Mark Ashamalla

Gynecomastia is a common condition affecting adolescent males, and recurrence following surgical excision is not uncommon. Cannabis has been proposed as a potential endocrine system disruptor, though its role in gynecomastia or its recurrence remains unclear. We present a case series of 3 adolescent males who underwent initial excision for gynecomastia, reported postoperative cannabis use, and developed recurrence requiring secondary surgery. All patients had normal baseline endocrine evaluations and varied in body mass index, disease severity, and laterality. Recurrence occurred despite stable or decreased body weight. Secondary surgical management was successful, with no further recurrence at 1-year follow-up, and patients discontinued cannabis use. While causality cannot be established, these cases highlight a potential association between cannabis use and recurrent male breast glandular proliferation. Clinicians should consider counseling patients on modifiable risk factors, including substance use. Further prospective studies are needed to better define this relationship and its underlying mechanisms.

Gene therapy represents a transformative frontier in ophthalmology, offering the potential to address inherited and acquired retinal diseases at their genetic origin rather than through symptomatic management. By introducing exogenous genetic material to restore or modulate gene expression, gene therapy aims to preserve or even restore vision in patients with mutations that disrupt normal retinal function. The eye’s small, compartmentalized structure, relative immune privilege, and direct accessibility through subretinal or intravitreal routes make it an ideal target for localized delivery with minimal systemic exposure. The approval of voretigene neparvovec-rzyl for RPE65-mediated retinal dystrophy marked a pivotal milestone, establishing proof of concept for durable and safe gene replacement therapy. Looking ahead, continued refinements in vector design, CRISPR-based editing strategies, and delivery platforms are expected to expand the therapeutic reach of gene therapy beyond monogenic disorders. With multiple early-phase clinical trials underway for inherited and acquired retinal diseases, the coming decade is poised to bring broader applicability, improved durability, and more accessible gene-based treatments across the spectrum of retinal pathology.