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Causes and Advanced Treatments of Macular Edema
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Causes and Advanced Treatments of Macular Edema

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Ophthalmology".

Deadline for manuscript submissions: 30 June 2025 | Viewed by 2837

Special Issue Editors

Dr. Gawęcki Maciej

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Guest Editor
Dobry Wzrok Ophthalmological Clinic, Zabi Kruk 10, 80-822 Gdansk, Poland
Interests: medical retina; OCT-angiography; fluorescein angiography; subthreshold retinal laser treatment; central serous chorioretinopathy; cataract surgery; strabismus surgery
Special Issues, Collections and Topics in MDPI journals
Dr. Slawomir Teper

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Guest Editor
Chair and Clinical Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 40-055 Katowice, Poland
Interests: retinal diseases; uveitis; ophthalmic genetics; imaging of the posterior segment of the eye
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Diagnosis and treatment of macular edema (ME) has become an everyday engagement of clinical ophthalmologists. This entity constitutes a frequent syndrome or complication of numerous ophthalmic disorders. In recent decades, significant progress has been made in the diagnosis and treatment of ME with intravitreal injections, non-damaging retinal lasers, and pars plana vitrectomy. The introduction of optical coherence tomography and OCT angiography equipped with modern software has enabled numerical evaluation of ME and precise detection of macular ischemia. The aim of this Special Issue is to present new research that explores the utilization of new diagnostic techniques and treatment options in clinical practice. We hope to explore the relationship between diagnostic imaging and functional impairment in ME. We encourage papers with new wide-field imaging techniques. We also seek contributions that involve the analysis of the efficacy of retinal lasers, photodynamic therapy, intravitreal agents, or surgical approaches in the management of ME.

Both research papers and review articles are welcome for this issue.

We look forward to receiving your contributions.

Dr. Gawęcki Maciej
Dr. Slawomir Teper
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • macular edema
  • laser photocoagulation
  • subthreshold laser
  • anti-VEGF
  • optical coherence tomography
  • fluorescein angiography
  • angio-OCT

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Published Papers (3 papers)

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Research

11 pages, 2199 KiB  
Article
A Novel Effect of Microaneurysms and Retinal Cysts on Capillary Perfusion in Diabetic Macular Edema: A Multimodal Imaging Study
by Bilal Haj Najeeb, Bianca S. Gerendas, Alessio Montuoro, Christian Simader, Gábor G. Deák and Ursula M. Schmidt-Erfurth
J. Clin. Med. 2025, 14(9), 2985; https://doi.org/10.3390/jcm14092985 - 25 Apr 2025
Viewed by 294
Abstract
Background/Objectives: The aim of this study was to investigate the potential contribution of microaneurysms (MAs) and retinal cysts to the pathogenesis of macular non-perfusion in patients with diabetic macular edema (DME) using multimodal imaging. Methods: In this cross-sectional study, 42 eyes with DME [...] Read more.
Background/Objectives: The aim of this study was to investigate the potential contribution of microaneurysms (MAs) and retinal cysts to the pathogenesis of macular non-perfusion in patients with diabetic macular edema (DME) using multimodal imaging. Methods: In this cross-sectional study, 42 eyes with DME were analyzed using color fundus photography, fluorescein angiography (FA) and optical coherence tomography (OCT). Macular non-perfusion within the central 3000 µm was categorized by location and extent into foveal avascular zone enlargement (FAZE), focal non-perfusion (FNP) and diffuse non-perfusion (DNP). A custom-developed software was used to assess the colocalization of retinal cysts on OCT with areas of non-perfusion on the corresponding FA images. Also, the presence of leaky MAs adjacent to retinal cysts on FA was verified. Results: Colocalization between retinal cysts and non-perfusion was observed in 32 of 42 (76%) eyes: 19 of 23 (83%) eyes with FAZE and 13 of 16 (81%) eyes with FAZE+FNP. No cysts colocalization was found in all three eyes (100%) presenting with DNP. None of the eyes presented with FNP alone. In the remaining seven eyes (four eyes with FAZE and three eyes with FAZE+FNP), no colocalization was noticed. At least one leaky MA adjacent to retinal cysts was identified in all eyes presented with colocalization. Conclusions: Retinal cysts may contribute to the development of limited non-perfusion in DME. Leaky MAs appear to be the primary source of cyst formation, which may lead to localized capillary occlusion in the macula. Full article
(This article belongs to the Special Issue Causes and Advanced Treatments of Macular Edema)
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13 pages, 1376 KiB  
Article
Switching to Faricimab in Therapy-Resistant Macular Edema Due to Retinal Vein Occlusion: Initial Real-World Efficacy Outcomes
by Michael Hafner, Tina R. Herold, Alexander Kufner, Ben Asani, Andreas Anschütz, Franziska Eckardt, Siegfried G. Priglinger and Johannes Schiefelbein
J. Clin. Med. 2025, 14(7), 2454; https://doi.org/10.3390/jcm14072454 - 3 Apr 2025
Viewed by 662
Abstract
Background/Objectives: Macular edema (ME), due to retinal vein occlusion (RVO), is a major cause of vision impairment. Many patients experience suboptimal responses to anti-vascular endothelial growth factor (anti-VEGF) monotherapy, necessitating alternative treatment approaches. Faricimab, a bispecific antibody targeting VEGF-A and angiopoietin-2 (Ang-2), [...] Read more.
Background/Objectives: Macular edema (ME), due to retinal vein occlusion (RVO), is a major cause of vision impairment. Many patients experience suboptimal responses to anti-vascular endothelial growth factor (anti-VEGF) monotherapy, necessitating alternative treatment approaches. Faricimab, a bispecific antibody targeting VEGF-A and angiopoietin-2 (Ang-2), introduces a novel dual-mechanism therapy. This study evaluates the short-term real-world efficacy of switching to Faricimab in patients with treatment-resistant ME secondary to RVO. Methods: This retrospective study included patients from LMU University Hospital who were switched to Faricimab due to an inadequate response or adverse events related to prior intravitreal therapy (Ranibizumab, Aflibercept, or OzurdexTM). All patients completed a structured loading phase of four monthly injections. Key outcome measures included changes in best-corrected visual acuity (BCVA, logMAR), central subfield thickness (CST, µm), and intraretinal fluid (IRF) presence on optical coherence tomography (OCT). Changes were assessed from baseline (mo0) to three months (mo3). Results: The study included 19 eyes from 19 patients (mean age 63.0 ± 14.2 years). BCVA improved from 0.20 logMAR at baseline to 0.00 logMAR at mo3 (p < 0.01). CST decreased from 325 µm to 280 µm (p < 0.01). The proportion of eyes with IRF reduced from 100% to 32% (p < 0.01). Significant reductions in retinal volume within the 1 mm and 6 mm (both p < 0.01) circles of the ETDRS grid were observed. Conclusions: Switching to Faricimab in patients resulted in significant short-term improvements in BCVA, CST, and IRF resolution. Given the small sample size and retrospective design, these findings should be interpreted as exploratory and hypothesis-generating. Further studies are needed to evaluate long-term efficacy and optimal treatment regimens. Full article
(This article belongs to the Special Issue Causes and Advanced Treatments of Macular Edema)
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11 pages, 2689 KiB  
Article
Wide-Field Optical Coherence Tomography in Patients with Diabetic Macular Edema
by Krzysztof Kiciński and Maciej Gawęcki
J. Clin. Med. 2024, 13(14), 4242; https://doi.org/10.3390/jcm13144242 - 20 Jul 2024
Cited by 1 | Viewed by 1353
Abstract
Background: The goal of the study was to analyze variations in central, perifoveal, and peripheral retinal thickness (RT) and choroidal thickness (CT) in patients with diabetic macular edema (DME) measured with ultra-wide-field optical coherence tomography (UWF-OCT). Additionally, correlations between RT and CT [...] Read more.
Background: The goal of the study was to analyze variations in central, perifoveal, and peripheral retinal thickness (RT) and choroidal thickness (CT) in patients with diabetic macular edema (DME) measured with ultra-wide-field optical coherence tomography (UWF-OCT). Additionally, correlations between RT and CT in the central, perifoveal, and peripheral sectors and the presence of selected systemic factors were evaluated. Methods: A total of 74 consecutive adult diabetic patients with DME and 75 healthy controls were included. Study participants were divided into three groups: DME patients without panretinal photocoagulation (PRP; 84 eyes), DME patients after PRP (56 eyes), and healthy controls (125 eyes). RT and CT were analyzed in three zones: a central circle of 3 mm diameter (central), a ring contained between a centered 9 mm circle and the central 3 mm circle (perifoveal), and a second, more peripheral ring between centered 18 mm and 9 mm circles (peripheral). Additionally, DME subgroups were analyzed according to the correlation of RT and CT with age, axial length, best corrected visual acuity (BCVA), diabetes duration, insulin therapy duration, body mass index (BMI), glycosylated hemoglobin (HbA1c) values, intravitreal injection (IVI) count, and the advancement of retinopathy assessed by the simplified diabetic retinopathy severity scale (DRSS). Results: The increase in RT in the far peripheral sectors in DME patients was not significant. The increases in central and perifoveal RT and lower values of CT in PRP-naive DME patients were strongly associated with poorer BCVA. Patients with DME after PRP presented with BCVA improvements significantly related to the number of IVIs. The amount of DME and RT in peripheral sectors were both independent of systemic factors such as BMI, duration of diabetes, duration of insulin intake, retinopathy severity, and HbA1c levels. Conclusions: Peripheral retinal sectors in DME patients are less affected in terms of increase in their thickness compared to central ones. Functional and morphological associations of DME with UWF-OCT testing refer to central and perifoveal sectors. Full article
(This article belongs to the Special Issue Causes and Advanced Treatments of Macular Edema)
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