A middle-aged Hispanic woman presented for evaluation of an asymptomatic epiretinal membrane in the left eye. She had an ocular history of amblyopia in the left eye, a medical history significant for chronic neuropathy, ataxia, and myelopathy of unknown etiology, and nystagmus on examination. Genetic testing revealed variants in the SACS and SLC5A7 genes. What is your diagnosis?

ImportanceDiabetic retinopathy (DR) is the leading cause of blindness among adults in the US. The US Centers for Disease Control and Prevention recommends annual DR monitoring for all individuals with diabetes, yet monitoring rates remain below 70%.ObjectiveTo evaluate how patient preferences and expectations about DR monitoring are associated with expected monitoring adherence behaviors.Design, Setting

Importance Limited studies have assessed the long-term benefit/risk of gene therapy for Leber hereditary optic neuropathy (LHON). Objective To determine the safety and efficacy of lenadogene nolparvovec in patients with LHON due to the MT-ND4 gene variant for up to 5 years after administration. Design, Setting, and Participants The RESCUE and REVERSE Long-Term Follow-up Study (RESTORE), conducted from

This case report describes an outer retinal abnormality associated with taking a RET inhibitor during a clinical trial in a 52-year-old patient with right lung adenocarcinoma and a RET gene fusion.

ImportanceIn-office suprachoroidal viscopexy (SCVEXY) is a relatively new procedure for rhegmatogenous retinal detachment (RRD), but minimal information is available regarding outcomes and safety.ObjectiveTo report outcomes with in-office SCVEXY for primary acute RRD.Design, Setting, and ParticipantsThis retrospective case series was conducted at St Michael’s Hospital in Toronto, Ontario, Canada from

A 75-year-old woman with a history of essential thrombocythemia presented with 3 months of progressively enlarging right upper eyelid lesions. Examination revealed a thickened eyelid margin, madarosis, and erythema with some tenderness to palpation but an otherwise normal ocular examination. What would you do next?

ImportanceDiscrimination in the workforce is a barrier to achieving diversity, equity, and inclusion. A previous study of ophthalmologists in Australia and New Zealand reported high rates of discrimination, but little is known about discrimination among ophthalmologists in the US.ObjectiveTo describe the frequency, nature, and outcomes of discrimination experienced by US ophthalmologists and trainees

ImportanceEmpagliflozin might lower the risk of diabetic retinopathy (DR) by preventing retinal pericyte loss. However, the role of empagliflozin with respect to DR in patients with type 2 diabetes (T2D) remains unclear.ObjectiveTo compare the risk of incident nonproliferative DR (NPDR) and DR progression in patients with T2D initiating empagliflozin vs a dipeptidyl peptidase 4 inhibitor (DPP4i).Design

This case report describes a patient whose autopsy revealed that the posterior choroid of the right eye had a focal eosinophil-rich inflammatory infiltrate with a cross-section of a possible degenerating Strongyloides stercoralis larva and a coiled, incompletely sectioned, filariform larva in a medium-caliber choroidal artery.

ImportanceIndividuals with mild traumatic brain injury (TBI) often report vision problems despite having normal visual acuity and fundus examinations. Diagnostics are needed for these patients.ObjectiveTo determine if a battery of assessments or machine-learning approaches can aid in diagnosing visual dysfunction in patients with mild TBI.Design, Setting, and ParticipantsThis prospective, observational

ImportanceSome eyes with proliferative diabetic retinopathy (PDR) treated to stability with panretinal photocoagulation (PRP) continue to lose vision without diabetic macular edema. One presumed cause is macular capillary nonperfusion (CNP)–associated ischemia or infarction. Natural history data of macular CNP might guide treatment trials for it.ObjectiveTo assess visual function and optical coherence

A 63-year-old woman with a history of type 1 diabetes presents with gradually progressive vision loss in the right eye for the past year. What would you do next?

ImportanceEarly detection of glaucoma is essential to timely monitoring and treatment, and primary open-angle glaucoma risk can be assessed by measuring intraocular pressure (IOP) or optic nerve head vertical cup-disc ratio (VCDR). Polygenic risk scores (PRSs) could provide a link between genetic effects estimated from genome-wide association studies (GWASs) and clinical applications to provide estimates

This case report describes a diagnosis of iatrogenic fluorescein dosing error in a girl aged 10 months who presented for routine fluorescein angiography examination in the setting of incontinentia pigmenti.

Importance Primary open-angle glaucoma (POAG) polygenic risk scores (PRSs) continue to be evaluated in primarily European-ancestry populations despite higher prevalence and worse outcomes in African-ancestry populations. Objective To evaluate how established POAG PRSs perform in African-ancestry samples from the Genetics in Glaucoma Patients of African Descent (GIGA), Genetics of Glaucoma in Individuals

ImportanceLong-term variability of blood pressure may be associated with visual field (VF) progression in patients with glaucoma.ObjectivesTo investigate the association between blood pressure parameters and VF progression over time in patients with glaucoma.Design, Setting, and ParticipantsThis retrospective cohort study of longitudinal data included patients with suspected or confirmed glaucoma who

This case report describes an HIV-positive patient with bilateral syphilitic panuveitis, for whom diagnosis was initially delayed by negative treponemal testing.

A 20-year-old Chinese woman was experiencing fever, malaise, headache, nausea, vomiting, and neck stiffness for 2 weeks. Further examination revealed inflammation, vitritis and cystoid macular edema, tortuous dilatation of retinal venous vessels with fluorescence leakage, and hyperfluorescence in the optic disc. What would you do next?

A 46-year-old woman is referred for a second opinion with recent onset of suspected seizures and imbalance. Fundus examination revealed bilateral discrete perifoveal circular areas of atrophy. What would you do next?

ImportanceThe association of race and detection of pathogenic variants using wide-panel genetic testing for inherited retinal diseases (IRD), to our knowledge, has not been studied previously.ObjectiveTo investigate the genetic detection rates of wide-panel testing in Black and non-Hispanic White patients with IRDs.Design, Setting, ParticipantsThis 2-group comparison used retrospective patient data

ImportancePrimary open-angle glaucoma (POAG) is a heritable disease. A polygenic risk score (PRS) threshold may be used to identify individuals at low risk of disease onset.ObjectiveTo assess the utility of a POAG PRS to identify ocular hypertensive individuals at low risk of disease onset.Design, Setting, and ParticipantsThis is a post hoc analysis of the Ocular Hypertension Treatment Study (OHTS)

Importance This was the first study, to the authors' knowledge, to statistically evaluate the predictive accuracy of Collaborative Ocular Tuberculosis Study (COTS) calculator in guiding initiation of antitubercular therapy (ATT) in patients with clinically suspicious tubercular uveitis (TBU) in an international cohort. Objective To evaluate the accuracy of a score of 4 or greater on the online COTS

A 17-year-old male with an unremarkable medical history presented with 2 days of painless blurred vision in the right eye. Three weeks prior, he was admitted with fever, myalgias, hepatosplenomegaly, lymphadenopathy, and truncal rash. What would you do next?

ImportanceAge-related macular degeneration (AMD) is a highly prevalent and debilitating retinal condition that affects more than 200 million people globally, with the severe late-stage forms—neovascular AMD (nAMD) and geographic atrophy (GA)—affecting more than 11 million people globally. However, much is unknown about the economic burden of the disease.ObjectiveTo estimate the economic burden associated

This cohort study examines patient data from January 2019 to December 2023 to evaluate national trends in the use of artificial intelligence–based screenings to detect diabetic retinopathy among patients with types 1 or 2 diabetes.

ImportanceSince fibroblast growth factor receptor inhibitors (FGFRi) are used for treatment of intrahepatic cholangiocarcinoma (iCCA), understanding potential complications following longer-term use in clinical practice settings is warranted. This study describes cataract formation or progression as a complication of FGFRi use for the treatment of iCCA, even after treatment discontinuation.ObjectiveTo

ImportanceCurcuma-based nutritional supplements (CBNS) are natural anti-inflammatory and antioxidant agents that may confer benefits against age-related macular degeneration (AMD).ObjectiveTo examine the association between the use of CBNS and the risk of development or progression of AMD.Design, Setting, and ParticipantsThis was a retrospective cohort study with data collection in June of 2024. Data

Importance Prompt and accurate diagnosis of arteritic anterior ischemic optic neuropathy (AAION) from giant cell arteritis and other systemic vasculitis can contribute to preventing irreversible vision loss from these conditions. Its clinical distinction from nonarteritic anterior ischemic optic neuropathy (NAION) can be challenging, especially when systemic symptoms are lacking or laboratory markers

A 70-year-old male is referred for evaluation of a conjunctival mass in the right eye, which has grown slowly over 27 years. Examination reveals a superonasal, multilobulated, pigmented lesion with episcleral feeder vessels and spontaneous vascular pulsations within the intraocular component. What would you do next?

ImportanceGlaucoma is the leading cause of irreversible blindness worldwide and, in the US, disproportionately affects people from racial and ethnic minority groups. Glaucoma prevalence has not been estimated for the US in more than a decade, and state- and county-level estimates are not available.ObjectiveTo estimate glaucoma and vision-affecting glaucoma prevalence by demographic factors and US state

ImportanceEvidence is limited to support therapies to treat submacular hemorrhage (SMH) secondary to neovascular age-related macular degeneration (AMD) as an adjunct to anti–vascular endothelial growth factor therapy (anti-VEGF).ObjectiveTo determine if intravitreal tissue plasminogen activator (TPA) or gas improves visual acuity or promotes resolution of SMH secondary to neovascular AMD in eyes treated

This case report discusses a diagnosis of retinal cystoid abnormality and retinal detachment on ultra-widefield optical coherence tomography (OCT) in the setting of fluctuating visual loss in the right eye.

Importance Studies on the epidemiology of retinoblastoma (RB) could lead to improvement in management. Objective To estimate the incidence and survival of RB in European children and the occurrence of second primary tumors (other than RB) in these patients. Design, Setting, and Participants This cohort study used population-based data from 81 cancer registries in 31 European countries adhering to the

ImportanceRandomized clinical trials are conducted to establish both drug safety and efficacy. However, evidence of adverse events associated with these drugs in the clinical practice setting can be of value at generating hypotheses regarding less common safety issues, even if causality cannot be determined.ObjectiveTo present and analyze cases of intraocular inflammation associated with faricimab

This cohort study examines racial and ethnic differences in varieties of advanced retinal imaging received among patients with diabetes at a single tertiary care institution.

A child aged 4 years presented with a 3-day history of worsening redness, pain, and swelling over the left lower eyelid and nose. Visual acuity was normal, and systemic examination revealed cervical lymphadenopathy and hepatosplenomegaly. The patient showed no improvement after 3 days of intravenous ceftriaxone, and a computed tomography scan showed a collection in the lacrimal sac. What would you

This Viewpoint discusses the prevalence of youth-onset diabetes and the associated rates of diabetic retinopathy and addresses the need for surveillance of patients with youth-onset diabetes.

ImportanceThe incidence of retinopathy of prematurity (ROP) has been increasing in the US since 2003. Understanding the progression of and racial disparities in ROP incidence in California can provide a contrasting perspective that may guide future research and practice in the management and prevention of ROP.ObjectiveTo describe how the screening and incidence of ROP among very preterm infants in