Special Issue: Recent Advances in Pathogenesis and Management of Eye Diseases

The pathogenesis and management of eye diseases have seen significant advancements in recent years, driven by technological innovations, a deeper understanding of molecular mechanisms, and novel therapeutic approaches. Some of these aspects have been demonstrated and/or discussed in the scientific papers presented in the Special Issue “Recent Advances in Pathogenesis and Management of Eye Diseases”, and the present Editorial aims to summarize the contents of these works.

According to the World Health Organization (WHO), at least 2.2 billion people experience vision impairment, and in at least 1 billion of these people, it could have been prevented or is yet to be addressed [1]. The Pentacam system is an advanced diagnostic device used in ophthalmology, particularly for anterior segment imaging of the eye, including the cornea, anterior chamber, and lens. It employs a rotating Scheimpflug camera to create a 3D model of the anterior eye segment, providing highly detailed and accurate measurements essential for diagnosing and managing various eye conditions [2,3,4]. Through the creation of a three-dimensional model utilizing the Pentacam system, researchers recently analyzed the behavior of the eyeball’s corneal surface when prolonged luminous beams irradiate it at a minimum distance [5]. The results showed that this is an effective approach to quantifying displacements on the corneal surface under light irradiation based on brightness, distance, and wavelength [5].

Glaucoma is the second leading cause of blindness in the world [6]. It is a complex, progressive, and irreversible eye disease characterized by increased intraocular pressure, leading to damage to the optic nerve [7]. The early stages of glaucoma generally lack symptoms or pain. Therefore, patients might become aware of the disease only when significant vision loss occurs [8]. Considering the gravity of the pathology, early detection is essential to provide an appropriate treatment to slow down or halt disease progression [9]. Traditional methods for measuring intraocular pressure (IOP) are invasive and uncomfortable and provide only a single measurement at a time on widely varying parameters. On the contrary, contact lenses represent a valid instrument for the continuous monitoring IOP. Recently, Alqurash et al. [10] treated commercial contact lenses with a carbon dioxide laser to obtain a concentric pair of rings on their surfaces, in the form of microchannels. These rings proved to be a novel and non-invasive method of detecting IOP values in glaucoma patients. Moreover, smartphones can be used as readers to capture interspacing changes, providing rapid and precise results.

Another common eye disease is keratoconus. It affects 1 in 2000 people and it is one of the leading causes of corneal transplantation [11]. Keratoconus is a bilateral and asymmetric disease characterized by cone-like steepening of the cornea, leading to irregular astigmatism and decreased visual acuity [12,13]. The etiology of keratoconus is multifactorial, and genetic factors seem to contribute to its pathogenesis [11,14,15]. A recent study investigated the involvement of the visual system homeobox 1 (VSX1) gene in the pathogenesis of keratoconus [16] via in silico analysis on autosomal recessive Pakistani families and sporadic keratoconus patients. In particular, their bioinformatic analysis revealed two single-nucleotide polymorphisms (SNPs) involved in keratoconus development. Considering that the etiology of keratoconus is multifactorial with genetic and environmental influences, it is necessary to adopt new genetic technologies to improve our knowledge on the pathogenesis of this disabling ocular pathology [15].

Another common cornea disease is diabetic keratopathy (DK), which is a degenerative corneal disease occurring in patients with diabetes. DK is induced by a hyperglycemic state responsible for corneal thickness, epithelial defects, fragility, delayed corneal wound healing, and recurrent corneal ulcers [17,18]. Despite current treatments, including lubricants, antibiotics, bandage contact lenses, and tarsorrhaphy, corneal epithelial wounds often heal slowly, increasing the risk of infections, and potentially causing severe and permanent vision loss [19]. In recent years, several studies have demonstrated the protective role of vasoactive intestinal peptide (VIP) family members, including VIP, pituitary adenylate cyclase-activating polypeptide (PACAP), and activity-dependent neuroprotective protein (ADNP), in the cornea [20,21,22,23,24,25]. In particular, PACAP, by activating its specific receptor, was shown to exert protective effects in DK, promoting cell viability and corneal epithelium re-epithelialization through epidermal growth factor receptor (EGFR) and extracellular signal-regulated kinase 1/2 (ERK) signaling activation [26]. However, the short half-life of these peptides has hampered their development as a therapeutic. Therefore, more efforts are needed to design and synthesize VIP family member analogs for use as therapeutic agents for DK or other ocular pathologies.

Based on the gravity of corneal injury, different strategies are applied, ranging from drug treatments to corneal transplantation in more severe cases [27,28]. The storage medium for the cornea is crucial for preserving its viability and function during transplantation. It must provide a suitable environment for maintaining the viability of donor endothelium and epithelium, metabolic activity, and optical clarity [29]. There are different storage media for corneas, and Optisol-GS represents the gold standard pharmaceutical composition to preserve corneas for transplantation [30]. Recently, Gimenes et al., [31] through a systematic review, compared the effects of different cold corneal storage media (CCSM) with Optisol-GS on corneal preservation quality. The results showed that most CCSM act as good storage media for donor cornea, but Cornisol and Cornea ColdTM showed better qualitative results at 10 days (p = 0.049) and up to 4 weeks (p < 0.05) as compared to Optisol-GS, suggesting that the perfect storage medium remains to be identified.

This Special Issue, “Advancement of Pathogenesis and Management of Eye Diseases” comprises five articles from Applied Sciences researchers [5,10,16,20,31]. These articles provide information regarding biomechanics; the cornea; displacements; luminous beams; structural deformation; keratoconus; rare variants; cis-acting elements; miRNA; diabetic keratopathy; contact lenses; glaucoma; carbon dioxide lasers; culture media; and organ preservation solutions. We hope that readers of Applied Sciences enjoy reading these significant works, which remind us of the crucial importance of interdisciplinary collaboration.