Latest Advances in the Diagnosis and Management of Vitreo-Retinal Disorders

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Ophthalmology".

Deadline for manuscript submissions: closed (15 November 2023) | Viewed by 6149

Special Issue Editor


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Guest Editor
Department of Ophthalmology, Akita University Graduate School of Medicine, Akita 010-8543, Japan
Interests: retinal diseases; vitreoretinal diseases; vitrectomy; vitreoretinal surgery; diabetic retinopathy; retinal vein occlusion
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Special Issue Information

Dear Colleagues,

In recent years, the management of retinal and choroidal diseases has undergone major advances in diagnosis and treatment. In the area of diagnosis, the past two decades have seen significant advances in optical coherence tomography (OCT) as well as OCT angiography and color scanning laser ophthalmoscopy, which have become popular worldwide. Thus, multimodal imaging has improved the accuracy of diagnosis and understanding of pathological conditions. The increase in testing equipment also means an increase in the number of images of healthy and diseased eyes.

Treatment for diseases has also evolved dramatically. No one would dispute that the first of these are anti-vascular endothelial growth factor (VEGF) drugs. Anti-VEGF drugs have become a mainstay in the treatment of retinal diseases such as age-related macular degeneration (AMD), diabetic retinopathy, and macular edema and have greatly expanded the potential of drug therapy for these diseases.

This Special Issue invites a wide range of research related to ophthalmic diagnosis and management. Our aim is for this issue to be of help in the diagnosis and management of vitreo-retinal disorders and to assist in your future research.

Prof. Dr. Takeshi Iwase
Guest Editor

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Keywords

  • vitreo-retinal disorders
  • optical coherence tomography (OCT)
  • OCT angiography
  • anti-VEGF therapy
  • image analysis
  • vitrectomy

Published Papers (5 papers)

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Research

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11 pages, 3703 KiB  
Article
Changes in Neurodegeneration and Visual Prognosis in Branch Retinal Vein Occlusion after Resolution of Macular Edema
by Chanjoon Park, Ji Ho Lee and Young Gun Park
J. Clin. Med. 2024, 13(3), 812; https://doi.org/10.3390/jcm13030812 - 31 Jan 2024
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Abstract
This study aimed to examine the thicknesses of the ganglion cell layer (GCL) and peripapillary retinal nerve fiber layer (RNFL) in eyes with resolved macular edema (ME) in branch retinal vein occlusion (BRVO) and determine their relationship with visual acuity (VA). This retrospective [...] Read more.
This study aimed to examine the thicknesses of the ganglion cell layer (GCL) and peripapillary retinal nerve fiber layer (RNFL) in eyes with resolved macular edema (ME) in branch retinal vein occlusion (BRVO) and determine their relationship with visual acuity (VA). This retrospective observational case–control study included 57 eyes of BRVO patients with resolved ME after treatment. The macular GCL thickness, peripapillary RNFL thickness, and central macular thickness (CMT) measured on swept-source optical coherence tomography scans with the contralateral eyes used as controls were evaluated. The mean CMT was 270.48 ± 32.7 μm; the mean RNFL thickness was 105.46 ± 25.94 μm in BRVO eyes. Although the average RNFL thickness was decreased in BRVO eyes compared to unaffected eyes, there was no significant difference between the groups. However, the temporal and nasal RNFL thicknesses were significantly different between the groups. The mean affected quadrant had a significantly thinner GCL compared to the corresponding opposite unaffected quadrant (p = 0.02). Final VA was significantly correlated with nasal and middle GCL thicknesses in the affected area (r = −0.512, p = 0.003 and r = −0.537, p = 0.001, respectively); no correlation was found between the average RNFL thickness and mean CMT. The peripapillary RNFL and GCL thicknesses of the affected area were reduced in BRVO eyes compared to unaffected eyes. VA significantly correlated with nasal and middle GCL thicknesses in the affected area. Inner retinal damage occurring in patients with ME secondary to BRVO may be related to the visual prognosis. Full article
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11 pages, 6812 KiB  
Article
Swept Source-Optical Coherence Tomography-Guided Facedown Posturing to Minimize Treatment Burden and Maximize Outcome after Macular Hole Surgery
by Mariko Sato and Takeshi Iwase
J. Clin. Med. 2023, 12(16), 5282; https://doi.org/10.3390/jcm12165282 - 14 Aug 2023
Cited by 1 | Viewed by 772
Abstract
We evaluated the closure of full-thickness macular holes (MHs) the day after surgery in minimizing the burden and maximizing patient outcomes. Herein, 25-gauge pars plana vitrectomy, internal limiting membrane peeling, and fluid–gas (20% sulfur hexafluoride) were performed for the treatment. Patients were instructed [...] Read more.
We evaluated the closure of full-thickness macular holes (MHs) the day after surgery in minimizing the burden and maximizing patient outcomes. Herein, 25-gauge pars plana vitrectomy, internal limiting membrane peeling, and fluid–gas (20% sulfur hexafluoride) were performed for the treatment. Patients were instructed to remain in the facedown position until the confirmation of MH closure, and the position was discontinued in cases where the closure was confirmed. In total, 43 eyes of 43 patients, whose average age was 69.7 ± 8.6 years, were enrolled in this study. We used swept source (SS)-optical coherence tomography (OCT) for the confirmation of MH closure for gas-filled eyes and used spectral domain (SD)-OCT for the reconfirmation of MH closure after the gas volume was reduced to less than half of the vitreous cavity. MH closure was confirmed in 40 eyes (93%, the closure group) on the next day after surgery. The time from surgery to SS-OCT imaging was 24.7 h. Although facedown positioning was terminated in cases where MH closure was confirmed, there were no cases in which the MH was re-opened afterward. The basal and minimum MH size was significantly larger in the non-closure group than that in the closure group (p = 0.027, p = 0.043, respectively). Therefore, checking with SS-OCT the day after surgery and terminating facedown positioning in cases where MH closure was confirmed would be a useful method, removing a great burden for the elderly without sacrificing the MH closure rate. Full article
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8 pages, 1304 KiB  
Article
Short-Term Outcomes of Faricimab Treatment in Aflibercept-Refractory Eyes with Neovascular Age-Related Macular Degeneration
by Maya Kishi, Akiko Miki, Aya Kamimura, Mina Okuda, Wataru Matsumiya, Hisanori Imai, Sentaro Kusuhara and Makoto Nakamura
J. Clin. Med. 2023, 12(15), 5145; https://doi.org/10.3390/jcm12155145 - 06 Aug 2023
Cited by 5 | Viewed by 1721
Abstract
To evaluate the functional and anatomical effects of switching to faricimab for patients with neovascular age-related macular degeneration (nAMD) refractory to intravitreal aflibercept, this retrospective study evaluated patients with nAMD who received intravitreal injections of aflibercept (IVA) every <8 weeks and were switched [...] Read more.
To evaluate the functional and anatomical effects of switching to faricimab for patients with neovascular age-related macular degeneration (nAMD) refractory to intravitreal aflibercept, this retrospective study evaluated patients with nAMD who received intravitreal injections of aflibercept (IVA) every <8 weeks and were switched to faricimab. After switching, the patients were treated with a treatment and extended regimen that started with the interval just before switching and received at least three injections. We evaluated changes in the best-corrected visual acuity (BCVA), central retinal thickness (CRT), central choroidal thickness (CCT), treatment interval, and presence of retinal fluid. Overall, 55 eyes from 55 patients were examined. After three injections of faricimab, the BCVA and CCT did not change significantly. However, the CRT decreased significantly (p < 0.05), the injection interval was significantly extended (7.5 ± 2.3 vs. 5.9 ± 1.5 weeks, p < 0.01), and the rates of the presence of intraretinal fluid and subretinal fluid decreased significantly to 16.4% and 40% of eyes, respectively (both p < 0.01). An ocular adverse event (retinal pigment epithelium tear) developed in one eye. Switching to faricimab was effective for anatomic changes. It may be an additional treatment option for some eyes refractory to IVA. Full article
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13 pages, 1137 KiB  
Article
Retinal Pigment Epithelial Abnormality and Choroidal Large Vascular Flow Imbalance Are Associated with Choriocapillaris Flow Deficits in Age-Related Macular Degeneration in Fellow Eyes
by Norihiro Nagai, Yasuaki Mushiga and Yoko Ozawa
J. Clin. Med. 2023, 12(4), 1360; https://doi.org/10.3390/jcm12041360 - 08 Feb 2023
Cited by 1 | Viewed by 1127
Abstract
Choriocapillaris flow deficits detected on optical coherence tomography angiographs were retrospectively analyzed. In 38 age-related macular degeneration (AMD) fellow eyes, without fundus findings (26 men, 71.7 ± 1.9 years old), and 22 control eyes (11 men, 69.4 ± 1.8), the choriocapillaris flow area [...] Read more.
Choriocapillaris flow deficits detected on optical coherence tomography angiographs were retrospectively analyzed. In 38 age-related macular degeneration (AMD) fellow eyes, without fundus findings (26 men, 71.7 ± 1.9 years old), and 22 control eyes (11 men, 69.4 ± 1.8), the choriocapillaris flow area (CCFA) ratio and coefficient of variation (CV) of the CCFA ratio (which represented the heterogeneity of the ratio), negatively and positively correlated with age (all p < 0.01), respectively. Moreover, the respective mean values were lower (p = 0.0031) and greater (p = 0.002) in AMD fellow eyes than in the control eyes. The high-risk condition of AMD fellow eyes was defined by a CCFA ratio <58.5%, and the CV of the CCFA ratio ≥0.165 (odds ratio (OR), 5.408; 95% confidence interval (CI): 1.117–21.118, p = 0.035, after adjusting for age and sex) was related to the presence of fundus autofluorescence abnormality (OR, 16.440; 95% CI, 1.262–214.240; p = 0.033) and asymmetrically dilated choroidal large vasculature (OR, 4.176; 95% CI, 1.057–16.503; p = 0.042), after adjusting for age and sex. The presence of fundus autofluorescence abnormality indicated a retinal pigment epithelium (RPE) abnormality. The RPE volume was reduced in the latter eye group, particularly in the thinner choroidal vasculature. In addition to aging, RPE abnormality and choroidal large vascular flow imbalances were associated with exacerbated heterogeneous choriocapillaris flow deficits in AMD fellow eyes without macular neovascularization. Full article
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Review

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20 pages, 5907 KiB  
Review
Acute-Onset Retinal Conditions Mimicking Acute Optic Neuritis: Overview and Differential Diagnosis
by Emanuela Interlandi, Francesco Pellegrini, Chiara Giuffrè, Daniele Cirone, Daniele Brocca, Andrew G. Lee and Giuseppe Casalino
J. Clin. Med. 2023, 12(17), 5720; https://doi.org/10.3390/jcm12175720 - 01 Sep 2023
Cited by 1 | Viewed by 1473
Abstract
Acute optic neuritis (AON) is a common cause of sudden visual loss in young patients. Because of the risk of demyelinating disease, patients affected by unilateral or bilateral optic neuritis should be evaluated and treated accordingly. Despite advancements in imaging of the brain [...] Read more.
Acute optic neuritis (AON) is a common cause of sudden visual loss in young patients. Because of the risk of demyelinating disease, patients affected by unilateral or bilateral optic neuritis should be evaluated and treated accordingly. Despite advancements in imaging of the brain and retina, misdiagnosis of AON is not uncommon. Indeed, some acute disorders of the retina have the potential to mimic AON and their prompt diagnosis may avoid unnecessary neurologic investigation, psychological stress to the patient, and delays in treatment. This review describes uncommon retinal disorders presenting with sudden-onset visual loss and absent or subtle funduscopic manifestation that can mimic AON. Multimodal retinal imaging is essential in detecting these conditions and in their differential diagnosis. It behooves neurologists and general ophthalmologists to be aware of these entities and be familiar with multimodal imaging of the retina. Full article
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