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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 (22 February 2023) | Viewed by 7299

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Dr. Grzegorz Łabuz

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Guest Editor

The David J Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University Hospital Heidelberg, Heidelberg, Germany
Interests: translational research; vision science; visual optics; medical imaging; optical quality; intraocular lenses; light scattering

Special Issue Information

Dear Colleagues,

In recent years, laboratory ophthalmic research has driven innovation to such an extent that it is transforming ophthalmic practice. Today, a routine slit-lamp examination is supported by advanced retinal imaging using devices developed in the laboratory. This new, non-invasive visualization of the internal ocular anatomy is widely used to diagnose and manage many diseases. Nevertheless, establishing the link between structural changes in the eye and the functional effects of these changes still remains challenging.

The introduction of new techniques of visual function and morphological testing reinforced by artificial intelligence may improve the accuracy of diagnosis and prognosis for patients with eye disorders. A recent introduction of virtual and augmented reality headsets gives a unique opportunity to simulate a patient experience, perform objective eye testing or serve as a rehabilitation tool. This is a fledgling area of research, and clearly much further laboratory work is needed.

Laboratory evaluation of ophthalmic devices such as intraocular lenses or corneal implants and modeling their eventual performance when implanted in the eye helps raise and maintain the highest standards in clinical practice—allowing clinicians to customize treatment options and predict postoperative outcomes. Ex vivo studies involving, for instance, human- or animal-cadaver eye models have long served in testing the safety and efficacy of new devices and techniques, and today, we regard these methods as intrinsic to experimental methods in ophthalmic research.

For this Special Issue, authors are encouraged to submit original articles or write reviews that focus on translational and laboratory studies in ophthalmology. Research areas may include the topics mentioned earlier. However, other experimental-eye-research papers where the work refines diagnosis and ophthalmic therapy and falls within the scope of Diagnostics will also be considered.

Dr. Grzegorz Łabuz
Guest Editor

Manuscript Submission Information

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.

Keywords

optical imaging
visual function
virtual/augmented reality
artificial intelligence
numerical modeling
optical quality
laboratory analysis
experimental ophthalmology
ex vivo models

Published Papers (4 papers)

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Research

16 pages, 2591 KiB

Open AccessArticle

Pitfalls of Using NIR-Based Clinical Instruments to Test Eyes Implanted with Diffractive Intraocular Lenses

by Fidel Vega, Miguel Faria-Ribeiro, Jesús Armengol and María S. Millán

Diagnostics 2023, 13(7), 1259; https://doi.org/10.3390/diagnostics13071259 - 27 Mar 2023

Cited by 3 | Viewed by 1473

Abstract

The strong wavelength dependency of diffractive elements casts reasonable doubts on the reliability of near-infrared- (NIR)-based clinical instruments, such as aberrometers and double-pass systems, for assessing, post-surgery, the visual quality of eyes implanted with diffractive multifocal intraocular lenses (DMIOLs). The results obtained for such patients when using NIR light can be misleading. Ordinary compensation for the refractive error bound to chromatic aberration is not enough because it only considers the best focus shift but does not take into account the distribution of light energy among the foci which strongly depends on the wavelength-dependent energy efficiency of the diffractive orders used in the DMIOL design. In this paper, we consider three commercial DMIOL designs with the far focus falling within the range of (−1, 0, +1)-diffractive orders. We prove theoretically the differences existing in the physical performance of the studied lenses when using either the design wavelength in the visible spectrum or a NIR wavelength (780 to 850 nm). Based on numerical simulation and on-bench experimental results, we show that such differences cannot be neglected and may affect all the foci of a DMIOL, including the far focus. Full article

(This article belongs to the Special Issue Refining Diagnosis in Ophthalmology through Laboratory Research)

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15 pages, 3823 KiB

Open AccessArticle

Retinal Vessel Local Tortuosity under a Macula-to-Optic Disc Central-Framing Change

by Natalia Ramírez, Miquel Ralló and Maria S. Millan

Diagnostics 2023, 13(6), 1030; https://doi.org/10.3390/diagnostics13061030 - 08 Mar 2023

Cited by 1 | Viewed by 1144

Abstract

Some ocular and cardiovascular diseases can be detected through the increased tortuosity of retinal blood vessels. Objective tortuosity measures can be obtained from digital image analysis of a retinography. This study tested a set of local tortuosity indices under a change in the frame center (macula, optic disc) of the eye fundus image. We illustrate the effects of such a change on 40 pairs of vessels evaluated with eight tortuosity indices. We show that the frame center change caused significant differences in the mean values of the vast majority of the tortuosity indices analyzed. The index defined as the ratio of the curvature to the arc length of a vessel segment proved to be the most robust in relation to a frame center change. Experimental results obtained from the analysis of clinical images are provided and discussed. Full article

(This article belongs to the Special Issue Refining Diagnosis in Ophthalmology through Laboratory Research)

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25 pages, 728 KiB

Open AccessArticle

Models and Algorithms for the Refinement of Therapeutic Approaches for Retinal Diseases

by Elfriede Friedmann, Simon Dörsam and Gerd U. Auffarth

Diagnostics 2023, 13(5), 975; https://doi.org/10.3390/diagnostics13050975 - 03 Mar 2023

Viewed by 1128

Abstract

We are developing a Virtual Eye for in silico therapies to accelerate research and drug development. In this paper, we present a model for drug distribution in the vitreous body that enables personalized therapy in ophthalmology. The standard treatment for age-related macular degeneration is anti-vascular endothelial growth factor (VEGF) drugs administered by repeated injections. The treatment is risky, unpopular with patients, and some of them are unresponsive with no alternative treatment. Much attention is paid to the efficacy of these drugs, and many efforts are being made to improve them. We are designing a mathematical model and performing long-term three-dimensional Finite Element simulations for drug distribution in the human eye to gain new insights in the underlying processes using computational experiments. The underlying model consists of a time-dependent convection-diffusion equation for the drug coupled with a steady-state Darcy equation describing the flow of aqueous humor through the vitreous medium. The influence of collagen fibers in the vitreous on drug distribution is included by anisotropic diffusion and the gravity via an additional transport term. The resulting coupled model was solved in a decoupled way: first the Darcy equation with mixed finite elements, then the convection-diffusion equation with trilinear Lagrange elements. Krylov subspace methods are used to solve the resulting algebraic system. To cope with the large time steps resulting from the simulations over 30 days (operation time of 1 anti-VEGF injection), we apply the strong A-stable fractional step theta scheme. Using this strategy, we compute a good approximation to the solution that converges quadratically in both time and space. The developed simulations were used for the therapy optimization, for which specific output functionals are evaluated. We show that the effect of gravity on drug distribution is negligible, that the optimal pair of injection angles is

(50^{\circ}, 50^{\circ})

, that larger angles can result in 38% less drug at the macula, and that in the best case only 40% of the drug reaches the macula while the rest escapes, e.g., through the retina, that by using heavier drug molecules, more of the drug concentration reaches the macula in an average of 30 days. As a refined therapy, we have found that for longer-acting drugs, the injection should be made in the center of the vitreous, and for more intensive initial treatment, the drug should be injected even closer to the macula. In this way, we can perform accurate and efficient treatment testing, calculate the optimal injection position, perform drug comparison, and quantify the effectiveness of the therapy using the developed functionals. We describe the first steps towards virtual exploration and improvement of therapy for retinal diseases such as age-related macular degeneration. Full article

(This article belongs to the Special Issue Refining Diagnosis in Ophthalmology through Laboratory Research)

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9 pages, 4320 KiB

Open AccessArticle

Visualization of Ray Propagation through Extended Depth-of-Focus Intraocular Lenses

by Isabella D. Baur, Gerd U. Auffarth, Weijia Yan, Grzegorz Łabuz and Ramin Khoramnia

Diagnostics 2022, 12(11), 2667; https://doi.org/10.3390/diagnostics12112667 - 02 Nov 2022

Cited by 5 | Viewed by 2519

Abstract

Extended depth-of-focus (EDoF) presbyopia-correcting intraocular lens (IOL) models differ in their optical design and performance. In the laboratory, we compared the ray propagation and light intensity profiles of four IOLs: the non-diffractive AcrySof IQ Vivity (Alcon Inc., Fort Worth, TX, USA) and two diffractive models, Symfony ZXR00 (Johnson & Johnson Vision, Jacksonville, FL, USA) and AT Lara 829 MP (Carl Zeiss Meditec, Berlin, Germany). A fourth lens, the monofocal AcrySof IQ SN60WF (Alcon Inc.) acted as the control. We projected a 520 nm laser light through each submerged lens in a bath of fluorescein solution. A camera mounted on a microscope captured the light that emerged from the IOL. We recorded the IOLs’ point spread function (PSF) to determine the presence of unwanted visual effects. The ray propagation visualization and light intensity profile of the monofocal control showed one distinct focus, while the AcrySof IQ Vivity demonstrated an extended focus area. We observed two distinct foci with each diffractive IOL. We found a lower level of light spread beyond the PSF center for the AcrySof IQ Vivity compared to the diffractive IOLs. In conclusion, we could confirm the extended range of focus for all the EDoF IOL models. However, the non-diffractive AcrySof IQ Vivity appears to have a smoother transition from a far to an intermediate range. We discuss whether, in clinical use, the higher level of spurious light we found in the diffractive designs may translate into increased dysphotopsia. Full article

(This article belongs to the Special Issue Refining Diagnosis in Ophthalmology through Laboratory Research)

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