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Medicina
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Ophthalmology: New Diagnostic and Treatment Approaches
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Ophthalmology: New Diagnostic and Treatment Approaches

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Ophthalmology".

Deadline for manuscript submissions: 25 May 2025 | Viewed by 4702

Special Issue Editors

Prof. Dr. Stephen G. Schwartz

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Guest Editor
Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Naples, FL 34108, USA
Interests: ophthalmology; retina; vitreous; macula
Dr. Krishna S. Kishor

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Guest Editor
Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Palm Beach Gardens, FL 33418, USA
Interests: opththalmology; glaucoma; surgical outcomes; big data
Dr. Víctor Manuel Villegas

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Guest Editor
Department of Ophthalmology, University of Puerto Rico School of Medicine, San Juan, PR 00936, USA
Interests: ocular oncology; ophthalmology; retina and vitreous
Dr. Christopher Leffler

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Guest Editor
Department of Ophthalmology, Virginia Commonwealth University, Richmond, VA, USA
Interests: pediatric ophthalmology; strabismus; ophthalmic public health
Prof. Dr. Andrzej Grzybowski

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Guest Editor
Foundation for Ophthalmology Development, Poznan, Poland
Interests: AI in ophthalmology; myopia prebention and treatment; cataract and refractive surgery; retina
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

There have been many recent advances in the diagnosis and treatment of eye diseases.

The aim of this Special Issue is to publish new evidence as well as to review the current state-of-the-art developments in the diagnosis and treatment of vision-threatening diseases. These include the following: cornea and external disease; vitreoretinal disease; uveitis; ocular oncology; glaucoma; neuro-ophthalmology; and oculoplastics and orbital disease.

Potential cutting-edge topics might include, but are not limited to, the following: new and evolving imaging modalities (including swept source optical coherence tomography and optical coherence tomography angiography), medical therapies (including the new complement inhibitor therapies for geographic atrophy), and surgical approaches.

We are soliciting both new research projects (including case reports and small case series) as well as comprehensive review articles of clinically important topics. We are especially interested in the differences in practice patterns between the different parts of the world. For example, endophthalmitis prophylaxis and treatment techniques differ considerably in different geographic locations.

Prof. Dr. Stephen G. Schwartz
Dr. Krishna S. Kishor
Dr. Víctor Manuel Villegas
Dr. Christopher Leffler
Prof. Dr. Andrzej Grzybowski
Guest Editors

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. Medicina is an international peer-reviewed open access monthly 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 2200 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

  • ophthalmology
  • ocular imaging
  • anti-vascular endothelial growth factor agents
  • complement inhibitors
  • intraocular surgery
  • genetic testing
  • intraocular lenses

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Published Papers (5 papers)

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Research

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12 pages, 1611 KiB  
Article
Non-Invasive Monitoring of Intracranial Pressure Pulse Waves from Closed Eyelids in Patients with Normal-Tension Glaucoma
by Laimonas Bartusis, Solventa Krakauskaite, Ugne Kevalaite, Austeja Judickaite, Arminas Zizas, Akvile Stoskuviene, Edvinas Chaleckas, Mantas Deimantavicius, Yasin Hamarat, Fabien Scalzo, Kristina Berskiene, Ingrida Januleviciene and Arminas Ragauskas
Medicina 2025, 61(4), 566; https://doi.org/10.3390/medicina61040566 - 22 Mar 2025
Viewed by 344
Abstract
Background and Objectives: Normal-tension glaucoma (NTG) is a subtype of primary open-angle glaucoma characterized by progressive optic nerve damage despite intraocular pressure (IOP) remaining within the normal range. The underlying pathophysiology of NTG remains incompletely understood, and its diagnosis is often delayed [...] Read more.
Background and Objectives: Normal-tension glaucoma (NTG) is a subtype of primary open-angle glaucoma characterized by progressive optic nerve damage despite intraocular pressure (IOP) remaining within the normal range. The underlying pathophysiology of NTG remains incompletely understood, and its diagnosis is often delayed due to the lack of a definitive screening tool. This study aimed to evaluate differences in intracranial pressure pulse wave amplitude recorded from closed eyelids between NTG patients and control subjects using a novel non-invasive monitoring technology. Materials and Methods: A cross-sectional observational study was conducted, enrolling NTG patients and age-matched controls. Intracranial pressure pulse wave signals were recorded from closed eyelids using the ’Archimedes’ 02 device, which employs a highly sensitive digital pressure sensor and hydromechanical coupling for signal transmission. The amplitude of recorded intracranial pressure pulse waves was analyzed and compared between groups. Statistical analyses were performed using IBM SPSS Statistics 30.0, with significance set at p < 0.05. Results: A total of 140 participants were enrolled, including 68 NTG patients and 72 controls. After applying exclusion criteria, 63 NTG patients and 68 controls were included in the final analysis. The median intracranial pressure pulse wave amplitude was significantly higher in NTG patients (0.1326 a.u.) than in controls (0.0889 a.u.), with p = 0.01. Conclusions: These findings suggest that intracranial pressure pulse wave monitoring may serve as a potential biomarker for NTG. Further studies are needed to determine the diagnostic accuracy, sensitivity, and specificity of this technology for NTG detection. Full article
(This article belongs to the Special Issue Ophthalmology: New Diagnostic and Treatment Approaches)
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14 pages, 4719 KiB  
Article
Disinfection of Human and Porcine Corneal Endothelial Cells by Far-UVC Irradiation
by Ben Sicks, Martin Hessling, Kathrin Stucke-Straub, Sebastian Kupferschmid and Ramin Lotfi
Medicina 2025, 61(3), 416; https://doi.org/10.3390/medicina61030416 - 27 Feb 2025
Viewed by 486
Abstract
Background and Objectives: The cornea protects the eye from external influences and contributes to its refractive power. Corneas belong to the most frequently transplanted tissues, providing a last resort for preserving the patient’s vision. There is a high demand for donor corneas [...] Read more.
Background and Objectives: The cornea protects the eye from external influences and contributes to its refractive power. Corneas belong to the most frequently transplanted tissues, providing a last resort for preserving the patient’s vision. There is a high demand for donor corneas worldwide, but almost 4% of these transplants are not eligible due to microbial contamination. The objective of this study is to ascertain the suitability of 222 nm Far-UVC irradiation for the decontamination of corneas without damaging corneal endothelial cells. Materials and Methods: To assess the destructive effect of irradiation and, thus, identify the applicable dose needed to decontaminate the cornea without interfering with its integrity, 141 porcine corneas were irradiated with 0, 60 or 150 mJ/cm2 at 222 nm. In the second step, a series of 13 human corneas were subjected to half-sided irradiation using 15 or 60 mJ/cm2 at 222 nm. After five days of in vitro culturing, the endothelial cell density of the non-irradiated area of each human cornea was compared to the irradiated area. Results: Irradiation with up to 60 mJ/cm2 had no detectably significant effect on the cell integrity of human corneas (p = 0.764), with only a minimal reduction in cell density of 3.7% observed. These findings were partially corroborated by tests on porcine corneas, wherein the variability between test groups was consistent, even at increased irradiation doses of up to 150 mJ/cm2, and no notable effects on the irradiated porcine endothelium were monitored. The efficacy of the antimicrobial treatment was evident in the disinfection tests conducted on corneas. Conclusions: These initial irradiation experiments demonstrated that 222 nm Far-UVC radiation has the potential to decontaminate the cornea without compromising sensitive endothelial cell viability. Full article
(This article belongs to the Special Issue Ophthalmology: New Diagnostic and Treatment Approaches)
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12 pages, 895 KiB  
Article
Changes in Protein Expression in Warmed Human Lens Epithelium Cells Using Shotgun Proteomics
by Hiroko Otake, Tetsushi Yamamoto, Naoki Yamamoto, Yosuke Nakazawa, Yoshiki Miyata, Atsushi Taga, Hiroshi Sasaki and Noriaki Nagai
Medicina 2025, 61(2), 286; https://doi.org/10.3390/medicina61020286 - 7 Feb 2025
Viewed by 628
Abstract
Background and Objectives: In previous studies, we reported that the assessment of the cumulative thermal dose in the crystalline lens, conducted through computational modeling utilizing a supercomputer and the biothermal transport equation, exhibited a significant association with the incidence of nuclear cataracts. [...] Read more.
Background and Objectives: In previous studies, we reported that the assessment of the cumulative thermal dose in the crystalline lens, conducted through computational modeling utilizing a supercomputer and the biothermal transport equation, exhibited a significant association with the incidence of nuclear cataracts. In this study, we have investigated the types of proteins that expressed underlying 35.0 °C (normal-temp) and 37.5 °C (warming-temp) by using the shotgun liquid chromatography (LC) with tandem mass spectrometry (MS/MS)-based global proteomic approach. Materials and Methods: We have discussed the changes in protein expression in warmed iHLEC-NY2 cells using Gene Ontology analysis and a label-free semiquantitative method based on spectral counting. Results: In iHLEC-NY2, 615 proteins were detected, including 307 (49.9%) present in both lenses cultured at normal-temp and warming-temp, 130 (21.1%) unique to the lens cultured at normal-temp, and 178 (29.0%) unique to the lens cultured at warming-temp. Furthermore, LC–MS/MS analysis showed that warming decreased the expression of actin, alpha cardiac muscle 1, actin-related protein 2, putative tubulin-like protein alpha-4B, ubiquitin carboxyl-terminal hydrolase 17-like protein 1, ubiquitin-ribosomal protein eL40 fusion protein, ribosome biogenesis protein BMS1 homolog, histone H2B type 1-M, and histone H2A.J. in iHLEC-NY2. Conclusions: The decreases in the specific protein levels of actin, tubulin, ubiquitin, ribosomes, and histones may be related to cataract development under warming conditions. This investigation could provide a critical framework for understanding the correlation between temperature dynamics and the development of nuclear cataracts. Full article
(This article belongs to the Special Issue Ophthalmology: New Diagnostic and Treatment Approaches)
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14 pages, 3788 KiB  
Article
The Potential of SHAP and Machine Learning for Personalized Explanations of Influencing Factors in Myopic Treatment for Children
by Jun-Wei Chen, Hsin-An Chen, Tzu-Chi Liu, Tzu-En Wu and Chi-Jie Lu
Medicina 2025, 61(1), 16; https://doi.org/10.3390/medicina61010016 - 26 Dec 2024
Viewed by 951
Abstract
Background and Objectives: The rising prevalence of myopia is a significant global health concern. Atropine eye drops are commonly used to slow myopia progression in children, but their long-term use raises concern about intraocular pressure (IOP). This study uses SHapley Additive exPlanations (SHAP) [...] Read more.
Background and Objectives: The rising prevalence of myopia is a significant global health concern. Atropine eye drops are commonly used to slow myopia progression in children, but their long-term use raises concern about intraocular pressure (IOP). This study uses SHapley Additive exPlanations (SHAP) to improve the interpretability of machine learning (ML) model predicting end IOP, offering clinicians explainable insights for personalized patient management. Materials and Methods: This retrospective study analyzed data from 1191 individual eyes of 639 boys and 552 girls with myopia treated with atropine. The average age of the whole group was 10.6 ± 2.5 years old. The refractive error of spherical equivalent (SE) in myopia degree was base SE at 2.63D and end SE at 3.12D. Data were collected from clinical records, including demographic information, IOP measurements, and atropine treatment details. The patients were divided into two subgroups based on a baseline IOP of 14 mmHg. ML models, including Lasso, CART, XGB, and RF, were developed to predict the end IOP value. Then, the best-performing model was further interpreted using SHAP values. The SHAP module created a personalized and dynamic graphic to illustrate how various factors (e.g., age, sex, cumulative duration, and dosage of atropine treatment) affect the end IOP. Results: RF showed the best performance, with superior error metrics in both subgroups. The interpretation of RF with SHAP revealed that age and the recruitment duration of atropine consistently influenced IOP across subgroups, while other variables had varying effects. SHAP values also offer insights, helping clinicians understand how different factors contribute to predicted IOP value in individual children. Conclusions: SHAP provides an alternative approach to understand the factors affecting IOP in children with myopia treated with atropine. Its enhanced interpretability helps clinicians make informed decisions, improving the safety and efficacy of myopia management. This study demonstrates the potential of combining SHAP with ML models for personalized care in ophthalmology. Full article
(This article belongs to the Special Issue Ophthalmology: New Diagnostic and Treatment Approaches)
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Review

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23 pages, 1576 KiB  
Review
Enhancing Ophthalmic Diagnosis and Treatment with Artificial Intelligence
by David B. Olawade, Kusal Weerasinghe, Mathugamage Don Dasun Eranga Mathugamage, Aderonke Odetayo, Nicholas Aderinto, Jennifer Teke and Stergios Boussios
Medicina 2025, 61(3), 433; https://doi.org/10.3390/medicina61030433 - 28 Feb 2025
Viewed by 1523
Abstract
The integration of artificial intelligence (AI) in ophthalmology is transforming the field, offering new opportunities to enhance diagnostic accuracy, personalize treatment plans, and improve service delivery. This review provides a comprehensive overview of the current applications and future potential of AI in ophthalmology. [...] Read more.
The integration of artificial intelligence (AI) in ophthalmology is transforming the field, offering new opportunities to enhance diagnostic accuracy, personalize treatment plans, and improve service delivery. This review provides a comprehensive overview of the current applications and future potential of AI in ophthalmology. AI algorithms, particularly those utilizing machine learning (ML) and deep learning (DL), have demonstrated remarkable success in diagnosing conditions such as diabetic retinopathy (DR), age-related macular degeneration, and glaucoma with precision comparable to, or exceeding, human experts. Furthermore, AI is being utilized to develop personalized treatment plans by analyzing large datasets to predict individual responses to therapies, thus optimizing patient outcomes and reducing healthcare costs. In surgical applications, AI-driven tools are enhancing the precision of procedures like cataract surgery, contributing to better recovery times and reduced complications. Additionally, AI-powered teleophthalmology services are expanding access to eye care in underserved and remote areas, addressing global disparities in healthcare availability. Despite these advancements, challenges remain, particularly concerning data privacy, security, and algorithmic bias. Ensuring robust data governance and ethical practices is crucial for the continued success of AI integration in ophthalmology. In conclusion, future research should focus on developing sophisticated AI models capable of handling multimodal data, including genetic information and patient histories, to provide deeper insights into disease mechanisms and treatment responses. Also, collaborative efforts among governments, non-governmental organizations (NGOs), and technology companies are essential to deploy AI solutions effectively, especially in low-resource settings. Full article
(This article belongs to the Special Issue Ophthalmology: New Diagnostic and Treatment Approaches)
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