Adult neurons in the mammalian central nervous system (CNS) fail to regenerate after injury due to a number of factors including the reduced intrinsic growth capacity together with the hostile environment of the injured CNS microenvironment [1-4]. However recent studies have shown that modifying the intrinsic growth capacity through a number of cell signalling pathways can promote regeneration of adult CNS neurons. For example, intrinsic factors such as cyclic adenosine monophosphate (cAMP), mammalian target of rapamycin (mTOR), and the repressors phosphatase and tensin homolog (PTEN) and suppressor of cytokine signalling 3 (SOCS3) promote CNS axon regeneration [5-7]. 

Enhanced recovery after surgery (ERAS) is a comprehensive care protocol that incorporates evidence-based practices to achieve the most optimal postoperative outcomes, safe on-time discharge, and surgical cost efficiency. ERAS protocols have been adapted for specialty-specific needs and implemented by a variety of surgical disciplines including thoracic surgery.

In this case report we present an unusual case of orbital cholesterol granuloma associated with compressive optic neuropathy and cranial nerve 6th palsy. Cholesterol granuloma results from a foreign body response to the presence of crystallized cholesterol. Cholesterol granuloma affecting the orbit are a rare presentation as they typically occur in the petrous apex of the temporal bone.

MPNSTs are aggressive Schwann cell-derived sarcomas, frequently associated with NF1 mutations. Traditional treatments, including surgery and chemotherapy, are largely ineffective, highlighting the urgent need for novel therapeutic strategies. NF1 loss leads to RAS pathway activation, which in turn activates multiple signaling cascades, including RAF-MEK-ERK1/2, PI3K-AKT, and RalGDS pathways. Inhibition of these pathways has been explored, with MEK inhibitors, such as selumetinib, showing some promise in clinical trials (NCT03433183).

This commentary systematically examines the pivotal role of non-human primate (NHP) models in advancing gene therapy for optic nerve diseases, alongside the ethical and practical challenges they face. It highlights how synergistic innovations in artificial intelligence (AI), organoid technology, CRISPR-based gene editing, and novel delivery systems are reshaping translational paradigms.