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Life
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Eye Manifestations of Systemic Disease
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Eye Manifestations of Systemic Disease

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Physiology and Pathology".

Deadline for manuscript submissions: closed (25 May 2023) | Viewed by 27555

Special Issue Editor

Dr. Manju Subramanian

E-Mail Website
Guest Editor
Department of Ophthalmology, Boston University School of Medicine, Boston, MA, USA
Interests: age related macular degeneration; diabetic retinopathy; ocular trauma; retinal detachments; hereditary retinal and macular diseases
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

As an extension of the brain, the eye is a sensory organ unlike any other because its neurological structures can be directly visualized on clinical examination. Systemic pathological changes such as infections, malignancies, and inflammatory disorders may be reflected in the eye, and if so, the ophthalmologist is often the first to diagnose them. In this Special Issue, we explore the eye as it relates to the body as a whole. We consider how systemic diseases such as diabetes can lead to both reversible and irreversible vision loss, and how the eye is an immunologically privileged organ that can still be affected by systemic infectious diseases and autoimmune disorders, leading to ocular inflammation. We also explore how ophthalmic signs and symptoms, as well as the cellular and vascular structures in the retina, can be diagnostic sources for neurological conditions such as multiple sclerosis, myasthenia gravis, and Alzheimer’s disease. Additionally, we review the latest advances in ocular imaging and its significance and impact on the diagnosis and management of ophthalmic disorders. Finally, we discuss recent advances in ophthalmic surgery for the treatment and prevention of blindness. Our goal in this Special Issue is to provide a comprehensive perspective of the eye and how the visual system interacts with the body during various states of disease.

Dr. Manju Subramanian
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. Life is an international peer-reviewed open access monthly 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

  • age-related macular degeneration
  • diabetic retinopathy
  • ocular trauma
  • retinal detachments
  • hereditary retinal and macular diseases

Published Papers (8 papers)

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Review

16 pages, 321 KiB  
Review
Systemic Associations with Keratoconus
by Prasida Unni and Hyunjoo Jean Lee
Life 2023, 13(6), 1363; https://doi.org/10.3390/life13061363 - 10 Jun 2023
Cited by 4 | Viewed by 1764
Abstract
Keratoconus is a disease of the cornea that results in progressive steepening and thinning of the cornea and subsequent vision loss. It nearly always presents as a bilateral disease, suggesting that there is an underlying abnormality of the corneas that becomes manifest with [...] Read more.
Keratoconus is a disease of the cornea that results in progressive steepening and thinning of the cornea and subsequent vision loss. It nearly always presents as a bilateral disease, suggesting that there is an underlying abnormality of the corneas that becomes manifest with time. However, the mechanisms underlying the development of keratoconus are largely unknown. Associations reported between keratoconus and systemic diseases are abundant in the literature, and the list of possible associations is very long. We found that atopy, Down syndrome, and various connective tissue diseases were the most frequently cited associations in our broad literature search. Additionally, Diabetes Mellitus has been increasingly studied as a possible protective factor against keratoconus. In this review, we have summarized the evidence for and against these particular systemic conditions and keratoconus and have discussed some of the implications of keratoconus patients having these conditions. Full article
(This article belongs to the Special Issue Eye Manifestations of Systemic Disease)
15 pages, 278 KiB  
Review
Update on the Management of Diabetic Retinopathy: Anti-VEGF Agents for the Prevention of Complications and Progression of Nonproliferative and Proliferative Retinopathy
by Tyler A. Bahr and Sophie J. Bakri
Life 2023, 13(5), 1098; https://doi.org/10.3390/life13051098 - 27 Apr 2023
Cited by 6 | Viewed by 2954
Abstract
Diabetic retinopathy (DR) is a microvascular disease caused by poorly controlled blood glucose, and it is a leading cause of vision loss in people with diabetes. In this review we discuss the current management of DR with particular focus on the use of [...] Read more.
Diabetic retinopathy (DR) is a microvascular disease caused by poorly controlled blood glucose, and it is a leading cause of vision loss in people with diabetes. In this review we discuss the current management of DR with particular focus on the use of intraocular anti-vascular endothelial growth factor (anti-VEGF) agents. Intraocular anti-VEGF agents were first studied in the 1990s, and now several of these agents are either FDA approved or used off-label as first-line treatments for DR. Recent evidence shows that anti-VEGF agents can halt the progression of markers of DR severity, reduce the risk of DR worsening, and reduce the onset of new macular edema. These significant benefits have been demonstrated in patients with proliferative DR and the milder nonproliferative DR (NPDR). A wealth of evidence from recent trials and meta-analyses has detailed the intraoperative and postoperative benefits of adjunctive anti-VEGF therapy prior to pars plana vitrectomy (PPV) for proliferative DR with vitreous hemorrhage. In this review, we also discuss literature comparing various anti-VEGF injection regimens including monthly, quarterly, as-needed, and treat and extend protocols. Combination protocols with panretinal photocoagulation (PRP) or PPV are also discussed. Current evidence suggests that anti-VEGF therapies are effective therapy for NPDR and PDR and may also provide significant benefits when used adjunctively with other DR treatment modalities such as PRP or PPV. Full article
(This article belongs to the Special Issue Eye Manifestations of Systemic Disease)
16 pages, 379 KiB  
Review
Modifiable Risk Factors and Preventative Strategies for Severe Retinopathy of Prematurity
by Minali Prasad, Ellen C. Ingolfsland and Stephen P. Christiansen
Life 2023, 13(5), 1075; https://doi.org/10.3390/life13051075 - 24 Apr 2023
Viewed by 2748
Abstract
Severe ROP is characterized by the development of retinal fibrovascular proliferation that may progress to retinal detachment. The purpose of this report is to review five of the most common and well-studied perinatal and neonatal modifiable risk factors for the development of severe [...] Read more.
Severe ROP is characterized by the development of retinal fibrovascular proliferation that may progress to retinal detachment. The purpose of this report is to review five of the most common and well-studied perinatal and neonatal modifiable risk factors for the development of severe ROP. Hyperoxemia, hypoxia, and associated prolonged respiratory support are linked to the development of severe ROP. While there is a well-established association between clinical maternal chorioamnionitis and severe ROP, there is greater variability between histologic chorioamnionitis and severe ROP. Neonatal sepsis, including both bacterial and fungal subtypes, are independent predictors of severe ROP in preterm infants. Although there is limited evidence related to platelet transfusions, the risk of severe ROP increases with the number and volume of red blood cell transfusions. Poor postnatal weight gain within the first six weeks of life is also strongly tied to the development of severe ROP. We also discuss preventative strategies that may reduce the risk of severe ROP. Limited evidence-based studies exist regarding the protective effects of caffeine, human milk, and vitamins A and E. Full article
(This article belongs to the Special Issue Eye Manifestations of Systemic Disease)
19 pages, 1547 KiB  
Review
Glaucoma and Systemic Disease
by Eugene Hsu and Manishi Desai
Life 2023, 13(4), 1018; https://doi.org/10.3390/life13041018 - 15 Apr 2023
Cited by 6 | Viewed by 4370
Abstract
Glaucoma is the leading cause of irreversible blindness in the world. Due to its potential to cause permanent vision loss, it is important to understand how systemic conditions and their respective treatments can be associated with or increase the risk for developing glaucoma. [...] Read more.
Glaucoma is the leading cause of irreversible blindness in the world. Due to its potential to cause permanent vision loss, it is important to understand how systemic conditions and their respective treatments can be associated with or increase the risk for developing glaucoma. In this review, we examined the literature for up-to-date discussions and provided commentary on glaucoma, its pathophysiology, and associated risk factors. We discuss systemic diseases and the impact, risk, and mechanism for developing glaucoma, including pharmacologically induced glaucoma; inflammatory and auto-immune conditions; infectious, dermatologic, cardiovascular, pulmonary, renal, urologic, neurologic, psychiatric and systemic malignancies: intraocular tumors; as well as pediatric, and genetic conditions. The goal of our discussion of systemic conditions including their commonality, mechanisms, treatments, and associations with developing glaucoma is to emphasize the importance of ocular examinations and follow-up with the multidisciplinary teams involved in the care of each patient to prevent unnecessary vision-loss. Full article
(This article belongs to the Special Issue Eye Manifestations of Systemic Disease)
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17 pages, 1900 KiB  
Review
The Role of Oxidative Stress in the Aging Eye
by Deniz Goodman and Steven Ness
Life 2023, 13(3), 837; https://doi.org/10.3390/life13030837 - 20 Mar 2023
Cited by 10 | Viewed by 3242
Abstract
Given the expanding elderly population in the United States and the world, it is important to understand the processes underlying both natural and pathological age-related changes in the eye. Both the anterior and posterior segment of the eye undergo changes in biological, chemical, [...] Read more.
Given the expanding elderly population in the United States and the world, it is important to understand the processes underlying both natural and pathological age-related changes in the eye. Both the anterior and posterior segment of the eye undergo changes in biological, chemical, and physical properties driven by oxidative stress. With advancing age, changes in the anterior segment include dermatochalasis, blepharoptosis, thickening of the sclera, loss of corneal endothelial cells, and stiffening of the lens. Changes in the posterior segment include lowered viscoelasticity of the vitreous body, photoreceptor cell loss, and drusen deposition at the macula and fovea. Age-related ocular pathologies including glaucoma, cataracts, and age-related macular degeneration are largely mediated by oxidative stress. The prevalence of these diseases is expected to increase in the coming years, highlighting the need to develop new therapies that address oxidative stress and slow the progression of age-related pathologies. Full article
(This article belongs to the Special Issue Eye Manifestations of Systemic Disease)
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19 pages, 5019 KiB  
Review
The Eye as a Diagnostic Tool for Alzheimer’s Disease
by Ahsan Hussain, Zahra Sheikh and Manju Subramanian
Life 2023, 13(3), 726; https://doi.org/10.3390/life13030726 - 08 Mar 2023
Cited by 2 | Viewed by 2957
Abstract
Alzheimer’s disease (AD) is a progressive neurodegenerative disorder impacting cognition, function, and behavior in the elderly population. While there are currently no disease-modifying agents capable of curing AD, early diagnosis and management in the preclinical stage can significantly improve patient morbidity and life [...] Read more.
Alzheimer’s disease (AD) is a progressive neurodegenerative disorder impacting cognition, function, and behavior in the elderly population. While there are currently no disease-modifying agents capable of curing AD, early diagnosis and management in the preclinical stage can significantly improve patient morbidity and life expectancy. Currently, the diagnosis of Alzheimer’s disease is a clinical one, often supplemented by invasive and expensive biomarker testing. Over the last decade, significant advancements have been made in our understanding of AD and the role of ocular tissue as a potential biomarker. Ocular biomarkers hold the potential to provide noninvasive and easily accessible diagnostic and monitoring capabilities. This review summarizes current research for detecting biomarkers of Alzheimer’s disease in ocular tissue. Full article
(This article belongs to the Special Issue Eye Manifestations of Systemic Disease)
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10 pages, 228 KiB  
Review
Adverse Ocular Effects of Systemic Medications
by Michael B. Green and Jay S. Duker
Life 2023, 13(3), 660; https://doi.org/10.3390/life13030660 - 28 Feb 2023
Viewed by 2840
Abstract
While ocular complications of systemic medications are uncommon, it is important to recognize that vision-threatening toxicities can occur. This review details the vision-threatening adverse effects of a select group of commonly prescribed systemic medications and describes the recommended screening guidelines for those that [...] Read more.
While ocular complications of systemic medications are uncommon, it is important to recognize that vision-threatening toxicities can occur. This review details the vision-threatening adverse effects of a select group of commonly prescribed systemic medications and describes the recommended screening guidelines for those that are particularly high risk. Full article
(This article belongs to the Special Issue Eye Manifestations of Systemic Disease)
17 pages, 2292 KiB  
Review
Thyroid Eye Disease
by Ramy Rashad, Raquel Pinto, Emily Li, Mahsa Sohrab and Alberto G. Distefano
Life 2022, 12(12), 2084; https://doi.org/10.3390/life12122084 - 12 Dec 2022
Cited by 4 | Viewed by 5099
Abstract
Thyroid eye disease (TED), an autoimmune inflammatory disorder of the orbit, presents with a potential array of clinical sequelae. The pathophysiology behind TED has been partially characterized in the literature. There remain certain elusive mechanisms welcoming of research advances. Disease presentation can vary, [...] Read more.
Thyroid eye disease (TED), an autoimmune inflammatory disorder of the orbit, presents with a potential array of clinical sequelae. The pathophysiology behind TED has been partially characterized in the literature. There remain certain elusive mechanisms welcoming of research advances. Disease presentation can vary, but those that follow a characteristic course start mild and increase in severity before plateauing into an inactive phase. Diagnosis and evaluation include careful physical examination, targeted laboratory work up, appropriate imaging studies, and tailored treatment regimens. Special consideration may apply to certain populations, such as pediatric and pregnant patients. Full article
(This article belongs to the Special Issue Eye Manifestations of Systemic Disease)
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