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Medicina
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Retinal Diseases: Novel Approaches for Diagnosis and Treatments
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Retinal Diseases: Novel Approaches for Diagnosis and Treatments

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Ophthalmology".

Deadline for manuscript submissions: closed (30 November 2022) | Viewed by 13181

Special Issue Editors

Dr. Maurizio Cammalleri

E-Mail Website
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
Special Issues, Collections and Topics in MDPI journals
Dr. Rosario Amato

E-Mail Website
Co-Guest Editor
Department of Biology, University of Pisa, Pisa, Italy
Interests: neurodegeneration; neoangiogenesis; retinal ganglion cells; neurovascular unit; glaucoma; diabetic retinopathy; optic neuropathy; retinitis pigmentosa; pattern electroretinogram
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Sight in humans is the primary sense for the perception of the surrounding environment, and for social relationships. Therefore, pathologies leading to alterations in visual function have a devastating impact on patients’ quality of life, and represent a significant social and economic burden.

Retinal diseases are among the most common and impactful causes of visual impairment, and they are currently among the hot topics in the research to prevent blindness. The multifactorial nature of retinal diseases, including genetic background, systemic pathologies, metabolism, ageing and environmental factors, leaves much room for further research of their complex pathophysiology and the subsequent advances in their clinical management. In the last several years, several steps forward have been made in this field thanks to the intensive research of novel technologies and new biomarkers for the improvement of diagnostic procedures, and on the characterization of new pathological targets for alternative and/or complementary treatment approaches. However, a strong research effort is still needed to obtain a significant improvement in the management of retinal diseases. The present Special Issue aims to broaden the knowledge of the diagnostic and therapeutic methods that may be used in the treatment of retinal diseases. Reviews and original papers highlighting progresses in molecular mechanisms, novel diagnostic proposals and new treatment possibilities will be welcome.

Dr. Maurizio Cammalleri
Dr. Rosario Amato
Guest Editors

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. Medicina 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 1800 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

  • neurodegeneration
  • vascular dysfunction
  • glaucoma
  • diabetic retinopathy
  • optic neuropathy
  • retinitis pigmentosa
  • retinopathy of prematurity
  • age-related macular degeneration
  • pattern electroretinogram
  • full-field electroretinogram

Published Papers (6 papers)

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Research

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13 pages, 1737 KiB  
Article
The HIT Study—The Hydroxychloroquine Effect in the Treatment of Patients with Age-Related Macular Degeneration: A Randomized Controlled Trial
by Tal Yahalomi, Yoav Pikkel, Roee Arnon, Dafi Porat and Joseph Pikkel
Medicina 2023, 59(3), 551; https://doi.org/10.3390/medicina59030551 - 11 Mar 2023
Cited by 2 | Viewed by 2257
Abstract
Background and Objectives: Decreased age-related macular degeneration (AMD) has been reported in individuals with rheumatoid arthritis treated with hydroxychloroquine (HCQ, plaquenil). Materials and Methods: In a randomized controlled trial with a parallel study design, we assessed visual acuity, central macular thickness measured with [...] Read more.
Background and Objectives: Decreased age-related macular degeneration (AMD) has been reported in individuals with rheumatoid arthritis treated with hydroxychloroquine (HCQ, plaquenil). Materials and Methods: In a randomized controlled trial with a parallel study design, we assessed visual acuity, central macular thickness measured with macular optical coherence tomography (OCT), and the number and size of drusen, following treatment with HCQ or a placebo in individuals with AMD. The patients received a daily dosage of 400 mg hydroxychloroquine (study group) or placebo (control group) during 12 months, and underwent complete ophthalmic examinations at 3, 6, 9, 12 and 24 months after initiation of treatment. Results: Of the 110 patients who were randomized to the treatment groups, 46 (29 females) in the study group and 50 (29 females) in the control group completed the study. The study group showed less visual acuity deterioration at two-year follow-up than did the control group (−0.03 ± 0.07 vs. −0.07 ± 0.07, p = 0.027). At two years after treatment initiation, the mean number of drusen per eye was lower for ARDS2 (8.1 vs. 12.3, p = 0.045) in the study group, compared to the control group. Compared to the control group, the proportion of eyes with increased drusen growth was smaller for both ARDS2 and ARDS3 drusen in the study group, and the proportion of the total drusen with growth was smaller for the study group as well: 32/46 eyes (70%) vs. 40/50 eyes (80%). Drusen volume growth, as calculated by the area and height measured with macular OCT, was also more reduced in the study than the control group (0.20 ± 0.15 vs. 0.23 ± 0.16 mm4, p = 0.05). None of the participants showed HCQ toxicity or adverse effects. Conclusion: Among patients with AMD, visual deterioration, the growth and the amount of drusen formation at two years after treatment initiation was less among those treated with HCQ than with a placebo. In this study, there was a negative association between HCQ treatment and wet AMD development. Full article
(This article belongs to the Special Issue Retinal Diseases: Novel Approaches for Diagnosis and Treatments)
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8 pages, 2592 KiB  
Article
Early OCTA Changes of Type 3 Macular Neovascularization Following Brolucizumab Intravitreal Injections
by Anthony Gigon, Maria Vadalà, Vincenza M. E. Bonfiglio, Michele Reibaldi and Chiara M. Eandi
Medicina 2022, 58(9), 1180; https://doi.org/10.3390/medicina58091180 - 30 Aug 2022
Cited by 4 | Viewed by 1437
Abstract
Background and Objectives: Brolucizumab is a novel anti-vascular endothelial growth factor (VEGF), whose efficacy has been shown in the Hawk and Harrier phase 3 clinical studies. The goal of the present case series is to report initial results of brolucizumab intravitreal injections (IVI) [...] Read more.
Background and Objectives: Brolucizumab is a novel anti-vascular endothelial growth factor (VEGF), whose efficacy has been shown in the Hawk and Harrier phase 3 clinical studies. The goal of the present case series is to report initial results of brolucizumab intravitreal injections (IVI) on type 3 neovascularization in neovascular age-related macular degeneration (nAMD), evaluated by optical coherence tomography angiography (OCTA). Materials and Methods: This is a bicentric retrospective case series. Patients with newly diagnosed type 3 MNV treated with brolucizumab IVI and at least 6 months follow-up were enrolled. OCTA en face images and B-scans were analyzed for lesions at baseline, 1 month, 3 months, and 6 months. Whenever detectable, lesion area on outer retina and choriocapillaris layers was measured. Results: Twelve eyes of 12 patients were included into the study. The most consistent OCTA sign at baseline was the presence of a vascular tuft in the outer retina (100%). The highest response was achieved at 3 months, with statistically significant decrease in lesion detection in the outer retina, in the choriocapillaris, and outer retinal lesion size. At 6 months, 58% of outer retinal lesions had disappeared. Conclusions: Brolucizumab IVI shows a good short-term efficacy for the treatment of type 3 neovascularizations. Further studies with greater number of patients and longer follow-up are warranted to confirm these findings. Full article
(This article belongs to the Special Issue Retinal Diseases: Novel Approaches for Diagnosis and Treatments)
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10 pages, 1018 KiB  
Article
Choroidal Changes in Blood Flow in Patients with Intermediate AMD after Oral Dietary Supplement Based on Astaxanthin, Bromelain, Vitamin D3, Folic Acid, Lutein, and Antioxidants
by Rossella D’Aloisio, Luca Di Antonio, Lisa Toto, Marco Rispoli, Angelo Di Iorio, Giancarlo Delvecchio and Rodolfo Mastropasqua
Medicina 2022, 58(8), 1092; https://doi.org/10.3390/medicina58081092 - 12 Aug 2022
Cited by 1 | Viewed by 1790
Abstract
Background and Objectives: The aim of this study was to investigate the impact of oral administration of the combination of astaxanthin (AXT), lutein, folic acid, vitamin D3, and bromelain with antioxidants on choroidal blood flow in patients with age-related intermediate macular degeneration [...] Read more.
Background and Objectives: The aim of this study was to investigate the impact of oral administration of the combination of astaxanthin (AXT), lutein, folic acid, vitamin D3, and bromelain with antioxidants on choroidal blood flow in patients with age-related intermediate macular degeneration (AMD). Materials and Methods: Patients affected by intermediate AMD and treated with daily oral nutritional supplement with AXT, bromelain, vitamin D3, folic acid, lutein, and antioxidants for a period of at least 6 months were included in this retrospective study. A control group homogenous for age and sex was also included in the analysis. All participants underwent a complete ophthalmologic examination, spectral domain optical coherence tomography (SD-OCT), and optical coherence tomography angiography (OCTA) evaluation. Outcome measures were choroidal thickness (CHT) and choriocapillary vessel density (CCVD) after six months of AXT assumption. Results: CCVD values showed statistically significant difference between cases and controls at baseline (p < 0.001) and in the cases during follow-up (p < 0.001). The CHT measurements showed statistically significant difference between cases and controls (p = 0.002) and in the cases during follow-up (p < 0.001). Conclusions: The combined use of structural OCT and OCTA allows for a detailed analysis in vivo of perfusion parameters of the choriocapillaris and choroid and evaluation of changes of choroidal blood flow after oral nutritional supplements that affect blood flow velocity. Full article
(This article belongs to the Special Issue Retinal Diseases: Novel Approaches for Diagnosis and Treatments)
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12 pages, 1559 KiB  
Article
Aqueous Humor Cytokines in Non-Proliferative Diabetic Retinopathy
by Otilia Obadă, Anca Delia Pantalon, Gabriela Rusu-Zota, Anca Hăisan, Smaranda Ioana Lupuşoru, Daniela Constantinescu and Dorin Chiseliţă
Medicina 2022, 58(7), 909; https://doi.org/10.3390/medicina58070909 - 08 Jul 2022
Cited by 5 | Viewed by 1806
Abstract
Background and Objectives: Cytokines are cell-signaling proteins whose identification may serve as inflammatory markers or early indicators for progressive disease. The aim of our study was to quantify several cytokines in aqueous humor (AH) and their correlations with biochemical parameters in diabetic [...] Read more.
Background and Objectives: Cytokines are cell-signaling proteins whose identification may serve as inflammatory markers or early indicators for progressive disease. The aim of our study was to quantify several cytokines in aqueous humor (AH) and their correlations with biochemical parameters in diabetic eyes with non-proliferative diabetic retinopathy (NPDR). Materials and Methods: A total of 62 eyes from 62 patients were included in the study: 37 eyes from nondiabetic patients (group 1), 13 diabetic eyes with no retinopathy changes (group 2) and 12 diabetic eyes with early and moderate NPDR (group 3). AH samples were collected during uneventful cataract surgery. The cytokines IL-1β, IL-6, IL-8, IL-10, IL-12, IP-10, MCP-1, TNF-α and VEGF were quantified using multiplex bead-based immunoassay. Due to unreliable results, IL-1β, TNF-α, IL-10 and IL-12 were excluded. Concentrations were compared between groups. Biochemical parameters (fasting blood sugar, glycated hemoglobin, C-reactive protein) and the duration of diabetes were recorded. Results: VEGF levels were significantly different between groups (p = 0.001), while levels of IL-6, IL-8, IP-10 and MCP-1 were comparable across all groups (p > 0.05). IL-6 concentration correlated with VEGF in group 1 (rho = 0.651, p = 0.003) and group 3 (rho = 0.857, p = 0.007); no correlation could be proved between IL-6, IL-8, IP-10, MCP-1 or VEGF and biochemical parameters. Duration of diabetes was not correlated with the cytokine levels in groups 2 and 3. The receiver operating characteristic (ROC) curve revealed that VEGF concentrations could discriminate early and moderate NPDR from diabetes, with an area under the curve (AUC) of 0.897 (p = 0.001, 95% CI = 0.74–1.0). Conclusions: Diabetes mellitus induces significant intraocular changes in the VEGF expression in diabetic patients vs. normal subjects, even before proliferative complications appear. VEGF was increasingly expressed once the diabetes progressed from no retinopathy to early or moderate retinopathy. Full article
(This article belongs to the Special Issue Retinal Diseases: Novel Approaches for Diagnosis and Treatments)
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12 pages, 1199 KiB  
Article
Comparison of Choroidal Thickness, Foveal Avascular Zone, and Macular Capillary Density in Macular Edema Secondary to Branch Retinal Vein Occlusion Treated with Ranibizumab or Aflibercept—A Prospective Study
by Yu-Te Huang, I Wang, Chun-Ju Lin, Chun-Ting Lai, Ning-Yi Hsia, Huan-Sheng Chen, Peng-Tai Tien, Henry Bair, Jane-Ming Lin, Wen-Lu Chen, Chang-He Chen, Wen-Chuan Wu and Yi-Yu Tsai
Medicina 2022, 58(4), 540; https://doi.org/10.3390/medicina58040540 - 14 Apr 2022
Cited by 2 | Viewed by 2020
Abstract
This prospective comparative case series aims to compare best-corrected visual acuity (BCVA), retinal microvasculature, and retinal structural changes in patients treated with either ranibizumab or aflibercept for macular edema (ME) secondary to treatment-naïve branch retinal vein occlusion (BRVO) by optical coherence tomography angiography [...] Read more.
This prospective comparative case series aims to compare best-corrected visual acuity (BCVA), retinal microvasculature, and retinal structural changes in patients treated with either ranibizumab or aflibercept for macular edema (ME) secondary to treatment-naïve branch retinal vein occlusion (BRVO) by optical coherence tomography angiography (OCTA). Ten patients were enrolled with macular capillary density of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) and foveal avascular zone (FAZ) measured in both eyes before and after treatment. Final central retinal thickness and BCVA improved significantly (p < 0.05), and densities of SCP and DCP of BRVO sectors were significantly lower at baseline than fellow eye counterparts and remained persistently lower during treatment, particularly in the aflibercept group (p < 0.05). SCP density, DCP density of both BRVO sectors (p = 0.0001, p < 0.0001), and non-BRVO sectors (p < 0.0001, p < 0.0001) were significantly correlated with final BCVA for diseased eyes. Using multivariate general linear model analysis, and including OCTA parameters only, but not all of the available clinical data, DCP density of BRVO sectors in both eyes was the most predictive factor for final visual outcome (probability p < 0.0001). OCTA offered further qualitative and quantitative evaluation of treatment-naïve BRVO. Judging by OCTA parameters, not only in the diseased eye but also in the fellow eye, DCP density of BRVO sectors was the most predictive factor of final visual outcome. Full article
(This article belongs to the Special Issue Retinal Diseases: Novel Approaches for Diagnosis and Treatments)
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Review

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18 pages, 2593 KiB  
Review
A Systematic Review of Artificial Intelligence Applications Used for Inherited Retinal Disease Management
by Meltem Esengönül, Ana Marta, João Beirão, Ivan Miguel Pires and António Cunha
Medicina 2022, 58(4), 504; https://doi.org/10.3390/medicina58040504 - 31 Mar 2022
Cited by 7 | Viewed by 3162
Abstract
Nowadays, Artificial Intelligence (AI) and its subfields, Machine Learning (ML) and Deep Learning (DL), are used for a variety of medical applications. It can help clinicians track the patient’s illness cycle, assist with diagnosis, and offer appropriate therapy alternatives. Each approach employed may [...] Read more.
Nowadays, Artificial Intelligence (AI) and its subfields, Machine Learning (ML) and Deep Learning (DL), are used for a variety of medical applications. It can help clinicians track the patient’s illness cycle, assist with diagnosis, and offer appropriate therapy alternatives. Each approach employed may address one or more AI problems, such as segmentation, prediction, recognition, classification, and regression. However, the amount of AI-featured research on Inherited Retinal Diseases (IRDs) is currently limited. Thus, this study aims to examine artificial intelligence approaches used in managing Inherited Retinal Disorders, from diagnosis to treatment. A total of 20,906 articles were identified using the Natural Language Processing (NLP) method from the IEEE Xplore, Springer, Elsevier, MDPI, and PubMed databases, and papers submitted from 2010 to 30 October 2021 are included in this systematic review. The resultant study demonstrates the AI approaches utilized on images from different IRD patient categories and the most utilized AI architectures and models with their imaging modalities, identifying the main benefits and challenges of using such methods. Full article
(This article belongs to the Special Issue Retinal Diseases: Novel Approaches for Diagnosis and Treatments)
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