Journal of Personalized Medicine

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12 pages, 497 KiB

Open AccessArticle

Diabetic Macular Edema in the Western Part of Romania: Screening to Improve Patient Outcomes

by Adriana Ivanescu, Simona Popescu, Deiana Roman, Monica Dragomir and Romulus Timar

J. Pers. Med. 2025, 15(3), 106; https://doi.org/10.3390/jpm15030106 - 9 Mar 2025

Viewed by 671

Abstract

Background: Diabetes mellitus (DM) is a global healthcare concern with a rising prevalence. Patients with DM have a severely diminished quality of life due to the extensive range of connected complications. One of the most impactful diabetes-associated pathologies is diabetic macular edema [...] Read more.

Background: Diabetes mellitus (DM) is a global healthcare concern with a rising prevalence. Patients with DM have a severely diminished quality of life due to the extensive range of connected complications. One of the most impactful diabetes-associated pathologies is diabetic macular edema (DME), as it is a major cause of blindness globally. Patients with DME present many concomitant diseases that influence their prognosis. The present research seeks to describe the most frequent DME-related comorbidities. Method: This study enrolled 105 participants previously diagnosed with type 1 DM (T1DM) or type 2 DM (T2DM) (77 presenting with DME), who were evaluated regarding other associated comorbidities. Results: Patients in the DME group presented a median age of 65, with a mean disease duration of 15 years and inadequate glycemic control, reflected by a mean HbA1c of 7.5%. All patients presented at least one comorbidity, with hypertension (100%) and dyslipidemia (62.3%) being the most prevalent. Spearman analysis revealed a statistically significant correlation between DME and diabetes duration (p = 0.01), proliferative diabetic retinopathy (p = 0.004), and chronic kidney disease (p = 0.034). Conclusions: Patients with DME often present multiple comorbidities that must be screened for and addressed through a multidisciplinary approach. Full article

(This article belongs to the Special Issue New Advances and Perspectives in Ophthalmology: Progress and Modern Challenges)

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12 pages, 1771 KiB

Open AccessArticle

Corrected Axial Length and Choroidal Thickness: A Correlation Analysis for Scientific Purposes

by Marco Gioia, Maddalena De Bernardo, Ferdinando Cione, Martina De Luca and Nicola Rosa

J. Pers. Med. 2025, 15(1), 15; https://doi.org/10.3390/jpm15010015 - 2 Jan 2025

Viewed by 795

Abstract

Purpose: Choroidal thickness (ChT) is an important measurement for evaluating eye and systemic disorders, but it is influenced by numerous elements, especially axial length (AL). It is known that the presence of a linear relationship between ChT and AL exists, but recently it [...] Read more.

Purpose: Choroidal thickness (ChT) is an important measurement for evaluating eye and systemic disorders, but it is influenced by numerous elements, especially axial length (AL). It is known that the presence of a linear relationship between ChT and AL exists, but recently it has been shown that the AL measurement obtained with the current optical biometry is not very precise and needs to be corrected. This study aimed to verify if a similar correlation also persists with this corrected AL (ALc). Methods: All subjects underwent a complete eye examination, including spectral domain optical coherence tomography (OCT) with enhanced depth image (EDI) mode and AL measurement with IOLMaster. After a normality check of the data, the correlations between ChT with AL and ALc were investigated through the Pearson correlation coefficient. p values < 0.05 were considered statistically significant. Results: In total, 100 eyes of 50 healthy patients were evaluated. The mean AL was 24.36 ± 1.23 mm and mean ALc was 24.25 ± 1.22 mm. The mean nasal ChT, subfoveal ChT, and temporal ChT were, respectively, 250.57 ± 93.93 µm, 307.18 ± 101.66 µm, and 313.72 ± 88.86 µm. A significant negative linear correlation was found by comparing both AL and ALc to ChT (all r < −0.500, all p < 0.050). The negative linear correlation was stronger between nasal ChT and both AL and ALc (all r = −0.581). Conclusions: Through OCT and optical biometry, we confirmed that a statistically significant correlation persists between ALc and ChT, equal to the uncorrected AL. On these bases, in ChT studies or protocols, we recommend stratifying population according to ALc because linear correlation is still present; however, the cut-off values should be changed according to the systematic errors in optical biometry. In addition, both AL and ChT changes should be evaluated according to ALc. Full article

(This article belongs to the Special Issue New Advances and Perspectives in Ophthalmology: Progress and Modern Challenges)

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16 pages, 1134 KiB

Open AccessArticle

Evaluating the Feasibility of a Telescreening Program for Retinopathy of Prematurity (ROP) in Denmark

by Hajer A. Al-Abaiji, Regitze Bangsgaard, Mads Kofod, Carsten Faber, Ann-Cathrine Larsen, Agnes Galbo Brost, Carina Slidsborg, Kristian Klemp, Morten Breindahl, Morten Dornonville de la Cour and Line Kessel

J. Pers. Med. 2024, 14(10), 1020; https://doi.org/10.3390/jpm14101020 - 24 Sep 2024

Viewed by 927

Abstract

Objectives: This study investigates the feasibility of implementing telescreening for retinopathy of prematurity (ROP) using the ICON GO^® widefield camera operated by a non-physician healthcare professional (NPHP). We hypothesized that images captured by an NPHP are adequate to evaluate ROP changes [...] Read more.

Objectives: This study investigates the feasibility of implementing telescreening for retinopathy of prematurity (ROP) using the ICON GO^® widefield camera operated by a non-physician healthcare professional (NPHP). We hypothesized that images captured by an NPHP are adequate to evaluate ROP changes without further examinations. Secondly, the level of agreement between independent ROP graders were evaluated based on the fundus photographs. Methods: National ROP screening criteria were gestational age (GA) < 32 weeks or birthweight (BW) < 1500 g. Exclusion criteria were children hospitalized and born outside the Capital Region and examinations not performed by an NPHP. The screenings were performed using the ICON GO^®. The NPHP selected the best images for evaluation by an on-site ophthalmologist, regarding whether re-examination was necessary and if so, whether the re-examination was beneficial. Lastly, the images were re-evaluated by an independent off-site ophthalmologist. Results: A total of 415 screening sessions on 165 patients performed by an NPHP were included. Re-examination was necessary in three screening sessions and beneficial in two. The level of agreement between the on-site and off-site ophthalmologists regarding ROP screening outcome was k = 0.82, ROP stage k = 0.69, plus disease k = 0.69, and lastly ROP zone k = 0.37. Of the screened children, ninety-seven (58.8%) had no ROP at any time points, sixty-two (37.6%) had some stage of ROP not requiring treatment, and six (3.6%) received ROP treatment. Conclusions: Telemedicine screening for ROP with the ICON GO^® camera performed by an NPHP was feasible with an almost-perfect agreement and negligible need for re-examinations. The approach effectively identified children needing treatment, supporting the use of telescreening in ROP management. Full article

(This article belongs to the Special Issue New Advances and Perspectives in Ophthalmology: Progress and Modern Challenges)

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9 pages, 268 KiB

Open AccessArticle

Subclinical Ocular Motility Dysfunction and Extraocular Muscle Changes in Inactive Graves’ Orbitopathy

by Filippo Lixi, Alberto Cuccu, Giuseppe Giannaccare, Matteo Onnis, Mihaela Madalina Timofte Zorila, Stefano Mariotti, Rosanna Vacca, Paola Elisa Meloni, Michela Pisu, Chiara Mura and Francesco Boi

J. Pers. Med. 2024, 14(8), 848; https://doi.org/10.3390/jpm14080848 - 10 Aug 2024

Cited by 1 | Viewed by 1588

Abstract

This study aimed to investigate the presence of structural and functional changes in extraocular muscles (EMs) among patients with inactive Graves’ orbitopathy (GO) classified according to the Clinical Activity Score (CAS). Sixty-seven patients with Graves’ disease (GD) and inactive GO were included. The [...] Read more.

This study aimed to investigate the presence of structural and functional changes in extraocular muscles (EMs) among patients with inactive Graves’ orbitopathy (GO) classified according to the Clinical Activity Score (CAS). Sixty-seven patients with Graves’ disease (GD) and inactive GO were included. The data collected included clinical parameters, thyroid function, autoantibody levels, EOM morphology via orbital ultrasound (US), and ocular motility. Patients were stratified into Red Filter Test (RFT)-positive or RFT-negative groups based on the presence or absence of latent diplopia during the RFT examination. Thirty-three patients (49.25%) exhibited latent diplopia on the RFT, despite not reporting double vision during standard ocular motility tests. Significant differences were observed between the two groups in terms of age, disease duration, intraocular pressure (IOP) elevation in up-gaze, and medial rectus muscle thickness (p < 0.05). No significant differences were found in thyroid status, TRAb and ATA levels, CASs, exophthalmos, or lateral rectus thickness between the two groups. This study revealed that in inactive GO, subclinical EM dysfunction and morphological changes may be present, which might not be apparent through routine ocular examinations. The RFT is effective in detecting latent diplopia, highlighting its utility in identifying subtle ocular motility issues and subclinical muscle involvement. Comprehensive evaluations combining functional tests like the RFT and imaging are essential for early detection of GO-related abnormalities, enabling tailored and prompt management and improving patient outcomes. Full article

(This article belongs to the Special Issue New Advances and Perspectives in Ophthalmology: Progress and Modern Challenges)

13 pages, 2365 KiB

Open AccessArticle

Intraocular Pressure Measurements in Standing, Sitting, Prone, and Supine Positions

by Maddalena De Bernardo, Ferdinando Cione, Ilaria De Pascale, Sergio Pagliarulo and Nicola Rosa

J. Pers. Med. 2024, 14(8), 826; https://doi.org/10.3390/jpm14080826 - 4 Aug 2024

Cited by 2 | Viewed by 1518

Abstract

In this study, intraocular pressure (IOP) was measured in sitting, supine, prone, and standing (ST) positions and again five minutes after standing (ST-5) utilizing a Tono-Pen AVIA in 124 eyes of 62 healthy subjects with ages ranging from 21 to 59 years (mean [...] Read more.

In this study, intraocular pressure (IOP) was measured in sitting, supine, prone, and standing (ST) positions and again five minutes after standing (ST-5) utilizing a Tono-Pen AVIA in 124 eyes of 62 healthy subjects with ages ranging from 21 to 59 years (mean 30 ± 10 years). In each subject, the average IOP of both eyes was used for the statistical evaluation. The mean IOP difference between the ST and sitting positions was −0.13 ± 1.63 mmHg (p = 0.548); between ST-5 and sitting, it was 0.53 ± 1.24 mmHg (p = 0.001); between supine and sitting, it was 1.30 ± 1.48 mmHg (p < 0.001); between ST and supine, it was −1.43 ± 1.74 mmHg (p < 0.001); between ST-5 and supine, it was −0.77 ± 1.59 mmHg (p < 0.001); between prone and supine, it was 2.24 ± 1.92 mmHg (p < 0.001); between ST and ST-5, it was −0.67 ± 1.84 mmHg (range: −7.5 to 5 mmHg) (p = 0.007); between prone and ST, it was 3.46 ± 2.01 mmHg (p < 0.001); between ST-5 and prone, it was −2.46 ± 1.67 mmHg (p < 0.001); and between sitting and prone, it was −3.22 ± 1.56 mmHg (p < 0.001). The results show a significant IOP increase in the ST-5 position, suggesting that such measurements need to be performed in an attempt to explain the progression of glaucoma in apparently normal-tension patients. Full article

(This article belongs to the Special Issue New Advances and Perspectives in Ophthalmology: Progress and Modern Challenges)

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Review

Jump to: Research

13 pages, 974 KiB

Open AccessReview

Ocular Ultrasound in the Diagnosis of Optic Neuropathies: A Review of the Literature

by Alessia Coppola, Giulia Abbinante, Ilaria De Pascale, Vincenzo Gagliardi, Giulio Salerno, Alfonso Pellegrino and Livio Vitiello

J. Pers. Med. 2024, 14(9), 949; https://doi.org/10.3390/jpm14090949 - 8 Sep 2024

Viewed by 1375

Abstract

Background: Optic neuropathies represent one of the most frequent causes of vision loss, and they can manifest alone or in conjunction with neurological or systemic symptoms and signs. In recent years, the diagnostic techniques used to detect optic neuropathies have significantly improved, facilitating [...] Read more.

Background: Optic neuropathies represent one of the most frequent causes of vision loss, and they can manifest alone or in conjunction with neurological or systemic symptoms and signs. In recent years, the diagnostic techniques used to detect optic neuropathies have significantly improved, facilitating diagnosis and improving treatment. Among these, ocular ultrasound has assumed a fundamental role, although with conflicting results in the published scientific literature. For this reason, the aim of this review is to analyze the role of ocular ultrasound in the precise and targeted diagnosis of optic neuropathies to better understand the presumed potential of this precious diagnostic tool in the management of these ocular and neurological disorders. Methods: We carried out a search on PubMed and Scopus utilizing terms related to optic neuropathies and ocular ultrasound, including only relevant English full-length research articles, case reports, or case series. Results: Most of the papers published in the scientific literature use only the B-scan ultrasound technique without considering the more precise and objective standardized A-scan technique that allows for performing more accurate diagnostic tests, such as the “30-degree test” and the “optic nerve exercise test”. Conclusions: Future clinical trials and research on optic neuropathies should also consider the use of the standardized A-scan technique in order to compare clinical findings not only with B-scan ultrasonography but also with other noninvasive procedures that could be helpful in reaching the correct diagnosis. Full article

(This article belongs to the Special Issue New Advances and Perspectives in Ophthalmology: Progress and Modern Challenges)

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18 pages, 2222 KiB

Open AccessReview

Ocular Manifestations and Complications of Patent Foramen Ovale: A Narrative Review

by Filippo Lixi, Luca Fazzini, Claudia Cannas, Roberta Montisci and Giuseppe Giannaccare

J. Pers. Med. 2024, 14(7), 695; https://doi.org/10.3390/jpm14070695 - 27 Jun 2024

Cited by 2 | Viewed by 2534

Abstract

Patent foramen ovale (PFO) is a prevalent congenital cardiac anomaly associated with a persistent opening between the atrial septum, allowing communication between the left and right atria. Despite often being asymptomatic, PFO can lead to various clinical presentations, including cryptogenic stroke and other [...] Read more.

Patent foramen ovale (PFO) is a prevalent congenital cardiac anomaly associated with a persistent opening between the atrial septum, allowing communication between the left and right atria. Despite often being asymptomatic, PFO can lead to various clinical presentations, including cryptogenic stroke and other embolic events. Transient visual disturbances, alterations in the visual field, migraine with aura, impaired eye movement and endogenous eye infections may prompt patients to seek ophthalmological consultation. Understanding these diverse clinical scenarios is crucial for early detection, appropriate management and mitigating the morbidity burden associated with PFO. This narrative review aims at examining the spectrum of clinical presentations of ocular pictures associated with PFO. The pathophysiology, diagnosis and treatment methods for PFO will be described, emphasizing the importance of a multidisciplinary approach involving ophthalmologists, cardiologists, neurologists and imaging specialists. In the future, prospective studies and clinical trials are warranted to provide further insights into the preventive role and optimal therapeutic strategies for managing PFO-related ocular complications, ultimately guiding clinical decision making and optimizing patient care. Full article

(This article belongs to the Special Issue New Advances and Perspectives in Ophthalmology: Progress and Modern Challenges)

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21 pages, 1773 KiB

Open AccessReview

The Role of Oral Supplementation for the Management of Age-Related Macular Degeneration: A Narrative Review

by Angela D’Angelo, Livio Vitiello, Vincenzo Gagliardi, Giulio Salerno, Ilaria De Pascale, Alessia Coppola, Giulia Abbinante, Alfonso Pellegrino and Giuseppe Giannaccare

J. Pers. Med. 2024, 14(6), 653; https://doi.org/10.3390/jpm14060653 - 18 Jun 2024

Cited by 5 | Viewed by 2774

Abstract

The majority of neurodegenerative eye disorders occur with aging and significantly impair quality of life. Age-related macular degeneration (AMD) is the third most common cause of visual impairment and blindness worldwide. One of the most important elements in the pathophysiology of neurodegenerative eye [...] Read more.

The majority of neurodegenerative eye disorders occur with aging and significantly impair quality of life. Age-related macular degeneration (AMD) is the third most common cause of visual impairment and blindness worldwide. One of the most important elements in the pathophysiology of neurodegenerative eye disease is certainly oxidative stress, with neuroinflammation and ocular ischemia which may also be significant factors. Antioxidants, either by food or oral supplementation, may be able to mitigate the deleterious effects of reactive oxygen species that build as a result of oxidative stress, ischemia, and inflammation. Over the past few decades, a number of research works examining the potential adjuvant impact of antioxidants in AMD have been published. In fact, there is not only more and more interest in already known molecules but also in new molecules that can help clinicians in the management of this complex multifactorial disease, such as astaxanthin and melatonin. However, while some studies showed encouraging outcomes, others were conflicting. In addition, more and more attention is also being paid to nutrition, considered a pivotal key point, especially to prevent AMD. For this reason, the purpose of this review is to analyze the main antioxidant molecules currently used as oral supplements for AMD treatment, as well as the role of diet and food intake in this ocular disease, to better understand how all these factors can improve the clinical management of AMD patients. Full article

(This article belongs to the Special Issue New Advances and Perspectives in Ophthalmology: Progress and Modern Challenges)

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