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Topic Review
Molecular Aspects in Choroidal Vasculature
Choriocapillaris (CC) density decreases significantly with aging and may have a systemic basis. Reduced perfusion of the CC, in combination with changes in the thickness and composition of Bruch’s membrane (BrM), further aggravates the metabolic homeostasis of the retinal pigment epithelium (RPE) and thus the photoreceptor cells. Indeed, the age-related modifications of the choroidal vasculature have been reported to be associated with a wide range of BrM alterations, basal linear and basal laminar deposits, and RPE changes. The arterial supply of the choroid is segmental from the PCAs to the CC. The segmental and lobular organization of choroidal vasculature can be appreciated at both the posterior pole and the equatorial retina.
  • 375
  • 28 Oct 2022
Topic Review
Role of Dysregulated miRNAs in Pathogenesis of AMD
Age-related macular degeneration (AMD) is an eye disease causing damage to the macular region of the retina where most of the photoreceptors responsible for central visual acuity are located. MicroRNAs (miRNAs) are small single-stranded non-coding RNA molecules that negatively regulate genes by silent post-transcriptional gene expressions. Studies have shown that changes in specific miRNAs are involved in the pathogenesis of eye diseases, including AMD. Altered expressions of miRNAs are related to disturbances of regulating oxidative stress, inflammation, angiogenesis, apoptosis and phagocytosis, which are known factors in the pathogenesis of AMD. Moreover, dysregulation of miRNA is involved in drusen formation. 
  • 373
  • 22 Aug 2022
Topic Review
Pathogenesis of Amblyopia
Amblyopia is a neurodevelopmental disorder caused by interocular suppression of visual input, affecting visual acuity, stereopsis, contrast sensitivity, and other visual functions. Conventional treatment comprises occlusion of the sound eye.
  • 373
  • 16 Jan 2024
Topic Review
Corticosteroids for the Management of Diabetic Macular Edema
Diabetic macular edema (DME) is a common complication of diabetes mellitus and a leading cause of visual impairment worldwide. It is defined as the diabetes-related accumulation of fluid, proteins, and lipids, with retinal thickening, within the macular area. DME affects a significant proportion of individuals with diabetes, with the prevalence increasing with disease duration and severity. Corticosteroids (CSs) are a group of hormones produced by the adrenal cortex.
  • 372
  • 05 Mar 2024
Topic Review
Mitochondrial Dysfunction in Diabetic Retinopathy
Diabetic Retinopathy (DR) is one of the most important microvascular complications of diabetes mellitus, which can lead to blindness in severe cases. Mitochondria are energy-producing organelles in eukaryotic cells, which participate in metabolism and signal transduction, and regulate cell growth, differentiation, aging, and death. Metabolic changes of retinal cells and epigenetic changes of mitochondria-related genes under high glucose can lead to mitochondrial dysfunction and induce mitochondrial pathway apoptosis. In addition, mitophagy and mitochondrial dynamics also change adaptively. These mechanisms may be related to the occurrence and progression of DR, and also provide valuable clues for the prevention and treatment of DR. 
  • 371
  • 29 Nov 2022
Topic Review
Retinal Pigment Epithelial Cells in Age-Related Macular Degeneration
Age-related macular degeneration (AMD) causes vision loss in the elderly population. Dry AMD leads to the formation of Drusen, while wet AMD is characterized by cell proliferation and choroidal angiogenesis. The retinal pigment epithelium (RPE) plays a key role in AMD pathogenesis. In particular, helioreceptor renewal depends on outer segment phagocytosis of RPE cells, while RPE autophagy can protect cells from oxidative stress damage.
  • 370
  • 21 Aug 2023
Topic Review
Drug Delivery Approach to PCO Prophylaxis
Posterior capsule opacification (PCO) remains the most common cause of vision loss post cataract surgery. The clinical management of PCO formation is limited to either physical impedance of residual lens epithelial cells (LECs) by implantation of specially designed intraocular lenses (IOL) or laser ablation of the opaque posterior capsular tissues; however, these strategies cannot fully eradicate PCO and are associated with other ocular complications.
  • 369
  • 04 May 2023
Topic Review
Role of Telemedicine in Diabetic Retinopathy
With the increasing prevalence of diabetic retinopathy (DR), screening is of the utmost importance to prevent vision loss for patients and reduce financial costs for the healthcare system. Telemedicine offers the opportunity to expand access to screening while reducing the economic and temporal burden associated with current in-person protocols. 
  • 356
  • 24 May 2023
Topic Review
Suprachoroidal Injections for Photoreceptor Loss
Suprachoroidal (SC) injections offer a potential therapeutic approach for diseases involving photoreceptor loss. These injections involve delivering therapeutic agents or cells into the space between the choroid and the sclera, known as the suprachoroidal space (SCS). This targeted delivery allows for direct access to the choroid, retinal pigment epithelium (RPE), and photoreceptor cells. Many retinal diseases such as age-related macular degeneration and retinitis pigmentosa can have shown positive responses to suprachoroidal treatments in multiple studies. Notably, suprachoroidal injections offer a novel route of administration for treatments such as gene therapy and stem cell treatments.
  • 356
  • 04 Dec 2023
Topic Review
Central Role of Inflammation and Parainflammation in AMD
Age-related macular degeneration (AMD) is an age-related condition that progressively impairs central vision with increasing age. AMD affects the central portion of the retina called the macula, which is required for central vision and visually demanding tasks like recognizing faces, reading, and driving.
  • 356
  • 26 Dec 2023
Topic Review
Orbital Metastases
Orbital metastases may significantly worsen the functional status of oncological patients, leading to debilitating visual impairments. Surgical resection, orbital exenteration, and complementary therapies may result in heterogeneous clinical outcomes. Most orbital metastases occur at later stages after primary tumors, frequently showing diffuse location within the orbit and rarely invading intracranial structures. Biopsy-only techniques were more frequently preferred in view of the less invasive approaches, but surgical resection and orbital radiotherapy were related to improved clinical outcomes. Although patients with primary breast cancer and patients undergoing resection showed superior prognoses, overall survival rates were generally poor, suggesting the need to better understand orbital metastases’ microenvironments for devising optimal systemic treatment strategies.
  • 354
  • 12 Jan 2022
Topic Review
Pathophysiology of Retinopathy of Prematurity
Retinopathy of prematurity (ROP) is a proliferative vascular ailment affecting the retina. It is the main risk factor for visual impairment and blindness in infants and young children worldwide. If left undiagnosed and untreated, it can progress to retinal detachment and severe visual impairment. Geographical variations in ROP epidemiology have emerged over recent decades, attributable to differing levels of care provided to preterm infants across countries and regions. 
  • 350
  • 05 Feb 2024
Topic Review
Ocular Infections Caused by Viruses
Ocular viral infections are common and widespread globally. These infectious diseases are a major cause of acute red eyes and vision loss. The eye and its nearby tissues can be infected by several viral agents, causing infections with a short course and limited ocular implications or a long clinical progression and serious consequences for the function and structure of the ocular region. Several surveillance studies underline the increased emergence of drug resistance among pathogenic viral strains, limiting treatment options for these infections. Currently, in the event of resistant infections, topical or systemic corticosteroids are useful in the management of associated immune reactions in the eye, which contribute to ocular dysfunction. 
  • 348
  • 06 Dec 2022
Topic Review
Quantitative Parameters Relevant for DME Evaluation by OCTA
Diabetic macular edema (DME) is one of the main ocular complications of diabetes mellitus (DM) that can lead to important vision loss in diabetic patients. In clinical practice, there are cases of DME with unsatisfying treatment responses, despite adequate therapeutic management. Diabetic macular ischemia (DMI) is one of the causes suggested to be associated with the persistence of fluid accumulation. The optical coherence tomography angiography (OCTA) devices currently available can provide various OCTA metrics that quantitatively assess the retinal microvasculature. OCTA metrics are useful instruments that can contribute to the evaluation of patients with DME.
  • 341
  • 10 Jul 2023
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.
  • 338
  • 04 Dec 2023
Topic Review
Rationale and Techniques of Suprachoroidal Injections
Suprachoroidal injection (SC) is an innovative drug delivery method that has the potential to greatly revolutionize the field of ophthalmology. In fact, this technique has shown to possess many advantages over certain traditional routes of administration such as its simplicity as well as its ability to bypass biological barriers. Notably, access to the SCS can be achieved using microcatheters, needles, or microneedles. Each technique has its own benefits and drawbacks, but so far, microneedle-based injections offer precise control, broad coverage, and improved safety compared to standard needles, making them the most promising route for drug administration.
  • 337
  • 04 Dec 2023
Topic Review
Myo/Nog Cells in the Lens
Myo/Nog cells, discovered by their expression of the skeletal muscle specific transcription factor MyoD, bone morphogenetic protein inhibitor Noggin, and brain specific angiogenesis inhibitor 1, are integrated into the eye during early stages of embryonic development. While their release of Noggin is critical normal eye morphogenesis, wounding may stimulate Myo/Nog cells to form contractile myofibroblasts that cause secondary cataracts and retinal detachment.
  • 336
  • 17 Jul 2023
Topic Review
OCT and OCT-A in Identifying Multiple Sclerosis Biomarkers
The prevalence of multiple sclerosis (MS) has been increasing among young people in developing countries over the last years. With the continuous development of new technology, the diagnosis and follow-up of these patients has received new parameters that physicians may use in their practice. 
  • 332
  • 28 Nov 2023
Topic Review
MicroShunt for Open-Angle Glaucoma
For moderate-to-severe glaucoma, trabeculectomy remains the “gold standard” intraocular pressure (IOP)-lowering treatment; nonetheless, this method requires extensive post-operative maintenance. Microinvasive glaucoma surgery (MIGS) treatments are designed to lessen intra- and post-operative care burden while offering an acceptable IOP decrease for individuals with mild to moderate glaucoma. The PreserFlo® MicroShunt (previously InnFocus MicroShunt) is an 8.5 mm glaucoma drainage device manufactured from poly(styrene-block-isobutylene-block-styrene) (SIBS), an extremely biocompatible and bioinert material. The lumen is narrow enough to prevent hypotony, but big enough to avoid being obstructed by sloughed cells or pigment. The device is implanted ab externo, as a stand-alone procedure or in conjunction with cataract surgery, with intraoperative mitomycin C, and a bleb is produced under the conjunctiva and Tenon’s capsule. The MicroShunt was CE-marked in 2012 and designed for primary open-angle glaucoma, the IOP of which remains uncontrolled after maximally tolerated topical treatment. Several clinical trials evaluating the MicroShunt’s long-term safety and effectiveness have been conducted, highlighting the effectiveness of the device over time, along with a tolerable safety profile.
  • 329
  • 16 Feb 2022
Topic Review
Enhanced Diagnostics for Corneal Ectatic Diseases
There are different fundamental diagnostic strategies for patients with ectatic corneal diseases (ECDs): screening, confirmation of the diagnosis, classification of the type of ECD, severity staging, prognostic assessment, and clinical follow-up. The conscious application of such strategies enables individualized treatments. The need for improved diagnostics of ECD is related to the advent of therapeutic refractive procedures that are considered prior to keratoplasty.
  • 324
  • 12 Jan 2023
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