Diagnosis, Treatment and Management of Eye Diseases

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Optical Diagnostics".

Deadline for manuscript submissions: closed (30 November 2023) | Viewed by 12684

Special Issue Editors


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Guest Editor
1. Department of Ophthalmology, “Gr.T.Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
2. “Prof. Dr. Nicolae Oblu” Emergency Clinical Hospital, 700309 Iasi, Romania
Interests: neuro-ophthalmology; orbit disease; cataract surgery; medical retina
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Guest Editor
1. Department of Ophthalmology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
2. Emergency County Hospital, 400006 Cluj-Napoca, Romania
Interests: vitreo-retinal surgery; medical retina; retinopathy of prematurity; artificial intelligence in retinal disease; stem cells; genetics in ophthalmology
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
Department of Pharmacology, Clinical Pharmacology and Toxicology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
Interests: pharmacology; doppler ultrasound; pharmacogenetics
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

In recent years, significant progress has been achieved in the diagnosis and management of eye diseases. Optical coherence tomography, progress in ophthalmic surgical technology, gene therapy, regenerative cellular therapies, nanotechnology, development of new molecules to target various ocular tissues and pathogenetic mechanisms, and artificial intelligence offer new tools to diagnose and treat ocular diseases in a multidisciplinary approach. This Special Issue focuses on the methods currently available to diagnose and treat various eye conditions, with a view to future developments and their potential to improve ophthalmological care. Original articles and reviews from all subspecialties of ophthalmology are welcome, with an emphasis on recent advances in diagnosis and therapy. The goal of this Special Issue is to publish articles from clinical, but also from experimental research with an impact on the diagnosis and treatment of eye diseases with a multidisciplinary approach.

Dr. Claudia Florida Costea
Prof. Dr. Simona Delia Nicoara
Dr. Ştefan Cristian Vesa
Guest Editors

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Keywords

  • optical coherence tomography
  • artificial intelligence
  • gene therapy
  • nanotechnology
  • stem cells
  • vitreo-retinal surgery
  • corneal transplantation
  • minimally invasive glaucoma surgery
  • cataract surgery
  • retinopathy of prematurity

Published Papers (12 papers)

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12 pages, 3013 KiB  
Article
The Features and Treatment Effects on Keratoepitheliopathy for Meibomitis-Related Keratoconjunctivitis
by Yukiko Sonomura, Norihiko Yokoi, Aoi Komuro, Hiroaki Kato and Chie Sotozono
Diagnostics 2024, 14(5), 487; https://doi.org/10.3390/diagnostics14050487 - 23 Feb 2024
Viewed by 454
Abstract
Meibomitis-related keratoconjunctivitis (MRKC) is characterized by meibomitis with corneal epithelial abnormalities, and can be divided into two types: MRKC accompanied with phlyctenular keratitis, and MRKC accompanied with keratoepitheliopathy that is similar to superficial punctate keratopathy (SPK). The purpose of this retrospective study was [...] Read more.
Meibomitis-related keratoconjunctivitis (MRKC) is characterized by meibomitis with corneal epithelial abnormalities, and can be divided into two types: MRKC accompanied with phlyctenular keratitis, and MRKC accompanied with keratoepitheliopathy that is similar to superficial punctate keratopathy (SPK). The purpose of this retrospective study was to investigate the characteristic features of keratoepitheliopathy and treatment outcomes for MRKC. This study involved 27 eyes of 18 MRKC patients (3 males and 15 females). National Eye Institute (NEI) scores and visual acuity were compared at pre and post treatment. All subjects were treated with a small-dose administration of clarithromycin. Keratoepitheliopathy characteristic to MRKC, yet different in appearance from SPK, was noted in 24 of the 27 eyes. Fluorescein staining revealed granular epithelial lesions generally larger than SPK that coexisted with small dark spots. In 17 eyes, keratoepitheliopathy was located within the pupillary zone, and the visual acuity in 12 eyes was less than 1.0. Our findings showed significant improvement in the NEI score in MRKC (p < 0.0001) and in visual acuity (p = 0.0157) post treatment, and the characteristic features of keratoepitheliopathy in MRKC that are often associated with decreased visual acuity were elucidated. The treatment of clarithromycin was found to be effective for MRKC with keratoepitheliopathy. Full article
(This article belongs to the Special Issue Diagnosis, Treatment and Management of Eye Diseases)
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19 pages, 21565 KiB  
Article
Advances in Transepithelial Photorefractive Keratectomy versus Laser-Assisted In Situ Keratomileusis
by Paul Filip Curcă, Cătălina Ioana Tătaru, George Sima, Marian Burcea and Călin Petru Tătaru
Diagnostics 2024, 14(5), 481; https://doi.org/10.3390/diagnostics14050481 - 23 Feb 2024
Viewed by 463
Abstract
(1) Background: Laser-assisted refractive surgery is a safe and effective surgical correction of refractive error. For most patients, both the newer Trans-PRK and the established LASIK technique can produce the required surgical correction, sparking the question of which technique should be opted for. [...] Read more.
(1) Background: Laser-assisted refractive surgery is a safe and effective surgical correction of refractive error. For most patients, both the newer Trans-PRK and the established LASIK technique can produce the required surgical correction, sparking the question of which technique should be opted for. (2) Methods: The study prospectively evaluated 121 patients (230 eyes) for at least one month postoperatively; 66 patients (126 eyes) and 45 patients (85 eyes) returned for 6 months and 1 year follow-up. (3) Results: No statistical difference was recorded at 1 week or 1 month post-operation. At 6 months, a difference was found for spherical diopters (Trans-PRK −0.0476 ± 0.7012 versus FS-LASIK +0.425 ± 0.874, p = 0.004) and spherical equivalent (Trans-PRK −0.1994 ± 0.0294 versus FS-LASIK +0.225 ± 0.646, p = 0.025) but not for CYL D (Trans-PRK −0.3036 ± 0.5251 versus FS-LASIK −0.4 ± 0.820, p = 0.499). Uncorrected visual acuity was better for Trans-PRK 6 months post-operation (UCVA logMAR 0.02523 versus 0.0768 logMAR; p = 0.015 logMAR). At 1-year, Trans-PRK was favored for spherical diopters (Trans-PRK −0.0294 ± 0.6493 versus FS-LASIK +0.646 ± 0.909, p < 0.001) and spherical equivalent (Trans-PRK −0.218 ± 0.784 versus FS-LASIK 0.372 ± 1.08, p = 0.007). Overall speed in visual recovery, variance of results and surgically induced astigmatism were in favor of Trans-PRK. (4) Conclusions: The study reported improvements for Trans-PRK patients, with both techniques found to be safe and effective. Full article
(This article belongs to the Special Issue Diagnosis, Treatment and Management of Eye Diseases)
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12 pages, 2694 KiB  
Article
Effectiveness of Single-Dose Oral Pilocarpine Administration in Patients with Sjögren’s Syndrome
by Aoi Komuro, Norihiko Yokoi, Chie Sotozono and Shigeru Kinoshita
Diagnostics 2024, 14(1), 91; https://doi.org/10.3390/diagnostics14010091 - 30 Dec 2023
Viewed by 768
Abstract
In this study, we evaluated the effectiveness of a single-dose oral pilocarpine administration on tear film (TF), as well as dry eye and dry mouth symptoms, in 53 eyes of 27 Sjögren syndrome (SS) patients who were experiencing dry mouth. To evaluate the [...] Read more.
In this study, we evaluated the effectiveness of a single-dose oral pilocarpine administration on tear film (TF), as well as dry eye and dry mouth symptoms, in 53 eyes of 27 Sjögren syndrome (SS) patients who were experiencing dry mouth. To evaluate the changes in tear volume, a digital video-meniscometer was used to measure the radius of the lower central tear meniscus curvature (R, mm) of each eye at prior to the administration of 5 mg oral pilocarpine, and at 15 (R:(15)), 30 (R:(30)), and 60 (R:(60)) minutes after administration. The fluorescein breakup time (FBUT, seconds) and ocular and oral dryness symptoms were evaluated before and at 60 min after administration using a visual analogue scale (VAS, mm). A significant increase in R was observed at 15 and 30 min after administration compared to that at prior to administration. FBUT showed significant improvement at 60 min after administration, and the VAS score for ocular and oral dryness symptoms was found to have decreased significantly at 60 min after administration. A single-dose administration of 5 mg oral pilocarpine had a beneficial effect on TF, as well as on ocular and oral dryness symptoms, in patients with SS. Full article
(This article belongs to the Special Issue Diagnosis, Treatment and Management of Eye Diseases)
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22 pages, 12601 KiB  
Article
Diabetic Macular Edema Optical Coherence Tomography Biomarkers Detected with EfficientNetV2B1 and ConvNeXt
by Corina Iuliana Suciu, Anca Marginean, Vlad-Ioan Suciu, George Adrian Muntean and Simona Delia Nicoară
Diagnostics 2024, 14(1), 76; https://doi.org/10.3390/diagnostics14010076 - 28 Dec 2023
Viewed by 861
Abstract
(1) Background: Diabetes mellitus (DM) is a growing challenge, both for patients and physicians, in order to control the impact on health and prevent complications. Millions of patients with diabetes require medical attention, which generates problems regarding the limited time for screening but [...] Read more.
(1) Background: Diabetes mellitus (DM) is a growing challenge, both for patients and physicians, in order to control the impact on health and prevent complications. Millions of patients with diabetes require medical attention, which generates problems regarding the limited time for screening but also addressability difficulties for consultation and management. As a result, screening programs for vision-threatening complications due to DM have to be more efficient in the future in order to cope with such a great healthcare burden. Diabetic macular edema (DME) is a severe complication of DM that can be prevented if it is timely screened with the help of optical coherence tomography (OCT) devices. Newly developing state-of-the-art artificial intelligence (AI) algorithms can assist physicians in analyzing large datasets and flag potential risks. By using AI algorithms in order to process OCT images of large populations, the screening capacity and speed can be increased so that patients can be timely treated. This quick response gives the physicians a chance to intervene and prevent disability. (2) Methods: This study evaluated ConvNeXt and EfficientNet architectures in correctly identifying DME patterns on real-life OCT images for screening purposes. (3) Results: Firstly, we obtained models that differentiate between diabetic retinopathy (DR) and healthy scans with an accuracy of 0.98. Secondly, we obtained a model that can indicate the presence of edema, detachment of the subfoveolar neurosensory retina, and hyperreflective foci (HF) without using pixel level annotation. Lastly, we analyzed the extent to which the pretrained weights on natural images “understand” OCT scans. (4) Conclusions: Pretrained networks such as ConvNeXt or EfficientNet correctly identify features relevant to the differentiation between healthy retinas and DR, even though they were pretrained on natural images. Another important aspect of our research is that the differentiation between biomarkers and their localization can be obtained even without pixel-level annotation. The “three biomarkers model” is able to identify obvious subfoveal neurosensory detachments, retinal edema, and hyperreflective foci, as well as very small subfoveal detachments. In conclusion, our study points out the possible usefulness of AI-assisted diagnosis of DME for lowering healthcare costs, increasing the quality of life of patients with diabetes, and reducing the waiting time until an appropriate ophthalmological consultation and treatment can be performed. Full article
(This article belongs to the Special Issue Diagnosis, Treatment and Management of Eye Diseases)
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15 pages, 2745 KiB  
Article
Dry Eye Subtype Classification Using Videokeratography and Deep Learning
by Norihiko Yokoi, Natsuki Kusada, Hiroaki Kato, Yuki Furusawa, Chie Sotozono and Georgi As. Georgiev
Diagnostics 2024, 14(1), 52; https://doi.org/10.3390/diagnostics14010052 - 26 Dec 2023
Viewed by 778
Abstract
We previously reported on ‘Tear Film Oriented Diagnosis’ (TFOD), a method for the dry eye (DE) subtype classification using fluorescein staining and an examination of fluorescein breakup patterns via slit-lamp biomicroscopy. Here, we report ‘AI-supported TFOD’, a novel non-invasive method for DE subtype [...] Read more.
We previously reported on ‘Tear Film Oriented Diagnosis’ (TFOD), a method for the dry eye (DE) subtype classification using fluorescein staining and an examination of fluorescein breakup patterns via slit-lamp biomicroscopy. Here, we report ‘AI-supported TFOD’, a novel non-invasive method for DE subtype classification using videokeratography (VK) and “Blur Value” (BV), a new VK indicator of the extent of blur in Meyer-ring images and deep learning (DL). This study involved 243 eyes of 243 DE cases (23 males and 220 females; mean age: 64.4 ± 13.9 (SD) years)—i.e., 31 severe aqueous-deficient DE (sADDE) cases, 73 mild-to-moderate ADDE (m/mADDE) cases, 84 decreased wettability DE (DWDE) cases, and 55 increased evaporation DE (IEDE) cases diagnosed via the fluorescein-supported TFOD pathway. For DL, a 3D convolutional neural network classification model was used (i.e., the original image and BV data of eyes kept open for 7 s were randomly divided into training data (146 cases) and the test data (97 cases), with the training data increased via data augmentation and corresponding to 2628 cases). Overall, the DE classification accuracy was 78.40%, and the accuracies for the subtypes sADDE, m/mADDE, DWDE, and IEDE were 92.3%, 79.3%, 75.8%, and 72.7%, respectively. ‘AI-supported TFOD’ may become a useful tool for DE subtype classification. Full article
(This article belongs to the Special Issue Diagnosis, Treatment and Management of Eye Diseases)
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13 pages, 1912 KiB  
Article
Effect of Punctal Occlusion on Blinks in Eyes with Severe Aqueous Deficient Dry Eye
by Hiroaki Kato, Norihiko Yokoi, Akihide Watanabe, Aoi Komuro, Yukiko Sonomura, Chie Sotozono and Shigeru Kinoshita
Diagnostics 2024, 14(1), 3; https://doi.org/10.3390/diagnostics14010003 - 19 Dec 2023
Viewed by 716
Abstract
Punctal occlusion (PO) is considered to improve both tear-film instability and increased friction during blinking and may consequently affect blinks. The purpose of this study was to investigate the effect of PO on blinks. This study involved 16 eyes of 16 severe aqueous [...] Read more.
Punctal occlusion (PO) is considered to improve both tear-film instability and increased friction during blinking and may consequently affect blinks. The purpose of this study was to investigate the effect of PO on blinks. This study involved 16 eyes of 16 severe aqueous deficient dry eye (ADDE) patients (mean age: 65.7 years). In all eyes, tear meniscus radius (TMR), spread grade (SG) of the tear-film lipid layer (i.e., SG 1-5: 1 being the best), fluorescein break-up time (FBUT), corneal epithelial damage score (CED), conjunctival epithelial damage score, corneal filament (CF) grade, lid-wiper epitheliopathy (LWE) grade, and superior limbic keratoconjunctivitis (SLK) grade were evaluated at before and at more than 1-month after PO. Moreover, using a custom-made high-speed blink analyzer, palpebral aperture height, blink rate, upper-eyelid closing-phase amplitude/duration/maximum velocity, and upper-eyelid opening-phase amplitude/duration/maximum velocity were measured at the same time point. After PO, TMR, SG, FBUT, CED, and the CF, LWE, and SLK grades were significantly improved, and upper-eyelid opening/closing-phase amplitude and maximum velocity significantly increased (all p < 0.04). The findings of this study suggest that PO improves ocular surface lubrication and that blink-related parameters can reflect the friction that occurs during blinking in eyes with severe ADDE. Full article
(This article belongs to the Special Issue Diagnosis, Treatment and Management of Eye Diseases)
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15 pages, 1261 KiB  
Article
Characteristics of Pre-Lens Tear Film Behavior in Eyes Wearing Delefilcon A Silicone Hydrogel Water Gradient Contact Lenses
by Norihiko Yokoi, Yuki Furusawa, Hiroaki Kato, Natsuki Kusada, Chie Sotozono, Petar Eftimov and Georgi As. Georgiev
Diagnostics 2023, 13(24), 3642; https://doi.org/10.3390/diagnostics13243642 - 12 Dec 2023
Viewed by 749
Abstract
The pre-lens tear film (PLTF) over (i) delefilcon A silicone hydrogel water gradient (WG; 33–80% from core to surface) contact lenses (CLs) (SHWG-CLs) and (ii) subjects’ own non-WG soft CLs (SCLs) (SO-SCLs) was studied in 30 eyes of 30 subjects to assess the [...] Read more.
The pre-lens tear film (PLTF) over (i) delefilcon A silicone hydrogel water gradient (WG; 33–80% from core to surface) contact lenses (CLs) (SHWG-CLs) and (ii) subjects’ own non-WG soft CLs (SCLs) (SO-SCLs) was studied in 30 eyes of 30 subjects to assess the hypothesized PLTF stabilization over SHWG-CLs. In both eyes, delefilcon A SHWG-CLs (DAILIES TOTAL1®; Alcon, Fort Worth, TX, USA) or SO-SCLs were worn. After 15 min of wearing each lens, the tear meniscus radius (TMR, mm), lipid-layer interference grade (IG) and spread grade (SG), and non-invasive breakup time (NIBUT, seconds) were evaluated and compared between the SHWG-CLs and the SO-SCLs. The comparison between the SHWG-CL and SO-SCL groups (SHWG-CL and SO-SCL, mean ± SD) revealed that TMRs temporarily decreased and reached a plateau value after 15 min (0.21 ± 0.06; 0.21 ± 0.06) compared to the value prior to CL insertion (0.24 ± 0.08; 0.25 ± 0.08), with no significant difference between the two groups. The NIBUT, IG, and SG values after 15 min of wearing the CLs were (9.7 ± 3.7; 4.7 ± 4.2), (1.0 ± 0.2; 1.8 ± 1.0), and (1.1 ± 0.4; 1.9 ± 1.5), respectively, and all values were significantly better in the SHWG-CL group (p < 0.0001, p = 0.0039, and p < 0.0001, respectively). We found that compared to the SO-SCLs, the maintenance of the PLTF on the SHWG-CLs was supported by the thicker and more stable PLTF. Full article
(This article belongs to the Special Issue Diagnosis, Treatment and Management of Eye Diseases)
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14 pages, 11572 KiB  
Article
Association between Corneal Higher-Order Aberrations Evaluated with a Videokeratographer and Corneal Surface Abnormalities in Dry Eye
by Natsuki Kusada, Norihiko Yokoi and Chie Sotozono
Diagnostics 2023, 13(21), 3319; https://doi.org/10.3390/diagnostics13213319 - 26 Oct 2023
Viewed by 901
Abstract
Analysis of higher-order aberrations (HOAs) is one reported method for evaluating dry eye disease (DED)-related loss of visual function. Tear film (TF) instability and corneal epithelial damage (CED) are both reportedly responsible for HOAs in DED, although, to the best of our knowledge, [...] Read more.
Analysis of higher-order aberrations (HOAs) is one reported method for evaluating dry eye disease (DED)-related loss of visual function. Tear film (TF) instability and corneal epithelial damage (CED) are both reportedly responsible for HOAs in DED, although, to the best of our knowledge, there are no reported methods that allow concurrent evaluation of their effects. In this study, we used a videokeratographer (VK) to continuously measure HOAs in DED after eye opening and investigated factors of ocular surface abnormalities that determine HOAs. This study involved 96 DED cases that underwent DED symptom assessment with a questionnaire and examination of tear volume, TF abnormalities (i.e., TF lipid-layer interference grades and spreading grades, and non-invasive breakup time and fluorescein breakup time), and CED, and their correlation with HOAs evaluated via VK. The results show that HOAs at 1 or 2 s after eye opening can reflect TF instability and CED within the central 4-millimeter-diameter area of the optical zone in DED eyes concurrently. This finding may be useful for the rapid and non-invasive detection and evaluation of degraded visual function in DED cases with a variety of clinical features. Full article
(This article belongs to the Special Issue Diagnosis, Treatment and Management of Eye Diseases)
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13 pages, 3649 KiB  
Article
Retinal Nerve Fiber Layer Imaging with Two Different Spectral Domain Optical Coherence Tomographs: Normative Data for Romanian Children
by Iulia-Andrada Nemeș-Drăgan, Ana-Maria Drăgan, Mădălina Claudia Hapca and Mara Oaida
Diagnostics 2023, 13(8), 1377; https://doi.org/10.3390/diagnostics13081377 - 10 Apr 2023
Cited by 1 | Viewed by 1135
Abstract
The purpose of this study is to analyze and compare pediatric normative data for the retinal nerve fiber layer of Romanian children using two different spectral domain optical coherence tomographs. Due to different scanning speeds and axial and transverse resolution, the results of [...] Read more.
The purpose of this study is to analyze and compare pediatric normative data for the retinal nerve fiber layer of Romanian children using two different spectral domain optical coherence tomographs. Due to different scanning speeds and axial and transverse resolution, the results of the measurements of scans cannot be transposed. A total of 140 healthy children aged 4 to 18 were enrolled in the study. Overall, 140 eyes were scanned with a Spectralis SD-OCT (Heidelberg Technology), and the other 140 eyes were imaged with a Copernicus REVO SOCT (Optopol Technology (Zawiercie, Poland)). The mean global RNFL thickness and average RNFL thickness for the four quadrants were measured and compared. The average peripapillary RNFL thickness measured with the Spectralis was 104.03 ± 11.42 (range 81 to 126 µm), while the one measured with the Revo 80 was 127.05 ± 15.6 (range 111.43–158.28). The RNFL thickness measurements taken with the Spectralis in the superior, inferior, nasal, and temporal quadrants were 132 ±19.1, 133.5 ± 21.77, 74 ± 16.48, and 73 ± 11.95 µm, respectively, while those taken with the Revo 80 were 144.44 ± 9.25, 144.86 ±23.12, 96.49 ± 19.41, and 77 ± 11.4 µm, respectively. Multivariate analysis showed that the average RNFL thickness was not influenced by gender or eye laterality and was negatively correlated with age when we used the Spectralis device. This study provides normative data for SD-OCT peripapillary RNFL in healthy Romanian children for two different tomographs. These data help the clinician evaluate and interpret the results of optical coherence tomography for a child, taking into consideration all the technical and individual parameters. Full article
(This article belongs to the Special Issue Diagnosis, Treatment and Management of Eye Diseases)
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15 pages, 2372 KiB  
Article
Evaluation of the Corneal Endothelium Following Cataract Surgery in Diabetic and Non-Diabetic Patients
by Adela-Laura Ciorba, George Roiu, Amir Mohamed Abdelhamid, Sameh Saber and Simona Cavalu
Diagnostics 2023, 13(6), 1115; https://doi.org/10.3390/diagnostics13061115 - 15 Mar 2023
Viewed by 2164
Abstract
The aim of this study was to evaluate the influence of phacoemulsification cataract surgery on the state of the corneal endothelium in diabetic versus non-diabetic patients. We compared the corneal cell morphology in 48 diabetics with good glycemic control and 72 non-diabetic patients [...] Read more.
The aim of this study was to evaluate the influence of phacoemulsification cataract surgery on the state of the corneal endothelium in diabetic versus non-diabetic patients. We compared the corneal cell morphology in 48 diabetics with good glycemic control and 72 non-diabetic patients before and after uneventful phacoemulsification. Corneal cell density, central corneal thickness, and hexagonality were measured preoperatively and post-surgery (at 1 and 4 weeks) by specular microscopy. The effect of age, gender, axial length, and anterior chamber depth on the parameters of the corneal endothelium were evaluated. We noticed a drop in the endothelial density in both groups postoperatively: a mean endothelial cell loss of 472.7 ± 369.1 in the diabetic group was recorded versus 165.7 ± 214.6 mean loss in the non-diabetic group after the first week. A significant increase in central corneal thickness was also noticed in both groups one week after phacoemulsification, but no statistical significance after 4 weeks in the diabetic group. In terms of cell hexagonality, statistically significant differences were noticed after 4 weeks in both groups. Overall, a significant difference between diabetic and non-diabetic population was noticed in terms of corneal endothelial cell loss after uneventful phacoemulsification cataract surgery. Routine specular microscopy and HbA1c evaluation is recommended before cataract surgery, while intraoperative precautions and high monitorisation in terms of pacho power intensity and ultrasound energy, along with a proper application of the dispersive viscoelastic substances are essential to reduce the risk of endothelial damage. Full article
(This article belongs to the Special Issue Diagnosis, Treatment and Management of Eye Diseases)
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4 pages, 1818 KiB  
Interesting Images
Immunohistochemistry in an Adult Case of Bitot’s Spots Caused by Vitamin A Deficiency
by Hideki Fukuoka, Norihiko Yokoi and Chie Sotozono
Diagnostics 2023, 13(24), 3676; https://doi.org/10.3390/diagnostics13243676 - 15 Dec 2023
Viewed by 825
Abstract
Bitot’s spots (BS) are the buildup of superficially located keratin in the conjunctiva and are early indicators of vitamin A deficiency (VAD), primarily due to malnutrition and malabsorption, thus leading to xerophthalmia. BS are particularly prevalent in developing countries, and their presence necessitates [...] Read more.
Bitot’s spots (BS) are the buildup of superficially located keratin in the conjunctiva and are early indicators of vitamin A deficiency (VAD), primarily due to malnutrition and malabsorption, thus leading to xerophthalmia. BS are particularly prevalent in developing countries, and their presence necessitates prompt vitamin A supplementation to avert blindness, with the immunohistochemical characteristics of BS aiding in understanding the extent of epithelial abnormalities and the efficacy of vitamin A supplementation. We describe the case of a 34-year-old male with persistent BS despite extensive vitamin A supplementation and topical treatments who underwent surgical excision of the BS followed by amniotic membrane transplantation, thus resulting in symptom relief and epithelialization, with no recurrence observed during follow-up. Histopathologic and immunohistochemical evaluations revealed expression of keratinization-related proteins, along with an absence of mucin-5AC-positive cells, suggesting impaired differentiation into goblet cells due to VAD. This case highlights the potential age-related disparity in the efficacy of vitamin A supplementation, emphasizing the need for early detection and a multidisciplinary approach in the management of VAD, especially in young adults. The favorable outcome of surgical intervention highlights its viability in the management of persistent BS and encourages further investigation to optimize therapeutic strategies for VAD-related ocular manifestations. Full article
(This article belongs to the Special Issue Diagnosis, Treatment and Management of Eye Diseases)
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35 pages, 2538 KiB  
Systematic Review
The Predictive Capabilities of Artificial Intelligence-Based OCT Analysis for Age-Related Macular Degeneration Progression—A Systematic Review
by George Adrian Muntean, Anca Marginean, Adrian Groza, Ioana Damian, Sara Alexia Roman, Mădălina Claudia Hapca, Maximilian Vlad Muntean and Simona Delia Nicoară
Diagnostics 2023, 13(14), 2464; https://doi.org/10.3390/diagnostics13142464 - 24 Jul 2023
Cited by 4 | Viewed by 1565
Abstract
The era of artificial intelligence (AI) has revolutionized our daily lives and AI has become a powerful force that is gradually transforming the field of medicine. Ophthalmology sits at the forefront of this transformation thanks to the effortless acquisition of an abundance of [...] Read more.
The era of artificial intelligence (AI) has revolutionized our daily lives and AI has become a powerful force that is gradually transforming the field of medicine. Ophthalmology sits at the forefront of this transformation thanks to the effortless acquisition of an abundance of imaging modalities. There has been tremendous work in the field of AI for retinal diseases, with age-related macular degeneration being at the top of the most studied conditions. The purpose of the current systematic review was to identify and evaluate, in terms of strengths and limitations, the articles that apply AI to optical coherence tomography (OCT) images in order to predict the future evolution of age-related macular degeneration (AMD) during its natural history and after treatment in terms of OCT morphological structure and visual function. After a thorough search through seven databases up to 1 January 2022 using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, 1800 records were identified. After screening, 48 articles were selected for full-text retrieval and 19 articles were finally included. From these 19 articles, 4 articles concentrated on predicting the anti-VEGF requirement in neovascular AMD (nAMD), 4 articles focused on predicting anti-VEGF efficacy in nAMD patients, 3 articles predicted the conversion from early or intermediate AMD (iAMD) to nAMD, 1 article predicted the conversion from iAMD to geographic atrophy (GA), 1 article predicted the conversion from iAMD to both nAMD and GA, 3 articles predicted the future growth of GA and 3 articles predicted the future outcome for visual acuity (VA) after anti-VEGF treatment in nAMD patients. Since using AI methods to predict future changes in AMD is only in its initial phase, a systematic review provides the opportunity of setting the context of previous work in this area and can present a starting point for future research. Full article
(This article belongs to the Special Issue Diagnosis, Treatment and Management of Eye Diseases)
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