The vitreous body makes up about 80% of the volume of the eye. It is a transparent gel-like substance, which consists mostly of water, collagen, and hyaluronic acid. We have a relatively extensive body of knowledge about the vitreous itself, but the anterior vitreous membrane and the vitreolenticular interface are less researched parts of the vitreous. In order to understand and see the role of this distinguished area in its context, it is worth reviewing the development, anatomy, and physiological significance of the vitreous body as a whole. All the changes occurring during the four overlapping stages of vitreous embryology also affect the final structure of the anterior vitreous. The Berger’s space represents the virtual space between the posterior surface of the lens and the anterior vitreous membrane. The hyalocapsular ligament (also known as Wieger's ligament) attaches the vitreous to the posterior lens capsule, forming a ring of 8-9 mm in diameter, 1 mm apart from the lens edge. Like the rest of the vitreous, the anterior vitreous is primarily important as an optical refractive medium, but there is increasing evidence that the vitreolenticular interface also plays a significant role in accommodation. There are specific congenital or acquired diseases of the anterior vitreous and the vitreolenticular interface. Phacoemulsification affects the state of the Berger’s space significantly; therefore, the use of gentle surgical techniques is important not only for endothelial protection and preservation of the zonula, but also for preserving the integrity of the vitreolenticular interface.

Introduction: Approximately 5% of the uveitis population is younger than 16 years old. The special challenges in the treatment of uveitis in children are a major concern today. They may be at special risk of complications because the inflammation is frequently chronic, and the diagnosis is often delayed because of the absence of noticeable signs and symptoms and the failure to report changes in vision in children. The systemic treatment with corticosteroids for non-infectious uveitis in childhood has an impact on the immature immune system and the developing bones. When a higher posterior effect is necessary, periocular corticosteroids can be administered. We retrospectively studied the data of children with uveitis treated with sub-Tenon triamcinolone acetonide at the Department of Ophthalmology of Szeged.
Patients and methods: We treated 46 uveitic children at the Department of Ophthalmology between 2017 and 2021. There were 23 girls and 23 boys; the mean age at the time of the diagnosis of uveitis was eleven years. Their first ophthalmological examinations included visual acuity, intraocular pressure (IOP), exams with a slit lamp, optical coherence tomography and funduscopy.
Results: We studied the data of five patients treated with sub-Tenon triamcinolone acetonide. All of the patients had intermediate and posterior uveitis, and they received three injections 3 weeks apart. Their vision improved after the prompt treatment, and the cystoid macular oedema also had resolved. To enhance their status of minimal uveitic symptoms, they were started on methotrexate therapy.
Conclusions: Juvenile uveitis can cause several complications, and decrease visual acuity. Treating these children could be adventurous. The best route and dose are determined for each patient individually, but only the minimum amount needed to control inflammation should be used to reduce complications. The sub-Tenon approach works to deposit a long-lasting steroid around the eye, and the side effects are fewer than in systematic treatment.

Purpose: To investigate the relationship between best-corrected visual acuity (BCVA) and central retinal thickness (CRT) in eyes receiving anti-vascular endothelial growth factor (VEGF) for exudative age-related macular degeneration (AMD).
Methods: In our retrospective case series study, we compared the CRT values of the spectral-domain optical coherence tomography (SD-OCT) images of 37 eyes of 37 patients treated with exudative AMD with the BCVA values examined at the same time. We compared CRT and BCVA values measured before anti-VEGF (aflibercept) treatment and in the twelfth month of treatment. The relationship between the changes in the two parameters during the treatment was analysed using Pearson correlation.
Results: The average CRT decreased from 467.8 (±20.3) µm measured before the start of treatment to 321.4 (±11.3) µm by the 12th month. Compared to baseline, the mean value of BCVA increased from 56.8 (±1.7) to 63.8 (±2.2) letters at 12 months. At the beginning of the study, we measured a low correlation between BCVA and CRT values (r=–0.379). After 12 months of treatment, there was no detectable correlation between CRT and BCVA (r=–0.082), and in the 12th month no correlation was found between the changes of BCVA and CRT compared to the baseline value (r= 0.307).
Conclusion: The low correlation between CRT and BCVA measured at baseline was not detectable in the 12th month of treatment and the change between the two time points suggest that the progression of visual acuity is a combination of more complex processes. In line with clinical experience, visual function is not solely determined by changes in CRT.

Purpose: The purpose of extended-depth-of-focus (EDoF) intraocular lenses is to provide excellent distance and intermediate vision and good functional vision, but not necessarily perfect near visual acuity, so full spectacle independence is often not possible. However, after implantation of Medicontur ELON lenses, near vision is often better than expected. Our aim was to analyse which preoperative and postoperative parameters are associated with the near visual performance achieved with EDoF lenses.
Patients and Methods: Before the surgeries, standard biometric data, higher order corneal aberrations (HOA) and angle kappa were measured with a Topcon Aladdin device. At least 4 weeks after surgery, we recorded subjective and objective refractive errors, visual acuity, including 40-45 cm near monocular visual acuity, the repeated biometric data and photopic and mesopic pupil diameter. Multivariate regression analysis was used to investigate whether there was any parameter measured pre- or postoperatively that was associated with postoperative near visual acuity.
Results: Data from 143 eyes of 73 patients were analysed, with patient age ranging from 42.3 to 81.2 years and axial length from 20.88 to 26.35 mm. The mean of the near uncorrected visual acuity was 0.23 logMAR (SD: 0.12, range: 0.0–0.59). Multivariate regression models showed a significant correlation between axial length, anterior chamber depth, keratometric readings, postoperative pupil size and near visual acuity. No significant correlations were found with other parameters (e.g., planned postoperative refraction, HOA, angle cappa, corneal astigmatism, age).
Conclusion: The often better than expected near visual acuity achieved with the ELON intraocular lens may be due to specific anatomical factors in addition to better neuroadaptation, higher patient motivation and higher tolerance to defocus. Although these measurable factors are beyond our control, their observation may be useful in preoperative assessments, patient information and prediction of expected outcomes.

Introduction: Lens tilt, along with other optical aberrations, induces astigmatism. According to literature, there is a correlation between the tilt of the natural lens and that of the implanted intraocular lens (IOL). This raises the possibility of considering preoperative lens tilt in the calculation of toric IOLs. Although the anterior segment imaging device available to us (Anterion®, Heidelberg Engineering) provides accurate images of the spatial arrangement of the anterior segment and the lens, it does not measure lens tilt, so we developed a computer program to calculate it.
Objective: Our goal was to create a computer program capable of determining lens tilt.
Method: Using the “Metrics” app on the Anterion® anterior segment biometer, we recorded and then exported the six radial OCT images taken with a 30° angular separation under dilated pupil conditions. A Python script written by us determined the tilt of the lens plane in each image and calculated the lens tilt and its direction from these data. Lens tilt direction was defined as the vector of the foremost part of the lens. Nasal direction was considered as 0o, the upward deviations with positive, the downward ones with negative notations, respectively.
Results: The difference in lens tilt between two consecutive measurements on the same eye was 0.22±0.12°, 0.01°, and 0.54° for phakic eyes, and 0.27±0.15°, 0.06°, and 0.48° (mean±SD, min., max.) for eyes with intraocular lenses. The differences in the direction of tilt were 6.55±8.42°, and 0.25°, 33.50° for natural lenses, and 5.10±4.61°, 1.00°, and 14.75° for IOLs. The direction of lens tilt was typically along an axis close to vertical, with the nasal part tilted forward, and the magnitude of tilt was measured as 4.97±1.78°, 0.96°, and 8.25° for phakic eyes and 5.10±1.24°, 2.83°, and 6.68° for eyes with IOLs.
Conclusion: The computer program we developed determines lens tilt, reproducibly. The anterior segment analysis performed in this way, including lens tilt calculation, can provide an additional parameter for lens design. Although the astigmatism induced by lens tilt is minimal in the majority of cases, taking it into account may contribute to the success of toric IOL calculations.

Alport syndrome is the hereditary disorder of type IV collagen of the basal membrane, characterized by progressive renal impairment, sensorineural hearing loss, cornea, lens, and retina disorders. Frequent manifestations in the eye are recurrent cornea erosion, anterior lenticonus, central and peripheral dot and fleck retinopathy.
Case Presentation: A 38-years-old male patient visited our clinic due to blurred vision for 2 months. He had previously undergone renal transplantation as a consequence of chronic glomerulonephritis and suffered from hypertension. Upon ophthalmic examination, besides the normal anterior segment, no lenticonus was discovered; the mid-peripheral retina did not show signs of dot and fleck retinopathy; however, we found pigment irregularities in the macula. A macula OCT scan was performed, which revealed macular atrophy. Fluorescein angiography showed perimacular and macular hyperfluorescent dots, without leakage. Later the patient visited an otorhinolaryngology clinic due to bilateral tinnitus and hearing impairment; the performed examinations proved bilateral sensorineural hearing loss
Conclusion: Along with the frequently seen corneal erosions, anterior lenticonus, and dot and fleck retinopathy, macular atrophy can occur as a rare ocular manifestation in Alport syndrome. Awareness about this condition is crucial in predicting the prognosis of the vision.

Introduction: To date, the differential diagnosis of intraocular tumours, and within that of the ciliary body, is still difficult, as the tumour is located behind the sclera and causes symptoms late.
Case report: We present the case of a 22-year-old woman who visited our clinic with complaints of blurred vision in her right eye for four months. Slit-lamp and ultrasound examinations revealed a pigmented, oval-shaped mass originating from the ciliary body, leading to a presumptive diagnosis of uveal malignant melanoma, for which enucleation was performed. Histopathological and immunohistochemical analysis of the enucleated eye confirmed the diagnosis of epithelioid leiomyoma.
Conclusion: Histopathology and immunohistochemical examination are essentials for the differential diagnosis of intraocular leiomyoma and malignant melanoma, as the clinical presentation and ultrasound findings may show significant similarities. This case highlights that in the presence of a large leiomyoma of the ciliary body, clinical differentiation may not be possible without enucleation.

The surgical management of glaucoma is currently undergoing significant advancements, driven by the increasing prevalence of glaucoma and the continuous pursuit of surgical techniques that minimise patient burden. Furthermore, the growing demand for an improved quality of life among patients plays an increasingly critical role in the evolution of treatment modalities and surgical interventions. The objective of minimally invasive glaucoma surgery (MIGS) is to achieve sustained and effective intraocular pressure (IOP) reduction while preserving ocular anatomy and minimising tissue disruption. This can be accomplished at the level of the trabecular meshwork, Schlemm’s canal, or the suprachoroidal space through the implementation of aqueous humour drainage implants or surgical techniques. Recently, novel implants have been introduced that facilitate aqueous outflow toward the subconjunctival space, similar to trabeculectomy, but with greater efficiency and a lower rate of surgical complications. In addition to monotherapy with topical hypotensive agents, selective laser trabeculoplasty (SLT) has been incorporated into international guidelines as a first-line treatment for primary open-angle glaucoma (POAG). Moreover, clinical studies investigating excimer and femtosecond laser trabeculotomy have demonstrated promising outcomes. Cyclodestructive laser procedures, historically reserved for refractory glaucoma, have significantly improved in safety and efficacy due to optimised energy delivery, enhanced intraoperative visualisation, and precise dosing, resulting in more predictable therapeutic outcomes.

Pregnancy causes several changes in the pregnant woman's body, which can cause both mild and severe ophthalmological symptoms. Some of the symptoms may be considered physiological as they are caused by hormonal changes and are mostly reversible after delivery, others may be caused by pathological ocular changes which may be related to pre-existing ocular conditions such as diabetic retinopathy, glaucoma, refractive errors. There are also new ocular abnormalities which may compromise vision or even predict a life-threatening condition. This manuscript describes also these most important pathologies causing serious ocular abnormalities. The need for cooperation between ophthalmologists, obstetricians-gynecologists, neurologists and diagnostic imaging specialists should be emphasized to ensure that both maternal and fetal long-term health problems are avoided.

Purpose: to create a register with the data of the Hungarian cataract procedure for the year of 2024.
Methods: A questionnaire with 14+1 questions was sent to Hungarian institutions which are dealing with ophthalmic surgeries (cataract and refractive surgeries), 61 answered.
Results: Cataract operations were performed by 319 specialist and 44 residents in 2024. During this period 71,569 cataract surgeries were reported. Today more then 90% of cataract procedures are performed in a one-day surgery basis both in hospitals and one-day ophthalmic surgery centers. In 2024, the number of surgeries were in 4 institutions above 3,000, in 5 other institutions it was between 2,500–3,000 and in 16 cases between 100-500 and in none of the institutions was it below 100. The penetrance of the drop anesthesia is almost 100%, retrobulbar (4.5%) and peribulbar anaesthesia (1.08%) is still used unfrequently, general anaesthesia was available in 0.84% of the cases. The mode of incision is corneal wound in 99.21% in all institutions, in limited cases limbal incisions (0.59%) may be used if necessary and in 5 institutions other wound structure was created. The mode of nucleus removal was phacoemulsification in 98.73%, in 0.2% it was extracapsular cataract extraction (ECCE) and suction. The cortex was removed in 3.0% by bimanual technique and in most of the cases with one-handed I/A device. In 1.4% femtolaser assisted cataract procedure (FLACS) were performed. In 99.17% of the cases, surgeons used foldabel intraocular lenses and in 0.48% PMMA lenses. Silicon lenses were not reported at all. In 30.6% of the lens material was hyrdophilic and in 68.23% hydrophobic. In 12.73% toric intraocular lenses were implanted, in 2.82% multifocal lenses were used and in 1.14% multifocal-toric lenses were chosen. In 3.24% EDOF lenses were preferred in 2024. Intracameral cefuroxim were administered in all institutes at the end of the surgery, subconjunctival antibiotics was applied in 1.0%, into the conjunctival sac in 23%, subconjunctivally below 3.0%. During the preoperative period topical antibiotics is used in 14 institutions. Postoperatively in 90.0% only modern fluorokinolons, in 4.0% fluorokinolons/or aminoglykozids and in 4.0% only aminoglycosids were prescribed for 12 days on average. The ratio of tobramycion use decreased further. The surgical treatment of presbyopia is performed rather with multifocal lenses instead of other corneal procedures. The average hospital stay decreased to 4.5 hours in 2024, the average waiting time was 82 days (5 days more compared to 2023) and in 25 institutions there was a possibility for paying cataract procedures. According to the data in 3.8% the patients (2,818 catarat procedures) covered the expenses of the cataract operations, which is a slight increaqse compared to 2023. At the end of 2023, waiting list comprised of 11.675 patients, which means 227 patients on averagy in each institutions. The number of refractive procedures were around 9,000 in 2024, and 2 types of refractive procedures were performed, namely surface (PRK) and incisional (femto-LASIK). SMILE method (130) was also available in Hungary in 2024. LASEK, epi-LASIK were not performed in 2024. In case of surface refractive procedures in 94.0% of the cases Mitomycin-C was applied, and in 95.0% of the cases wavefront technology was used during reatemtn planning. The number of phototherapeutic keratectomies (PTK) is similar during the past years, the number of crosslinking (CXL) slightly increased. In the treatment of presbyopia Laser Blended Vision (LBV) technique was used in Hungary, Supracor treatment was not applied.
Conclusions: The COVID-19 pandemia decreased the number of cataract surgeries approximately by 30% in Hungary between 2020–2022. In 2024 surgical numbers increased, on the other hand the yearly number is still lower than in 2019. The implantation of multifocal lenses decreased, however the implantation of EDOF lenses increased. In order to keep the human resource, the achievement based financing should be introduced in the hospitals in order to motivate personal.