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.