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Topic Review
Recent Advancements in Retinal Prosthesis Technology
Significant progress has been made in retinal prostheses, including material science, visual field size, and integration of artificial intelligence. These advancements reflect innovation and provide insights into the future of retinal prostheses. Retinal prostheses utilize inorganic and organic electrodes. Smaller electrodes optimize electrical signaling, but current electrodes have physical limitations. Common metals used are iridium, gold, titanium, tin, and platinum due to their inertness, electrical properties, and biocompatibility. Recent advancements aim to improve the visual field of retinal prostheses. One such example, POLYRETINA, a foldable and photovoltaic epiretinal prosthetic, addresses the limited visual field in current technology since existing prosthetics have insufficient visual angle size (VAS) for mobility and object identification tasks. Additionally, a recent study developed a wireless photovoltaic retinal implant (PRIMA) to improve central vision in atrophic age-related macular degeneration patients without affecting peripheral vision. Retinal prostheses face challenges in effectiveness, surgical complexity, patient eligibility, long-term durability, and cost/accessibility, which is why advancements in technology, surgical techniques, and understanding of retinal physiology are needed.
  • 318
  • 18 Sep 2023
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.
  • 177
  • 18 Sep 2023
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.
  • 233
  • 18 Sep 2023
Topic Review
Posterior Reversible Encephalopathy Syndrome after Pazopanib
The term posterior reversible encephalopathy syndrome (PRES) refers to an acute syndrome characterised by a range of neurological symptoms and posterior transient changes on neuroimaging. Common clinical presentation includes headache, confusion, visual disturbances, seizures, and focal neurological deficit. With the advancement and increasing availability of neuroimaging, this syndrome is increasingly recognised. There are several underlying causes for PRES, including certain medications. Tyrosine kinase inhibitors (TKIs) such as pazopanib can increase the risk of developing PRES by markedly elevating the blood pressure due to its effect of inhibition of vascular endothelial growth factor receptors (VEGFRs). 
  • 163
  • 18 Sep 2023
Topic Review
Disease Burden of Atopic Dermatitis in China
Atopic dermatitis (AD) is now a global health problem and has been attracting extensive attention from both academic and public society in China. The prevalence of AD has been increasing rapidly in China, partially due to the increased recognition of the disease; there are still substantial amounts of over-diagnosed eczema and under-diagnosed AD. Chinese dermatologists see many AD patients with atypical manifestation, which poses a challenge to the diagnosis. The Chinese diagnostic criteria for adults and pediatric patients with AD have been proposed respectively and validated with high sensitivity and specificity. International and Chinese guidelines for management of AD have been popularized
  • 388
  • 18 Sep 2023
Topic Review
Metastatic Spinal Cord Compression Secondary to Lung Cancer
Metastatic spinal cord compression (MSCC) is characterised by the compression of the spinal cord due to direct or metastatic spread to the vertebrae, potentially leading to neurological deficits. This condition constitutes an urgent situation in oncology, demanding swift diagnosis and immediate intervention due to the considerable risk of spinal cord damage and irreversible neurological repercussions. Spinal tumours resulting from the metastasis of lung cancer are particularly connected with an unfavourable prognosis, often displaying rapid advancement and limited survival. Treatment approaches encompass a combination of radiotherapy and potential surgery, which are tailored to each patient’s situation. Identifying such prognostic factors associated with shorter or longer survival subsequent to MSCC could contribute to tailoring distinct, more or less intensive therapeutic strategies for these individuals.
  • 250
  • 18 Sep 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. 
  • 165
  • 18 Sep 2023
Topic Review
Screening HPV and Cervical Cancer in the UK
Cervical cancer is the fourth most common malignancy in females worldwide, and a leading cause of death in the United Kingdom (UK). The human papillomavirus (HPV) is the strongest risk factor for developing cervical intraepithelial neoplasia and cancer. Across the UK, the national HPV immunisation programme, introduced in 2008, has been successful in protecting against HPV-related infections. Furthermore, the National Health Service (NHS) implemented the cytology-based cervical cancer screening service to all females aged 25 to 64, which has observed a decline in cervical cancer incidence. In the UK, there has been an overall decline in age-appropriate coverage since April 2010. In 2019, the COVID-19 pandemic disrupted NHS cancer screening and immunisation programmes, leading to a 6.8% decreased uptake of cervical cancer screening from the previous year. Engagement with screening has also been associated with social deprivation. In England, incidence rates of cervical cancer were reported to be 65% higher in the most deprived areas compared to the least, with lifestyle factors such as cigarette consumption contributing to 21% of cervical cancer cases. 
  • 187
  • 18 Sep 2023
Topic Review
Estrogen Deficiency-Related Osteoporosis (EDOP)
Estrogen receptors (ERs) are highly expressed in osteoblasts, osteoclasts, and osteocytes, offering protective effects in bone. Osteoporosis is a serious health issue among aging postmenopausal women. The majority of postmenopausal women with osteoporosis have bone loss related to estrogen deficiency. The rapid bone loss results from an increase in bone turnover with an imbalance between bone resorption and bone formation. Osteoporosis can also result from excessive glucocorticoid usage, which induces bone demineralization with significant changes of spatial heterogeneities of bone at microscale, indicating potential risk of fracture. 
  • 188
  • 18 Sep 2023
Topic Review
Myelin Oligodendrocyte Glycoprotein Immunopathology, Treatment and Visual Outcome
The International Consensus Group on MOG autoantibody-associated disease (MOGAD) has proposed that the diagnostic criteria for MOGAD should include the presence of anti-MOG autoantibodies detected using cell-based assays. MOGAD is typically associated with acute disseminated encephalomyelitis (ADEM), optic neuritis (ON), and transverse myelitis (TM) and is less commonly associated with cerebral cortical encephalitis, brainstem or cerebellar symptoms, and clinical presentations including the combination of several phenotypes and sometimes accompanies other autoantibodies such as anti-N-methy-D aspartate receptor (NMDAR) autoantibodies with symptoms of autoimmune encephalitis.
  • 367
  • 18 Sep 2023
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