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

Deadline for manuscript submissions: 31 December 2026 | Viewed by 4598

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Prof. Dr. Edward Wylegala

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Clinical Department of Ophthalmology, Faculty of Medical Science Division in Zabrze, Medical University of Silesia, Katowice, Poland
Interests: keratoconus; deep anterior lamellar keratoplasty; penetrative keratoplasty; ophthalmology
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Special Issue Information

Dear Colleagues,

Ophthalmology is undergoing a transformative era marked by significant advancements in diagnostic precision and therapeutic innovation. The integration of high-resolution imaging technologies, artificial intelligence, and molecular diagnostics is reshaping how eye diseases are detected, monitored, and treated. Genetic discoveries have particularly deepened our understanding of inherited retinal disorders, glaucoma, and corneal dystrophies, paving the way for targeted therapies and gene-based interventions. At the same time, innovations in pharmacology, minimally invasive surgery, and tissue engineering are enhancing outcomes across a broad spectrum of ocular conditions. This Special Issue, "Progress in Clinical Diagnosis and Therapy in Ophthalmology", aims to present the latest developments in these rapidly evolving areas. Submissions are encouraged that explore breakthroughs in imaging, AI-assisted diagnostics, gene therapy, regenerative medicine, and other personalized approaches that promise to define the future of eye care. Interdisciplinary studies and translational research with clinical relevance are particularly welcome.

Prof. Dr. Edward Wylegala
Guest Editor

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Keywords

ophthalmic imaging
artificial intelligence in ophthalmology
retinal diseases
corneal transplantation
glaucoma diagnostics
ocular therapeutics
personalized medicine
ocular genetics

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Published Papers (6 papers)

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Research

10 pages, 2114 KB

Open AccessArticle

Choroidal Thickening and Reduced Macular Blood Flow in Children with Hyperopic Anisometropic Amblyopia

by Ryuya Hashimoto, Juri Kawamura, Naoki Fujioka, Kazufumi Tanaka, Moe Nunose, Sara Imai, Serika Moriyama, Ryo Yamazaki, Asato Hirota and Fumihiko Yagi

J. Clin. Med. 2026, 15(5), 2085; https://doi.org/10.3390/jcm15052085 - 9 Mar 2026

Viewed by 308

Abstract

Background/Objectives: This study aimed to evaluate macular choroidal blood flow dynamics and structural alterations in children with hyperopic anisometropic amblyopia and compare these findings with those of the fellow eyes. Methods: This retrospective observational study included 36 eyes from 18 children (mean age: 4.9 years) with unilateral hyperopic anisometropic amblyopia. Central choroidal thickness (CCT) was measured using enhanced depth imaging optical coherence tomography. Macular choroidal hemodynamics were assessed using laser speckle flowgraphy. Mean blur rate (MBR) was used as an index of blood flow, whereas beat strength (BS) was used as a measure of pulsatility. Ocular perfusion pressure (OPP) was also calculated. All parameters were compared between amblyopic and fellow eyes. Results: Amblyopic eyes demonstrated significantly greater CCT compared with fellow eyes (407.6 ± 84.9 µm vs. 326.4 ± 79.1 µm). Conversely, macular MBR was significantly lower in amblyopic eyes (9.28 ± 3.60 AU vs. 10.94 ± 4.68 AU), as was BS (5.73 ± 3.07 AU vs. 7.28 ± 3.59 AU). No significant differences were observed in central retinal thickness or OPP between amblyopic and fellow eyes. In amblyopic eyes, CCT was not significantly correlated with macular MBR or BS. Conclusions: Amblyopic eyes exhibited significant central choroidal thickening accompanied by reduced macular blood flow and pulsatility. These findings suggest that localized macular hemodynamic dysregulation may contribute to the pathophysiology of hyperopic anisometropic amblyopia. Full article

(This article belongs to the Special Issue Progress in Clinical Diagnosis and Therapy in Ophthalmology)

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11 pages, 1019 KB

Open AccessArticle

Introducing a Sustainable Framework for Preschool Visual Acuity Screening: The Alexandroupolis Case

by Georgios Labiris, Christos Giazitzis, Christina Mitsi, Minas Bakirtzis, Eirini-Kanella Panagiotopoulou, Eirini Vavanou, Aristeidis Konstantinidis, Panagiota Ntonti and Nikolaos Polyzos

J. Clin. Med. 2026, 15(5), 1907; https://doi.org/10.3390/jcm15051907 - 3 Mar 2026

Viewed by 333

Abstract

Background/Objectives: Western societies introduce school-based or school-linked programs in order to improve the physical health status of students and prevent the negative impact of the late diagnosis of a series of diseases and conditions. Preschool visual acuity (VA) screening represents an established school-based approach aimed at the early detection of amblyopia risk factors and vision-related learning difficulties. In this study, we report the methods and outcomes of the first officially organized kindergarten-based VA screening program in Greece, implemented using the Democritus Digital Visual Acuity Test (DDiVAT) screening suite and involving trained educators as part of the screening workflow. The present analysis focuses on the operational performance and screening outcomes within this defined setting. Methods: This study was a kindergarten-based screening. Each kindergarten was equipped with the DDiVAT screening framework, which consisted of a 32-inch, 4K, Android Smart TV with the DDiVAT application preinstalled, a site-license granting access to the secure DDiVAT database, and two vouchers for teachers to participate in the official lifelong DDiVAT training program. Results: From 2476 enrolled students, 207 (8.36%) were referred due to suboptimal presenting VA in one or both eyes. Average VA ranged from logMAR 0.11 to 0.07, which is consistent with former reports. Conclusions: No major technical difficulties were encountered, suggesting that DDiVAT may represent a feasible digital approach for preschool VA screening in real-world educational settings. Full article

(This article belongs to the Special Issue Progress in Clinical Diagnosis and Therapy in Ophthalmology)

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19 pages, 1185 KB

Open AccessArticle

Combined Occlusion Therapy and Home-Based Perceptual Learning in Children with Persistent Amblyopia: A Longitudinal Case Series

by Maria Pérez-Benito, Raquel Amigo-Gamero, Teresa Calderón-González, Juan de la Cruz Cardona-Pérez, Santiago Martín-González and Juan A. Portela-Camino

J. Clin. Med. 2026, 15(5), 1817; https://doi.org/10.3390/jcm15051817 - 27 Feb 2026

Viewed by 1074

Abstract

Objectives: Persistent amblyopia often shows limited response to occlusion therapy once visual acuity improvement plateaus. This study evaluated the efficacy of a two-phase protocol combining occlusion therapy and home-based perceptual learning (PL) in children with persistent amblyopia, including those with congenital pathology. Methods: This longitudinal case series included 40 patients (mean age 9.4 ± 3.4 years). Phase I consisted of occlusion therapy until best-corrected visual acuity (BCVA) plateaued. Phase II combined continued occlusion with home-based PL training until BCVA in amblyopic eye reached 0.00 logMAR or treatment was discontinued. BCVA and stereoacuity (TNO test) were assessed at baseline, after Phase I, after Phase II when applicable, and at a prospective evaluation visit. Treatment success was defined as a gain of ≥2 logMAR lines or a final BCVA ≤0.10 logMAR. Patients were stratified according to cumulative training exposure (<10 h vs. ≥10 h). Results: After Phase I, mean BCVA improved from 0.45 ± 0.23 to 0.26 ± 0.19 logMAR (p < 0.01). After Phase II, BCVA further improved to 0.13 ± 0.16 logMAR (p < 0.01). Stereoacuity showed a modest but significant improvement, from 928 ± 505 to 748 ± 558 arcsec (p = 0.01). Treatment success was achieved in 72% of patients completing ≥10 h of perceptual learning compared with 40% in those completing <10 h (RR = 1.94, 95% CI 1.01–3.73). Patients with non-pathological amblyopia achieved greater final BCVA than those with congenital pathology. Conclusions: The combination of occlusion therapy and home-based PL was associated with further improvement in visual acuity and modest gains in stereoacuity in children with persistent amblyopia. Greater cumulative training exposure was associated with higher treatment success, supporting PL as a clinically valuable adjunct to standard amblyopia management. Full article

(This article belongs to the Special Issue Progress in Clinical Diagnosis and Therapy in Ophthalmology)

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11 pages, 1491 KB

Open AccessArticle

Phenotypic Analysis of Intentionally Created Monocular Visual Field Defects During Bilateral Randomized Visual Field Testing Using the Imo Vifa^®

by Yuiko Kawaguchi, Yuki Takagi, Takashi Kojima, Akeno Tamaoki and Tatsushi Kaga

J. Clin. Med. 2026, 15(1), 9; https://doi.org/10.3390/jcm15010009 - 19 Dec 2025

Viewed by 569

Abstract

Background/Objectives: The imo Vifa^® is reportedly useful for diagnosing functional visual field loss; however, its potential for detecting malingering is unclear. Here, we intentionally simulated monocular visual field defects under bilateral randomized visual field testing conditions using the imo Vifa^® in healthy participants and compared their resulting defect phenotypes. Methods: Twenty participants (mean age, 37.3 ± 12.4 years; 12 orthoptists, 1 physician, and 7 administrative staff members) without ocular disease were enrolled. Four types of monocular visual field defects were simulated: right eye nasal hemianopia, left eye temporal hemianopia, right eye centripetal visual field constriction, and left eye central scotoma. Bilateral randomized visual field testing was performed using the AIZE-rapid mode with the 24-2 and 24plus(1) programs. Results: Accurate simulation of the intended defects was challenging. Orthoptists produced left homonymous hemianopia for right nasal hemianopia and left temporal hemianopia. Regarding right nasal hemianopia, many office workers generated patterns resembling right homonymous hemianopia-like, whereas for left temporal hemianopia, noncertified orthoptists produced patterns similar to those of left homonymous hemianopia-like. Considering the right centripetal constriction, all orthoptists produced the intended centripetal constriction, whereas non-orthoptists generated right homonymous hemianopia-like or patchy patterns. Orthoptists produced central scotomas or patchy patterns for the left central scotoma, whereas non-orthoptists generated left homonymous hemianopia-like patterns. Conclusions: Creating targeted monocular abnormalities during bilateral randomized visual field testing was challenging. Differences in the participants’ understanding of visual field testing influenced the resulting patterns. In future research, having participants create monocular visual field defects under occlusion conditions would be necessary. Full article

(This article belongs to the Special Issue Progress in Clinical Diagnosis and Therapy in Ophthalmology)

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9 pages, 400 KB

Open AccessArticle

Repository Corticotropin Therapy for Refractory Noninfectious Inflammatory Ocular Diseases

by Christian Nieves-Ríos, Ricardo A. Murati Calderon and Armando L. Oliver

J. Clin. Med. 2025, 14(21), 7785; https://doi.org/10.3390/jcm14217785 - 2 Nov 2025

Cited by 1 | Viewed by 773

Abstract

Objectives: To describe the outcomes of patients with refractory noninfectious ocular inflammatory diseases who underwent treatment with repository corticotropin injection (RCI). Methods: A retrospective cohort study was conducted. Patients who failed treatment with corticosteroids and were subsequently treated with RCI were included. Primary outcome measures were intraocular inflammatory activity, intraocular pressure (IOP), and the development of complications. Results: A total of 19 eyes from 10 patients were included. Most of the patients were women (70.0%) and the median age at presentation was 49.0 years (30.0–84.0 years). The ocular diagnoses were anterior/intermediate uveitis, intermediate/posterior uveitis, panuveitis, ocular cicatricial pemphigoid, and anterior scleritis. Seventeen (89.5%) eyes had active disease. The median duration of RCI treatment was 16.0 months (6.0–28.0 months). Nine (90.0%) patients, representing 17 (89.5%) eyes, achieved disease inactivity and remained quiescent at the last visit. No patient was on systemic corticosteroids at the last evaluation. The mean IOP was lower under RCI than corticosteroid at one month (16.0 mmHg ± 6.1 vs. 20.8 mmHg ± 9.5, p = 0.033) and four months (15.6 mmHg ± 2.9 vs. 17.8 mmHg ± 3.7, p = 0.046); however, the overall difference was not significant (16.2 mmHg ± 1.1 vs. 17.3 mmHg ± 1.8, p = 0.057). Incidence rates were the highest for posterior subcapsular cataracts (44.4% per eye-year). Relative risk analysis (RR) showed a 40.0% risk reduction for cystoid macular edema (RR = 0.60, p = 0.054). Conclusions: RCI may be an alternative treatment for refractory noninfectious ocular inflammatory diseases in patients who have failed treatment with corticosteroids. Full article

(This article belongs to the Special Issue Progress in Clinical Diagnosis and Therapy in Ophthalmology)

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14 pages, 457 KB

Open AccessArticle

Triple Procedure Long-Term Outcomes: Comparative Analysis of Penetrating Keratoplasty vs. DSAEK Combined with Cataract Surgery

by Dominika Szkodny, Adam Wylęgała, Agnieszka Szkaradek, Magdalena Kijonka, Magdalena Nandzik and Edward Wylęgała

J. Clin. Med. 2025, 14(16), 5670; https://doi.org/10.3390/jcm14165670 - 11 Aug 2025

Viewed by 982

Abstract

Background/Objectives: This study assessed outcomes between penetrating keratoplasty (PK) and Descemet’s stripping automated endothelial keratoplasty (DSAEK) when combined with cataract surgery as part of the triple procedure. Methods: Retrospective analysis of 727 triple procedures (525 PK and 202 DSAEK) from 2007–2023. Graft survival, visual acuity, and refractive outcomes were analyzed. Kaplan–Meier and Cox regression were used for survival and prognostic analysis. Results: No statistically significant difference in survival was found (PK—42 months; DSAEK—47 months). DSAEK had better visual acuity improvement and refractive stability. PK had higher astigmatism and variability in refractive error. Conclusions: While graft survival was comparable, DSAEK offers superior visual rehabilitation, supporting its use when refractive predictability is important. Full article

(This article belongs to the Special Issue Progress in Clinical Diagnosis and Therapy in Ophthalmology)

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