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Innovations in the Clinical Management of Retinal Diseases: Emerging Therapies and Visual Rehabilitation

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Dear Colleagues,

Retinal diseases, including age-related macular degeneration, diabetic retinopathy, retinal vascular occlusions, and retinitis pigmentosa, remain among the leading causes of vision loss worldwide. In recent years, the development of novel therapies has significantly improved the prognosis of these conditions. Anti-VEGF agents and photodynamic therapy have revolutionized the treatment of macular degeneration and retinal vascular occlusions, while advancements in gene therapies, such as MCO-010, have shown promising results in partially restoring visual function in patients with retinitis pigmentosa.

Retinal vascular occlusions, including both venous and arterial thrombosis, are a major cause of sudden vision loss and require innovative therapeutic approaches. Recent research has explored the role of intravitreal therapies and neuroprotection in improving visual outcomes for these patients.

Additionally, emerging strategies such as optogenetics, retinal implants, and neuroprotective treatments are expanding the available therapeutic options, offering new hope to patients with advanced retinal diseases. In this context, visual rehabilitation and low-vision aids play a crucial role in optimizing the quality of life of affected individuals.

This Special Issue aims to bring together innovative research on the diagnosis, treatment, and rehabilitation of retinal diseases, providing an updated perspective on the latest clinical and scientific advancements in this rapidly evolving field.

Dr. Francisco J. Povedano-Montero
Guest Editor

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13 pages, 1237 KB

Open AccessArticle

Mesopic and Low-Contrast Visual Acuity Deficits in Retinitis Pigmentosa: Clinical Markers for Early Functional Impairment

by Juan E. Cedrún-Sánchez, F. Javier Povedano-Montero, Eva Chamorro, Celia Sánchez-Ramos and María C. Puell

J. Clin. Med. 2025, 14(16), 5659; https://doi.org/10.3390/jcm14165659 - 10 Aug 2025

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Abstract

Background: Standard visual acuity (VA) is often preserved in early retinitis pigmentosa (RP), limiting its value as a marker of functional impairment. Alternative measures such as low-luminance deficit (LLD) and low-contrast deficit (LCD) may detect earlier changes in cone function. This study aimed to evaluate the diagnostic utility of these measures in RP patients under photopic and mesopic conditions. Methods: A prospective observational study was conducted on 57 RP patients and 54 age-matched controls. Binocular VA was assessed using ETDRS charts at 100% and 10% contrast under photopic (100 cd/m²) and mesopic (1 cd/m²) conditions. LLD and LCD scores were computed from VA differences across conditions. ROC curve analysis was used to determine diagnostic accuracy. Results: RP patients showed significant VA loss under reduced luminance and contrast (p < 0.001), independent of age. LLD under high contrast was reduced, while LLD under low contrast and LCD (both photopic and mesopic) were significantly higher than in controls. The mesopic LCD demonstrated the highest diagnostic capacity (AUC = 0.87), with a threshold of > 13 ETDRS letters yielding optimal sensitivity and specificity. Unlike standard VA, mesopic LCD correlated with functional symptoms and was unaffected by age. Conclusions: Low-contrast VA under mesopic conditions is a simple, reproducible, and sensitive marker for early visual dysfunction in RP. A difference > 13 ETDRS letters may serve as a clinically relevant threshold for disease monitoring and early detection in retinal dystrophies. Full article

(This article belongs to the Special Issue Innovations in the Clinical Management of Retinal Diseases: Emerging Therapies and Visual Rehabilitation)

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13 pages, 234 KB

Open AccessArticle

Patient-Reported Social Impact of Molecularly Confirmed Retinitis Pigmentosa

by Nina Zehe-Lindau, Birgit Lindau, Heidi Stöhr, Bernhard H. F. Weber, Georg Spital and Ulrich Kellner

J. Clin. Med. 2025, 14(9), 3229; https://doi.org/10.3390/jcm14093229 - 6 May 2025

Cited by 1 | Viewed by 527

Abstract

Objectives: To evaluate the patient-reported impact of retinitis pigmentosa (RP) in a large patient cohort to identify relevant disease-related disadvantages as key aspects for the improvement of ophthalmic and social care. Methods: Consecutive patients with molecularly confirmed RP older than 18 years of age were identified in two tertiary care centers in Germany. Patients were contacted to participate in an anonymized patient query regarding the impact of RP on their vocational training, professional career, and social, familial, and personal life, as well as their experience with ophthalmologic care. Results: Out of 241 contacted patients, 162 responded (67.2%; 52.5% female, 67.3% younger than 50 years of age). While the impact of RP on vocational training was limited, professional careers were frequently disrupted with early retirement rates of 39.8% (≥40 years of age) to 50% (≥50 years of age). Most respondents felt restricted in their participation in public life (66.3%). One-fifth complained about financial restrictions; however, one-third of this number did not obtain financial help. A negative impact on familial life (21.4%) was less frequently reported compared to personal impairments, especially anxiety (74.5%) and depression (24.2%). Most respondents considered their ophthalmic care as adequate; however, a delayed diagnosis (≥two years: 28.6%) and initial misdiagnosis (24.0%) were frequent. Insufficient psychological support was the major complaint about professional care. Conclusions: RP affects the lives of patients in multiple aspects. Ophthalmic and social care providers should focus on the acceleration of the diagnostic process, as well as easy access to financial assistance and psychological support, as key areas for improvement. Improvements in these areas are expected to reduce challenges for patients. They should have an impact on rehabilitation, participation in public life, and quality of life. Full article

(This article belongs to the Special Issue Innovations in the Clinical Management of Retinal Diseases: Emerging Therapies and Visual Rehabilitation)

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