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Advances in the Clinical Management of Diabetic Retinopathy
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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 November 2026 | Viewed by 1408

Editor

Prof. Dr. Takeshi Iwase

E-Mail Website
Guest Editor
Department of Ophthalmology, Akita University Hospital, Akita, Japan
Interests: pathophysiology of retinal diseases; development of novel therapies; ocular blood flow
Special Issues, Collections and Topics in MDPI journals

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

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 250 words) can be sent to the Editorial Office for assessment.

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-anonymized 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

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

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Published Papers (3 papers)

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Research

10 pages, 493 KB  
Article
Association of the Hemoglobin–Albumin–Lymphocyte–Platelet (HALP) Score with Diabetic Retinopathy Severity: A Case–Control Comparison with Non-Diabetic Ophthalmology Patients
by Nurcan Gürsoy and Ersan Gürsoy
J. Clin. Med. 2026, 15(15), 6112; https://doi.org/10.3390/jcm15156112 - 6 Aug 2026
Abstract
Background/Objectives: The hemoglobin–albumin–lymphocyte–platelet (HALP) score combines routine laboratory measures into an index of systemic immune–nutritional status. Its relationship with graded diabetic retinopathy (DR) severity is not fully established. We compared HALP between patients with DR and ophthalmology controls without documented diabetes and examined [...] Read more.
Background/Objectives: The hemoglobin–albumin–lymphocyte–platelet (HALP) score combines routine laboratory measures into an index of systemic immune–nutritional status. Its relationship with graded diabetic retinopathy (DR) severity is not fully established. We compared HALP between patients with DR and ophthalmology controls without documented diabetes and examined its association with retinopathy stage and proliferative disease. Methods: This prospective single-center case–control study enrolled 209 consecutive adults: 105 patients with DR and 104 controls. DR was recorded across eight ordered stages and additionally classified as non-proliferative DR (NPDR) or proliferative DR (PDR). Between-group tests, Spearman correlation, logistic regression, and receiver operating characteristic analysis were used. Results: HALP was lower in the DR group than in controls (47.47 [26.44] vs. 52.67 [31.83], p = 0.048) and in PDR than in NPDR (45.98 [17.62] vs. 52.90 [42.49], p = 0.008). HALP declined modestly with increasing stage (rho = −0.260, p = 0.007). In an exploratory age- and sex-adjusted model, each 10-unit increase in HALP was associated with lower odds of case-group membership (OR = 0.850, 95% CI: 0.750–0.963; p = 0.011). Within the DR cohort, HALP was not significantly associated with PDR after adjustment for age, sex, and HbA1c (OR = 0.809, 95% CI: 0.640–1.023; p = 0.077). Discrimination between cases and controls was limited (AUC = 0.579); a threshold of ≤52.09 provided 62.9% sensitivity and 53.8% specificity. Conclusions: Lower HALP values accompanied DR case status and greater retinopathy severity, but the adjusted association with PDR was not significant. Because diabetes status differed between groups, the case–control finding may reflect systemic effects of diabetes as well as retinal involvement. Full article
(This article belongs to the Special Issue Advances in the Clinical Management of Diabetic Retinopathy)
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10 pages, 5778 KB  
Article
Faricimab for Diabetic Macular Edema in Eyes Vitrectomized for Proliferative Diabetic Retinopathy: A 12-Month Retrospective Study
by Kyunga Yoon, Ayumi Usui-Ouchi, Yoshihito Sakanishi, Nobuyuki Ebihara and Shintaro Nakao
J. Clin. Med. 2026, 15(14), 5370; https://doi.org/10.3390/jcm15145370 - 9 Jul 2026
Viewed by 309
Abstract
Background/Objectives: Faricimab is a novel bispecific antibody simultaneously inhibiting vascular endothelial growth factor-A (VEGF-A) and angiopoietin-2 (Ang-2). Its efficacy in vitrectomized eyes with diabetic macular edema (DME), a setting with altered intravitreal pharmacokinetics, remains poorly characterized. We evaluated the 12-month outcomes of intravitreal [...] Read more.
Background/Objectives: Faricimab is a novel bispecific antibody simultaneously inhibiting vascular endothelial growth factor-A (VEGF-A) and angiopoietin-2 (Ang-2). Its efficacy in vitrectomized eyes with diabetic macular edema (DME), a setting with altered intravitreal pharmacokinetics, remains poorly characterized. We evaluated the 12-month outcomes of intravitreal faricimab (IVF) for DME in eyes vitrectomized for proliferative diabetic retinopathy (PDR). Methods: We retrospectively reviewed 12 consecutive eyes of 11 patients (mean age 59.4 ± 10.5 years) with DME after pars plana vitrectomy (PPV) for PDR who received IVF (6 mg/0.05 mL) between September 2022 and August 2024 with at least 12 months of follow-up. Best-corrected visual acuity (BCVA, logMAR) and central retinal thickness (CRT) were assessed at baseline (BL), 6 months (M6), and 12 months (M12). Results: Eight eyes were treatment-naïve and 4 had been switched from prior anti-VEGF therapy. Two eyes (16.7%) required a change in therapy: one for intraocular inflammation and one for inadequate anatomical response. In the 10 eyes that continued IVF, the mean number of injections was 4.1 ± 1.9. CRT decreased significantly from 489.5 ± 95.9 µm at BL to 328.5 ± 74.7 µm at M6 (p = 0.0065) and 307.0 ± 64.3 µm at M12 (p = 0.0023; repeated-measures ANOVA with Dunnett’s post hoc test). Mean BCVA improved from 0.33 ± 0.26 to 0.23 ± 0.21 logMAR at M12 (p = 0.0894). Conclusions: In this small retrospective study of vitrectomized eyes with DME after PPV for PDR, IVF was associated with significant anatomical improvement, while visual acuity remained stable over 12 months, with a relatively low injection burden. Faricimab may be a useful therapeutic option in this challenging population, although larger prospective studies are warranted to confirm these findings. Full article
(This article belongs to the Special Issue Advances in the Clinical Management of Diabetic Retinopathy)
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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 537
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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