Journal of Clinical Medicine

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Updates in the Diagnosis, Imaging, and Treatment of Retinal and Macular Diseases

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Dear Colleagues,

Retinal and macular diseases, including age-related macular degeneration, diabetic retinopathy and inherited retinal disorders, remain leading causes of visual impairment and blindness worldwide. In recent years, remarkable advances in diagnostic imaging, artificial intelligence (AI) and novel therapeutic approaches have revolutionized our understanding and management of these conditions.

This Special Issue aims to highlight recent progress and emerging trends in the clinical diagnosis, imaging technologies and treatment strategies for retinal and macular diseases. We particularly welcome submissions that explore AI-assisted image analysis, deep learning–based diagnostic systems and multimodal imaging techniques such as OCT, OCTA, fundus autofluorescence and adaptive optics.

In addition, contributions focusing on novel pharmacologic treatments, surgical innovations, gene and cell therapies as well as personalized or precision medicine approaches are highly encouraged. Reviews, original research articles and clinical case studies that provide new insights into patient management and disease outcomes are also welcome.

Through this Special Issue, we aim to provide a comprehensive update on how digital technologies and translational research are reshaping clinical ophthalmology, ultimately improving the prevention, early detection and treatment of retinal and macular diseases.

Prof. Dr. Makoto Inoue
Guest Editor

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10 pages, 3263 KB

Open AccessArticle

Intravitreal Faricimab Prior to Direct Photocoagulation Improves Anatomical Outcomes in Focal Diabetic Macular Edema

by Yuki Sanada, Yoshihiro Takamura, Yutaka Yamada, Hideyuki Oshima, Makoto Gozawa, Takehiro Matsumura and Masaru Inatani

J. Clin. Med. 2026, 15(9), 3487; https://doi.org/10.3390/jcm15093487 - 2 May 2026

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Abstract

Purpose: To determine the optimal treatment sequence for combination therapy using intravitreal faricimab (IVF) and direct photocoagulation (PC) in eyes with non-center-involved diabetic macular edema (DME). Methods: This retrospective study included 35 eyes with focal DME treated with IVF and PC targeting microaneurysms (MAs). Treatment success was defined as resolution of focal edema, indicated by disappearance of the white area (WA) on optical coherence tomography. Eyes were assigned to a PC-IVF group (initial PC followed by IVF if edema persisted after 2 months; n = 20) or an IVF-PC group (initial IVF followed by PC for residual edema; n = 15). Additional PC was performed every 2 months as needed. Results: Cumulative success rates at 2, 4, and 6 months were 35.0%, 70.0%, and 90.0% in the PC-IVF group and 60.0%, 93.3%, and 100% in the IVF-PC group, respectively. Macular volume significantly decreased at all time points in the IVF-PC group (all p < 0.01), whereas a significant reduction was observed only after 6 months in the PC-IVF group (p < 0.01). The number of MAs and the extent of edema were significantly reduced after 2 months in both groups, with greater reductions in the IVF-PC group (p < 0.05). The number of laser shots required for initial PC was significantly lower in the IVF-PC group (p < 0.0001), and the mean number of PC sessions was also reduced (0.6 vs. 1.8). In the PC-IVF group, baseline edema size was significantly smaller in successfully treated eyes (p < 0.001). Conclusions: Initiating treatment with IVF prior to PC may be advantageous in focal DME, particularly in eyes with larger edema, enabling faster anatomical improvement and reducing the need for laser treatment. Direct PC alone may be sufficient for small focal lesions with limited edema, supporting an individualized treatment strategy. Full article

(This article belongs to the Special Issue Updates in the Diagnosis, Imaging, and Treatment of Retinal and Macular Diseases)

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14 pages, 709 KB

Open AccessArticle

Surgical Outcomes and Differences in Values of Ocular Parameters Following Vitrectomy for Macular Hole over a 10-Year Period

by Tomohiko Torikai, Hiromi Ohara, Jun Takeuchi, Tadashi Yokoi, Yuji Itoh, Takashi Koto, Atsushi Shiraishi and Makoto Inoue

J. Clin. Med. 2026, 15(2), 570; https://doi.org/10.3390/jcm15020570 - 10 Jan 2026

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Background/Objectives: We aimed to compare the surgical outcomes of macular hole (MH) cases and evaluate how the axial length (AL) affected the outcomes. Methods: Six hundred and sixty-three eyes with MHs that underwent vitrectomy over the past 10 years were reviewed. The changes in AL were compared to those of 1948 eyes with idiopathic epiretinal membranes (ERMs) operated on during the same period. The MH cases for the 5 years from 2014 to 2018 were designated as the MH2014 group, and those from 2019 to 2023 as the MH2019 group. The ERM cases were divided similarly into the ERM2014 and ERM2019 groups. The clinical characteristics of the cases and surgical outcomes were compared. Results: The MH diameter, closure rate, and baseline and postoperative visual acuity were not significantly different. The use of the inverted internal limiting membrane flap technique was significantly higher in the MH2019 group (58%) than in the MH2014 group (24%, p < 0.001). The mean AL was significantly longer in the MH2019 group (25.2 ± 2.4 mm) than in the MH2014 group (24.6 ± 2.1 mm, p = 0.004). The incidence of myopic MHs with AL ≥ 26 mm and AL ≥ 30 mm was higher in the MH2019 group (30.9%, p = 0.008, 6.4%, p = 0.017, respectively). There was a significant trend for longer ALs over 10 years in the MH group (p = 0.002), but not in the ERM group. Conclusions: The increased AL and the rising proportion of eyes with myopic MHs indicate that the patient profile of eyes with MHs has changed over the past decade. Full article

(This article belongs to the Special Issue Updates in the Diagnosis, Imaging, and Treatment of Retinal and Macular Diseases)

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