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Advances in the Clinical Management of Diabetic Retinopathy

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

Deadline for manuscript submissions: 25 May 2026 | Viewed by 596

Special Issue Editor

Special Issue Information

Dear Colleagues,

Diabetic retinopathy (DR) remains a leading cause of vision loss worldwide, with increasing prevalence driven by the global diabetes epidemic. While advances in imaging, pharmacotherapy, and surgical techniques have transformed patient care, significant challenges persist in early detection, individualized treatment, and prevention of disease progression. This Special Issue aims to provide a comprehensive platform for current research and clinical innovations in DR management. Key topics include novel biomarkers, imaging modalities, anti-VEGF and corticosteroid therapies, laser strategies, and vitreoretinal surgical approaches. By bringing together leading experts and fostering multidisciplinary collaboration, this Special Issue seeks to address core problems—delayed diagnosis, treatment resistance, and health disparities—while defining future directions for precision medicine in DR. Clinicians, researchers, and public health specialists are invited to submit their research, with the aim of mobilizing knowledge that will shape the next generation of DR care.

Prof. Dr. Takeshi Iwase
Guest Editor

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Keywords

  • retinal imaging
  • clinical outcomes
  • optical coherence tomography (OCT)
  • vitrectomy
  • blood flow

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Published Papers (1 paper)

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Research

12 pages, 1029 KB  
Article
Intraoperative Ocular Blood Flow Dynamics in Response to Intraocular Pressure Fluctuations During Vitrectomy for Proliferative Diabetic Retinopathy
by Ryuya Hashimoto, Naoki Fujioka, Kazufumi Tanaka, Serika Moriyama and Takatoshi Maeno
J. Clin. Med. 2026, 15(5), 2080; https://doi.org/10.3390/jcm15052080 - 9 Mar 2026
Viewed by 320
Abstract
Background/Objectives: This study aimed to evaluate the autoregulatory capacity of optic nerve head (ONH) tissue blood flow in response to intraocular pressure (IOP) fluctuations during vitrectomy in patients with proliferative diabetic retinopathy (PDR). We hypothesized that impaired autoregulation of ONH tissue blood flow [...] Read more.
Background/Objectives: This study aimed to evaluate the autoregulatory capacity of optic nerve head (ONH) tissue blood flow in response to intraocular pressure (IOP) fluctuations during vitrectomy in patients with proliferative diabetic retinopathy (PDR). We hypothesized that impaired autoregulation of ONH tissue blood flow in response to intraoperative IOP fluctuations could contribute to subsequent ONH atrophy and the development of visual field defects in PDR patients following vitrectomy. Methods: We included five eyes from five patients with PDR (mean age 70.6 ± 9.0 years) undergoing 25-gauge pars plana vitrectomy. ONH tissue blood flow was quantitatively assessed using intraoperative laser speckle flowgraphy. Mean blur rate in the tissue area (MT), an indicator of ONH tissue blood flow, was measured at baseline (infusion pressure 0 mmHg), during sustained elevation to 25 mmHg (at 5 and 10 min), and 1 min after return to baseline (11 min). IOP was modulated using the IOP Control system of the Constellation platform. Results: Elevation of IOP to 25 mmHg significantly reduced ONH tissue blood flow, with MT decreasing by 29% at 10 min compared with baseline (p < 0.05, Dunn’s multiple comparisons test). After IOP returned to baseline, MT significantly recovered compared with the 10 min measurement (p < 0.05) and returned to levels not significantly different from baseline (p > 0.05). Conclusions: MT decreases during intraoperative IOP elevation in PDR undergoing vitrectomy, but recovers after the return to baseline pressure, suggesting preserved short-term autoregulatory capacity. Careful IOP management during vitrectomy remains important in eyes with PDR. Full article
(This article belongs to the Special Issue Advances in the Clinical Management of Diabetic Retinopathy)
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