Distinguishing the subtypes of wet age-related macular degeneration (AMD) is of paramount importance, as the course of the disease and the response to therapy among the subtypes may differ. With the development of certain imaging procedures and the possibility of multimodal imaging, the differen­tiation of wet AMD subtypes and the identification of pachychoroid neovasculopathy (PNV) have become easier. The aim of this article is to describe the subtypes of wet AMD and pachychoroid neovasculopathy using multimodal imaging, with special emphasis on OCT-based diagnostics as a tool with high diagnostic precision that is now more readily available in our country.

Myopia is one of the fastest-growing public health problems, affecting 2.6 billion people worldwide and potentially causing serious ophthalmic complications. Therefore, the prevention, early detection, and slowing of the progression of this refractive error are essential. It is crucial to develop effective interventions that can prevent or at least delay the onset and progression of myopia. Scientific knowledge about the causes of myopia, its genetic background, environmental factors, and the various treatment options – including methods for prevention, delayed onset, and slow progression – is rapidly expanding. However, many questions remain unresolved, making it difficult to establish a widely applicable management strategy. This rapid growth of knowledge creates particular challenges for ophthalmologists in everyday clinical practice and also requires the continuous evaluation and integration of new research findings into patient care. To support this, a myopia management algorithm has been developed, providing a comprehensive overview of the entire process of myopia management. Its aim is to offer practical guidance to professionals in designing effective, individualised strategies. The algorithm integrates the latest evidence and covers the full spectrum of currently available, evidence-based options, from primary prevention to interventions intended to slow progression.

Bacillary layer detachment (BALAD) in the retina is a recently identified phenomenon detectable by optical coherence tomography (OCT). It has been observed in a variety of pathological conditions, including inflammatory, vascular, and degenerative ophthalmic diseases. BALAD results from a splitting within the myoid zone of the retina. In recent years, an increasing number of studies have focused on the pathophysiology, clinical significance, and prognostic implications of BALAD, making it a prominent topic in contemporary ophthalmic research. In this article, we present the anatomical and pathophysiological background of BALAD, its diagnostic characteristics, and differential diagnostic considerations. Special emphasis is placed on its clinical presentation through examples of various ophthalmic diseases.

Introduction: We present a case of fundus abnormalities associated with Waldenström macroglobulinemia, a rare, malignant haematological disease discovered in the background of visual impairment caused by bilateral retinal vein occlusion.

Case report: A 63-year-old male patient with no prior ophthalmologic history presented to our institution with a sudden, bilateral, rapidly progressing vision loss that had started ten days earlier. The examination revealed visual acuity of finger counting in both eyes. Anterior segments appeared intact and unremarkable. Fundus examination showed blurred and oedematous optic disc margins, dilated and tortuous veins, and oedematous macula, as well as haemorrhages around the optic disc and throughout the fundus. Optical coherence tomography imaging demonstrated cystoid macular oedema and significant serous macular detachment in both eyes, along with thickening of the peripapillary nerve fibre layer. Systemic evaluation revealed pancytopenia, an increased erythrocyte sedimentation rate, and significantly elevated total protein and serum IgM levels. These findings raised suspicion of hyperviscosity syndrome. Bone marrow biopsy confirmed the diagnosis of Waldenström macroglobulinemia. As a result of systemic treatment, the patient's vision improved in both eyes, the retinal haemorrhages resolved, and the macular oedema decreased.

Conclusion: Early diagnosis of the disease and initiation of systemic treatment may reduce the extent of serous macular detachment, thus preventing the development of permanent visual impairment. Simultaneous bilateral retinal venous circulation disorders may alert the patient to a serious medical condition.

Congenital eyelid malposition is a condition characterised by the drooping of one or both eyelids. It can occur at birth or develop during the first year of life. This condition can lead to significant visual impairment, especially in children, as it can cause astigmatism on the one hand and deprivation amblyopia on the other. Treatment is initially conservative with the aim of avoiding potential amblyopia. Surgical therapies are aimed at resection / shortening to strengthen the eyelid levator muscle, aponeurosis reinsertion, aponeurosis advancement, levator plication if levator function is better than 4 mm, or at a connection with the frontal muscle if levator function is worse than 4 mm (frontalis suspension). This was previously performed indirectly using silicone, fascia lata or other non-biological materials. The frontal flap technique is a surgical procedure in which a direct connection is created between the frontal muscle and the eyelid without the use of foreign materials. The aim of this case series is to show the clinical investigations of patients with congenital ptosis and to present a new surgical treatment method called frontal eyelid surgery, which has recently become available in Hungary. The frontal flap technique appears to be permanent even one year after surgery. The advantage of this technique is that it promises very good results, excludes complications from foreign materials used and provides better chances for a successful treatment of deprivation amblyopia in ptosis.

In our report we discuss the case of our 23-year-old female patient, who presented at our clinic complaining of an intermittently appearing stagnant blur in the visual field of her left eye. Her examination revealed bilateral papilloedema with a distinct left predominance. Urgent neurological examination and, per the neurologist’s recommendation, cranial imaging (computed tomography – CT) were performed, which did not reveal any intracranial space-occupying lesions. The patient had been severely obese for several years by the time of presentation (BMI: 38.9) and took 200 mg of the antibiotic doxycycline daily for a 10-day period 7 days before she first noticed the described visual disturbance. The subsequent onset of complaints suggested drug-induced intracranial hypertension. She received 2×500 mg oral acetazolamide daily for 20 weeks, then 2×250 mg for a further 4 weeks – after initiation her visual complaints subsided within 1 week, her visual field monitored by standard automated perimetry normalised, and the level of papilloedema quantified by retinal imaging (optical coherence tomography – OCT) slowly and continually decreased and eventually completely ceased. Taking into account the patient’s age, sex, obesity and history, we can safely assume a predisposition for the development of intracranial hypertension with doxycycline as its trigger. To our knowledge, no other case of intracranial hypertension induced by tetracycline antibiotics has been described before in the Hungarian ophthalmic literature.