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Topic Review
Inherited Optic Neuropathies
Inherited optic neuropathies, including Leber Hereditary Optic Neuropathy (LHON) and Dominant Optic Atrophy (DOA), are monogenetic diseases with a final common pathway of mitochondrial dysfunction leading to retinal ganglion cell (RGC) death and ultimately loss of vision.
  • 638
  • 13 Apr 2021
Topic Review
Artificial Intelligence in Glaucoma
Glaucoma is a multifactorial neurodegenerative illness requiring early diagnosis and strict monitoring of the disease progression. Artificial intelligence algorithms can extract various optic disc features and automatically detect glaucoma from fundus photographs.
  • 638
  • 20 Feb 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.
  • 634
  • 04 Dec 2023
Topic Review
Second Tumors in Retinoblastoma Survivors after Ionizing Radiation
Retinoblastoma (RB) is the most common ocular neoplasm in children, whose development depends on two mutational events that occur in both alleles of the retinoblastoma susceptibility gene (RB1). Regarding the nature of these mutational events, RB can be classified as hereditary if the first event is a germline mutation and the second one is a somatic mutation in retina cells or nonhereditary if both mutational events occur in somatic cells. Although the rate of survival of RB is significantly elevated, the incidence of second malignant neoplasms (SMNs) is a concern, since SMNs are the main cause of death in these patients. Furthermore, evidence confirms that hereditary RB survivors are at a higher risk for SMNs than nonhereditary RB survivors. This risk seems to increase with the use of ionizing radiation in some therapeutic approaches commonly used in the treatment of RB.
  • 633
  • 20 Nov 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.
  • 631
  • 04 May 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. 
  • 629
  • 25 Jan 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. 
  • 624
  • 06 Dec 2022
Topic Review
Intraoperative OCT
Intraoperative OCT is an innovative and promising technology which allows anterior and posterior segment ocular surgeons to obtain a near-histologic cross-sectional and tomographic image of the tissues. Intraoperative OCT has several applications in ocular surgery which are particularly interesting in the context of corneal transplantation. Indeed, iOCT images provide a direct and meticulous visualization of the anatomy, which could guide surgical decisions. In particular, during both big-bubble and manual DALK, the visualization of the relationship between the corneal layers and instruments allows the surgeon to obtain a more desirable depth of the trephination, thus achieving more type 1 bubbles, better regularity of the plane, and a reduced risk of DM perforation. During EK procedures, iOCT supplies information about proper descemetorhexis, graft orientation, and interface quality in order to optimize the postoperative adhesion and reduce the need for re-bubbling. Finally, mushroom PK, a challenging technique for many surgeons, can be aided through the use of iOCT since it guides the correct apposition of the lamellae and their centration. The technology of iOCT is still evolving: a larger field of view could allow for the visualization of all surgical fields, and automated tracking and iOCT autofocusing guarantee the continued centration of the image.
  • 613
  • 05 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.
  • 612
  • 04 Dec 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. 
  • 608
  • 28 Nov 2023
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.
  • 603
  • 08 Jun 2023
Topic Review
NLRP3 Inflammasome in Inflammatory Eye Diseases Treatment
Due to their potent immunoregulatory and angio-modulatory properties, mesenchymal stem cells (MSCs) and their exosomes (MSC-Exos) have emerged as potential game-changers in regenerative ophthalmology, particularly for the personalized treatment of inflammatory diseases. NLRP3 inflammasome, composed of Nod-like receptor family pyrin domain-containing protein 3 (NLRP3), apoptosis-associated speck-like protein containing a caspase activation and recruitment domain (CARD) (ASC), and pro-caspase-1 is dysregulated in almost all inflammatory eye disease. Accordingly, a large number of experimental findings suggested that this multi-protein complex could be considered an important intracellular target for MSC-based therapy of inflammatory eye disorders.
  • 595
  • 20 Oct 2023
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. 
  • 588
  • 10 Aug 2023
Topic Review
IOCT-Assisted Endothelial Keratoplasty
iOCT serves as a guidance tool for key surgical processes in endothelial keratoplasty, from scoring the Descemet membrane to guaranteeing graft apposition at the conclusion of the procedure. For this reason, both Descemet stripping anterior endothelial keratoplasty (DSAEK) and Descemet membrane endothelial keratoplasty (DMEK) are made easier by intraoperative OCT.
  • 587
  • 02 Apr 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. 
  • 587
  • 22 Aug 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.
  • 586
  • 10 Jul 2023
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. 
  • 583
  • 18 Sep 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.
  • 579
  • 18 Sep 2023
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.
  • 576
  • 28 Oct 2022
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. 
  • 576
  • 01 Sep 2023
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