Pathophysiology of Retinopathy in Precision Medicine Era

A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Clinical Medicine, Cell, and Organism Physiology".

Deadline for manuscript submissions: closed (11 December 2024) | Viewed by 2604

Special Issue Editors


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Guest Editor
AIBILI—Association for Innovation and Biomedical Research on Light and Image, 3000-548 Coimbra, Portugal
Interests: diabetic retinopathy; macular degeneration

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Guest Editor
Department of Ophthalmology, Tufts University School of Medicine, Boston, MA, USA
Interests: age-related macular degeneration; OCT imaging

Special Issue Information

Dear Colleagues,

Sight in humans is the primary sense for the perception of the surrounding environment and social relationships. Central to the process of vision is the retina, a light-sensing tissue that lines the back of the eye, which converts light signals into electric signals that the brain finally interprets as vision. Retinal diseases, the leading causes of vision loss and blindness, are associated with complicated pathogeneses such as angiogenesis, inflammation, immune regulation, fibrous proliferation, and neurodegeneration.

This Special Issue aims to broaden the knowledge of the physiology together with diagnostic and therapeutic methods that may be used in the treatment of retinopathy. Original articles and reviews highlighting progresses regarding its novel treatment and mechanisms will be welcome.

Dr. Luís Guilherme Arneiro Mendes
Dr. Daniela Ferrara
Guest Editors

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Keywords

  • diabetic retinopathy
  • macular degeneration
  • age-related macular degeneration
  • OCT imaging
  • ophthalmology

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Published Papers (2 papers)

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Research

16 pages, 275 KiB  
Article
Characterization and Automatic Discrimination between Predominant Hypoperfusion and Hyperperfusion Stages of NPDR
by Luís Mendes, Luísa Ribeiro, Inês Marques, Conceição Lobo and José Cunha-Vaz
J. Pers. Med. 2024, 14(9), 977; https://doi.org/10.3390/jpm14090977 - 14 Sep 2024
Viewed by 894
Abstract
Background/Objectives: Diabetic retinopathy (DR) is a common diabetes complication that can lead to blindness through vision-threatening complications like clinically significant macular edema and proliferative retinopathy. Identifying eyes at risk of progression using non-invasive methods could help develop targeted therapies to halt diabetic retinal [...] Read more.
Background/Objectives: Diabetic retinopathy (DR) is a common diabetes complication that can lead to blindness through vision-threatening complications like clinically significant macular edema and proliferative retinopathy. Identifying eyes at risk of progression using non-invasive methods could help develop targeted therapies to halt diabetic retinal disease progression. Methods: A set of 82 imaging and systemic features was used to characterize the progression of nonproliferative diabetic retinopathy (NPDR). These features include baseline measurements (static features) and those capturing the temporal dynamic behavior of these static features within one year (dynamic features). Interpretable models were trained to distinguish between eyes with Early Treatment Diabetic Retinopathy Study (ETDRS) level 35 and eyes with ETDRS levels 43–47. The data used in this research were collected from 109 diabetic type 2 patients (67.26 ± 2.70 years; diabetes duration 19.6 ± 7.26 years) and acquired over 2 years. Results: The characterization of the data indicates that NPDR progresses from an initial stage of hypoperfusion to a hyperperfusion response. The performance of the classification model using static features achieved an area under the curve (AUC) of the receiver operating characteristics equal to 0.84 ± 0.07, while the model using both static and dynamic features achieved an AUC of 0.91 ± 0.05. Conclusion: NPDR progresses through an initial hypoperfusion stage followed by a hyperperfusion response. Characterizing and automatically identifying this disease progression stage is valuable and necessary. The results indicate that achieving this goal is feasible, paving the way for the improved evaluation of progression risk and the development of better-targeted therapies to prevent vision-threatening complications. Full article
(This article belongs to the Special Issue Pathophysiology of Retinopathy in Precision Medicine Era)
12 pages, 1703 KiB  
Article
Mechanical Ventilation, Retinal Avascularity and Rate of Vascularisation: A Triad of Predictors for Retinopathy of Prematurity Treatment
by Olena Protsyk and José Luis García Serrano
J. Pers. Med. 2024, 14(4), 379; https://doi.org/10.3390/jpm14040379 - 31 Mar 2024
Cited by 2 | Viewed by 1191
Abstract
Aim: The temporal avascular area of the retina and the duration of mechanical ventilation (DMV) may predict the need to treat retinopathy of prematurity (ROP). This study considers whether the rate of retinal vascularisation and related risk factors should be included in a [...] Read more.
Aim: The temporal avascular area of the retina and the duration of mechanical ventilation (DMV) may predict the need to treat retinopathy of prematurity (ROP). This study considers whether the rate of retinal vascularisation and related risk factors should be included in a predictive model of the need for ROP treatment. Methods: This single-centre, observational retrospective case–control study was conducted on 276 preterm infants included in an ROP screening programme. All had undergone at least three examinations of the fundus. The main outcome measures considered were DMV (in days of treatment), the temporal avascular area (in disc diameters, DD) and the rate of temporal retinal vascularisation (DD/week). Results: The multivariate logistic model that best explains ROP treatment (R2 = 63.1%) has three significant risk factors: each additional day of mechanical ventilation (OR, 1.05 [95% CI, 1.02–1.09]; p = 0.001); each additional DD of temporal avascular area (OR, 2.2 [95% CI, 1.7–2.9]; p < 0.001) and a vascularisation rate <0.5 DD/week (OR, 19.0 [95% CI, 6.5–55.5]; p < 0.001). Two tables are presented for calculating the expected need for ROP treatment according to these three risk factors. Conclusions: A greater DMV, a broad avascular area of the temporal retina at the first binocular screening and slow retinal vascularisation strongly predict the need for ROP treatment. The predictive model we describe must be validated externally in other centres. Full article
(This article belongs to the Special Issue Pathophysiology of Retinopathy in Precision Medicine Era)
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