Eye & ENT Research最新文献

{"title":"Human Metapneumovirus and Its Association With Otorhinolaryngological Manifestations: A Systematic Review With Descriptive Synthesis","authors":"Ali Gohar,&nbsp;Muhammad Husnain Ahmad,&nbsp;Hamza Zaheer,&nbsp;Fizza Inam,&nbsp;Moeez Ahmad Saeed,&nbsp;Nimra Mehmood,&nbsp;Abdul Rehman Shahid Khan,&nbsp;Alishbah Saeed,&nbsp;Hanzala Zahid,&nbsp;Yashika Gupta,&nbsp;Muhammad Bilal Akram,&nbsp;Habban Ghani,&nbsp;Muhammad Ahmad Farooq","doi":"10.1002/eer3.70044","DOIUrl":"https://doi.org/10.1002/eer3.70044","url":null,"abstract":"<p>Human metapneumovirus (HMPV) is a respiratory virus that predominantly affects the pediatric population. Its role as an infective agent in ear, nose, and throat (ENT) diseases is not yet well understood. To systematically review the available literature on the association between HMPV and ENT manifestations, following PRISMA guidelines, a detailed search was conducted on PubMed/Medline from January 1, 2000 to May 25, 2025. Studies reporting ENT conditions associated with laboratory confirmed HMPV infection were included. Data were synthesized descriptively due to heterogeneity in study designs, populations, diagnostic methods, and reported outcomes, which precluded formal meta-analysis. Twelve studies were included in the final analysis out of 1345 initially identified records. All percentages represent study-level proportions unless otherwise specified. Quality assessment was performed using the Joanna Briggs Institute checklist and Newcastle-Ottawa Scale. Twelve studies including a total of 2302 patients were identified, the majority of whom were pediatric (88.3%). The USA contributed half of the studies. Acute otitis media was reported in 50.0% of included studies, followed by upper respiratory tract infections in 25.0%. The most frequently used test to confirm infection was RT-PCR (41.67% of studies). Antibiotic use was reported in all included studies (100.0% of studies), regardless of confirmed bacterial infection. Outcomes were inconsistently reported with 33.3% of studies lacking follow-up data. This systematic review highlights a possible association between HMPV and ENT manifestations; however, due to limited and heterogeneous evidence, no causal relationship can be established, and further well-designed studies are required.</p>","PeriodicalId":100519,"journal":{"name":"Eye & ENT Research","volume":"3 3","pages":"111-117"},"PeriodicalIF":0.0,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/eer3.70044","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Review of Artificial Intelligence in Ophthalmology: Key Aspects, Challenges, and Future Directions","authors":"Partha Pratim Ray","doi":"10.1002/eer3.70049","DOIUrl":"https://doi.org/10.1002/eer3.70049","url":null,"abstract":"<p>Artificial intelligence (AI) is increasingly reshaping ophthalmology because the specialty depends heavily on structured imaging, quantitative measurements, and repeatable diagnostic workflows. This review provides a clinically grounded and translationally oriented synthesis of AI in ophthalmology, covering methodological foundations, ophthalmic imaging modalities, public datasets, disease-specific applications, evaluation metrics, deployment barriers, and future directions. Unlike reviews that mainly summarize algorithmic performance by disease category or model type, this article organizes ophthalmic AI through an integrated framework that emphasizes clinical use cases, evidence maturity, translational readiness, and real-world implementation requirements. The review examines applications across population screening, referral triage, disease grading, progression monitoring, prognosis, treatment guidance, workflow support, and automated reporting. Major disease domains include diabetic retinopathy, glaucoma, age-related macular degeneration, cataract, infectious keratitis, and keratoconus. Particular attention is given to the distinction between retrospective proof-of-concept studies, external validation, multicenter evaluation, prospective trials, and real-world deployment. The review also interprets evaluation metrics from a clinical perspective, highlighting the importance of threshold selection, sensitivity, specificity, false referral burden, missed disease, calibration, uncertainty, segmentation adequacy, robustness, and generalization. Key translational challenges include dataset bias, domain shift, interpretability, privacy, regulatory oversight, infrastructure constraints, workflow integration, and post-deployment monitoring. Emerging paradigms such as multimodal AI, foundation models, generative AI, and edge-based point-of-care systems are discussed cautiously, with emphasis on hallucination risk, clinical grounding, accountability, and the gap between benchmark performance and deployment readiness. Overall, the review argues that the next phase of ophthalmic AI should move beyond high accuracy values toward prospective validation, external generalization, clinician-centered design, calibrated uncertainty, and accountable integration into real-world eye-care pathways.</p>","PeriodicalId":100519,"journal":{"name":"Eye & ENT Research","volume":"3 3","pages":"125-154"},"PeriodicalIF":0.0,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/eer3.70049","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prone Positioning–Associated Anisocoria: A Diagnostic Pitfall in Critical Care","authors":"Saim Mahmood Khan,&nbsp;Zarnab Saleem,&nbsp;Mehwish Hayat,&nbsp;Anoosha Minhas,&nbsp;Aisha Tariq Khan,&nbsp;Surraiya Riaz Mahmood Khan","doi":"10.1002/eer3.70047","DOIUrl":"https://doi.org/10.1002/eer3.70047","url":null,"abstract":"&lt;p&gt;Prone positioning is used for managing severe respiratory failure, especially in patients with acute respiratory distress syndrome (ARDS), by enhancing ventilation-perfusion matching and air distribution. Despite its survival benefits, the position places patients at risk for rare but severe complications [&lt;span&gt;1&lt;/span&gt;]. Among these, the development of anisocoria (unequal pupil size) often raises immediate concern for neurological emergencies like intracranial hemorrhage, stroke, or uncal herniation.&lt;/p&gt;&lt;p&gt;However, emerging evidence suggests that anisocoria in the intensive care unit (ICU) may also arise from benign, transient mechanisms related specifically to prone positioning. The actual prevalence of this phenomenon remains undetermined, as pupillary changes may be underreported or obscured by positioning devices. Understanding these mechanisms is essential, as it helps clinicians recognize the transient nature of this condition and guides appropriate clinical decision-making.&lt;/p&gt;&lt;p&gt;In one reported case, a 74-year-old man with COVID-19–related ARDS developed unilateral pupillary dilation while sedated in the prone position. Baseline pupils were equal and reactive (3 mm each) before proning. Dilation of the left pupil to 6 mm developed approximately 18 h into the proning session. At this time, no focal neurological deficits were observed; brainstem reflexes remained intact, and motor response was appropriate for the sedation level (Glasgow Coma Scale [GCS] remained stable). No new motor or sensory deficits were identified, and brainstem reflexes (including pupillary and corneal reflexes) remained intact. Neuroimaging ruled out intracranial pathology, and ophthalmologic evaluation diagnosed subacute angle-closure glaucoma. This occurs because prone positioning causes a gravity-dependent anterior shift of the lens-iris diaphragm. In anatomically predisposed individuals, especially those with hyperopia (farsightedness) or a family history of glaucoma, the ocular anatomy favors anterior displacement of the lens-iris diaphragm during prone positioning. This movement precipitates the pupillary block, where aqueous humor is trapped in the posterior chamber of the eye, bowing the peripheral iris forward and obstructing the trabecular meshwork. This leads to an acute rise in intraocular pressure (IOP), which is further exacerbated by venous congestion and impaired orbital venous outflow commonly seen in prone positioning. Unlike positional causes, this mechanism required targeted glaucoma therapy, with resolution occurring over several days [&lt;span&gt;2&lt;/span&gt;]. No signs of stroke or brainstem involvement were noted, supporting a benign versus neurological emergency etiology.&lt;/p&gt;&lt;p&gt;In another case, a second ARDS patient developed miosis and ptosis features of Horner syndrome which resolved spontaneously upon returning the patient to a supine position [&lt;span&gt;3&lt;/span&gt;]. Baseline examination indicated symmetric 4 mm pupils. Miosis and 2 mm of ptosis in t","PeriodicalId":100519,"journal":{"name":"Eye & ENT Research","volume":"3 3","pages":"175-178"},"PeriodicalIF":0.0,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/eer3.70047","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low-Dose Atropine for Myopia Control in Children: A Comprehensive Review With Indian Evidence","authors":"Ragni Kumari","doi":"10.1002/eer3.70048","DOIUrl":"https://doi.org/10.1002/eer3.70048","url":null,"abstract":"<p>Myopia is an increasingly prevalent public health concern in India, particularly among school-aged children in urban and academically demanding environments. Early-onset myopia is associated with rapid progression and an increased lifetime risk of vision-threatening complications such as retinal detachment, myopic maculopathy, glaucoma, and early cataract. Low-dose atropine has emerged as an effective pharmacological intervention for controlling myopia progression; however, the applicability of global evidence to Indian pediatric populations requires careful evaluation. This structured narrative review synthesized evidence from randomized controlled trials, prospective studies, retrospective multicentric cohorts, and real-world clinical investigations evaluating low-dose atropine (≤ 0.05%) for myopia control in Indian children. Literature searches were conducted in PubMed, Scopus, Web of Science, Google Scholar, and the <i>Indian Journal of Ophthalmology</i> archive for studies published between January 2005 and October 2025. Study quality was assessed using Joanna Briggs Institute critical appraisal tools, and findings were synthesized narratively due to heterogeneity in study designs and outcome measures. Indian studies consistently demonstrate that 0.01% atropine reduces myopia progression by approximately 50%–65% with minimal adverse effects. Higher concentrations such as 0.05% atropine provide greater efficacy but are associated with slightly increased mild ocular side effects. These findings align with major international trials, including Atropine for the Treatment of Myopia (ATOM) and Low-Concentration Atropine for Myopia Progression (LAMP). Low-dose atropine, particularly 0.01%, is an effective and safe therapy for controlling myopia progression in Indian children and represents a practical strategy for national myopia-control programs.</p>","PeriodicalId":100519,"journal":{"name":"Eye & ENT Research","volume":"3 3","pages":"118-124"},"PeriodicalIF":0.0,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/eer3.70048","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148871936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Septal Release: A Targeted Surgical Strategy for Recurrent Epistaxis","authors":"Alexandra Welschmeyer,&nbsp;Daniel Karasik,&nbsp;Christopher L. Crafton,&nbsp;Eve Tranchito,&nbsp;Sarah Ridge,&nbsp;Cyrus C. Rabbani,&nbsp;Jay Shah","doi":"10.1002/eer3.70053","DOIUrl":"https://doi.org/10.1002/eer3.70053","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Recurrent epistaxis is a common pediatric condition that is typically managed with conservative therapies, but a subset of patients require surgical intervention after treatment failure. We seek to describe the efficacy of septal release for refractory pediatric epistaxis patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To compare outcomes of septal release for refractory epistaxis in pediatric patients with and without underlying bleeding disorders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A retrospective review was performed of 19 pediatric patients who underwent septal release for recurrent epistaxis from 2014 to 2024. We compared demographics, number of pre-operative epistaxis episodes, pre-operative treatments (ointments, nasal saline, chemical decongestants, chemical cauterizations), and post-operative annual epistaxis episodes among patients with and without bleeding disorders. Bleeding disorders included von Willebrand disease, thalassemia, platelet dysfunction, and dysfibrinogenemia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Five patients had bleeding disorders; 14 did not. There was a significantly lower rate of epistaxis post-septal release in patients without bleeding disorders (<i>p</i> = 0.016). Patients with bleeding disorders showed a decrease in episodes, though not statistically significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Septal release is an effective and safe treatment for refractory pediatric epistaxis, providing the most significant benefit to those without underlying coagulopathies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100519,"journal":{"name":"Eye & ENT Research","volume":"3 3","pages":"163-167"},"PeriodicalIF":0.0,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/eer3.70053","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"One-Year Results of Accelerated Transepithelial Corneal Cross-Linking for Progressive Keratoconus: A Prospective Interventional Study","authors":"Rafea Allawi Fayyadh,&nbsp;Omar Salim Mahmood,&nbsp;Aktham Badia Abdulelah,&nbsp;Husam Abu Dawood,&nbsp;Hashem Abu Serhan","doi":"10.1002/eer3.70054","DOIUrl":"https://doi.org/10.1002/eer3.70054","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Keratoconus is a progressive corneal ectatic disorder. Accelerated transepithelial corneal cross-linking (ATE-CXL) aims to halt progression while preserving the epithelium, but evidence on its 12-month efficacy requires further evaluation.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Purpose&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To evaluate the 12-month topographic, visual, biomechanical, and safety outcomes of ATE-CXL in eyes with progressive keratoconus.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Method&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This prospective interventional study included 126 eyes from 63 patients with documented progressive keratoconus. Both eyes of each patient were included when the eligibility criteria were met. Progression before treatment was defined as at least one of the following during the preceding 12 months: an increase in maximum keratometry (Kmax) of ≥ 1.0 diopter (D), a decrease in minimum corneal thickness of &gt; 10 μm, or a loss of more than two lines of corrected distance visual acuity (CDVA). All eyes underwent epithelium-on ATE-CXL using a two-step transepithelial riboflavin protocol followed by pulsed ultraviolet-A irradiation at 45 mW/cm&lt;sup&gt;2&lt;/sup&gt; for 320 s, delivering 7.2 J/cm&lt;sup&gt;2&lt;/sup&gt;. Outcomes included Kmax, flat keratometry (K1), steep keratometry (K2), uncorrected distance visual acuity (UDVA), CDVA, corneal hysteresis (CH), corneal resistance factor (CRF), central corneal thickness (CCT), progression, and adverse events. Outcomes were summarized descriptively using aggregate values.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Kmax decreased from 52.3 ± 1.8 D at baseline to 49.7 ± 1.5 D at 12 months. CDVA improved from 0.35 ± 0.10 logMAR to 0.20 ± 0.08 logMAR, and UDVA improved by 30.9% from baseline. CH increased from 8.4 ± 1.0 mmHg to 9.1 ± 1.2 mmHg, and CRF increased from 8.0 ± 1.1 mmHg to 8.8 ± 1.3 mmHg. Disease progression, defined as Kmax increase ≥ 1.0 D at 12 months, occurred in 8 of 126 eyes (6.3%). Accordingly, 118 of 126 eyes (93.7%) remained stable by the prespecified Kmax criterion. No severe adverse events were documented.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;ATE-CXL was associated with 12-month improvements in corneal topography, visual acuity, and ocular-response-analyzer biomechanical parameters in this prospective cohort of eyes with progressive keratoconus. These findings should be interpreted cautiously because the study lacked an epithelium-off or untreated control group, had only 12 months of follow-up, and inc","PeriodicalId":100519,"journal":{"name":"Eye & ENT Research","volume":"3 3","pages":"168-174"},"PeriodicalIF":0.0,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/eer3.70054","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148871960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Causal Association Between Lifestyle Behavior and Potential Risk Factors With Blepharoptosis","authors":"Shiqi Hui,&nbsp;Zhijia Hou,&nbsp;Dong-mei Li","doi":"10.1002/eer3.70046","DOIUrl":"https://doi.org/10.1002/eer3.70046","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Blepharoptosis is among the most common disorders of eyelid malposition that may influence appearance and damage visual function, and both of these can have negative effects on the quality of life. Various types of blepharoptosis have been reported, including neurogenic, traumatic, congenital, mechanical, psychogenic, and myogenic, while about 15%–25% remain uncertain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>To determine the targets for preventing blepharoptosis and its associated disease burden, we employed a two-sample Mendelian randomization approach to explore the causal relationships between reported potential risk factors and lifestyle behaviors and blepharoptosis. We chose genetic variants (<i>p</i> &lt; 5 × 10⁻⁸) related to prediabetic status, obesity parameters, smoking, alcohol and coffee consumption, hypertension, education level, physical activity, and sleep duration from European-descent genome-wide association studies. The genetic associations with blepharoptosis were derived from the FinnGen Study, included 1349 cases and 203,231 controls. Inverse-variance weighted was mainly used for statistical analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Genetically predicted leisure screen time (odds ratio per 1 standard deviation [95% confidence interval], 1.79 [1.23–2.60]) was associated with higher odds of blepharoptosis. There is indicative evidence that a higher body mass index (BMI) and current smoking are associated with higher blepharoptosis odds, whereas physical activity and smoking cessation are associated with lower blepharoptosis odds. No association with other genetically predicted factors was observed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The Mendelian randomization study identified current smoking status and BMI as causal risk factors, and smoking cessation as protective factor for blepharoptosis. This suggests that these modifiable risk factors are crucial targets for preventing blepharoptosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100519,"journal":{"name":"Eye & ENT Research","volume":"3 3","pages":"155-162"},"PeriodicalIF":0.0,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/eer3.70046","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ancient Schwannoma in the Nasal Cavity—A Rare Case Report With Brief Literature Review","authors":"Shikhar Chohan,&nbsp;Annmy Jose,&nbsp;Sufian Zaheer","doi":"10.1002/eer3.70051","DOIUrl":"https://doi.org/10.1002/eer3.70051","url":null,"abstract":"&lt;p&gt;Schwannomas, also known as neurilemmomas, are benign tumors, arising from any nerve covered by a Schwann cell sheath, which includes the cranial nerves (except for optic and olfactory), the spinal nerves, and autonomic nervous system [&lt;span&gt;1&lt;/span&gt;]. While schwannomas are relatively common tumors in the head and neck region, they are rare within the nasal cavity and paranasal sinuses, comprising only a small fraction of benign nasal masses [&lt;span&gt;1, 2&lt;/span&gt;]. Among the various subtypes of schwannomas, ancient schwannoma is an uncommon variant characterized by degenerative changes, including cystic alterations, nuclear atypia, hemorrhage, and hyalinization, which typically occur in longstanding tumors. These changes can complicate the diagnosis, as they may mimic more aggressive neoplasms on both imaging and histological examination [&lt;span&gt;1&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Ancient schwannoma was first described by Ackerman and Taylor in 1951 [&lt;span&gt;3&lt;/span&gt;], and has since been recognized as a unique subtype of schwannoma that demonstrates “ancient” or degenerative features [&lt;span&gt;4&lt;/span&gt;]. These alterations are thought to result from slow tumor growth, leading to areas of ischemia within the tumor, which then undergo degeneration over time. Due to these distinct histopathological features, distinguishing an ancient schwannoma from other benign or malignant nasal tumors requires careful analysis, particularly when the lesion presents with atypical radiological or histopathological features [&lt;span&gt;4&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Imaging studies, particularly computed tomography (CT) and magnetic resonance imaging (MRI), play an essential role in evaluating the extent and behavior of nasal schwannomas [&lt;span&gt;2&lt;/span&gt;]. On CT, nasal schwannomas may appear as well-defined, expansile masses with pressure effects on adjacent bony structures, including the nasal septum, ethmoid sinuses, and maxillary walls. MRI can further characterize these lesions by demonstrating the heterogeneous nature of the mass due to cystic or hemorrhagic changes, typical of ancient schwannoma. T1-weighted MRI images often show iso- or hypointense signals, while T2-weighted images reveal hyperintense areas corresponding to cystic degeneration, making MRI valuable for preoperative assessment and surgical planning [&lt;span&gt;2&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Given their rarity in the nasal cavity, ancient schwannomas can be misdiagnosed as other benign or malignant conditions, emphasizing the importance of a comprehensive diagnostic approach. This case report illustrates the presentation, diagnostic challenges, and successful management of a rare ancient schwannoma in the nasal cavity, underscoring the role of a multidisciplinary approach involving clinical evaluation, radiology, histopathology, and surgical excision in achieving optimal patient outcomes.&lt;/p&gt;&lt;p&gt;A 42-year-old female presented to the ENT outpatient department (OPD) with complaints of worsening left nasal obstruction and epistaxis over the last 9 months. Other as","PeriodicalId":100519,"journal":{"name":"Eye & ENT Research","volume":"3 3","pages":"179-185"},"PeriodicalIF":0.0,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/eer3.70051","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148871930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visualization of Extracellular Vesicles on the Ocular Surface: Coexistence of Ectosome and Exosome Budding in a Single Corneal Endothelial Cell","authors":"Yiming Wu,&nbsp;Minjie Zhang,&nbsp;Han Wu,&nbsp;Minqing Cai,&nbsp;Sijie Lin,&nbsp;Wei Li,&nbsp;Shangkun Ou","doi":"10.1002/eer3.70055","DOIUrl":"https://doi.org/10.1002/eer3.70055","url":null,"abstract":"&lt;p&gt;Dear Editors,&lt;/p&gt;&lt;p&gt;In a transmission electron microscopy (TEM) study of the cornea involving 30 C57BL/6J mice, we made a fortunate discovery: a high-resolution, two-dimensional ultrastructural image capturing both ectosomes (ECTs) and exosomes (EXOs) within corneal endothelial cells (CEnCs). ECTs and EXOs represent two distinct classes of extracellular vesicles (ECVs), each playing a crucial role in intercellular communication.&lt;/p&gt;&lt;p&gt;ECVs were first reported before the 1990s and are released by various mammalian cells under both normal and pathological conditions. Nearly 30 years later, two distinct ECV subtypes, ECTs and EXOs, were identified. Both carry bioactive molecules like proteins, nucleic acids, and lipids, and facilitate intercellular communication via body fluids, influencing target cells through signaling, receptor transfer, or cargo delivery. ECTs (100–500 nm) and EXOs (50–150 nm, with the upper limit varying slightly between publications) differ in size due to their unique biogenesis. ECTs form by outward budding directly from the plasma membrane via specialized microdomains. EXOs, in contrast, originate from inward budding within endocytic membranes, forming multivesicular bodies (MVBs) that release EXOs through exocytosis. Unlike EXOs, ECT release bypasses the exocytic pathway. Both vesicle types offer advantages such as targeted delivery, protection of internal contents, and efficient transport of hydrophobic molecules.&lt;/p&gt;&lt;p&gt;Despite the growing recognition of their importance, ultrastructural imaging for budding of ECTs and EXOs in ocular surface cells had not been reported. Using TEM, we observed for the first time the simultaneous budding of these two vesicle types in CEnCs. In Figure 1A, we present ECTs in the midst of their outward budding, while Figure 1B reveals EXOs during their inward budding phase, underscoring the transient coexistence of both vesicle types within the single cell.&lt;/p&gt;&lt;p&gt;In Figure 1A, the isolated ECV measures approximately 275 nm in diameter, which exceeds the typical size range of EXOs (up to 150 nm). Its outward budding from the plasma membrane further indicates that it is most likely an ECT. The adjacent membrane-like structure near the ECT suggests that the process of extracellular release is almost complete. A key characteristic distinguishing ECTs from EXOs is the potential accumulation of luminal proteins at high concentrations during ECT formation [&lt;span&gt;1&lt;/span&gt;]. These proteins can become concentrated through various mechanisms within the vesicles. When such protein-enriched, dense areas are visualized using TEM, the denser regions absorb or scatter more electrons as the electron beam interacts with the sample. As a result, these areas appear darker in the TEM images, providing a clear visual cue of their composition and density.&lt;/p&gt;&lt;p&gt;In Figure 1B, we observed three vesicles at various stages of budding within a multivesicular body. Two of these vesicles are small (diameters &lt; 150 nm)","PeriodicalId":100519,"journal":{"name":"Eye & ENT Research","volume":"3 3","pages":"186-189"},"PeriodicalIF":0.0,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/eer3.70055","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of Life in Myopia: Laser-Assisted In Situ Keratomileusis Versus Contact Lenses","authors":"Maisara Shehab,&nbsp;Ziad W. Elmezayen,&nbsp;Hashem Abu Serhan,&nbsp;Shawkat Shawkat,&nbsp;Shahd Mahmoud,&nbsp;Farah Afr,&nbsp;Marah Maysara Khayyal,&nbsp;Khaled Moghib,&nbsp;Mayar Hussam Rehan,&nbsp;Husam Abu Dawood,&nbsp;Albraa Ashraf Hamad","doi":"10.1002/eer3.70045","DOIUrl":"https://doi.org/10.1002/eer3.70045","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Laser-assisted in situ keratomileusis (LASIK) and contact lenses are commonly used to correct refractive errors, but their effects on quality of life, patient satisfaction, and dry eye disease remain variable. This study compares these outcomes between LASIK and contact lens users.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aims to bridge the knowledge gaps by evaluating the effects of LASIK versus contact lenses on vision-related quality of life, patient satisfaction, and dry eye disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Our protocol was registered prospectively on PROSPERO (CRD42025636623). A comprehensive literature search was conducted across four electronic databases (Web of Science, Scopus, PubMed, and the Cochrane Library) to find eligible articles. The primary outcome assessed was quality of life, while the secondary outcomes included the prevalence of dry eyes and patient satisfaction. A meta-analysis was conducted using R Statistical Software (version 2024.04.2 Build 764) and the “meta” package (version 7.0-0). The quality of the included studies was assessed using the Newcastle-Ottawa Scale.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 1806 initial records, four studies met the inclusion criteria, enrolling 2141 participants, and were included in our meta-analysis. Meta-analysis revealed moderate improvement in quality of life for LASIK users (standardized mean difference [SMD] = 0.45; <i>p</i> &lt; 0.0001), while patient satisfaction was notably higher in the LASIK group (88% vs. 54% for contact lenses). Complication rates were lower in LASIK patients (6.7% vs. 19.9% for contact lenses), although LASIK was associated with a higher incidence of acute dry eye disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This meta-analysis demonstrated that LASIK significantly enhances quality of life compared to contact lens use and yields markedly higher patient satisfaction. Moreover, LASIK was associated with lower overall complication rates, though it carried a greater risk of acute dry eye disease.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100519,"journal":{"name":"Eye & ENT Research","volume":"3 2","pages":"75-82"},"PeriodicalIF":0.0,"publicationDate":"2026-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/eer3.70045","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148324452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}