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Topic Review
Gene Therapy for Neovascular Age-Related Macular Degeneration
Age-related macular degeneration (AMD) is a complex and multifactorial disease and a leading cause of irreversible blindness in the elderly population. The anti-vascular endothelial growth factor (anti-VEGF) therapy has revolutionized the management and prognosis of neovascular AMD (nAMD) and is currently the standard of care for this disease. However, patients are required to receive repeated injections, imposing substantial social and economic burdens. The implementation of gene therapy methods to achieve sustained delivery of various therapeutic proteins holds the promise of a single treatment that could ameliorate the treatment challenges associated with chronic intravitreal therapy, and potentially improve visual outcomes. Several early-phase trials are currently underway, evaluating the safety and efficacy of gene therapy for nAMD; however, areas of controversy persist, including the therapeutic target, route of administration, and potential safety issues.
  • 801
  • 18 Dec 2023
Topic Review
Clinical Investigations and Diagnosis of Peripapillary Intrachoroidal Cavitation
Peripapillary intrachoroidal cavitation (PICC) is a yellow-orange lesion, located at the outer border of the myopic conus. First described as a localized detachment of the retinal pigment epithelium, its intrachoroidal location was later revealed, justifying its current name. PICC is related to other myopic complications such as posterior staphyloma, but its pathogenesis is not clear to date. Although it has been considered a benign condition, most eyes with PICC show visual field defects, which leads to diagnostic uncertainty as these deficits resemble those seen in glaucoma. Furthermore, eyes with PICC may develop macular detachment with retinoschisis.
  • 800
  • 21 Jul 2023
Topic Review
Optical Coherence Tomography Angiography in Uveitis
The global and precise follow-up of uveitis has become possible with the availability of dual fluorescein (FA) and indocyanine green angiography (ICGA) since the mid-1990s. Progressively, additional non-invasive imaging methods have emerged, bringing value-added precision to the imaging appraisal of uveitis, including, among others, optical coherence tomography (OCT), enhanced-depth imaging OCT (EDI-OCT) and blue light fundus autofluorescence (BAF). More recently, another complementary imaging method, OCT-angiography (OCT-A), further allowed retinal and choroidal circulation to be imaged without the need for dye injection. Promoting the possibility that non-invasive OCT-A can substitute the invasive dye methods is deleterious, giving the elusive impression that dye methods are no longer inevitable for evaluating uveitis patients. Nevertheless, OCT-A is a precious tool in uveitis research.
  • 796
  • 27 Feb 2023
Topic Review
Ocular Manifestations of Systemic Lupus Erythematosus
Systemic lupus erythematosus (SLE) is a chronic autoimmune systemic disorder of the connective tissue that does not affect only one certain organ but has a diversified effect all over the body. The etiology of SLE is may be idiopathic, genetic, hormonal, or environmental. The diagnosis of SLE is difficult and requires a series of tests and findings which can be systemic or ocular. Approximately one-third of those diagnosed with SLE experience ocular manifestations that range from mild to severe sight-threatening conditions. Ocular manifestations of SLE include keratoconjunctivitis sicca, uveitis, and posterior segment pathologic signs.
  • 795
  • 29 Feb 2024
Topic Review
Posterior Capsule Opacification: Experimental Review
Posterior capsule opacification (PCO) is the most common complication of cataract surgery. It causes a gradual deterioration of visual acuity, which would otherwise improve after a successful procedure. Despite recent advances in ophthalmology, this complication has not been eradicated, and the incidence of PCO can be as high as 10%.
  • 792
  • 06 Jul 2021
Topic Review
Ru-106 Brachytherapy
Ruthenium-106 brachytherapy emits beta radiation (Ru-106 gives off radiation in the form of high energy electrons called beta particles as it decays into rhodium-106 and then into palladium-106, which isn't radioactive) and is used for tumors up to 5 mm in height due to the limited range of radiation penetration, but in some centers, it is used to treat thicker tumors. Therefore, ruthenium is intended for the treatment of small and some medium-sized tumors.
  • 790
  • 10 Jul 2023
Topic Review
Neurodegeneration and Death of Retinal Ganglion Cells
Retinal ganglion cells (RGC) transmit light and visual information to the brain via the long axons that form the optic nerve. RGCs are the measurable endpoints in current research into experimental therapies and diagnosis in multiple ocular pathologies, like glaucoma. RGC subtype classifications are based on morphological, functional, genetical, and immunohistochemical aspects.
  • 788
  • 22 Apr 2022
Topic Review
Immune System, Inflammation and Autoantigens in wAMD
Wet age-related macular degeneration (wAMD) is a chronic inflammation-associated neurodegenerative disease affecting the posterior part of the eye in the aging population. Aging results in the reduced functionality of cells and tissues, including the cells of the retina. Initiators of a chronic inflammatory and pathologic state in wAMD may be a result of the accumulation of inevitable metabolic injuries associated with the maintenance of tissue homeostasis from a young age to over 50. Apart from this, risk factors like smoking, genetic predisposition, and failure to repair the injuries that occur, alongside attempts to rescue the hypoxic outer retina may also contribute to the pathogenesis. Aging of the immune system (immunosenescence) and a compromised outer blood retinal barrier (BRB) result in the exposure of the privileged milieu of the retina to the systemic immune system, further increasing the severity of the disease. 
  • 788
  • 12 Dec 2023
Topic Review
Macular Edema in Vascular Retinal Diseases
Macular edema (ME) is a disease characterized by the swelling of the macula due to the abnormal accumulation of fluid. It is associated with increased macular thickness and significantly reduced visual acuity, and it may develop in various ocular conditions.
  • 782
  • 01 Dec 2021
Topic Review
Dietary Flavonoid Intake and Chronic Sensory Conditions
Dietary flavonoids have antioxidant, anti-inflammatory, and vascular health benefits, which align with the proposed pathophysiology of age-related eye conditions and hearing problems (hearing loss and tinnitus). The flavonoid subclass, flavonols, are protective against eye conditions, including age-related macular degeneration, cataract, and glaucoma. Dietary flavonol intake appears to be protective against some chronic eye conditions. 
  • 781
  • 27 Jul 2022
Topic Review
Biomechanics of Suprachoroidal Injection
Suprachoroidal injections are a valuable strategy for ocular drug delivery, with effectiveness dependent on various parameters: injection force, injectate volume, formulation characteristics, and compartmentalization. For example, viscosity plays a critical role, as higher viscosity agents favor anterior drug localization, while lower viscosity enables greater posterior delivery. Higher viscosity formulations also slow clearance rates, prolonging the drug's duration of action. Particle size in suspensions is another key factor. Larger particles remain in the suprachoroidal space for longer periods and are less prone to washout by choroidal circulation, thereby extending therapeutic effects. By skillfully manipulating these parameters, researchers and clinicians can personalize drug delivery based on the specific location and chronicity of the ocular disease being treated, leading to improved treatment outcomes and patient satisfaction. This advancement marks a significant step toward precision medicine in ophthalmology.
  • 776
  • 04 Dec 2023
Topic Review
Data-Driven AI in High Myopia and Pathologic Myopia
Myopia is a global health issue, and the prevalence of high myopia has increased significantly in the past five to six decades. Artificial intelligence (AI) has been identified as one of the key drivers of the Fourth Industrial Revolution. Because of the growth of digital databases, the number of AI-based applications in the medical field based on Python or C has increased immensely in recent years.
  • 774
  • 20 May 2022
Topic Review
Computer Vision Syndrome
Computer vision syndrome (CVS), also known as digital eye strain (DES), represents a range of ocular, musculoskeletal, and behavioral conditions caused by prolonged use of devices with digital screens.
  • 774
  • 14 Mar 2023
Topic Review
Eye Pathological Angiogenesis
Angiogenesis is the new formation of vessels. Physiologically, it is essential for tissue repair; while its aberrant presentation, it may produce pathological disorders, such as Proliferative Diabetic Retinoptahy, Age Related Macular Degeneration, among many others. 
  • 772
  • 22 Sep 2021
Topic Review
Overview of Mesenchymal Stem Cell-Derived Exosomes in Ophthalmology
The field of mesenchymal stem cell (MSC) therapy has shown promise in treating ophthalmic diseases. However, MSC-based therapy faces limitations due to suboptimal biocompatibility, penetration, and delivery to the target ocular tissues. To overcome these challenges, researchers have turned their attention to a new aspect of MSCs - their exosomes. These extracellular vesicles possess properties similar to MSCs and can efficiently deliver therapeutic factors to ocular tissues that are typically difficult to target using conventional therapy and MSC transplantation. Exosomes, small vesicles derived from MSCs, exhibit properties such as anti-inflammatory, anti-apoptotic, and immunomodulatory that are similar to their parent cells. These characteristics make exosomes an attractive alternative to MSCs for ocular therapy. Due to their nano-size, MSC-derived exosomes have the potential to better penetrate biological barriers, such as the blood-retinal barrier, and deliver their cargo effectively to ocular tissues. In addition, their cargo is protected from degradation, leading to increased bioavailability. This makes exosomes a promising candidate for ocular drug-delivery applications.
  • 771
  • 08 Jun 2023
Topic Review
Diabetic Retinopathy and Hyperglycaemia
Diabetes mellitus (DM) has become a vital societal problem as epidemiological studies demonstrate the increasing incidence of type 1 and type 2 diabetes. Lesions observed in the retina in the course of diabetes, referred to as diabetic retinopathy (DR), are caused by vascular abnormalities and are ischemic in nature. Vascular lesions in diabetes pertain to small vessels (microangiopathy) and involve precapillary arterioles, capillaries and small veins. Pericyte loss, thickening of the basement membrane, and damage and proliferation of endothelial cells are observed. Endothelial cells (monolayer squamous epithelium) form the smooth internal vascular lining indispensable for normal blood flow. Breaking its continuity initiates blood coagulation at that site.
  • 770
  • 01 Mar 2021
Topic Review
Emerging Pathogens and Ophthalmic Disease
Ophthalmologists are essential health care workers who provide urgent and emergent vision care services during outbreaks and address the ocular consequences of epidemic and pandemic infectious diseases. In 2017, the World Health Organization (WHO) identified high priority pathogens likely to cause a future epidemic with the goal of guiding research and development to improve diagnostic tests, vaccines, and medicines. 
  • 760
  • 14 May 2021
Topic Review
Drug-Eluting Contact Lens Technologies
Due to an ageing population and climate change, the number of ophthalmic patients will increase, overwhelming healthcare systems and likely leading to under-treatment of chronic eye diseases. Since drops are the mainstay of therapy, clinicians have long emphasised the unmet need for ocular drug delivery. Alternative methods, i.e., with better compliance, stability and longevity of drug delivery, would be preferred. Drug-loaded contact lenses are among the most promising and are a real step toward dropless ocular therapy, potentially leading to a transformation in clinical ophthalmic practice.
  • 755
  • 13 Jun 2023
Topic Review
Emerging Interventions for Autosomal Recessive ABCA4-Associated Stargardt Disease
Autosomal recessive Stargardt disease (STGD1) is an inherited retinal degenerative disease associated with a mutated ATP-binding cassette, subfamily A, member 4 (ABCA4) gene. STGD1 is the most common form of juvenile macular degeneration with onset in late childhood to early or middle adulthood and causes progressive, irreversible visual impairment and blindness. 
  • 754
  • 23 Oct 2023
Topic Review
Extracellular Matrix Components of Idiopathic Epiretinal Membranes
Idiopathic epiretinal membranes (iERMs) are fibrocellular sheets of tissue that develop at the vitreoretinal interface. The iERMs consist of cells and an extracellular matrix (ECM) formed by a complex array of structural proteins and a large number of proteins that regulate cell–matrix interaction, matrix deposition and remodelling. Many components of the ECM tend to produce a layered pattern that can influence the tractional properties of the membranes. 
  • 749
  • 01 Sep 2022
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