Idiopathic posterior uveitis (IPU) is a vision-threatening inflammatory condition affecting the posterior segment of the eye with poorly understood molecular mechanisms. This study aimed to identify the key molecular actors and functional pathways involved in IPU using protein-protein interaction (PPI) network analysis. In silico bioinformatics study using PPI network analysis to identify key molecular pathways in IPU. Sixteen proteins previously linked to IPU pathogenesis were identified in a comprehensive literature review. These seed proteins were used to query the STRING v12 database to retrieve high-confidence interactions (score ≥ 700). An expanded PPI network was built and analyzed using Python tools, including NetworkX and Louvain community detection algorithm. Topological metrics (degree, betweenness, and eigenvector centrality) were calculated to identify the hub and bottleneck proteins. Functional enrichment analysis was performed to assess the biological significance. The resulting PPI network consisted of 260 proteins and 281 interactions. The network exhibited a low density (0.008) but a high modularity (0.8426), which is consistent with typical biological networks. Key hub proteins included PDGFRB, ORM1, IL23A, and TIMP1. Proteins such as IL6, KITLG, and STAT4 emerged as critical bottlenecks based on betweenness centrality. Multimetric centrality analysis highlighted TIMP1, TIMP2, KITLG, and IL6 as potential master regulators. The findings highlight the inflammatory, structural, and neurotrophic pathways as key components of disease pathogenesis, suggesting novel molecular targets for future therapeutic investigations. PPI network analysis offers a robust framework for uncovering the disease mechanisms in complex ocular inflammatory conditions.

Hyperreflective choroidal foci (HCF) are a finding on optical coherence tomography that may serve as a biomarker in various retinal and choroidal pathologies. These discrete hyperreflective spots, identified in various layers of the choroid, have been linked to inflammatory, vascular, and degenerative conditions. This review examines the clinical significance, histopathological correlation, and implications of HCF in various diseases, including diabetic retinopathy, age-related macular degeneration, Stargardt disease, choroideremia, Vogt-Koyanagi-Harada disease (VKH), idiopathic posterior uveitis, retinitis pigmentosa, and central serous chorioretinopathy (CSR), as well as non-pathological states. Although further studies are required to validate the findings in each pathology described herein, HCF may be used as a background prognostic marker of disease progression and therapeutic response, albeit with caution.

A 29-year-old woman experienced long-term phthisis bulbi owing to previous refractory idiopathic posterior uveitis since childhood and eventually underwent evisceration. Histological examination revealed that the retina was intermingled with the unusual glial mass lesion, which contained spindle cells with the elongated fibrillary process and columnar cells surrounding the round lumen with pseudorosettes formation. Mitoses were rarely seen. The tumor cells expressed S100, glial fibrillary acidic protein, CD99, and vimentin, while Ki67 was not detected. The final diagnosis was intraocular retinal ependymoma. Intraocular ependymoma was extremely rare and lacked comprehensive literature reviews. Our case is the very first example of retinal ependymoma in East Asia. Evisceration or enucleation followed by regular scrutinization is regarded sufficient for treating this condition.

The intraretinal hyperreflective line (IHL) is a novel posterior segment finding demonstrable using careful optical coherence tomography (OCT) examination. It likely indicates a reaction against photoreceptor, Muller cell, and/or retinal pigment epithelial damage. This study analyzed the spectral-domain OCT characteristics of IHLs to disclose their presence in various retinal conditions. A retrospective review of the charted and imaging records of participants with IHL was conducted at Dokuz Eylul University Department of Ophthalmology between January 2019 and August 2023. The inclusion criterion was the detection of an IHL on good-quality B-scan spectral-domain OCT. An IHL was defined as a vertical line extending from the ellipsoid zone band (or lower) through the outer nuclear layer to the internal limiting membrane in the central fovea. Associated retinal conditions were recorded as potential causative factors for the presence of IHL. IHL was observed on spectral-domain OCT in 40 eyes of 38 participants with several retinal diseases assessment. Fourteen eyes (35%) underwent vitreoretinal surgery pre-IHL detection (12 were operated for full-thickness macular hole [FTMH], one for epiretinal membrane [ERM], and one for rhegmatogenous retinal detachment). In six eyes (15%) a microhole coexisted. Four eyes (10%) had a concurrent lamellar macular hole. The IHL preceded the occurrence of FTMH in three eyes (7.5%), and diabetic macular edema and type 2 idiopathic macular telangiectasia (MacTel-2) were present in three eyes (7.5%) each. The remaining conditions included vitreomacular traction (VMT), nonarteritic anterior ischemic optic neuropathy with central retinal artery occlusion, commotio retinae, exudative age-related macular degeneration, ERM, non-infectious idiopathic posterior uveitis, and Coats' disease, each affecting one eye (2.5%). Of the two participants with bilateral involvement, one was diagnosed with MacTel-2 and the other had IHL with VMT in the right eye that was detected post-vitreoretinal surgery for FTMH in the left eye. Although IHLs are mostly identified in eyes with vitreomacular surface diseases, clinicians may encounter IHLs in other types of retinal pathology. Further large-scale, multicenter, long-term studies on the presence of IHLs in OCT imaging are required to provide more substantial insight on this biomarker.

To compare distinctive features of hyperreflective particles observed on spectral-domain optical coherence tomography (OCT) sections in eyes with acute toxoplasma chorioretinitis (TC) and non-infectious uveitis (NIU). Medical records and the spectral-domain OCT images of the patients with TC and NIU were retrospectively reviewed. The TC and NIU groups were compared in terms of age, sex, mean OCT image quality, mean central macular thickness (CMT), presence of intraretinal fluid (IRF), presence of subretinal fluid (SRF), number of hyperreflective particles in the posterior vitreous area and mean particle measurement in the posterior vitreous area. Non-infectious uveitis group included nine patients (60 %) with Behcet's uveitis, five patients (33.3 %) with idiopathic posterior uveitis or panuveitis, and the remaining patient (6.7 %) with HLA-B27 associated uveitis. Comparison of the mean age, sex distribution, mean OCT image quality, mean CMT, presence of IRF, presence of SRF and the mean number of hyperreflective particles in the posterior vitreous area between the two groups showed no statistically significant differences (p = 0.085, p = 0.051, p = 0.748, p = 0.431, p = 0.109, p = 0.080 and p = 0.152, respectively). However, the mean length of the hyperreflective particles in the posterior vitreous area was 27.22 ± 8.60 μm in the TC group, and 21.91 ± 3.58 μm in the NIU group, with a significant difference between the two groups (p = 0.036). This pilot study aimed to assess the hyperreflective particles in the posterior vitreous area using spectral-domain OCT images and image processing software. Despite its limitations, such as the small sample size, limited understanding of the nature of hyperreflective particles, and the absence of differentiation between acute and chronic uveitis, our study points out the potential role of the measurement of the hyperreflective particle length located in the posterior vitreous in differentiating the acute infectious versus non-infectious uveitis as the hyperreflective particles tend to be larger in infectious cases.