Management of Vitreoretinal Disease and Endophthalmitis

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

Deadline for manuscript submissions: closed (20 February 2022) | Viewed by 6968

Special Issue Editors


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Guest Editor
Nihon University Hospital, Tokyo, Japan
Interests: bacterial flora; postoperative endophthalmitis; povidone-iodine; resistant bacteria; vitrectomy; vitreoretinal disease

E-Mail Website1 Website2
Guest Editor
1. Institute for Research in Ophthalmology, Foundation for Ophthalmology Development, ul. Mickiewicza 24 / 3B, 60-836 Poznan, Poland
2. Department of Ophthalmology, University of Warmia and Mazury, 10-719 Olsztyn, Poland
Interests: myopia; refractive errors; epidemiology of eye disorders; cataract and refractive disorders; retina disorders
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Special Issue Information

Dear Colleagues,

The advent of devices such as optical coherence tomography (OCT) and OCT angiography has allowed minimally invasive observation of vitreoretinal diseases. These devices provide useful information of the pathophysiology of vitreoretinal disease, surgical indication, and postoperative evaluation. The surgical results of vitrectomy have improved with the development of new devices and tools as well as advances in surgical procedures and diagnosis. Intravitreal injection of anti-vascular endothelial growth factor has become the first-line treatment for age-related macular degeneration, retinal vein occlusion, and diabetic macular edema. However, if normal flora of the conjunctiva are introduced into the eye during vitrectomy or intravitreal injection, there is a risk that endophthalmitis may develop. Repeated use of antibacterial eye drops during treatment results in an increase of antibiotic-resistant bacteria in the conjunctiva, and endophthalmitis caused by resistant bacteria has unfavorable prognosis. Moreover, hemorrhagic occlusive retinal vasculitis caused by intraocular vancomycin injection at the end of surgery for preventing endophthalmitis has also become a problem. Whether vancomycin should be used as the initial treatment for endophthalmitis in the future is being debated.

Aim and the Scope of the Special Issue:

This special issue aims to provide new information on pathological mechanisms, examination methods, and treatment methods for various vitreous retinal diseases. It will also focus on new preventative measures and treatments for endophthalmitis. It also covers genetic and experimental studies on the vitreous and retina.

Prof. Dr. Hiroyuki Shimada
Prof. Dr. Andrzej Grzybowski
Guest Editors

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Keywords

  • age-related macular degeneration
  • anti-vascular endothelial growth factor
  • diabetic macular edema
  • intravitreal injection
  • OCT
  • OCT angiography
  • resistant bacteria
  • retinal vein occlusion
  • vitrectomy
  • vitreoretinal disease

Published Papers (3 papers)

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Research

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12 pages, 956 KiB  
Article
One-Year Outcome of Intravitreal Tissue Plasminogen Activator, Ranibizumab, and Gas Injections for Submacular Hemorrhage in Polypoidal Choroidal Vasculopathy
by Yorihisa Kitagawa, Hiroyuki Shimada, Ryusaburo Mori, Koji Tanaka, Yu Wakatsuki, Hajime Onoe, Hiroyuki Kaneko, Yumiko Machida and Hiroyuki Nakashizuka
J. Clin. Med. 2022, 11(8), 2175; https://doi.org/10.3390/jcm11082175 - 13 Apr 2022
Cited by 4 | Viewed by 1568
Abstract
This study investigated one-year outcomes of treatment with one session of intravitreal recombinant tissue plasminogen activator, ranibizumab, and gas injections for submacular hemorrhage secondary to polypoidal choroidal vasculopathy (PCV). An extended study of a previous prospective trial of this treatment modality in PCV [...] Read more.
This study investigated one-year outcomes of treatment with one session of intravitreal recombinant tissue plasminogen activator, ranibizumab, and gas injections for submacular hemorrhage secondary to polypoidal choroidal vasculopathy (PCV). An extended study of a previous prospective trial of this treatment modality in PCV patients was conducted in 64 patients (64 eyes). Early Treatment Diabetic Retinopathy Study (ETDRS) score, central retinal thickness (CRT), and central pigment epithelial detachment thickness (CPEDT) before and 1, 3, and 12 months after treatment were analyzed. Mean ETDRS score increased from 58 at baseline to 64 letters (p = 0.0122), CRT decreased from 543 to 192 μm (p < 0.0001), and CPEDT decreased from 161 to 103 μm (p = 0.0668) at 3 months and were maintained until 12 months. Complications requiring reoperation occurred within one month in four eyes. Recurrence was observed in 46 eyes (72%), and 1.6 ± 1.5 (0–7) intravitreal aflibercept injections were given pro re nata. Univariate and multivariate analyses identified CPEDT as the pre- and post-treatment factor affecting 12-month ETDRS score (p < 0.0001). Improved visual acuity stabilized 3 months after treatment. Although 72% of patients experienced recurrence, an average of 1.6 aflibercept injections/patient maintained visual acuity up to 12 months. CPEDT was the most important factor associated with visual outcome. Full article
(This article belongs to the Special Issue Management of Vitreoretinal Disease and Endophthalmitis)
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9 pages, 3112 KiB  
Article
Two-Thirds Dose Photodynamic Therapy for Pachychoroid Neovasculopathy
by Koji Tanaka, Ryusaburo Mori, Yu Wakatsuki, Hajime Onoe, Akiyuki Kawamura and Hiroyuki Nakashizuka
J. Clin. Med. 2021, 10(10), 2168; https://doi.org/10.3390/jcm10102168 - 17 May 2021
Cited by 4 | Viewed by 1508
Abstract
Pachychoroid neovasculopathy (PNV) is treated with antivascular endothelial growth factor (VEGF) injection and photodynamic therapy (PDT), but no curative treatment has yet been established. We aimed to clarify the treatment results of a reduced dose of PDT for PNV. The subjects were 27 [...] Read more.
Pachychoroid neovasculopathy (PNV) is treated with antivascular endothelial growth factor (VEGF) injection and photodynamic therapy (PDT), but no curative treatment has yet been established. We aimed to clarify the treatment results of a reduced dose of PDT for PNV. The subjects were 27 eyes of 27 patients (male:female = 20:7, mean age 58.9 years). PDT, at 2/3 of the conventional dose (2/3PDT), was administered once. The patients were then observed for one year. Eyes with polypoidal choroidal vasculopathy (PCV) were excluded. We investigated the associations among the central retinal thickness, choroidal thickness, and visual acuity changes before treatment and one, three, six and 12 months after PDT. When serous retinal detachment was increased or unchanged or new hemorrhages were observed, as compared with pretreatment findings, intravitreal injection of an anti-VEGF agent was performed. Visual acuity was significantly improved, as compared to before treatment, at three, six, and 12 months after 2/3PDT. Foveal retinal thickness was significantly decreased after versus before treatment in the 2/3PDT group (p < 0.001). Foveal choroidal thickness was also significantly reduced in the 2/3PDT group (p = 0.001). Additional intravitreal anti-VEGF agent injections were administered to three patients (11%), while 24 (89%) required no additional treatment during the one-year follow-up period. For PNV without polyps, 2/3PDT appears to be effective. Full article
(This article belongs to the Special Issue Management of Vitreoretinal Disease and Endophthalmitis)
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Review

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16 pages, 5557 KiB  
Review
Retinal Diseases Regulated by Hypoxia—Basic and Clinical Perspectives: A Comprehensive Review
by Ari Shinojima, Deokho Lee, Kazuo Tsubota, Kazuno Negishi and Toshihide Kurihara
J. Clin. Med. 2021, 10(23), 5496; https://doi.org/10.3390/jcm10235496 - 24 Nov 2021
Cited by 11 | Viewed by 2456
Abstract
In recent years, the number of patients with age-related macular degeneration (AMD) is increasing worldwide along with increased life expectancy. Currently, the standard treatment for wet-AMD is intravitreal injection of anti-vascular endothelial growth factor (VEGF) drugs. The upstream of VEGF is hypoxia-inducible factor [...] Read more.
In recent years, the number of patients with age-related macular degeneration (AMD) is increasing worldwide along with increased life expectancy. Currently, the standard treatment for wet-AMD is intravitreal injection of anti-vascular endothelial growth factor (VEGF) drugs. The upstream of VEGF is hypoxia-inducible factor (HIF), a master regulator of hypoxia-responsive genes responsive to acute and chronic hypoxia. HIF activation induces various pathological pro-angiogenic gene expressions including VEGF under retinal hypoxia, ultimately leading to the development of ocular ischemic neovascular diseases. In this regard, HIF is considered as a promising therapeutic target in ocular ischemic diseases. In clinical ophthalmology, abnormal hypofluorescent areas have been detected in the late-phase of indocyanine green angiography, which are thought to be lipid deposits at the level of Bruch’s membrane to choriocapillaris in vitreoretinal diseases. These deposits may interfere with the oxygen and nutrients that should be supplied to the retinal pigment epithelium, and that HIF/VEGF is highly suspected to be expressed in the hypoxic retinal pigment epithelium, leading to neovascularization. In this review, we comprehensively summarize pathophysiology of AMD-related ocular diseases with the HIF/VEGF pathway from basic and clinic researches with recent findings. Full article
(This article belongs to the Special Issue Management of Vitreoretinal Disease and Endophthalmitis)
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