Ahmed A. Alessa

Background: Ocular symptoms and eye conditions are common among adults in Saudi Arabia, yet many affected individuals do not receive professional eye assessment or management. The factors associated with this gap in care remain unclear. We estimated the prevalence of unmet eye-care need among adults in Jeddah and identified associated factors. Methods: A cross-sectional study was conducted among adults aged 18 years or older residing in Jeddah between August and November 2025, using a self-administered Arabic-language questionnaire and convenience sampling. Eye care need was classified from ten ocular symptom items as fully met, partially met, fully unmet, or asymptomatic. The primary outcome was unmet need (fully or partially unmet), with analysis restricted to participants with a need for eye care. Associations were examined by bivariate testing and multivariable logistic regression. Reporting followed the Strengthening the Reporting of Observational Studies in Epidemiology. Results: Among 442 participants (median age 24.0 years, interquartile range 21.0–40.0; 58.6% male), 291 were identified as having an eye-care need. Of these, 181 (62.2%) had a partially or fully unmet need. The most frequently reported barriers were a busy schedule (47.1%), perceiving the eye problem as non-serious (47.1%), and perceiving vision changes as normal aging (40.0%). After adjustment, unmet need was independently associated with a family history of eye disease (aOR 1.99, 95% CI 1.17–3.41, p = 0.012) and a preference for home or traditional treatments (aOR 2.47, 95% CI 1.22–4.97, p = 0.012), and inversely associated with a previously diagnosed eye disorder (aOR 0.36, 95% CI 0.19–0.66, p = 0.001) and having been informed about the importance of regular eye examinations (aOR 0.50, 95% CI 0.29–0.86, p = 0.013). Neither cost (p = 0.762) nor health insurance (p = 0.498), nor any sociodemographic characteristic, differed between groups. Conclusion: Unmet need for eye care affected 62.2% of adults with an identified need. The associated factors were clinical, attitudinal, and informational rather than financial or sociodemographic, suggesting that strategies to improve utilization may need to address health beliefs and the perceived value of routine eye examination alongside measures aimed at convenience and affordability.

Objective: This review aimed to evaluate the existing literature to determine the incidence and associated risk factors of cochlear implant complications. Data Sources: A comprehensive literature search was conducted across PubMed, Web of Science, Embase, and Scopus up to 12 April 2025. Methods: The review protocol was registered on PROSPERO (ID: CRD420251012225) on 15 March 2025, and the systematic review was performed according to PRISMA guidelines. Results: We included a total of 100 records based on 81 studies with 42,167 patients. The overall incidence was 13.7%. Major complications occurred in 5.2%, with device failure being the most common at 2.8%. Minor complications affected 7.8%, with superficial wound infections being most frequent at 2.3%. Vestibular complications (vertigo/dizziness) were prevalent at 12.4%. Adults had significantly higher overall and major complication rates compared to pediatric patients. The mastoidectomy with posterior tympanotomy approach (MPTA) was associated with lower rates (5.4%) than the suprameatal approach (SMA) (7.8%). A significant temporal trend showed decreased complication rates from 8.9% in the early era (1991–2010) to 4.1% in the recent era (2011–2025). Significant risk factors were identified including older age at implantation, inner ear malformations, chronic otitis media, previous otologic surgery, and longer surgery duration. A substantial heterogeneity was present across the included studies (I² up to 93.6%), and the evidence base was predominantly retrospective in nature, which limits the certainty of these estimates. Conclusions: Cochlear implantation appears to be a generally safe procedure. However, these findings should be interpreted with caution. The high heterogeneity, predominantly retrospective study designs, inconsistent complication definitions, and detected publication bias collectively limit the certainty of the pooled estimates. Standardized complication reporting, prospective multicenter designs, and consensus-based outcome definitions are essential to strengthen the evidence base and guide safer clinical practice.

Background/Objectives: Diabetic macular edema (DME) is a leading cause of vision loss in diabetic patients, with anti-vascular endothelial growth factor (anti-VEGF) therapy being the standard management. However, treatment response varies significantly among patients, necessitating predictive tools. This systematic review and meta-analysis evaluated the diagnostic accuracy of artificial intelligence (AI) models in predicting anti-VEGF treatment response in DME patients. Methods: We conducted a dedicated literature review following PRISMA 2020 guidelines, searching PubMed, Web of Science, Embase, Scopus, and Cochrane Library databases from inception up to 30 September 2025. Studies evaluating AI-based prediction models for anti-VEGF response in DME patients were included. The primary outcomes were sensitivity, specificity, and area under the receiver operating characteristic curve (AUC). A bivariate random-effects meta-analysis was performed using available diagnostic accuracy data. Results: From 3107 participants across 18 studies, six studies with 427 participants provided complete diagnostic accuracy data for meta-analysis. The pooled sensitivity was 86.4% (95% CI: 82.1–90.1%) and the specificity was 77.6% (95% CI: 72.8–82.0%). The summary AUC was 0.89 with a diagnostic odds ratio of 22.0 (95% CI: 12.8–37.9). AI models demonstrated superior performance compared to other methods in 87.5% of comparative studies. Moderate heterogeneity was observed (I² = 45.2%). Conclusions: AI models demonstrate good diagnostic accuracy for predicting anti-VEGF treatment response in DME patients, with a promising role for improving personalized management strategies and improved outcomes.