J. Clin. Transl. Ophthalmol., Volume 3, Issue 4 (December 2025) – 5 articles

Smartphone-based fundus cameras and telemedicine are an opportunity for accessing ocular health inequalities in under-resourced areas. The objective of this study is to evaluate the prevalence of retinal findings in a community in the Amazon and propose strategies to enhance ocular health. A retrospective study was conducted in a riverside community. Retinal photos from the posterior pole and optic disc were captured using a portable fundus camera. All photos and data were analyzed remotely by a retina specialist. The final sample was 107 participants, aged 52 ± 17. Retinal findings were detected in 37.4% (95%CI 28.7–46.8) of the sample; the three main retinal findings were epithelial changes (10.3%, 95%CI 5.6–17.1), chorioretinal scars (8.4%, 95%CI 4.2–14.8), and dry age-related macular degeneration (7.5%, 95%CI 3.6–13.6). This study detected retinal alterations in a similar prevalence to that of other under-resourced areas. Telemedicine is an opportunity to address health inequities, especially in ophthalmology, through relatively low-cost portable devices, supporting clinical decisions in areas with low health access; however, maintaining assistance after implementation is a challenge. Enhancing medical education and training local non-specialized health professionals in risk assessment, device handling, and data base use is reasonable to ensure follow-up. Full article

Background: Uveitis, although a rare complication of multiple sclerosis (MS), poses a significant challenge in clinical management. Traditional treatments like corticosteroids, immunosuppressants, and surgical interventions often provide limited efficacy. Treatment for MS-associated uveitis involves a combination of traditional and emerging therapies, with a growing emphasis on monoclonal antibodies (mAbs). While there is an increasing use of disease-modifying therapies for MS such as interferon-beta (IFN-β), mAbs are gaining attention for their potential to address both neurological and ophthalmological symptoms. Methods: We conducted a systematic review of the existing literature and analyzed the clinical effect of IFN-β and mAb therapies in the context of MS-associated uveitis, assessing their efficacy in reducing inflammation, maintaining visual acuity (VA), and minimizing steroid dependency. Results: MS-associated uveitis had improved or maintained VA in 95% (35/37) of eyes (21 patients) after an average of 34.7 months (range of 7.9 to 78.7 months) of IFN-β treatment. One hundred percent (10/10) of patients (19/19 eyes) had improved or maintained VA after a mean of 25 months (range 8 to 43 months) of mAb treatment. We also found that IFN-β effect on MS-associated uveitis is comparable to mAbs. Conclusions: We outline the need for further research through human data to strengthen current findings and guide evidence-based clinical practice. Full article

Optogenetics is a field that emerged with the goal of studying the physiology of nerve cells by selectively expressing opsins—channel proteins that can be activated by light exposure. Once the methodology was established, several research groups sought to express these proteins in damaged nerve tissue to restore proper signal transmission. Over the years, numerous efforts have been made to restore vision in patients with chronic degenerative diseases, particularly retinitis pigmentosa, with clinical trials yielding encouraging results. However, significant challenges remain, such as the difficulty of delivering the signal to specific retinal cells and the complexity of replicating the physiological activation of the target cells. As research continues, optogenetics remains a promising yet evolving field. This review aims to highlight the therapeutic advantages of optogenetics over currently available strategies and to promote further scientific exploration of this emerging discipline. Full article

Background: Glaucoma is the leading cause of irreversible blindness around the world and is characterized as a group of irreversible optic neuropathies with multiple risk factors such as age, race/ethnicity, sex, and intraocular pressure (IOP), amongst many others that play a role in disease etiology. However, IOP is the only modifiable risk factor, with higher IOP often causing increased damage to the optic nerve, resulting in the vast majority of medical and surgical treatments aiming to reduce IOP. There are a number of interventions available to treat glaucoma including micro-invasive glaucoma surgery (MIGS), whose usage has drastically increased due to its safety and efficacy. Studies also highlight the IOP-reducing effect of cataract surgery, which is the most common procedure performed globally. However, other, more targeted therapies and surgeries have been shown to have a more significant effect on IOP reduction. The objective of this study is to compare the IOP and medication reduction between cataract surgery (CS), MIGS, and MIGS and cataract surgery (MACS) clinical trials. Methods: This analysis consisted of publicly available data on CS, MIGS, and MACS clinical trials from 2005 to 2017 using ClinicalTrials.gov. Data reporting and synthesis adhered to PRISMA guidelines. MIGS interventions studied in this analysis include iStent^®, CyPass^® Micro-Stent, Ex-PRESS^®, Hydrus^®, PRESERFLO^™ MicroShunt, and XEN^® Gel Stent. The main variables of interest are the mean IOP and mean number of glaucoma medications used. The primary outcomes were the baseline, post-procedure, and reduction in IOP and glaucoma medication use. Cohorts were further subdivided by the follow-up period (6, 12, and 24 months), as well as their medicated or unmedicated status for pre-op IOP measurement. PROSPERO CRD42025102892. Results: A total of 21 trials were included in this review, comprising 3330 clinical trial participants: 7 CS trials (N = 570), 13 MIGS trials (N = 1577), and 9 MACS trials (N = 1183). All interventions studied resulted in a decrease in both the IOP and medication usage with varying degrees. At 12 months, the wash-out baseline IOP reduction (mmHg) was 6.9 (27.5%) for CS, 8.8 (34.0%) for MIGS, and 8.2 (32.6%) for MACS. The medication reduction was 0.8 (56.1%) following CS, 1.0 (39.5%) for MIGS, and 1.3 (86.4%) for MACS. At 24 months, the wash-out baseline IOP reduction was 6.3 (25.1%) for CS, 8.4 (33.1%) for MIGS, and 7.6 (30.1%) for MACS. At 24 months, the medication reduction was 0.9 (58.3%) for CS, 1.5 (79.8%) for MIGS, and 1.3 (86.1%) for MACS. Conclusions: The results indicate that CS, MIGS, and MACS all result in a decrease in the IOP and glaucoma medications; however, MIGS and MACS outperform CS in IOP and medication reduction. Adopting MIGS and MACS for patients with ocular hypertension or mild-to-moderate glaucoma will help improve patient outcomes through reducing the IOP and medication burden. Given that glaucoma affects certain populations to a greater degree, future research analyzing racial representation is critical in ensuring the appropriate applicability of clinical trial results toward diverse populations. Full article

The prevalence of vision impairment and eye disease is higher among patients with chronic kidney disease (CKD), yet there are no standardized guidelines for this vulnerable population. We hypothesized that there are self-reported unmet ophthalmic care needs among patients receiving hemodialysis. We also hypothesized that limited awareness of the connection between eye health and CKD is a significant barrier to receiving eye care. Methods: From June 2022 to July 2022, patients on dialysis were recruited in-person at two Independent Dialysis Foundation sites in Baltimore, Maryland. Participants completed a survey assessing recent eye exam history, barriers to care, and health literacy. Results: Of 82 participants, 43 (52%) had not received a complete eye exam within the past year. The most common reasons were scheduling conflicts (15 [35%]), not wanting an eye exam (12 [28%]), and costs (6 [14%]). Less than half of respondents (40, 41%) were unaware of a relationship between kidney disease and eye health. Conclusions: Results suggest potential unmet eye care needs and low awareness of CKD-related ocular risks among dialysis patients. Interventions to enhance provider recommendations, improve health literacy, and reduce logistical barriers may help prevent avoidable vision loss in this high-risk population. Full article