic pitfalls of recurrent red eye in primary care, the importance of recognizing chronic inflammatory ocular surface disease, and the value of timely ophthalmologic referral in preventing irreversible corneal complications.