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Topic Review
Pathomolecular Mechanisms of Retinitis Pigmentosa
Retinitis pigmentosa, defined more properly as cone–rod dystrophy, is a paradigm of inherited diffuse retinal dystrophies, one of the rare diseases with the highest prevalence in the worldwide population and one of the main causes of low vision in the pediatric and elderly age groups. Generally speaking, the pathomolecular mechanisms of RP involve primarily genetic mutations that disrupt the normal functioning of the retina and the retinal pigment epithelium through specific and common pathways.
  • 236
  • 24 Oct 2023
Topic Review
Diagnostic Imaging for Infectious Keratitis
Infectious keratitis (IK) is among the top five leading causes of blindness globally. Early diagnosis is needed to guide appropriate therapy to avoid complications such as vision impairment and blindness. Slit lamp microscopy and culture of corneal scrapes are key to diagnosing IK. Slit lamp photography was transformed when digital cameras and smartphones were invented. The digital camera or smartphone camera sensor’s resolution, the resolution of the slit lamp, and the focal length of the smartphone camera system are key to a high-quality slit lamp image. Alternative diagnostic tools include imaging, such as optical coherence tomography (OCT) and in vivo confocal microscopy (IVCM). OCT’s advantage is its ability to accurately determine the depth and extent of the corneal ulceration, infiltrates, and haze; therefore characterizing the severity and progression of the infection. However, OCT is not a preferred choice in the diagnostic tool package for infectious keratitis. Rather, IVCM is a great aid in diagnosing fungal and Acanthamoeba keratitis with overall sensitivities of 66–74% and 80–100% and specificity of 78–100% and 84–100%, respectively. Deep learning (DL) models have been shown to be promising aids for diagnosing IK via image recognition. 
  • 236
  • 17 Nov 2023
Topic Review
Epigenetic Implications in Glaucoma Neurodegenerative Disease
Glaucoma, a complex and multifactorial neurodegenerative disorder, is a leading cause of irreversible blindness worldwide. Despite significant advancements in the understanding of its pathogenesis and management, early diagnosis and effective treatment of glaucoma remain major clinical challenges. Epigenetic modifications, encompassing deoxyribonucleic acid (DNA) methylation, histone modifications, and non-coding RNAs, have emerged as critical regulators of gene expression and cellular processes.
  • 236
  • 04 Mar 2024
Topic Review
Nanoporous Materials for Advancing Ophthalmic Treatments
The landscape of ophthalmology is undergoing significant transformations, driven by technological advancements and innovations in materials science. One of the advancements in this evolution is the application of nanoporous materials, endowed with unique physicochemical properties ideal for a variety of ophthalmological applications. Characterized by their high surface area, tunable porosity, and functional versatility, these materials have the potential to improve drug delivery systems and ocular devices.
  • 235
  • 08 Nov 2023
Topic Review
Vasoactive Intestinal Peptide Family Members in Diabetic Keratopathy
Diabetic keratopathy (DK) is a common ocular complication of diabetes, characterized by alteration of the normal wound-healing mechanism, reduction of epithelial hemidesmosomes, disruption of the basement membrane, impaired barrier function, reduced corneal sensitivity, corneal ulcers, and corneal edema.
  • 229
  • 28 Feb 2024
Topic Review
Anatomy and Barriers of Ocular Drug Delivery
Ocular diseases profoundly impact patients’ vision and overall quality of life globally. However, effective ocular drug delivery presents formidable challenges within clinical pharmacology and biomaterial science, primarily due to the intricate anatomical and physiological barriers unique to the eye.
  • 228
  • 13 Nov 2023
Topic Review
Insulin-like Growth Factor (IGF) System in Corneal Epithelium
The corneal epithelium, comprising three layers of cells, represents the outermost portion of the eye and functions as a vital protective barrier while concurrently serving as a critical refractive structure. Maintaining its homeostasis involves a complex regenerative process facilitated by the functions of the lacrimal gland, tear film, and corneal nerves. Crucially, limbal epithelial stem cells located in the limbus (transitional zone between the cornea and the conjunctiva) are instrumental for the corneal epithelium integrity by replenishing and renewing cells. Re-epithelialization failure results in persistent defects, often associated with various ocular conditions including diabetic keratopathy. The insulin-like growth factor (IGF) system is a sophisticated network of insulin and other proteins essential for numerous physiological processes.
  • 227
  • 04 Mar 2024
Topic Review
Suprachoroidal Injections for Vision-Altering Diseases
Multiple eye pathologies have serious and vision-altering effects that can greatly affect the patients' quality of life. Notably, retinal detachment occurs when the retina, which is the thin layer of tissue at the back of the eye responsible for detecting light and transmitting visual signals to the brain, becomes separated from its underlying supportive layers. This separation can disrupt the normal flow of nutrients and oxygen to the retina, leading to vision loss if not promptly treated. Glaucoma, on the other hand, refers to a group of eye conditions characterized by damage to the optic nerve, which is responsible for transmitting visual information from the eye to the brain. This damage is often associated with increased intraocular pressure (IOP) due to a buildup of fluid within the eye. Glaucoma is typically a progressive condition that can lead to permanent vision loss if left untreated. Finally, myopia is a common vision problem worldwide, and its prevalence has been increasing in recent years, especially in urbanized and highly educated populations. It affects the ability to see distant objects clearly. Suprachoroidal injection thus offers a novel approach to the treatment of these conditions.
  • 226
  • 04 Dec 2023
Topic Review
Suprachoroidal Injections for Inflammatory and Neoplasic Pathologies
Ocular inflammatory diseases, including uveitis, involve inflammation within the eye and can affect various parts of the eye, leading to discomfort, vision impairment, and potentially serious complications if left untreated. The causes of uveitis and ocular inflammatory diseases can vary, including autoimmune disorders, infections (such as viral, bacterial, or fungal), systemic diseases (such as rheumatoid arthritis or inflammatory bowel disease), or sometimes the cause may remain unknown (idiopathic). Symptoms of uveitis and ocular inflammatory diseases may include eye redness, pain, light sensitivity, blurred vision, floaters, and in severe cases, vision loss. Another pathology affecting the middle layer of the eye is uveal melanoma, which is the most common primary intraocular malignancy in adults that develops in the uveal melanocytes. Since these are serious and potentially life-altering diseases, proper diagnosis, treatment, and ongoing monitoring are crucial to effectively manage these conditions and maintain ocular health. In this regard, suprachoroidal injections is being investigated as a new potential treatment options for these conditions. 
  • 223
  • 04 Dec 2023
Topic Review
Treatment Strategies for Anti-VEGF Resistance in neovascular AMD
Despite extensive use of intravitreal anti-vascular endothelial growth factor (anti-VEGF) biologics for over a decade, neovascular age-related macular degeneration (nAMD) or choroidal neovascularization (CNV) continues to be a major cause of irreversible vision loss in developed countries. Many nAMD patients demonstrate persistent disease activity or experience declining responses over time despite anti-VEGF treatment. The underlying mechanisms of anti-VEGF resistance are poorly understood, and no effective treatment strategies are available to date. Emerging strong evidence from animal models and clinical studies supports the roles of neovascular remodeling and arteriolar CNV formation in anti-VEGF resistance. Cholesterol dysregulation, inflammation, and ensuing macrophage activation are critically involved in arteriolar CNV formation and anti-VEGF resistance. Combination therapy by neutralizing VEGF and enhancing cholesterol removal from macrophages is a promising strategy to combat anti-VEGF resistance in CNV.
  • 223
  • 18 Mar 2024
Topic Review
Engineering of Retinal Prostheses
Retinal prostheses depend on specific outcomes and engineering constraints. These include effective electrical stimulation by direct contact with the retina, achieving high-resolution images through miniaturization, selective targeting of retinal cells, and customization with bidirectional functionality. Clinical results of retinal prostheses have shown limited visual resolution, posing challenges for object recognition and visual acuity. The pixel size of microelectrodes in prostheses limits acuity, indicating smaller pixels may improve resolution. Physiologically, smaller, densely packed electrodes are desired to stimulate individual retinal neurons. However, miniaturization increases charge density, necessitating material innovations to maintain safe stimulation. Considerations of biocompatibility and manufacturability are crucial. Retinal prostheses' success hinges on meeting key outcomes: effective stimulation, high-resolution images, selective targeting, and customization. These design considerations shape their manufacturing and market adoption, explored here for a comprehensive understanding.
  • 222
  • 18 Sep 2023
Topic Review
Ocular Complications of COVID-19
Coronaviruses are a large family of viruses that can cause illness in animals and humans. They are named for their crown-like spikes on their surface. Coronaviruses can cause a range of illnesses, from the common cold to more severe diseases such as severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and COVID-19. Coronaviruses are spread mainly through respiratory droplets when an infected person coughs, sneezes, talks, or breathes. They can also be spread by touching a surface contaminated with the virus and then touching your mouth, nose, or eyes.
  • 218
  • 14 Sep 2023
Topic Review
Molecular Basis of Diabetic Retinopathy
Diabetes mellitus (DM) is a growing problem nowadays, and diabetic retinopathy (DR) is its predominant complication. 
  • 214
  • 05 Aug 2024
Topic Review
Advancing Glaucoma Care
Glaucoma, the leading cause of irreversible blindness worldwide, comprises a group of progressive optic neuropathies requiring early detection and lifelong treatment to preserve vision. Artificial intelligence (AI) technologies are now demonstrating transformative potential across the spectrum of clinical glaucoma care.
  • 203
  • 30 Jan 2024
Topic Review
DNA Nanostructures for Ophthalmic Drug Delivery
Nanomedicine in gel or particle formation holds considerable potential for enhancing passive and active targeting within ocular drug delivery systems. The complex barriers of the eye, exemplified by the intricate network of closely connected tissue structures, pose significant challenges for drug administration. Leveraging the capability of engineered nanomedicine offers a promising approach to enhance drug penetration, particularly through active targeting agents such as protein peptides and aptamers, which facilitate targeted release and heightened bioavailability. Simultaneously, DNA carriers have emerged as a cutting-edge class of active-targeting structures, connecting active targeting agents and illustrating their potential in ocular drug delivery applications.
  • 202
  • 26 Sep 2023
Topic Review
Adipose-Tissue-Derived Mesenchymal Stem Cell-Based Therapy for Retinal Diseases
With the rapid development of stem cell research in modern times, stem cell-based therapy has opened a new era of tissue regeneration, becoming one of the most promising strategies for currently untreatable retinal diseases. Among the various sources of stem cells, adipose tissue-derived mesenchymal stem cells (ADSCs) have emerged as a promising therapeutic modality due to their characteristics and multiple functions, which include immunoregulation, anti-apoptosis of neurons, cytokine and growth factor secretion, and antioxidative activities. ADSCs can facilitate the replacement of dying cells, promote tissue remodeling and regeneration, and support the survival and growth of retinal cells. 
  • 194
  • 17 Nov 2023
Topic Review
Types of Retinal Cell Death in Diabetic Retinopathy
Diabetic retinopathy (DR) is a major complication of diabetes and a leading cause of blindness worldwide. DR was recently defined as a neurovascular disease associated with tissue-specific neurovascular impairment of the retina in patients with diabetes. Neurovascular cell death is the main cause of neurovascular impairment in DR.
  • 191
  • 01 Sep 2023
Topic Review
Measurement of Retrobulbar Blood Flow and Vascular Reactivity
Abnormal retrobulbar hemodynamics have been linked to the development of various ocular diseases, including glaucoma, age-related macular degeneration, and diabetic retinopathy. Additionally, altered retrobulbar blood flow has been observed in patients with severe cardiovascular diseases, including carotid artery occlusion, stroke, heart failure, and acute coronary syndrome.
  • 189
  • 05 Dec 2023
Topic Review
Advances in Diagnosis Approaches in Fungal Keratitis
Fungal keratitis represents a potentially sight-threatening infection associated with poor prognosis, as well as financial burden. Novel diagnostic methods include polymerase-chain-reaction (PCR)-based approaches, metagenomic deep sequences, in vivo confocal microscopy, and antifungal susceptibility testing. The ideal therapeutic approaches and outcomes have been widely discussed, with early therapy being of the utmost importance for the preservation of visual acuity, minimizing corneal damage and reducing the scar size. However, combination therapy can be more efficacious compared to monotherapy. Understanding the pathogenesis, early diagnosis, and prevention strategies can be of great importance. 
  • 185
  • 18 Feb 2024
Topic Review
Treatment of Uveitic Glaucoma
Glaucoma is a common and potentially blinding complication of uveitis. Many mechanisms are involved alone or in combination in the pathogenesis of uveitic glaucoma (UG). In terms of diagnostic evaluation, the effects of inflammatory activity in the retinal nerve fiber layer may be a source of bias in the interpretation of optical coherence tomography measurements. For the successful treatment of UG, the control of intraocular inflammation specific to the cause or anti-inflammatory treatment, combined with IOP management, is mandatory. The early institution of specific treatment improves the prognosis of UG associated with CMV. The young age of UG patients along with increased failure rates of glaucoma surgery in this group of patients warrants a stepwise approach. Conservative and conjunctival sparing surgical approaches should be adopted. Minimally invasive surgical approaches were proved to be effective and are increasingly being used in the management of UG along with the traditionally used techniques of trabeculectomy or tubes.
  • 185
  • 14 Mar 2024
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