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Advances in the Diagnosis and Management of Age-Related Macular Degeneration:...
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Advances in the Diagnosis and Management of Age-Related Macular Degeneration: 2nd Edition

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

Deadline for manuscript submissions: 28 May 2025 | Viewed by 1658

Special Issue Editor

Prof. Dr. Tsutomu Yasukawa

E-Mail Website
Guest Editor
Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Japan
Interests: age-related macular degeneration; drug delivery system; retina; ophthalmology; choroid
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

It is my pleasure to invite you to contribute to the second volume of the Special Issue entitled “Advances in the Diagnosis and Management of Age-Related Macular Degeneration: 2nd Edition”. In the first volume, 21 papers were published. For more details, please visit the following link: https://www.mdpi.com/journal/jcm/special_issues/INK8O7U28B.

Age-related macular degeneration (AMD) is a major cause of legal blindness in developed nations. AMD is classified into two types: neovascular and non-neovascular (atrophic) AMD. Recent advances in imaging and therapeutic approaches have improved visual outcomes in eyes with neovascular AMD; that is, antivascular endothelial growth factor (VEGF) therapy has become a first-line treatment, supported by multimodal imaging with optical coherence tomography (OCT), fundus photography, fluorescein and indocyanine green angiography, OCT angiography, etc. Photodynamic therapy (PDT) is seldom used at this moment, especially in Western countries; despite this, PDT is still useful in the treatment of polypoidal choroidal vasculopathy and other pachychoroid spectrum diseases, which are predominant phenotypes in Asia. Future candidates of new treatment modalities include drug delivery for bioactive proteins, such as anti-VEGF agents, stem-cell-derived retinal pigment epithelial cell or photoreceptor transplant, gene therapy to produce soluble VEGF receptors, neurotrophic factors (e.g., pigment epithelial growth factor), etc. In spite of these challenging approaches, this sight-threatening disease should be prevented via the use of prophylactic approaches, including antioxidant supplementation. This Special Issue will recruit original works or reviews regarding the recent status and advances in the diagnosis as well as management of neovascular and non-neovascular AMD.

Prof. Dr. Tsutomu Yasukawa
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 100 words) can be sent to the Editorial Office for announcement on this website.

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-blind 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

  • age-related macular degeneration
  • angiography
  • antivascular endothelial growth factor therapy
  • choroidal neovascularization
  • geographic atrophy
  • multimodal imaging
  • ophthalmology
  • optical coherence tomography
  • photodynamic therapy
  • retinal pigment epithelium

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Published Papers (3 papers)

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Research

11 pages, 236 KiB  
Article
Predictors of Disengagement and Loss to Follow-Up of Intravitreal Injection for Neovascular Age-Related Macular Degeneration in a Real-World Clinical Setting: Post Hoc Analysis of the Multicenter Survey from the Japanese Clinical Retinal Study (J-CREST) Group
by Masaya Imazeki, Masaru Takeuchi, Tsutomu Yasukawa, Hiroto Terasaki, Yuki Yamamoto, Tatsuya Jujo, Makiko Wakuta, Hisashi Matsubara, Yoshinori Mitamura, Aki Kato, Mineo Kondo, Kazuhiro Kimura, Hitoshi Takagi, Fumi Gomi and Taiji Sakamoto
J. Clin. Med. 2025, 14(6), 1803; https://doi.org/10.3390/jcm14061803 - 7 Mar 2025
Viewed by 482
Abstract
Background/Objectives: In a recent study, we investigated anti-VEGF treatment strategies for three subtypes of neovascular age-related macular degeneration (nAMD)—typical AMD (tAMD), polypoidal choroidal vasculopathy (PCV), and retinal angiomatous proliferation (RAP)—among a large cohort of Japanese patients. To further explore these findings, we [...] Read more.
Background/Objectives: In a recent study, we investigated anti-VEGF treatment strategies for three subtypes of neovascular age-related macular degeneration (nAMD)—typical AMD (tAMD), polypoidal choroidal vasculopathy (PCV), and retinal angiomatous proliferation (RAP)—among a large cohort of Japanese patients. To further explore these findings, we conducted a post hoc analysis of this cohort to identify factors associated with the discontinuation of anti-VEGF therapy for nAMD in a real-world clinical setting. Methods: We collected medical records of patients newly diagnosed with nAMD who initiated intravitreal anti-VEGF antibody injection therapy. Patients were divided into two groups: those who continued anti-VEGF therapy for one year and those who discontinued treatment. Baseline best-corrected visual acuity, optical coherence tomography (OCT) findings, injection regimen, and the type of anti-VEGF antibody drug used were analyzed using univariate and multivariate analyses. Results: A total of 667 treatment-naïve nAMD patients initiated anti-VEGF agents and followed the therapy for 1 year. The one-year dropout rate in this study was 13%. Logistic regression analysis revealed that poor initial visual acuity and a PRN treatment regimen were significantly associated with higher odds of dropout. Age, gender, systemic factors, and the choice of intravitreal injection did not show any significant differences. Conclusions: Poor initial visual acuity and PRN treatment regimens may increase the risk of treatment dropout and should be carefully monitored. Full article
(This article belongs to the Special Issue Advances in the Diagnosis and Management of Age-Related Macular Degeneration: 2nd Edition)
9 pages, 907 KiB  
Article
Comparison Between Intravitreal Anti-Vascular Endothelial Growth Factor Monotherapy and Vitrectomy in Age-Related Macular Degeneration with Large Submacular Hemorrhages
by Misa Miyazato, Maiko Maruyama-Inoue, Shin Tanaka, Tatsuya Inoue, Yasuo Yanagi and Kazuaki Kadonosono
J. Clin. Med. 2025, 14(5), 1477; https://doi.org/10.3390/jcm14051477 - 22 Feb 2025
Viewed by 537
Abstract
Objectives: To compare the 1-year visual outcomes of patients treated with intravitreal anti-vascular endothelial growth factor (VEGF) monotherapy or vitrectomy for large submacular hemorrhages (SMHs) due to neovascular age-related macular degeneration (nAMD). Methods: We retrospectively studied 31 eyes with severe SMHs exceeding 3 [...] Read more.
Objectives: To compare the 1-year visual outcomes of patients treated with intravitreal anti-vascular endothelial growth factor (VEGF) monotherapy or vitrectomy for large submacular hemorrhages (SMHs) due to neovascular age-related macular degeneration (nAMD). Methods: We retrospectively studied 31 eyes with severe SMHs exceeding 3 disc areas (DAs) secondary to nAMD treated with anti-VEGF agents or a vitrectomy. Patients undergoing anti-VEGF monotherapy received three monthly loading doses of intravitreal injections of aflibercept or brolucizumab followed by as-needed injections or proactive treatment (anti-VEGF group); those undergoing vitrectomies underwent a 25-gauge vitrectomy and a submacular injection of tissue plasminogen activator (25 μg) and 0.4 mL of air with a microneedle having an outer diameter of 50 μm. The best-corrected visual acuities (BCVAs) were compared before and 6 and 12 months after initial treatment. Factors affecting the visual acuity (VA) at 12 months and VA improvements were determined. Results: A total of 17 eyes from 16 patients (54.8%) received anti-VEGF treatment and 14 eyes from 14 patients (45.2%) underwent vitrectomy. The baseline and 12-month mean logarithm of the minimum angle of resolution BCVAs in all eyes after treatment were 0.78 and 0.82, respectively, which were not significantly different (p = 0.661). The lens status, central foveal thickness (CFT) height, and baseline VA were associated significantly with the 12-month BCVA (p = 0.028, p = 0.008, and p = 0.021, respectively) and VA improvement (p = 0.015, p = 0.002, and p = 0.003, respectively). Conclusions: Anti-VEGF monotherapy and vitrectomy maintained functionality in patients with large SMHs due to nAMD. Greater CFT was associated with worse 12-month BCVA and less BCVA improvement despite the treatment modality. Full article
(This article belongs to the Special Issue Advances in the Diagnosis and Management of Age-Related Macular Degeneration: 2nd Edition)
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15 pages, 9658 KiB  
Article
Treatment Outcomes of Simple and Complex Central Serous Chorioretinopathy
by Hiroyuki Kamao, Katsutoshi Goto, Tatsuhiro Ouchi, Yuki Shirakawa, Ryutaro Hiraki, Kenichi Mizukawa and Atsushi Miki
J. Clin. Med. 2025, 14(5), 1458; https://doi.org/10.3390/jcm14051458 - 21 Feb 2025
Viewed by 362
Abstract
Objectives: To assess the association between clinical outcomes and the multimodal imaging-based classification of central serous chorioretinopathy (CSC). Methods: This retrospective study included 207 eyes from 155 treatment-naïve patients with CSC. The eyes were categorized into two groups, including the simple [...] Read more.
Objectives: To assess the association between clinical outcomes and the multimodal imaging-based classification of central serous chorioretinopathy (CSC). Methods: This retrospective study included 207 eyes from 155 treatment-naïve patients with CSC. The eyes were categorized into two groups, including the simple CSC group (n = 164) and the complex CSC group (n = 43), based on the presence of retinal pigment epithelial atrophy spanning two or more disc areas. All patients were initially observed without treatment for 3–6 months. For cases with persistent subretinal fluid after this observation period, treatment modalities, including continued observation, photocoagulation (PC), or photodynamic therapy (PDT), were selected. Results: Patients in the complex CSC group were more likely to be older (p = 0.01) and male (p = 0.01) than those in the simple group and to exhibit a higher prevalence of bilateral involvement (p < 0.001) and previous CSC episodes (p < 0.001) than those exhibited by patients in the simple group. Eyes with complex CSC exhibited a comparable incidence of spontaneous resolution within 6 months and a higher incidence of recurrence after spontaneous resolution within 6 months than eyes with simple CSC. In both the simple and complex CSC groups, the PDT subgroup exhibited a lower recurrence rate than that of the PC subgroup (simple CSC: p < 0.001, complex CSC: p = 0.03). Conclusions: Although CSC is typically a self-limiting disease often managed conservatively, patients with complex CSC, characterized by bilateral involvement or a history of previous episodes, are at a higher risk of subretinal fluid recurrence and may benefit from early interventions without a period of observation, such as PDT. Full article
(This article belongs to the Special Issue Advances in the Diagnosis and Management of Age-Related Macular Degeneration: 2nd Edition)
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