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Topic Review
Presentation of PCV on SS-OCTA
Polypoidal choroidal vasculopathy (PCV) was generally considered as a subtype of age-related macular degeneration. Currently, the gold standard for diagnosing PCV is indocyanine green angiography (ICGA). However, it has been concerned about its rare but deadly complications and inconvenience during clinical visits. ICGA cannot provide detailed anatomical information about the disease lesions, either. Swept-source optical coherence tomography angiography (SS-OCTA) is a new, noninvasive, fast, and high-quality imaging method for PCV, which is significantly improved in many aspects compared with the previous spectral domain OCTA (SD-OCTA). With SS-OCTA, the lesion characteristics of PCV have been extensively studied. SS-OCTA revealed a new morphological pattern of the polypoidal lesions (PLs) call “tangled vasculature”, suggesting the neovascular essence of PLs, instead of aneurysmal dilations. In addition, by assessing the changes of choroidal structure, such as the choriocapillaris flow voids, the hypothetical developing model of PCV has been proposed. Due to the improved detecting ability, SS-OCTA might also play a more important role in differential diagnosis, disease reactivation monitoring in the future. 
  • 324
  • 10 Aug 2023
Topic Review
Alternative Emerging Therapies to Retinal Prostheses
Retinal prostheses show promise in restoring vision, but ongoing clinical trials and high costs limit their adoption. To explore alternatives for treating retinal diseases, we present an overview of cell-based and gene-based therapies. This entry aims to determine if retinal prostheses are losing favor as a therapeutic option. Cell-based therapies, particularly using pluripotent stem cells like induced pluripotent stem cells (iPSCs) and retinal progenitor cells (RPCs), hold promise for treating retinal diseases. iPSC-derived retinal pigment epithelium (RPE) cells show potential in delaying disease progression and restoring vision loss when the RPE layer is damaged. Additionally, bone marrow stem cells (BMSCs) release beneficial factors and have the ability to migrate towards lesion sites, although full differentiation into photoreceptors is not confirmed. Gene therapy also shows promise for treating retinal diseases caused by genetic mutations. Different approaches are used depending on the type of mutation (recessive or dominant). For example. viral vectors like AAV are commonly employed due to their efficient targeting and low immunogenicity. Optogenetics is a novel approach for treating inherited retinal diseases (IRDs) by introducing photosensitive proteins (opsins) to the degenerated retina. Opsins restore function and photosensitivity to remaining retinal cells. Clinical trials are underway, but more research is needed to understand opsin properties.
  • 319
  • 18 Sep 2023
Topic Review
Myopia Control in Children
The growing incidence of myopia worldwide justifies the search for efficient methods of myopia prevention. Numerous pharmacological, optical, and lifestyle measures have already been utilized, but there remains a need to explore more practical and predictable methods for myopia control.
  • 318
  • 26 Oct 2023
Topic Review
The Pharmacological Approaches in NTG Therapy
Normal tension glaucoma (NTG) is defined as a subtype of primary open-angle glaucoma (POAG) in which the intraocular pressure (IOP) values are constantly within the statistically normal range without treatment and represents approximately the 30–40% of all glaucomatous cases. NTG first recognized as a clinical entity by von Graefe in 1857, is a subtype of primary glaucoma characterized by open-angle and IOP values constantly within the statistically normal range without treatment.
  • 313
  • 01 Sep 2023
Topic Review
Diabetic Keratopathy
Diabetes mellitus, the most prevalent endocrine disorder, not only impacts the retina but also significantly involves the ocular surface. Diabetes contributes to the development of dry eye disease and induces morphological and functional corneal alterations, particularly affecting nerves and epithelial cells. These changes manifest as epithelial defects, reduced sensitivity, and delayed wound healing, collectively encapsulated in the context of diabetic keratopathy. In advanced stages of this condition, the progression to corneal ulcers and scarring further unfolds, eventually leading to corneal opacities. This critical complication hampers vision and carries the potential for irreversible visual loss. 
  • 311
  • 25 Jan 2024
Topic Review
Mesenchymal Stem Cell-Derived Exosomes in Posterior Segment Diseases
Mesenchymal stem cell (MSC) therapy has shown promise in treating ophthalmic diseases, but suboptimal biocompatibility, penetration, and delivery to the target ocular tissues remain limitations. To address these challenges, researchers have turned to MSC-derived exosomes, which 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 anti-inflammatory, anti-apoptotic, and immunomodulatory properties, making them an attractive alternative to MSCs for ocular therapy. Due to their nano-size, MSC-derived exosomes can better penetrate biological barriers, such as the blood-retinal barrier, and deliver their cargo effectively to ocular tissues. Moreover, their cargo is protected from degradation, leading to increased bioavailability. As a result, exosomes have great potential for ocular drug-delivery applications. MSC-based therapies in regenerative medicine. Utilizing exosomes could eliminate the risks associated with MSC-centered therapies, such as immunological rejection, unwanted differentiation, and obstruction of small vessels through intravenous MSC injection. Avoiding these risks is critical for optimal treatment outcomes.
  • 311
  • 08 Jun 2023
Topic Review
Posterior Polar Annular Choroidal Dystrophy
Posterior polar annular choroidal dystrophy (PPACD) is a rare ocular disorder and presents as symmetric degeneration of the retinal pigment epithelium (RPE) and the underlying choriocapillaris, encircling the retinal vascular arcades and optic disc. This condition distinctively preserves the foveal region, optic disc, and the outermost regions of the retina. Despite its distinct clinical presentation, due to the infrequency of its occurrence and the limited number of reported cases, the pathophysiology, and the genetic foundations of PPACD are still largely uncharted.
  • 311
  • 29 Feb 2024
Topic Review
The Activity of Substance P on Corneal Epithelium
In 1931, Von Euler and Gaddum isolated substance P (SP), an undecapeptide from the tachykinin family, from equine brain and intestine tissue extracts. Numerous types of cells, including neurons, astrocytes, microglia, epithelial, and endothelial cells, as well as immune cells including T-cells, dendritic cells, and eosinophils, are responsible for its production. The corneal epithelium, immune cells, keratocytes, and neurons all express the two isoforms of NK1R, which has the highest affinity for SP. 
  • 306
  • 05 May 2023
Topic Review
Deep Learning Methods for Retinal Disease Diagnosis
The advancement of digital medical imaging has brought about a significant change in ophthalmology as it has introduced effective technologies that help in the detection of such diseases. By improving early detection through image analysis and identifying minuscule anomalies, Artificial Intelligence (AI) has considerably coped with retinal diseases. Different Machine Learning (ML) and Convolutional Neural Networks (CNNs) are efficient at analyzing images and are particularly incredible at recognizing complex patterns in medical images.
  • 305
  • 21 Oct 2023
Topic Review
Suprachoroidal Injections for Choroidal Neovascularization and Retinal Detachment
Choroidal neovascularization (CNV) is a pathological process characterized by the growth of abnormal blood vessels beneath the retina and choroid, the vascular layer located behind the retina. CNV is a common complication of various eye conditions, with age-related macular degeneration (AMD) being the most prevalent cause. In AMD, CNV is often referred to as "wet" or "neovascular" AMD, as it involves the formation of new blood vessels that are fragile and prone to leakage. These vessels disrupt the normal structure and function of the retina, leading to vision loss or distortion. CNV can also occur in other conditions like myopia, inflammatory eye diseases, and ocular trauma. The underlying cause of CNV is an imbalance of angiogenic factors, particularly vascular endothelial growth factor (VEGF). Increased levels of VEGF promote the growth of abnormal blood vessels. The new vessels are fragile, leaky, and prone to bleeding, causing damage to the surrounding tissues and impairing vision. Suprachorodal injections therefore offers a novel treatment modality for these serious and vision-altering pathologies.  
  • 303
  • 04 Dec 2023
Topic Review
Sinonasal Orbital Apex Syndrome
Rhinosinusitis (RS) is an inflammatory disease of the nose and paranasal sinuses with a clinical picture of anterior or posterior nasal discharge, congestion, olfactory dysfunction, and facial pain or pressure. It must be confirmed with endoscopic or radiological signs of inflammation. By its duration, it is classified into acute (i.e., duration <4 weeks), subacute (4–12 weeks), and chronic RS (>12 weeks). Moreover, RS can be named according to the inflamed paranasal sinus, e.g., sphenoiditis in sphenoid sinus inflammation. RS significantly affects the patient’s quality of life due to the significant impact on personal development, sleep hygiene, mental health, physical condition, self-perception, and family relationships.
  • 300
  • 02 Aug 2023
Topic Review Video
Airborne Chemical Exposure and Ocular Surface Irritation
In our recent paper "An Assessment of the Ocular Toxicity of Two Major Sources of Environmental Exposure" we discuss the impact on the eye of specific chemicals released from burn pits and from the East Palestine, Ohio train derailment. This entry discusses the importance of investigating the nature and consequences of these exposures in hopes of raising awareness of an underrecognized health issue.
  • 300
  • 19 Jul 2024
Topic Review
The Ocular Surface Microbiota
The human microbiota refers to a large variety of microorganisms (bacteria, viruses, and fungi) that live in different human body sites, including the gut, oral cavity, skin, and eyes. Throughout evolution, various microorganisms, especially bacteria, colonized the conjunctiva and the cornea as commensals, constituting the so-called ocular surface microbiota (OSM). The presence of an ocular surface microbiota with a crucial role in maintaining ocular surface homeostasis by preventing colonization from pathogen species has been demonstrated. 
  • 299
  • 18 Sep 2023
Topic Review
Complement Dysregulation in Glaucoma Patients
Glaucoma is a progressive neurodegenerative disease characterized by damage to the optic nerve that results in irreversible vision loss. While the exact pathology of glaucoma is not well understood, emerging evidence suggests that dysregulation of the complement system, a key component of innate immunity, plays a crucial role. In glaucoma, dysregulation of the complement cascade and impaired regulation of complement factors contribute to chronic inflammation and neurodegeneration.
  • 294
  • 04 Mar 2024
Topic Review
Retinal Prothesis
Retinal prosthetics show promise in restoring vision for individuals with retinal diseases. Technological advancements have led to various implant designs, expanding possibilities for enhancing visual acuity. A research explores pre-clinical and clinical studies, engineering aspects, safety, adverse events, and rehabilitation programs. The debate over alternative therapies is addressed, comparing retinal prostheses to cell-based and gene-based therapies and optogenetics. Advancements in wireless technology and artificial intelligence are discussed. The retinal structure and function are outlined, emphasizing the importance of different retinal layers. Retinal physiology poses challenges for prosthetic devices, requiring selective stimulation for optimal outcomes. Visual prosthetics aim to restore vision by replicating retinal ganglion cells' electrical signals. Two mechanisms are used: (1) external camera systems process images to deliver electrical impulses via an implanted microelectrode array, as seen in the ARGUS II prosthetic, and (2) photodiode arrays directly convert light energy to electrical signals.
  • 293
  • 18 Sep 2023
Topic Review
General Characteristics and Pathophysiology of Glaucoma
Glaucoma, a group of diseases characterized by progressive retinal ganglion cell loss, cupping of the optic disc, and a typical pattern of visual field defects, is a leading cause of severe visual impairment and blindness worldwide.
  • 280
  • 30 Aug 2023
Topic Review
Ocular Manifestations of COVID-19
Since its emergence in early 2020, the SARS-CoV-2 infection has had a significant impact on the entire eye care system. Ophthalmologists have been categorized as a high-risk group for contracting the virus due to the belief that the eye may be a site of inoculation and transmission of the SARS-CoV-2 infection. 
  • 278
  • 01 Sep 2023
Topic Review
Suprachoroidal Injections for Macular Edema
Macular edema is characterized by the accumulation of fluid in the macula, leading to vision impairment. Suprachoroidal injections can help with macular edema by delivering medication directly to the affected area, allowing for targeted treatment. Suprachoroidal injections offer several advantages in treating macular edema such as providing a more localized delivery of medication compared to other route and allowing for sustained drug release, which prolongs the duration of the therapeutic effect. This approach therefore minimizes potential side effects and systemic exposure to the medication as well as improving patient comfort. Depending on the exact etiology of macular edema, different substances can be delivered through this method, whether is is triamcinolone acetonide or corticosteroids.  
  • 277
  • 04 Dec 2023
Topic Review
Molecular Biology of Uveal Melanoma
Uveal melanoma arises from the pigment-producing cells in the iris, ciliary body, and choroid. Its annual incidence is estimated to be around 5–6 cases per million people, but is the most common primary intraocular malignancy in adults. 
  • 275
  • 21 Feb 2024
Topic Review
Biofilms in Ocular Infection
Fungi represent a very important cause of microbial eye infections, especially in tropical and developing countries, as they could cause sight-threating disease, such as keratitis and ocular candidiasis, resulting in irreversible vision loss. Candida species are among the most frequent microorganisms associated with fungal infection. Although Candida albicans is still the most frequently detected organism among Candida subspecies, an important increase in non-albicans species has been reported. Mycotic infections often represent an important diagnostic-clinical problem due to the difficulties in performing the diagnosis and a therapeutic problem due to the limited availability of commercial drugs and the difficult penetration of antifungals into ocular tissues. The ability to form biofilms is another feature that makes Candida a dangerous pathogen.
  • 274
  • 16 Aug 2023
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