PurposeTo describe a patient with acute central retinal artery occlusion (CRAO) during vitrectomy surgery and the possible role of vitrectomy in acute CRAO management.ObservationsAn 84-year-old man presented with broad vitreomacular traction and epiretinal membrane in the right eye. Preoperative assessment clearly showed normal retinal vasculature. On starting vitrectomy, complete CRAO with marked segmentation of all retinal vessels was noted. Vitrectomy was performed in the usual manner and once the posterior hyaloid detached from the disc, immediate complete revascularization of the retinal vessels was noted. The patient had a complete visual recovery.Conclusions and importanceImmediate vitrectomy with induction of posterior vitreous detachment may have a role in selected cases of acute CRAO, particularly if performed within a short window.

Pregnancy may precipitate several physiological changes that can have ocular consequences; many of these are innocuous and require little more than reassurance for the patient. There are uncommon instances of new sight-threatening pathology that necessitate a prompt approach. Pregnant women presenting to the ophthalmologist with ocular symptoms can cause concern because alternative differentials may need to be considered; and the potential teratogenic or fetotoxic effects of investigations or treatment mean that management decisions may, in some cases, differ to those of the nonpregnant patient. Learning objectives To be aware of both physiological and pathological ocular changes that may occur during pregnancy. To develop a greater understanding of investigations and management of ophthalmic and neuro-ophthalmic disorders in pregnancy. To develop an understanding of referral pathways, enabling an optimal outcome for both mother and baby.

Purpose of reviewThe aging world population accounts for the increasing prevalence of neurodegenerative diseases such as Alzheimer's and Parkinson's which carry a significant health and economic burden. There is therefore a need for sensitive and specific noninvasive biomarkers for early diagnosis and monitoring. Advances in retinal and optic nerve multimodal imaging as well as the development of artificial intelligence deep learning systems (AI-DLS) have heralded a number of promising advances of which ophthalmologists are at the forefront.Recent findingsThe association among retinal vascular, nerve fiber layer, and macular findings in neurodegenerative disease is well established. In order to optimize the use of these ophthalmic parameters as biomarkers, validated AI-DLS are required to ensure clinical efficacy and reliability. Varied image acquisition methods and protocols as well as variability in neurogenerative disease diagnosis compromise the robustness of ground truths that are paramount to developing high-quality training datasets.SummaryIn order to produce effective AI-DLS for the diagnosis and monitoring of neurodegenerative disease, multicenter international collaboration is required to prospectively produce large inclusive datasets, acquired through standardized methods and protocols. With a uniform approach, the efficacy of resultant clinical applications will be maximized.

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