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Medicina
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Ophthalmology: New Diagnostic and Treatment Approaches (2nd Edition)
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Ophthalmology: New Diagnostic and Treatment Approaches (2nd Edition)

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

Deadline for manuscript submissions: closed (25 April 2026) | Viewed by 3900

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 34103, USA
Interests: ophthalmology; retina; vitreous; macula
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Andrzej Grzybowski

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

Special Issue Information

Dear Colleagues,

Many recent advances have been made 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 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.

This Special Issue is a continuation of the Special Issue “Ophthalmology: New Diagnostic and Treatment Approaches” (https://www.mdpi.com/journal/medicina/special_issues/374PR2P11D).

Prof. Dr. Stephen G. Schwartz
Prof. Dr. Andrzej Grzybowski
Dr. Victor M. Villegas
Dr. Christopher Leffler
Dr. Krishna S. Kishor
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 250 words) can be sent to the Editorial Office for assessment.

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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Related Special Issue

Published Papers (5 papers)

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Research

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15 pages, 655 KB  
Article
Outer Retinal Hyperreflective Foci as a Predictor of Hyperreflective Material Boundary Remodeling and Visual Outcomes in Neovascular Age-Related Macular Degeneration
by Mihailo Jovanović, Jelena Milošević, Marta Carrasco Guijarro, Svetlana Jovanović, Dušan Todorović, Nenad Petrović, Svetlana Paunović, Katarina Janićijević and Maja L. J. Živković
Medicina 2026, 62(5), 895; https://doi.org/10.3390/medicina62050895 - 6 May 2026
Viewed by 274
Abstract
Purpose: The purpose of this study was to characterize the distribution and longitudinal evolution of intraretinal and subretinal hyperreflective foci (HF) in treatment-naive neovascular age-related macular degeneration (nAMD), and to examine associations between HF burden, hyperreflective material boundary remodeling (HRM-BR), and best-corrected visual [...] Read more.
Purpose: The purpose of this study was to characterize the distribution and longitudinal evolution of intraretinal and subretinal hyperreflective foci (HF) in treatment-naive neovascular age-related macular degeneration (nAMD), and to examine associations between HF burden, hyperreflective material boundary remodeling (HRM-BR), and best-corrected visual acuity (BCVA) outcomes following bevacizumab treat-and-extend therapy. Methods: This was a retrospective observational study of 84 treatment-naive nAMD eyes receiving intravitreal bevacizumab via a treat-and-extend protocol. Spectral-domain OCT (Revo FC, Optopol) was performed at baseline (M0), month 3 (M3), and month 6 (M6). HF were quantified in the intraretinal and subretinal compartments using ImageJ software (version 1.54, National Institutes of Health, Bethesda, MD, USA) by two masked graders, with inter-rater agreement assessed by intraclass correlation coefficient (ICC). Eyes were classified into four HRM evolution patterns following the framework of Yu et al. Primary outcome was BCVA change from M0 to M6. Multivariable linear regression was performed to assess independent predictors of BCVA change. Results: Baseline intraretinal HF counts increased significantly across HRM Patterns 1 through 4 (median 0, 6, 4, and 8, respectively; Kruskal–Wallis p < 0.001; 95% CI for Spearman r = 0.471: [0.286, 0.623]). A higher baseline intraretinal HF count correlated with worse BCVA change at M6 (r = −0.300, 95% CI [−0.483, −0.092], p_adj = 0.010). In the primary multivariable model (n = 67), both intraretinal HF burden (β = −0.449, 95% CI [−0.879, −0.020], p = 0.041) and HRM width (β = −0.003, 95% CI [−0.005, −0.001], p = 0.014) were independent predictors of BCVA change. The transient M3 intraretinal HF peak in Pattern 3 eyes (median 4 → 12 → 4) was statistically confirmed by Wilcoxon signed-rank testing (M0 → M3: p = 0.004; M3 → M6: p = 0.001). Conclusions: Intraretinal HF burden is a graded marker of HRM pattern severity and an independent predictor of visual outcomes in nAMD, alongside HRM width. The statistically validated transient M3 HF peak in Pattern 3 may represent an early OCT signal of active boundary remodeling. Full article
(This article belongs to the Special Issue Ophthalmology: New Diagnostic and Treatment Approaches (2nd Edition))
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14 pages, 1286 KB  
Article
The Short-Term Outcomes of Intravitreal Faricimab for Treatment-Naïve and -Refractory Neovascular Age-Related Macular Degeneration: A Real-World Study
by Huai-Lung Chang, Ling-Uei Wang, Tzu-Lun Huang, Pei-Yao Chang, Wei-Ting Ho, Yung-Ray Hsu, Fang-Ting Chen, Yun-Ju Chen, Cheng-Hung (Dixson) Lin and Jia-Kang Wang
Medicina 2026, 62(5), 863; https://doi.org/10.3390/medicina62050863 - 30 Apr 2026
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Abstract
Background and Objectives: Neovascular age-related macular degeneration (nAMD), including typical nAMD (tAMD) and polypoidal choroidal vasculopathy (PCV), is a leading cause of visual impairment. This study investigated the real-world short-term outcomes of faricimab, a bispecific antibody targeting Ang-2 and VEGF-A, in patients [...] Read more.
Background and Objectives: Neovascular age-related macular degeneration (nAMD), including typical nAMD (tAMD) and polypoidal choroidal vasculopathy (PCV), is a leading cause of visual impairment. This study investigated the real-world short-term outcomes of faricimab, a bispecific antibody targeting Ang-2 and VEGF-A, in patients with treatment-naïve or -refractory nAMD. Materials and Methods: This retrospective study analyzed treatment-naïve or -refractory nAMD eyes receiving one, two, or three monthly intravitreal faricimab injections. Primary outcomes were changes in best-corrected visual acuity (BCVA) and central foveal thickness (CFT) one month after the last injection. Secondary outcomes included the dry macula rate (absence of subretinal and intraretinal fluid) and subgroup comparisons between tAMD and PCV. Results: After a single injection, both treatment-naïve (n = 76) and -refractory (n = 44) eyes showed significant CFT reduction (p < 0.0001) but no significant BCVA improvement (p > 0.05). Dry macula was achieved in 63.2% of treatment-naïve and 71.4% of treatment-refractory eyes. In 38 treatment-naïve eyes receiving three injections, both CFT and BCVA significantly improved from baseline (p < 0.001 and p = 0.02, respectively), with a 94.7% dry macula rate. Subgroup analysis of those receiving three injections revealed that PCV eyes exhibited significant visual improvement, whereas tAMD eyes did not. No serious systemic or ocular adverse events were observed over the short-term follow-up period. Conclusions: Intravitreal faricimab is effective for both treatment-naïve and -refractory nAMD in the short term. While anatomical improvements were comparable between subtypes, the PCV subgroup showed a trend toward greater visual improvement in this small cohort; however, this may be influenced by the significantly younger age of PCV patients. These findings are exploratory and require validation in larger, age-matched prospective studies. Full article
(This article belongs to the Special Issue Ophthalmology: New Diagnostic and Treatment Approaches (2nd Edition))
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9 pages, 1057 KB  
Article
The Real-World Results of the Single Intravitreal Injection of Faricimab in Treatment-Naïve Subfoveal Myopic Choroidal Neovascularization
by Hao-Chun Chang, Ling-Uei Wang, Tzu-Lun Huang, Pei-Yao Chang, Wei-Ting Ho, Yung-Ray Hsu, Fang-Ting Chen, Yun-Ju Chen, Cheng-Hung Lin and Jia-Kang Wang
Medicina 2026, 62(5), 832; https://doi.org/10.3390/medicina62050832 - 27 Apr 2026
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Abstract
Background and Objectives: Myopic choroidal neovascularization (mCNV) is a vision-threatening complication of pathologic myopia. While anti-VEGF monotherapy is the current standard of care, recurrence and suboptimal responses remain challenges. Faricimab is a novel bispecific antibody that targets both vascular endothelial growth factor [...] Read more.
Background and Objectives: Myopic choroidal neovascularization (mCNV) is a vision-threatening complication of pathologic myopia. While anti-VEGF monotherapy is the current standard of care, recurrence and suboptimal responses remain challenges. Faricimab is a novel bispecific antibody that targets both vascular endothelial growth factor (VEGF) and angiopoietin-2 (Ang-2) to improve vascular stability. This study aims to evaluate the short-term efficacy and safety of a single intravitreal faricimab injection in eyes with active mCNV. Materials and Methods: This retrospective, single-center study included 27 eyes from 24 patients with active mCNV, including both treatment-naïve and previously treated cases. All eyes received a single intravitreal injection of faricimab (6.0 mg/0.05 mL). Best-corrected visual acuity (BCVA) in logMAR and central retinal thickness (CRT) via spectral-domain optical coherence tomography were assessed at baseline and one month post injection. Statistical significance was determined using paired and independent t-tests (p < 0.05). Results: The study population (mean age 55.5 ± 13.9 years; mean axial length 29.3 ± 1.6 mm) showed significant improvements at one month. Mean BCVA improved from 0.77 ± 0.71 logMAR to 0.51 ± 0.52 logMAR (p < 0.005). Mean CRT decreased from 290.2 ± 66.0 μm to 242.5 ± 45.7 μm (p < 0.005). No ocular adverse events, such as intraocular inflammation, retinal detachment, or endophthalmitis, were observed. Conclusions: A single intravitreal injection of faricimab provides significant short-term functional and anatomical improvement in this small retrospective series. Dual inhibition of VEGF-A and Ang-2 appears to be a safe and effective approach for stabilizing retinal vasculature in patients with high myopia. Larger, long-term prospective studies are needed to determine optimal treatment intervals for mCNV. Full article
(This article belongs to the Special Issue Ophthalmology: New Diagnostic and Treatment Approaches (2nd Edition))
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Review

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16 pages, 1272 KB  
Review
Cell Motility Dynamics in Glaucoma: Mechanisms, Pathogenic Roles, and Therapeutic Targeting
by Dario Rusciano, Caterina Gagliano, Alessandro Avitabile and José Fernando Maya-Vetencourt
Medicina 2025, 61(12), 2219; https://doi.org/10.3390/medicina61122219 - 16 Dec 2025
Viewed by 990
Abstract
Cell motility—the dynamic process encompassing migration, adhesion modulation, cytoskeletal remodeling, and extracellular matrix (ECM) interactions—is fundamental to ocular homeostasis. In glaucoma, disrupted motility of trabecular meshwork (TM) and Schlemm’s canal (SC) cells contributes to impaired aqueous humor outflow and elevated intraocular pressure (IOP), [...] Read more.
Cell motility—the dynamic process encompassing migration, adhesion modulation, cytoskeletal remodeling, and extracellular matrix (ECM) interactions—is fundamental to ocular homeostasis. In glaucoma, disrupted motility of trabecular meshwork (TM) and Schlemm’s canal (SC) cells contributes to impaired aqueous humor outflow and elevated intraocular pressure (IOP), while reactive motility of optic nerve head (ONH) glial cells promotes fibrosis and neurodegeneration. Mechanistically, TM/SC motility is regulated by Rho GTPase and ROCK signaling, focal adhesion dynamics, and ECM interactions, while glial cells respond to mechanical stress and cytokines such as TGF-β2. Cytoskeletal alterations, ECM stiffening, and endothelial–mesenchymal transition (EndMT) contribute to glaucomatous damage by reducing normal cell motility and tissue remodeling capacity. Aberrant motility at the ONH, including heterogeneous astrocytic reactivity, leads to lamina cribrosa remodeling and retinal ganglion cell degeneration. Therapeutically, ROCK inhibitors improve TM/SC motility and outflow, suppress EndMT, and may confer neuroprotection. Stem cell-based strategies and modulation of TGF-β2 or mechanotransduction pathways represent emerging approaches to restore physiological motility and regenerative potential. Despite promising advances, challenges remain in ensuring targeted, durable, and safe modulation of cellular dynamics. Understanding and therapeutically harnessing cell motility offers a unifying framework to address both pressure-dependent and neurodegenerative mechanisms in glaucoma. Full article
(This article belongs to the Special Issue Ophthalmology: New Diagnostic and Treatment Approaches (2nd Edition))
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16 pages, 923 KB  
Review
Beyond the Surface: Revealing the Concealed Effects of Hyperglycemia on Ocular Surface Homeostasis and Dry Eye Disease
by Marco Zeppieri, Matteo Capobianco, Federico Visalli, Mutali Musa, Alessandro Avitabile, Rosa Giglio, Daniele Tognetto, Caterina Gagliano, Fabiana D’Esposito and Francesco Cappellani
Medicina 2025, 61(11), 1992; https://doi.org/10.3390/medicina61111992 - 6 Nov 2025
Cited by 3 | Viewed by 1326
Abstract
Background and Objectives: Dry eye disease (DED) is a multifactorial ocular surface disease that markedly diminishes quality of life. Although diabetes mellitus is well-known for its retinal consequences, anterior segment symptoms including dry eye disease are often overlooked. Chronic hyperglycemia causes metabolic, [...] Read more.
Background and Objectives: Dry eye disease (DED) is a multifactorial ocular surface disease that markedly diminishes quality of life. Although diabetes mellitus is well-known for its retinal consequences, anterior segment symptoms including dry eye disease are often overlooked. Chronic hyperglycemia causes metabolic, neurovascular, and immunological changes that undermine tear film stability, corneal innervation, and ocular surface integrity. This review seeks to consolidate existing knowledge regarding the concealed impacts of diabetes on ocular surface homeostasis, highlighting processes, diagnostic difficulties, and treatment prospects. Materials and Methods: A narrative review of the literature was performed by searching PubMed for publications from January 2020 to July 2025 using the terms “diabetic dry eye,” “hyperglycemia AND ocular surface,” “tear proteomics AND diabetes,” “corneal nerves AND diabetes,” and “neurotrophic keratitis.” Eligible studies were experimental research, clinical trials, and translational investigations concerning tear film function, corneal neuropathy, inflammatory indicators, or lacrimal gland dysfunction in diabetes. The exclusion criteria were non-English language, lack of primary data, and inadequate methodological description. Results: Hyperglycemia compromises lacrimal gland functionality, modifies lipid secretion from Meibomian glands, and diminishes corneal nerve density, resulting in neurotrophic deficits. Inflammatory cytokines and oxidative stress compromise epithelial integrity, but proteome alterations in tears serve as sensitive indicators of disease. Diagnosis is impeded by corneal hypoesthesia, resulting in a disconnection between symptoms and findings. Progress in imaging, proteomics, and artificial intelligence may facilitate earlier detection and improved risk assessment. Novel therapeutics, such as neurotrophic drugs, antioxidants, and customized anti-inflammatory approaches, show promise but remain under clinical evaluation. Conclusions: Diabetes-related dry eye disease is a multifaceted and underappreciated condition influenced by systemic metabolic dysfunction. The ocular surface may act as an initial indicator for systemic disease load. Narrative synthesis emphasizes the necessity for customized diagnostic instruments, individualized treatment approaches, and collaborative management. Reconceptualizing diabetic dry eye disease within the context of systemic metabolic care presents prospects for precision medicine strategies that enhance both ocular and systemic results. Full article
(This article belongs to the Special Issue Ophthalmology: New Diagnostic and Treatment Approaches (2nd Edition))
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