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.

Retinal vein occlusion (RVO) is the second most common retinal vascular disease after diabetic retinopathy and can result in significant vision loss and ocular morbidity. Vision loss may result from hemorrhages, macular ischemia (if there is significant closure of the perifoveal capillaries), and, most commonly, macular edema. Recent advances in retinal imaging and antivascular endothelial growth factor (anti-VEGF) agents have improved the diagnosis and treatment of RVO. This has resulted in significant improvements in visual and anatomic outcomes. Anti-VEGF agents remain first-line treatment options for macular edema, with intravitreal steroids and grid laser photocoagulation as second-line treatment options. Panretinal photocoagulation is the treatment of choice for neovascular complications associated with RVO, with anti-VEGF agents as adjunct therapy. Despite therapeutic advances, RVO remains a chronic disease requiring long-term monitoring and treatment, which can sometimes result in treatment fatigue and loss to follow-up. There remains a need for long-term and more durable treatment options. The choice of treatment should be individually tailored based on discussion among the patient, family, and physician.

Vascular dysfunction and abnormal vascularization are primary characteristics of many proliferative retinopathies. Research on proliferative retinopathies has primarily focused on understanding the role of cells and factors that regulate endothelial cell function in ischemic retinopathies. Pericyte coverage of the retina is deemed essential for the survival of endothelial cells, and recently significant efforts have been made to comprehend the role of pericytes under stress conditions such as diabetes and ischemia. Understanding the significance of retinal pericytes in proliferative retinopathies is essential, particularly because of the often-contradictory findings reported regarding their role in these conditions. This review will not only explore the role of retinal pericytes and their interactions with retinal endothelial cells in physiological vascularization but also highlight its importance in the pathogenesis of retinopathy of prematurity, diabetic retinopathy, age-related macular degeneration, and retinal vein occlusion. A deeper comprehension of pericyte-endothelial interactions in proliferative retinopathies would aid in diagnosis and the formulation of viable therapeutics to avert vision loss associated with these proliferative retinopathies.

Retinal vein occlusion (RVO) is one of a leading cause of blindness with complex etiology. This study aims to investigate the relationship between blood heavy metal concentrations and RVO, and explored transcriptomic effects of lead on endothelial cells.

Purpose: To report a case of POEMS syndrome presenting with unilateral optic disc edema and unexpectedly low systemic vascular endothelial growth factor (VEGF) levels in the setting of contralateral intravitreal (IVT) anti-VEGF therapy. Methods: A single case was reviewed. Results: A 65-year-old man with branch retinal vein occlusion in the right eye receiving IVT anti-VEGF injections presented with optic disc edema in the left eye. Systemic symptoms included skin hyperpigmentation; shortness of breath; and peripheral neuropathy characterized by numbness, tingling, swelling, and weakness of his extremities. Imaging demonstrated pachymeningeal enhancement, mixed sclerotic and lytic bone lesions, lymphadenopathy, and splenomegaly. Laboratory evaluation workup revealed a monoclonal gammopathy, and lymph node biopsy findings were consistent with the plasma cell variant of Castleman disease, supporting a diagnosis of POEMS syndrome. Notably, systemic VEGF levels were unexpectedly low (8.7 pg/mL, normal <96.2 pg/mL), likely secondary to the IVT anti-VEGF injection. Conclusions: This case highlights an atypical presentation of POEMS syndrome with unilateral disc edema and suppressed systemic VEGF levels, potentially confounded by contralateral IVT anti-VEGF treatment. Awareness of this interaction is important for accurate interpretation of VEGF levels and timely diagnosis.

Purpose: To evaluate whether vitamin B12 deficiency with elevated homocysteine is associated with increased risk of retinal vein occlusion (RVO). Methods: A retrospective cohort study was conducted using the TriNetX US Collaborative Network (August 2005-August 2025). Adults (≥18 years) with vitamin B12 deficiency (International Classification of Diseases, Tenth Revision code D51.0-D51.9) and hyperhomocysteinemia (>15.00 µmol/L) were matched in a 1:1 ratio to controls without B12 deficiency and with homocysteine status unrestricted, using propensity scores for age, sex, race, ethnicity, body mass index, hypertension, diabetes, ischemic heart disease, and nicotine dependence. Patients with pre-index RVO were excluded. The primary outcome was incident RVO (central or branch) over 10 years, analyzed with risk ratios, odds ratios, hazard ratios, and Kaplan-Meier cumulative incidence curves. Results: After matching and exclusion of patients with prior RVO, 10 161 individuals were included (5070 with B12 deficiency and hyperhomocysteinemia, 5091 controls). The cohorts were well-balanced across demographics and comorbidities. Incident RVO occurred in 32 patients (0.63%) with B12 deficiency and hyperhomocysteinemia compared with 15 patients (0.29%) among the control group, corresponding to a statistically significant increased risk (risk ratio, 2.142 [95% CI, 1.162-3.951]; odds ratio, 2.149 [95% CI, 1.163-3.974]; both P = .012). Kaplan-Meier curves demonstrated a higher cumulative incidence of RVO in the B12 deficiency and hyperhomocysteinemia cohort (log-rank χ[2] = 7.551, P = .006; hazard ratio, 2.306 [95% CI, 1.249-4.260]). Conclusions: Vitamin B12 deficiency with hyperhomocysteinemia was associated with an increased RVO risk. These findings highlight a modifiable risk factor, and prospective studies are needed to assess causality and evaluate whether correction of vitamin B12 deficiency or hyperhomocysteinemia reduces RVO risk.

Background: Retinal vascular diseases, including neovascular age-related macular degeneration (nAMD), diabetic macular edema (DME), retinal vein occlusion (RVO), and myopic choroidal neovascularization (mCNV), often require repeated intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy. Although ranibizumab is well established, long-term affordability remains challenging. Objective: To compare the functional, anatomical, treatment-burden, and safety outcomes of biosimilar ranibizumab (Ranieyes) and innovator ranibizumab (Lucentis/Accentrix) in routine clinical practice. Methods: This multicenter retrospective comparative study included 4997 eyes from 3577 patients treated across five tertiary eye-care centers in India. The biosimilar group comprised 2543 eyes from 1812 patients (10,893 injections), and the innovator group comprised 2454 eyes from 1765 patients (10,136 injections). Eligible indications were nAMD, DME, BRVO, CRVO, mCNV, and an exploratory miscellaneous preoperative adjunct subgroup. BCVA (logMAR), central subfield thickness (CST; µm), injection burden, and ocular/systemic adverse events were assessed over 24 months. Results: Both groups showed early improvement in BCVA and CST across the major disease categories, followed by long-term stabilization. Between-group differences were generally small, not sustained over follow-up, and of limited clinical magnitude. Serious ocular and systemic adverse events were rare in both groups, and no new safety signal emerged. Conclusions: In this large real-world cohort, the biosimilar ranibizumab Ranieyes showed outcomes broadly comparable to innovator ranibizumab across the major retinal disease subgroups, although these findings should be interpreted as observational comparative evidence rather than formal proof of equivalence.

Background/Objectives: Retinal vein occlusion (RVO) commonly causes vision loss from macular edema (ME). OCT biomarkers (IRF, SRF, HRF, and ELM/EZ disruption) inform prognosis and treatment but are rarely quantified routinely due to time burden and interobserver variability. We aimed to validate a deep-learning algorithm for automated detection and quantification of key OCT biomarkers in RVO-ME versus expert assessment. Methods: In this retrospective single-center study, 93 eyes with RVO-ME imaged with spectral-domain OCT were analyzed. The AI quantified IRF/SRF volumes, ELM/EZ interruption, and HRF counts. Two masked expert clinicians provided reference evaluations. Performance and agreement were assessed using ROC AUC, Cohen's kappa, intraclass correlation coefficient (ICC), Pearson correlation, and Bland-Altman analysis. Image-quality metrics (foveal centration and retinal layer segmentation) were recorded. Results: The AI showed high diagnostic performance (AUC: SRF 0.969; ELM 0.871; EZ 0.958) and substantial-to-almost-perfect agreement (kappa: SRF 0.807; ELM 0.788; EZ 0.914). HRF quantification correlated strongly with experts (r = 0.89, p < 0.001), with very good agreement (ICC = 0.87) and minimal bias. Image-quality accuracy exceeded 98% for foveal centration and layer segmentation. Conclusions: This AI software enables reliable, rapid automated assessment of major OCT biomarkers in RVO-ME, supporting streamlined personalized management; prospective studies should confirm longitudinal monitoring and treatment-guidance value.