Purtscher-like retinopathy (PLR) is a rare, vision-threatening occlusive microvasculopathy. We report a rare case of unilateral PLR following the initiation of chemotherapy for recurrent cervical carcinoma. A 54-year-old female with recurrent carcinoma of the cervical vault presented with sudden, painless diminution of vision in the left eye (visual acuity: 2/60), five days post-initiation of chemotherapy with gemcitabine and bevacizumab. Fundus examination revealed multiple superficial hemorrhages, cotton wool spots, and Purtscher flecken with macular edema, initially diagnosed elsewhere as a combined central retinal artery and vein occlusion. Systemic laboratory workup was unremarkable. A diagnosis of chemotherapy-induced PLR secondary to localized thrombotic microangiopathy was established. The patient was managed conservatively with close oncological follow-up. Gemcitabine and bevacizumab can precipitate localized thrombotic microangiopathy leading to PLR. Precise funduscopic evaluation is essential to distinguish PLR from combined retinal vascular occlusions to prevent unnecessary interventions and guide appropriate multidisciplinary management.

This multicenter, retrospective real-world study evaluated the efficacy and safety of aflibercept 2 mg biosimilar SB15 (Afilivu®) across multiple retinal diseases. A total of 1083 eyes from 984 patients received 2762 injections between March 2023 and February 2025 at three South Korean tertiary centers, comprising 188 treatment-naïve (17.4%) and 895 switching eyes (82.6%). Diagnoses included neovascular age-related macular degeneration (nAMD, n = 611), retinal vein occlusion (RVO, n = 182), diabetic macular edema (DME, n = 173), and other conditions (n = 117). Over a mean follow-up of 5.17 ± 2.76 months with 2.55 ± 1.09 injections, central foveal thickness decreased significantly by - 47.5 µm (95% CI - 55.2 to - 39.8; P < 0.001), while best-corrected visual acuity remained stable (mean change - 0.003 LogMAR; P = 0.572). Treatment-naïve eyes demonstrated greater anatomical improvement than switching eyes (- 93.9 vs. - 37.9 µm; P < 0.001). Retinal fluid resolved significantly across diagnostic groups: in nAMD, subretinal fluid decreased from 51.2 to 29.6% (P < 0.001); in RVO, intraretinal fluid reduced from 92.9 to 76.4% (P < 0.001); and in DME, intraretinal fluid decreased from 90.8 to 84.4% (P = 0.002). One case (0.09%) of rhegmatogenous retinal detachment occurred; no intraocular inflammation or other serious adverse events were observed. These findings support the real-world effectiveness and safety of SB15 (Afilivu®) in both treatment-naïve and switching populations across diverse retinal diseases.

Aging has long been implicated in the onset and progression of major retinal diseases, including age-related macular degeneration (AMD), diabetic retinopathy (DR), and retinal vein occlusion (RVO). Glaucoma is likewise increasingly recognized as an age-related disorder. Across these conditions, converging patterns of neurodegeneration and microvascular injury contribute to age-associated ocular decline. Structural and neuronal degeneration of the retina, including loss of retinal ganglion cell axons, along with impaired microvascular circulation and chronic inflammation, contribute to the pathogenesis of glaucoma, AMD, DR, and RVO. Geroprotectors, a class of longevity-promoting pharmacologic agents investigated for systemic benefits in cardiovascular and neurological aging, have therefore drawn growing ophthalmic interest for their potential relevance to ocular health and the management of age-associated eye diseases. These agents are now frequently encountered as concomitant medications in ophthalmic practice, yet their ocular effects remain incompletely characterized, variably reported, and in some cases controversial. Glucagon-like peptide-1 (GLP-1) receptor agonists, widely used for glycemic control and increasingly for weight management, have been associated with reduced risk of age-related glaucoma but also with unconfirmed reports of severe nonarteritic anterior ischemic optic neuropathy. Similar uncertainties surround other geroprotective, metabolic, and weight-modifying therapies, creating challenges for clinicians attempting to incorporate evolving pharmacologic evidence without compromising patient safety. This review synthesizes reported therapeutic and adverse ocular outcomes across geroprotective agents to support clinical awareness, identify knowledge gaps, and guide future investigation. The agents reviewed include GLP-1 receptor agonists, metformin, sodium-glucose cotransporter-2 inhibitors, statins, cannabinoids, calcium channel blockers, spermidine, taurine, nicotinamide adenine dinucleotide precursors, rapamycin, and mifepristone.

Retinal diseases (RD), which often cause irreversible vision impairment and lack effective treatments, necessitate more attention than common ocular conditions like cataract (CA), and aqueous humor metabolic analysis has proven an invaluable tool for their investigation. In this work, a robust, high-performance heterojunction nanoconstruct (MZ-D) with cost-effectiveness (∼2.7 yuan per gram), streamlined two-step synthesis, high reproducibility, was developed. Combined with high-throughput mass spectrometry and machine learning, aqueous humor metabolic profiles were extracted and analyzed for multiple RD, including age-related macular degeneration (AMD), diabetic retinopathy (DR), and retinal vein occlusion (RVO). We identified key metabolic features that delivered 92.87% accuracy, 0.9340 AUC, and 92.94% precision for RD recognition against CA, which was used as a control to simulate clinical settings, and 86.59% accuracy, 0.9591 AUC, and 86.59% precision for differentiating AMD, DR, and RVO. Notably, retinaldehyde and 2-hydroxylauroylcarnitine were unveiled as specific metabolic signatures of RD, and beyond playing a pivotal role in robustly distinguishing RD from CA, they exhibited significant discriminatory power across multiple RD subtypes, yielding accuracy and precision both exceeding 80%. This work paves the way for clinical translation of nanomaterial-enabled ocular metabolic diagnostics.

Plant-based diets may influence age-related eye diseases (AREDs), but whether ocular benefits depend on diet quality remains unclear. We examined associations of a healthy plant-based diet index (PDI-H) and an unhealthy plant-based diet index (PDI-U) with age-related macular degeneration (AMD), cataract, glaucoma, diabetic retinopathy (DR), and retinal vein occlusion (RVO) using the UK Biobank prospective cohort and an independent Tianjin hospital-based cross-sectional sample. Cox regression, logistic regression, propensity score matching, restricted cubic splines, subgroup analyses, multi-omics profiling, and machine learning were applied. Higher PDI-H was associated with lower risks of AMD, cataract, glaucoma, and DR, whereas higher PDI-U was associated with increased risks of AMD, cataract, and DR. Associations with RVO were weak or absent. Findings from Tianjin were directionally consistent with UK Biobank results and should be interpreted as supportive cross-sectional evidence. Proteomic and metabolomic analyses linked plant-based diet quality to inflammation, lipid metabolism, glycaemic regulation, and hormonal signalling. Predictive models incorporating dietary indices showed good discrimination for AMD and cataract, with modest but consistent AUC improvements after adding PDI-H and PDI-U to traditional risk factors. These findings suggest that plant-based diet quality, rather than plant-based eating alone, may be a modifiable determinant of major AREDs.

Stem cell therapy presents a new solution to cure degenerative diseases of the retina, which normally have limited ability to regenerate after injury. Stem cells are cells capable of self-renewal and differentiation into more specialized cells, and can be derived from both embryonic and adult sources. This definition encompasses a heterogeneous group of cells possessing varied potency and characteristics. Current attempts in applying stem cell technology to the retina have primarily focused on regenerating the retinal pigment epithelium (RPE) and light-sensing photoreceptor cells. They have not only shown the ability to prevent the death of host photoreceptors, but they can also differentiate into all major retinal cell types to replace lost cells. In vivo experiments, primarily performed in mice, have found that stem cell-derived RPE cells, photoreceptors, and their precursors can survive long-term in animal models without tumorigenicity or immune rejection. Following transplantation, these cells were able to integrate and mature in vivo, forming synapse-like structures with host retinal cells. Furthermore, transplants in mice were able to rescue visual function at a cellular and behavioral level. These promising preclinical results have led to clinical trials testing cell therapy in numerous diseases, including Stargardt macular dystrophy, age-related macular degeneration, retinitis pigmentosa, and central retinal vein occlusion. These trials have demonstrated the safety of cell therapy and have improved visual function in some patients. Scientific advances in the culturing of retinal organoids and the understanding of cell redifferentiation are informing the development of better stem cell therapies, which hold great potential for restoring vision to patients with retinal dystrophies.