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Corneal and Retinal Diseases: Diagnostic and Therapeutic Approaches

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

Deadline for manuscript submissions: closed (31 October 2020) | Viewed by 25836

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Dr. Maurizio Cammalleri

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Guest Editor

Department of Biology, University of Pisa, Pisa, Italy
Interests: neurodegeneration; neoangiogenesis; retinal ganglion cells; neurovascular unit; diabetic retinopathy; retinopathy of prematurity; age-related macular degeneration; retinitis pigmentosa; full-field electroretinogram
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Dr. Caterina Gagliano

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Co-Guest Editor

Eye Clinic, Catania University, San Marco Hospital, Catania, Italy
Interests: glaucoma; clinical ophthalmology; retinal diseases; inflammation; immunology of infectious diseases; OCT; macular degeneration; eye diseases; corneal diseases; retinal degeneration
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Corneal and retinal diseases are among the main causes of blindness and visual impairment in the ageing population. Vision loss can have a devastating impact on affected people, causing high social and economic burden. Corneal diseases can be congenital/hereditary or acquired (band keratopathy, neurotrophic keratitis, etc.). Retinal diseases can be also hereditary, related to age, or related to pathologies. The pathophysiological characteristics of these diseases may differ, however common mechanisms can be identified in corneal and retinal tissue, including the occurrence of inflammation and/or neovascularization (i.e., the formation of vessels in the form of new vessels from vascularized structures (choroid/retina) or neovascular buttons in areas without vessels such as the cornea). In the end, these process cause neuronal death and vision impairment or loss.

Although much remains to be discovered about the causes of different corneal and retinal pathologies, the idea that new diagnostic and therapeutic approaches are needed to provide substantial benefits has been established in recent years. Researchers are indeed actively studying corneal and retinal pathologies with a variety of technological devices to identify common pathogenetic mechanisms and to evaluate the effectiveness of treatments.

In this Special Issue, we are collecting reviews or original papers including new findings in the field of corneal and retinal diseases. New and original studies highlighting molecular mechanisms involved in the pathogenesis of corneal and retinal disorders, as well as new treatment possibilities, will be welcome. The aim is to broaden the knowledge of the diagnostic and therapeutic methods that may be used in the treatment of corneal and retinal diseases.

Dr. Maurizio Cammalleri
Guest Editor

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Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

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Published Papers (9 papers)

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25 pages, 9174 KiB

Open AccessArticle

Microangiopathy in Ocular Sarcoidosis Using Fluorescein Gonio and Fundus Angiography from Diagnostic and Therapeutic Aspects

by Teruhiko Hamanaka, Noriko Akabane, Tetsuro Sakurai, Soichiro Ikushima, Toshio Kumasaka and Tamiko Takemura

Diagnostics 2021, 11(1), 39; https://doi.org/10.3390/diagnostics11010039 - 28 Dec 2020

Cited by 3 | Viewed by 2462

Abstract

In this retrospective study, we investigated vascular abnormalities in sarcoidosis using fluorescein gonioangiography (FGA) to detect angle neovascularization (ANV), fundus fluorescein angiography (FFA), and pathological specimens from the aspects of microangiopathy. In 57 sarcoidosis patients, clinical data was reviewed by dividing the cases into three groups (Group I: histologically diagnosed; Group II: positive bilateral hilar lymphadenopathy (BHL); Group III: negative BHL). The FFA, FGA, and pathological examination data in the autopsy eyes and trabeculectomy specimens were investigated. FGA and FFA detected ANV (91%) and nodule-associated abnormalities (87%), respectively. No intraocular pressure (IOP) elevation was observed after continuous topical betamethasone, except in the steroid responder group. Maximum IOP had significant correlation with nodules in the angle (p = 0.02696) and visual field defect (p = 0.0151). Granulomas adjacent to blood vessels, including the Schlemm’s canal, and thickening of the retinal blood vessel wall caused occlusion of those vessels. Photocoagulation was required for retinal tears (14%) and the retinal blood vessel occlusion (7%). Suppression of IOP elevation via continuous topical betamethasone may be important to avoid irreversible outflow-route changes and optic-nerve damage, and the concept of microangiopathy in ocular sarcoidosis may be important for understanding the proper treatment of serious complications. Full article

(This article belongs to the Special Issue Corneal and Retinal Diseases: Diagnostic and Therapeutic Approaches)

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17 pages, 2791 KiB

Open AccessArticle

Ophthalmic Evaluation of Diagnosed Cases of Eye Cystinosis: A Tertiary Care Center’s Experience

by Malgorzata Kowalczyk, Mario Damiano Toro, Robert Rejdak, Wojciech Załuska, Caterina Gagliano and Przemyslaw Sikora

Diagnostics 2020, 10(11), 911; https://doi.org/10.3390/diagnostics10110911 - 07 Nov 2020

Cited by 5 | Viewed by 2543

Abstract

Background: We aimed to identify diagnosed cases of ocular cystinosis and describe clinical, epidemiological and therapeutic characteristics. Methods: This is a descriptive and retrospective case series. All patients underwent a full check-up examination every 4–6 months by ophthalmologists, nephrologists and other required specialists. Results: Of the seven cases, six (85.7%) were females and one (14.2%) was male. The infantile nephropathic form of cystinosis was observed in five patients and the juvenile nephropathic form in two patients. No patients with the ocular form of cystinosis were identified. Corneal cystine crystals (CCC) were found in all analyzed patients. Severe ocular and general complications of the disease that had been standing for years, connected to the infantile nephropathic form, delayed diagnosis or inappropriate treatment, were observed only in two patients. All patients received topical therapy. No adverse events related to the therapy were observed. Conclusions: Cystinosis is a rare, progressive disease. Early diagnosis and treatment prevent serious complications from numerous systemic organs. Patients require constant systematic monitoring by various specialists. Full article

(This article belongs to the Special Issue Corneal and Retinal Diseases: Diagnostic and Therapeutic Approaches)

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13 pages, 1292 KiB

Open AccessArticle

Relationship between Corneal Morphogeometrical Properties and Biomechanical Parameters Derived from Dynamic Bidirectional Air Applanation Measurement Procedure in Keratoconus

by Francisco Cavas, David Piñero, José S. Velázquez, Jorge Mira and Jorge L. Alió

Diagnostics 2020, 10(9), 640; https://doi.org/10.3390/diagnostics10090640 - 27 Aug 2020

Cited by 8 | Viewed by 2557

Abstract

The morphogeometric analysis of the corneal structure has become a clinically relevant diagnostic procedure in keratoconus (KC) as well as the in vivo evaluation of the corneal biomechanical properties. However, the relationship between these two types of metrics is still not well understood. The current study investigated the relationship of corneal morphogeometry and volume with two biomechanical parameters: corneal hysteresis (CH) and corneal resistance factor (CRF), both provided by an Ocular Response Analyzer (Reichert). It included 109 eyes from 109 patients (aged between 18 and 69 years) with a diagnosis of keratoconus (KC) who underwent a complete eye examination including a comprehensive corneal topographic analysis with the Sirius system (CSO). With the topographic information obtained, a morphogeometric and volumetric analysis was performed, defining different variables of clinical use. CH and CRF were found to be correlated with these variables, but this correlation was highly influenced by corneal thickness. This suggests that the mechanical properties of KC cornea contribute only in a partial and limited manner to these biomechanical parameters, being mostly influenced by morphogeometry under normal intraocular pressure levels. This would explain the limitation of CH and CRF as diagnostic tools for the detection of incipient cases of KC. Full article

(This article belongs to the Special Issue Corneal and Retinal Diseases: Diagnostic and Therapeutic Approaches)

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18 pages, 1524 KiB

Open AccessArticle

Systemic Alterations of Immune Response-Related Proteins during Glaucoma Development in the Murine Model DBA/2J

by Andrés Fernández-Vega Cueto, Lydia Álvarez, Montserrat García, Enol Artime, Ana Álvarez Barrios, Ignacio Rodríguez-Uña, Miguel Coca-Prados and Héctor González-Iglesias

Diagnostics 2020, 10(6), 425; https://doi.org/10.3390/diagnostics10060425 - 23 Jun 2020

Cited by 2 | Viewed by 2552

Abstract

Animal models of glaucoma, a neurodegenerative disease affecting the retina, offer the opportunity to study candidate molecular biomarkers throughout the disease. In this work, the DBA/2J glaucomatous mouse has been used to study the systemic levels of several proteins previously identified as potential biomarkers of glaucoma, along the pre- to post-glaucomatous transition. Serum samples obtained from glaucomatous and control mice at 4, 10, and 14 months, were classified into different experimental groups according to the optic nerve damage at 14 months old. Quantifications of ten serum proteins were carried out by enzyme immunoassays. Changes in the levels of some of these proteins in the transition to glaucomatous stages were identified, highlighting the significative decrease in the concentration of complement C4a protein. Moreover, the five-protein panel consisting of complement C4a, complement factor H, ficolin-3, apolipoprotein A4, and transthyretin predicted the transition to glaucoma in 78% of cases, and to the advanced disease in 89%. Our data, although still preliminary, suggest that disease development in DBA/2J mice is associated with important molecular changes in immune response and complement system proteins and demonstrate the utility of this model in identifying, at systemic level, potential markers for the diagnosis of glaucoma. Full article

(This article belongs to the Special Issue Corneal and Retinal Diseases: Diagnostic and Therapeutic Approaches)

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13 pages, 3252 KiB

Open AccessArticle

The Application of Structural Retinal Biomarkers to Evaluate the Effect of Intravitreal Ranibizumab and Dexamethasone Intravitreal Implant on Treatment of Diabetic Macular Edema

by Ida Ceravolo, Giovanni William Oliverio, Angela Alibrandi, Ahsan Bhatti, Luigi Trombetta, Robert Rejdak, Mario Damiano Toro and Costantino John Trombetta

Diagnostics 2020, 10(6), 413; https://doi.org/10.3390/diagnostics10060413 - 17 Jun 2020

Cited by 51 | Viewed by 3242

Abstract

Background: The aim of this study was to compare the therapeutic effect of intravitreal treatment with ranibizumab and dexamethasone using specific swept-source optical coherence tomography retinal biomarkers in patients with diabetic macular edema (DME). Methods: 156 treatment-naïve patients with DME were divided in two groups: 75 patients received 3 monthly intravitreal injections of ranibizumab 0.5 mg (Lucentis^®) (Group 1) and 81 patients received an intravitreal implant of dexamethasone 0.7 mg (Ozurdex^®) (Group 2). Patients were evaluated at baseline (V1), at three months post-treatment in Group 1, and at two months post-treatment in Group 2 (V2). Best-corrected visual acuity (BCVA) and swept source-OCT were recorded at each interval. Changes between V1 and V2 were analyzed using the Wilcoxon test and differences between the two groups of treatment were assessed using the Mann–Whitney test. Multiple regression analysis was performed to evaluate the possible OCT biomarker (CRT, ICR, CT, SND, HRS) as predictive factors for final visual acuity improvement. Results: In both groups, BCVA improved (p-value < 0.0001), and a significant reduction in central retinal thickness, intra-retinal cysts, red dots, hyper-reflective spots (HRS), and serous detachment of neuro-epithelium (SDN) was observed. A superiority of dexamethasone over ranibizumab in reducing the SDN height (p-value = 0.03) and HRS (p-value = 0.01) was documented. Conclusions: Ranibizumab and dexamethasone are effective in the treatment of DME, as demonstrated by functional improvement and morphological biomarker change. DME associated with SDN and HRS represents a specific inflammatory pattern for which dexamethasone appears to be more effective. Full article

(This article belongs to the Special Issue Corneal and Retinal Diseases: Diagnostic and Therapeutic Approaches)

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13 pages, 846 KiB

Open AccessArticle

Dry Eye in Systemic Sclerosis Patients: Novel Methods to Monitor Disease Activity

by Caterina Gagliano, Elisa Visalli, Mario Damiano Toro, Roberta Amato, Giovanni Panta, Davide Scollo, Giovanni Scandura, Salvatore Ficili, Giorgio Amato, Alessia Benenati, Roberta Foti, Giulia Malaguarnera, Giuseppe Gagliano, Raffaele Falsaperla, Teresio Avitabile and Rosario Foti

Diagnostics 2020, 10(6), 404; https://doi.org/10.3390/diagnostics10060404 - 13 Jun 2020

Cited by 6 | Viewed by 3421

Abstract

Background: In systemic sclerosis (SSc) patients, dry eye syndrome (DES) is the most frequent ocular feature. The aim of this study was to investigate ocular DES-related SSc patients and to establish any correlation with the severity of the disease. Methods: Retrospectively, data from 60 patients with SSc underwent ophthalmic examination, where non-invasive film tear break-up time (NIF-TBUT), tear film lipid layer thickness (LLT), anesthetic-free Schirmer test I, tear osmolarity measurement (TearLab System), and modified Rodnan skin score (mRSS) data were collected. The visual analog scale (VAS) and Symptom Assessment in Dry Eye (SANDE) methods were utilized. The results were correlated with mRSS and the duration of SSc. Results: Severe DES occurred in 84% of cases, and was more severe in women. The eyelids were involved in 86.6%, secondary to meibomian gland disease (MGD). A direct correlation was found between the tear osmolarity (mean 328.51 ± 23.8 SD) and skin score (mRSS) (r = 0.79; p < 0.01). Significantly reduced NIF-TBUT, LLT, and Schirmer test I values were observed in the case of severe skin involvement. Conclusions: SSc patients show lipid tear dysfunction related to the severity and duration of the disease due to inflammation and the subsequent atrophy of the meibomian glands. Full article

(This article belongs to the Special Issue Corneal and Retinal Diseases: Diagnostic and Therapeutic Approaches)

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12 pages, 1610 KiB

Open AccessArticle

Changes in the 3D Corneal Structure and Morphogeometric Properties in Keratoconus after Corneal Collagen Crosslinking

by Ramón Alifa, David Piñero, José Velázquez, Jorge L. Alió del Barrio, Francisco Cavas and Jorge L. Alió

Diagnostics 2020, 10(6), 397; https://doi.org/10.3390/diagnostics10060397 - 11 Jun 2020

Cited by 11 | Viewed by 2529

Abstract

Keratoconus is an ectatic disorder that is presently considered one of the most prevalent reasons for keratoplasty. Corneal collagen crosslinking (CXL) is the only proven treatment option available that is capable of halting the progression of the disease by stabilizing the cone in 90% of cases, and by also reducing refractive error and maximal keratometry. This study assesses, by means of a 3D morphogeometric analysis procedure developed by our research team, the corneal structure changes that occur immediately after CXL treatment and during a 6 month follow-up period. A total of 19 eyes from 19 patients diagnosed with keratoconus who underwent CXL were included, and several variables derived from the morphogeometric analysis were calculated and evaluated for the pre-operative, 3 month postoperative, and 6 month postoperative states. Significant reductions were detected in central corneal thickness and corneal spherical-like root mean square (RMS) 3 months after surgery, with non-significant regression of the effect afterward. Significant reductions in the total corneal area/volume were found, with some levels of regression after 6 months in certain volumetric parameters. In conclusion, the eyes with higher values for morphogeometric parameters—posterior apex deviation (PAD), anterior minimum thickness point deviation (AMTPD), and posterior minimum thickness point deviation (PMTPD)—seemed more likely to undergo aberrometric improvement as a result of CXL surgery. Full article

(This article belongs to the Special Issue Corneal and Retinal Diseases: Diagnostic and Therapeutic Approaches)

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10 pages, 1149 KiB

Open AccessArticle

Hypotensive Effect of Nanomicellar Formulation of Melatonin and Agomelatine in a Rat Model: Significance for Glaucoma Therapy

by Massimo Dal Monte, Maurizio Cammalleri, Salvatore Pezzino, Roberta Corsaro, Nicola Pescosolido, Paola Bagnoli and Dario Rusciano

Diagnostics 2020, 10(3), 138; https://doi.org/10.3390/diagnostics10030138 - 03 Mar 2020

Cited by 9 | Viewed by 2623

Abstract

Background: Melatoninergic agents are known to reduce intraocular pressure (IOP). The present study was performed to evaluate the effect of nanomicellar formulations of melatoninergic agents on IOP in the rat. Methods: Tonometry was used to measure IOP in eyes instilled with melatonin or agomelatine. Ocular hypertension was induced by the injection of methylcellulose in the anterior chamber. Results: Melatonin formulated in nanomicelles had a longer lasting hypotonizing effect on IOP with respect to melatonin in saline. Nanomicellar formulations of melatonin and agomelatine, either alone or in combination, had lowering effects that did not depend on their concentration or their combination, which, however, resulted in an increased duration of the hypotonizing effect. The duration of the lowering effect was further increased by the addition of lipoic acid. Conclusions: We demonstrated the effective hypotonizing activity of melatonin and agomelatine in combination with lipoic acid. Although results in animals cannot be directly translated to humans, the possibility of developing novel therapeutical approaches for patients suffering from hypertensive glaucoma should be considered. Full article

(This article belongs to the Special Issue Corneal and Retinal Diseases: Diagnostic and Therapeutic Approaches)

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9 pages, 1850 KiB

Open AccessCase Report

Bilateral Acute Macular Neuroretinopathy in a Young Patient: Imaging and Visual Field during Two-Year-Follow-Up

by Alessandro Porta, Sarah Tripodi, Mario Damiano Toro, Robert Rejdak, Konrad Rejdak, Emma Clara Zanzottera and Fabio Ferentini

Diagnostics 2020, 10(5), 259; https://doi.org/10.3390/diagnostics10050259 - 28 Apr 2020

Cited by 8 | Viewed by 3138

Abstract

Acute macular neuroretinopathy (AMN) is a rare disorder. We report a case of bilateral AMN in a young female patient, without any risk factors. She referred a positive scotoma in both eyes after flu-like symptoms. Fundus examination revealed parafoveal dark-reddish oval lesions in both eyes. Therefore, we performed visual field, optical coherence tomography (OCT), fluorescein angiography (FA) and indocyanine green angiography (ICG) at baseline and several times during the two years of follow-up. The infrared (IR) imaging showed one rounded hyporeflective lesion in the left eye and two similar lesions in the right eye. The OCT demonstrated the characteristic alterations in the outer retina. The visual field also demonstrated scotomas corresponding with these lesions. The OCT and IR features disappeared at the end of the follow-up except for the left eye, which continued to have hyperreflective spots in the outer plexiform layer. The patient complained about a residual scotoma only in the left eye after two years. Our case shows a difference in disease progression in the two eyes of the same patient, suggesting that several mechanisms can be implicated in the pathology of AMN. Full article

(This article belongs to the Special Issue Corneal and Retinal Diseases: Diagnostic and Therapeutic Approaches)

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