{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T04:41:19Z","timestamp":1792384879081,"version":"4.4.0"},"reference-count":51,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>Metabolic syndrome (MetS) is defined by central obesity, insulin resistance, hypertension and dyslipidemia. MetS affects over one\u2010third of US adults. Beyond its cardiovascular burden, MetS has clinically relevant associations with ocular health and may contribute to a systemic vascular and neuro\u2010metabolic phenotype involving the retina, optic nerve, lens, ocular surface and choroid.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Evidence Acquisition<\/jats:title>\n                    <jats:p>This narrative review searched PubMed through May 2026 using combinations of free\u2010text and MeSH\u2010based terms related to \u2018metabolic syndrome\u2019, \u2018insulin resistance\u2019, \u2018obesity\u2019, \u2018hypertension\u2019, \u2018dyslipidemia\u2019, \u2018diabetes\u2019, \u2018diabetic retinopathy\u2019, \u2018diabetic macular edema\u2019, \u2018glaucoma\u2019, \u2018cataract\u2019, \u2018dry eye\u2019, \u2018macular degeneration\u2019, \u2018retinal vascular occlusion\u2019 and \u2018optic neuropathy\u2019. Reference lists of relevant reviews and primary studies were also screened. English\u2010language human, translational, epidemiologic, clinical\u2010trial, systematic\u2010review and meta\u2010analysis articles were prioritized. This was not designed as a systematic review, and formal PRISMA screening, risk\u2010of\u2010bias grading and meta\u2010analysis were not performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Evidence Synthesis<\/jats:title>\n                    <jats:p>MetS and its components are associated with diabetic retinopathy, diabetic macular edema (DME), non\u2010diabetic retinopathy, primary open\u2010angle glaucoma, cataract, dry eye disease, age\u2010related macular degeneration (AMD), retinal vascular occlusions and non\u2010arteritic anterior ischemic optic neuropathy (NAION). Shared mechanisms include chronic inflammation, oxidative stress, endothelial dysfunction, insulin resistance\u2010driven retinal neurodegeneration, dyslipidemia\u2010related lipotoxicity, hypertension\u2010related microvascular injury and microvascular rarefaction. Management requires both systemic risk\u2010factor optimization and disease\u2010specific ophthalmic therapy, including anti\u2010VEGF therapy, intraocular pressure reduction, laser or surgical procedures when indicated, ocular surface\u2010directed therapy and cataract surgery when visually significant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Ocular complications associated with MetS are common and may be vision\u2010threatening. Risk\u2010based ocular surveillance and metabolic optimization are justified, particularly in patients with diabetes, hypertension, dyslipidemia, visual symptoms or established vascular disease. However, the strength of disease\u2010specific evidence varies: interventional evidence is strongest for diabetic retinopathy risk reduction and glaucoma treatment through intraocular pressure lowering, whereas evidence for AMD, NAION, RVO, cataract and dry eye disease is more frequently observational or indirect.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.71133","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T03:02:00Z","timestamp":1784602920000},"page":"9809-9818","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Ocular Manifestations of Metabolic Syndrome: A Systemic Vascular Phenotype"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6198-4352","authenticated-orcid":false,"given":"Ron T.","family":"Varghese","sequence":"first","affiliation":[{"name":"Sleep\u2010Endocrinology Integrated Clinic. Division of Endocrinology, Department of Internal Medicine Bascom Palmer Eye Institute, University of Miami  Miami Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ansu A.","family":"John","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Bascom Palmer Eye Institute, University of Miami  Miami Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,20]]},"reference":[{"key":"e_1_2_19_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.169404"},{"key":"e_1_2_19_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.192644"},{"key":"e_1_2_19_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.287.3.356"},{"key":"e_1_2_19_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms26052174"},{"issue":"1","key":"e_1_2_19_6_1","article-title":"Global Prevalence of Metabolic Syndrome in Children","volume":"19","author":"Noubiap J. 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