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Topic Review
Pediatric Conjunctivitis
Conjunctivitis is a common pediatric problem and is broadly divided into infectious and non-infectious etiologies. Bacterial conjunctivitis makes up the majority of cases in children and often presents with purulent discharge and mattering of the eyelids. Treatment is supportive with an individual approach to antibiotic use in uncomplicated cases since it may shorten symptom duration, but is not without risks. Viral conjunctivitis is the other infectious cause and is primarily caused by adenovirus, with a burning, gritty feeling and watery discharge. Treatment is supportive. Allergic conjunctivitis is largely seasonal and presents with bilateral itching and watery discharge. Treatment can include topical lubricants, topical antihistamine agents, or systemic antihistamines. Other causes of conjunctivitis include foreign bodies and non-allergic environmental causes. 
  • 847
  • 15 May 2023
Topic Review
Normal Tension Glaucoma
Glaucoma is a neurodegenerative disease of the eye, which involves degeneration of retinal ganglion cells (RGCs): the output neurons of the retina to the brain, which with their axons comprise the optic nerve. Glaucoma is usually associated with elevated intraocular pressure (IOP), but there is a subtype of glaucoma, termed normal tension glaucoma, that presents with normal IOP.
  • 843
  • 12 Feb 2021
Topic Review
Small Leucine-Rich Proteoglycans in Retina
Small Leucine-Rich Proteoglycans (SLRPs) are key extracellular matrix proteins that play a role in many fundamental biological processes involved in the maintenance of retinal homeostasis. 
  • 839
  • 26 Jul 2021
Topic Review
Pharmacological Treatment in Presbyopia
Pharmacological treatment of presbyopia may be an alternative for those who want a spectacle-free scenario and an easy-to-use method with lower risk of irreversible ocular adverse events. There are two main agents, miotics and lens softeners, investigated as agents for the pharmacological treatment. Miotic agents treat presbyopia by creating a pinhole effect which may increase the depth of focus at all working distances. Lens softeners increase the elasticity of the lens, which is targeted at one of the etiologic mechanisms of presbyopia. 
  • 838
  • 14 Mar 2022
Topic Review
Gel-Based Materials
The most common route of administration of ophthalmic drugs is the topical route because it is convenient, non-invasive, and accessible to all patients. Unfortunately, drugs administered topically are not able to reach effective concentrations. Moreover, their bioavailability must be improved to decrease the frequency of administrations and their side effects, and to increase their therapeutic efficiency. For this purpose, in recent decades, particular attention has been given to the possibility of developing prolonged-release forms that are able to increase the precorneal residence time and decrease the loss of the drug due to tearing. Among these forms, gel-based materials have been studied as an ideal delivery system because they are an extremely versatile class with numerous prospective applications in ophthalmology. These materials are used in gel eye drops, in situ gelling formulations, intravitreal injections, and therapeutic contact lenses. 
  • 830
  • 08 Sep 2021
Topic Review
The Alter Retina
Alternative splicing of mRNA is an essential mechanism to regulate and increase the diversity of the transcriptome and proteome. Alternative splicing frequently occurs in a tissue- or time-specific manner, contributing to differential gene expression between cell types during development. Neural tissues present extremely complex splicing programs and display the highest number of alternative splicing events. As an extension of the central nervous system, the retina constitutes an excellent system to illustrate the high diversity of neural transcripts. The retina expresses retinal specific splicing factors and produces a large number of alternative transcripts, including exclusive tissue-specific exons, which require an exquisite regulation. In fact, a current challenge in the genetic diagnosis of inherited retinal diseases stems from the lack of information regarding alternative splicing of retinal genes, as a considerable percentage of mutations alter splicing or the relative production of alternative transcripts. Modulation of alternative splicing in the retina is also instrumental in the design of novel therapeutic approaches for retinal dystrophies, since it enables precision medicine for specific mutations.
  • 822
  • 22 Sep 2021
Topic Review
Non-Invasive Imaging and Proliferative Diabetic Retinopathy
Diabetic retinopathy (DR) is a leading cause of vision impairment in people aged 20–74 years. There is a trend of moving away from invasive (e.g., fundus fluorescein angiography) to non-invasive (e.g., wide-field optical coherence tomography (OCT), OCT angiography and colour fundus photography) imaging modalities to allow for more objective assessments that can be readily repeated in a time-efficient manner without compromising patient safety. Such quantitative assessments generating large amounts of data could benefit from artificial intelligence approaches to aid clinical decision making.
  • 818
  • 02 Dec 2021
Topic Review
Neuroplasticity
Neuroplasticity can be defined as the ability of the nervous system to modify its structure on the basis of different environmental changes and stimulation.
  • 803
  • 28 Oct 2021
Topic Review
Reis–Bücklers Corneal Dystrophy
Corneal dystrophies are a group of non-inflammatory inherited disorders of the cornea. Reis–Bücklers corneal dystrophy (RBCD) is a bilateral and autosomal dominant disease caused by a mutation in keratoepithilin, i.e., BIGH3, also known as transforming human growth factor (TGFBI), on chromosome 5q.
  • 801
  • 12 Apr 2023
Topic Review
SARS-CoV-2 Affect Eyes
The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection has become a worldwide threat resulting in a pandemic in 2020. SARS-CoV-2 infection manifests itself as coronavirus disease 2019 (COVID-19) that is evidenced in a vast number of either specific or nonspecific symptoms. Except for typical (but nonspecific) symptoms such as fever, dry cough, or muscle weakness, the infected patients might also present atypical symptoms including neurological, dermatological, or ophthalmic manifestations.
  • 800
  • 20 Jun 2022
Topic Review
Advanced DDS for Delivering Anti-VEGF Agents
The treatment of posterior segment eye diseases is challenging due to the complex anatomy of the eye, which limits the effective delivery of medications. Conventional treatments such as topical eye drops and intravitreal injections have poor bioavailability and short residence time, requiring frequent dosing. Biodegradable nano-based drug delivery systems (DDSs) offer a potential solution to these limitations, with longer residence time in ocular tissues and better penetration through ocular barriers. These DDSs use biodegradable polymers that are nanosized, reducing the risk of toxicity and adverse reactions.
  • 800
  • 12 May 2023
Topic Review
Lactoferrin in Ocular Diseases
Besides the well-known antibacterial effect of lactoferrin, novel interest has been rising towards its potential application in the field of dry eye and viral infections. A growing body of evidence supports the antimicrobial efficacy of lactoferrin, which is not limited to its iron-chelating properties but also depends on its capability to directly interact with pathogen particles while playing immunomodulatory effects. Nowadays, lactoferrin antiviral activity is of special interest, since lactoferrin-based eye drops could be adopted to treat/prevent the new severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infection, which has conjunctivitis among its possible clinical manifestations. In the future, further data from randomized controlled studies are desirable to confirm the efficacy of lactoferrin in the wide range of ocular conditions where it can be used.
  • 798
  • 14 Oct 2020
Topic Review
Suprachoroidal Delivery of Therapeutic Agents
Suprachoroidal drug delivery technology has advanced rapidly and emerged as a promising administration route for a variety of therapeutic candidates, targeting multiple ocular diseases, ranging from neovascular age-related macular degeneration to choroidal melanoma. This entry summarizes the latest preclinical and clinical progress in suprachoroidal delivery of therapeutic agents, focusing on small molecule suspensions.
  • 795
  • 22 Sep 2021
Topic Review
Corneal Epithelial Stem Cells
In the human cornea, regeneration of the epithelium is regulated by the stem cell reservoir of the limbus, which is the marginal region of the cornea representing the anatomical and functional border between the corneal and conjunctival epithelium. In support of this concept, extensive limbal damage, e.g., by chemical or thermal injury, inflammation, or surgery, may induce limbal stem cell deficiency (LSCD) leading to vascularization and opacification of the cornea and eventually vision loss. These acquired forms of limbal stem cell deficiency may occur uni- or bilaterally, which is important for the choice of treatment. Moreover, a variety of inherited diseases, such as congenital aniridia or dyskeratosis congenita, are characterized by LSCD typically occurring bilaterally. Several techniques of autologous and allogenic stem cell transplantation have been established. The limbus can be restored by transplantation of whole limbal grafts, small limbal biopsies or by ex vivo-expanded limbal cells.
  • 791
  • 08 Apr 2022
Topic Review
Nanocarrier-Based Ocular Therapeutic System
Many strategies were designed in terms of the therapeutic modality of ocular diseases. The advent of nanotechnology-based therapeutic systems has acquainted the novel facet toward the optimized nanosize particle, which enables minimizing irritation, addressing the poor bioavailability, and improving ocular biocompatibility of therapeutics. 
  • 788
  • 10 Mar 2022
Topic Review
Epidermal Growth Factor Receptor in the Corneal Epithelium
It has been known for some time that the addition of epidermal growth factor (EGF) promotes the restoration of the corneal epithelium and patients using EGFR inhibitors as anti-cancer therapies are at increased risk of corneal erosions. However, the use of EGF in the clinic has been limited by downregulation of the receptor. More recent advances in EGFR signaling and trafficking in corneal epithelial cells have provided new insights in how to overcome receptor desensitization. 
  • 780
  • 25 Mar 2022
Topic Review Peer Reviewed
Improving Compliance with Medical Treatment Using Eye Drop Aids
Achieving optimal treatment outcomes in glaucoma requires patients to adhere to their medication regimens. Possible barriers to patients’ cooperation include the misunderstanding of a treatment’s importance or errors in applying instructions, forgetfulness, financial constraints and others. Due to the fact that glaucoma usually causes no apparent symptoms or pain, on the one hand, and the significant inconvenience that the eye drops used for glaucoma treatment can cause due to local irritation, on the other, patient compliance is a challenge. To address this challenge, we require strategies for improving adherence to glaucoma treatment. The importance of proper eye drop administration techniques cannot be overstated, particularly for vulnerable populations such as the elderly, the sick and the visually handicapped. Studies have shown that failure to comply with glaucoma treatment is a significant factor affecting disease progression, emphasizing the need for interventions that improve patient compliance. Educational interventions, medication reminders and the use of assistive devices such as eye drop aids have been shown to improve adherence to glaucoma treatment. By promoting strategies that can be used to enhance treatment adherence, healthcare providers can ensure that glaucoma patients receive the full benefits of their treatment plans, reducing the risk of disease progression. Many patients struggle with the complexity of their treatment regimens and the challenges of administering eye drops. This entry provides a comprehensive overview of the different barriers to patient adherence to glaucoma eye drop treatment, emphasizing the difficulties associated with eye drop instillation. This entry examines a range of eye drop aids available to patients, evaluating their modes of action, benefits, drawbacks and effectiveness in improving patient compliance. By providing detailed information on the barriers to adherence and the range of eye drop aids available, this entry aims to support healthcare providers in helping glaucoma patients to achieve better treatment adherence and outcomes.
  • 766
  • 19 Oct 2023
Topic Review
Choriocapillaris OCTA in AMD
The advent of optical coherence tomography angiography (OCTA) has facilitated remarkable advancements in our ability to image the blood vessels of the retina and choroid. This is particularly true of the choriocapillaris (CC), the blood vessel bed that feeds the outer retina. OCTA has more clearly defined the integral role of the CC in age-related macular degeneration (AMD), the leading cause of vision loss people over 50 years old. OCTA imaging shows that the choriocapillaris is impaired in intermediate and advanced non-neovascular AMD, and the severity of impairment may predict the advancement of disease. In advanced non-neovascular AMD, the choriocapillaris is severely impaired underneath the area of geographic atrophy, and the level of impairment surrounding geographic atrophy can predict the rate of atrophy enlargement. Macular neovascularization, harmful new blood vessels that grow in neovascular AMD, can be readily identified and classified using OCTA. It is still unclear however if neovascularization features with OCTA can predict the lesion’s level of activity. However, the choriocapillaris surrounding macular neovascularization is impaired while the more peripheral choriocapillaris is spared, implying that choriocapillaris disease may drive the growth of these new blood vessels. With continued innovation in OCTA image acquisition and analysis methods, new discoveries in AMD are set to follow.
  • 764
  • 22 Sep 2021
Topic Review
Fundus Autofluorescence Imaging
Non-invasive in vivo FAF imaging is based on the visualization of endogenous fluorophores in the ocular fundus. The first scanning laser ophthalmoscope was presented in 1980 by Webb et al. and continuously improved in the following years. FAF imaging using confocal scanning laser ophthalmoscopy (cSLO) was described in 1995. Since then, continuous and further developments have strengthened FAF imaging to become a safe and reproducible imaging method that is essential for the routine clinical examination of various chorioretinal diseases. Nowadays, different commercially available devices are used to record FAF. They may not be absolutely equivalent and comparable. Therefore, it is essential to understand the basic principles of FAF imaging techniques and to know the different imaging systems.
  • 757
  • 28 Apr 2022
Topic Review
Sex Hormones and Ocular Dryness
Dry eye syndrome (DES) is strictly connected to systemic and topical sex hormones. Breast cancer treatment, the subsequent hormonal therapy, the subsequent hyperandrogenism and the early sudden menopause, may be responsible for ocular surface system failure and its clinical manifestation as dry eye disease. This local dryness is part of the breast cancer iatrogenic dryness, which affects overall mucosal tissue in the fragile population of those with breast cancer.
  • 750
  • 18 Sep 2021
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