Purpose: To analyze and describe the proteome of the vitreous humour in eyes with idiopathic macular holes. Methods: We performed mass spectrometry (MS)-based label-free quantitative analysis of the vitreous proteome of idiopathic macular hole (IMH) and control donor vitreous. Comparative quantification was performed using SCAFFOLD software which calculated fold changes of differential expression. Bioinformatics analysis was performed using DAVID and STRING software. Results: A total of 448 proteins were identified by LC-MS/MS in IMH and cadaveric eye vitreous samples, of which 199 proteins were common. IMH samples had 189 proteins that were unique and 60 proteins were present only in the control cadaveric vitreous. We found upregulation of several extracellular matrix (ECM) and cytoskeletal proteins, namely collagen alpha-1 (XVIII) chain, N-cadherin, EFEMP1/fibulin-3, basement membrane-specific heparan sulfate proteoglycan core protein, and target of Nesh-3. Several cytoskeleton proteins, namely tubulin, actin, and fibronectin levels, were significantly lower in IMH vitreous, probably reflecting increased ECM degradation. IMH vitreous also had a downregulation of unfolded protein response-mediated-mediated apoptosis proteins, possibly related to a state of increased cell survival and proliferation, along with a remodelling and aberrant production of ECM contents. Conclusion: The pathogenesis of macular holes may involve ECM remodelling, epithelial–mesenchymal transformation, downregulation of apoptosis, protein folding defects, and complement pathway. The vitreo-retinal milieu in macular holes contain molecules related to both ECM degradation and inhibition of the same, thereby maintaining a homeostasis.

Purpose. To study the clinicodemographic profile of dome-shaped maculopathy (DSM) eyes in the Indian population and characterization using spectral-domain optical coherence tomography (SD-OCT). Methods. This observational cross-sectional study included 25 eyes of 14 patients diagnosed with DSM. All eyes underwent SD-OCT for characterization of the dome profile and also to measure central macular thickness (CMT), subfoveal choroidal thickness (SFCT), and dome height (DH) and to detect the presence of subretinal fluid (SRF). Results. The mean age of patients was 48.36 ± 14.23 years (range, 28–65 years). Eleven patients had bilateral involvement. Mean axial length of all eyes was 24.25 ± 1.95 mm and mean spherical equivalent −4.23 ± 3.79 DS. Overall, 11/25 eyes (44%) had round domes, 9/25 eyes (36%) had horizontal domes, and 5/25 eyes (20%) had vertical domes, with a mean dome height at fovea of 500.54 ± 291.58 µm. Vertical domes had higher DH compared to horizontal or combined domes p = 0.02 . Six eyes (6/25, 24%) showed the presence of SRF; 60% of vertical domes had SRF, and 22.2% of horizontal domes had SRF. The eyes having SRF had significantly higher CMT p = 0.017 and DH p = 0.001 , especially in horizontal domes p = 0.023 . The eyes with thicker SFCT tended to have higher DH and poorer visual acuity. Conclusion. Indian DSM eyes may have relatively lesser amounts of myopia. Choroidal thickening may play a role in development of DSM and may also be related to development of subretinal fluid in such eyes.

A gentleman without signs of tumour recurrence until a year following surgery for adenoid cystic carcinoma (ACC) of the maxillary sinus, presented with binocular diplopia, defective vision in the right eye and numbness in the right forehead. Examination revealed a right Adie's pupil that concurred with positive infraorbital nerve margins on intraoperative frozen section, indicating a perineural tumour spread. Diplopia and Hess charting verified a combined right sixth nerve and partial third nerve palsy. Neuroimaging confirmed extension of residual tumour to the right cavernous sinus apart from buckling of the right optic nerve. We report a unique case of recurrent ACC of maxillary sinus with partial cavernous sinus syndrome and an acquired Adie's pupil consequent to intracranial extension and perineural spread.