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21 pages, 10370 KB  
Article
Modeling Early Stages of Trophectoderm–Endometrium Interactions Using Trophoblastic and Endometrial Organoids and the Generation of Lacunoids/Cystoids
by Islam M. Saadeldin, Budur Alshehri, Maha AlThubyani, Falah H. Almohanna, Goran Matic, Ayman A. Swelum, Serdar Coskun, Khalid A. Awartani and Abdullah M. Assiri
Cells 2025, 14(14), 1051; https://doi.org/10.3390/cells14141051 - 9 Jul 2025
Viewed by 1214
Abstract
This study presents the first successful generation and comprehensive characterization of trophoblastic organoids (TOs) and the derivation of three-dimensional cavity- or sac-like structures—termed lacunoids/cystoids—from sheep intracytoplasmic sperm injection (ICSI) embryos. TOs were generated from sheep ICSI embryos for the first time and were [...] Read more.
This study presents the first successful generation and comprehensive characterization of trophoblastic organoids (TOs) and the derivation of three-dimensional cavity- or sac-like structures—termed lacunoids/cystoids—from sheep intracytoplasmic sperm injection (ICSI) embryos. TOs were generated from sheep ICSI embryos for the first time and were shown to express trophoblastic markers at levels comparable to those in embryonic tissue. Detailed morphological characterization was conducted for both the TOs and the derived lacunoids/cystoids. Additionally, the TOs’ interactions with endometrial organoids (EOs), as well as those with preimplantation embryos, were investigated through co-culture experiments. The TOs expressed key trophoblastic markers, including CDX2, GATA3, syncytin-1, KRT18, KRT7, and Sox2, confirming their validity as a model for studying sheep trophoblast biology. The generation of lacunoids/cystoids from the TOs further revealed their structural and developmental characteristics, contributing valuable insights into early placental development and trophoblast-related pathologies. The TOs also supported extended embryonic development, and their co-culture with EOs induced dynamic changes in gene expression, particularly in angiogenesis-related genes, in both organoid types. This novel and reproducible in vitro model offers a reliable platform to study early placental development, effectively recapitulating the biological crosstalk between the trophectoderm and endometrium. The in-depth characterization of TOs and lacunoids/cystoids highlights their potential to advance our understanding of trophoblast differentiation and related developmental disorders. Full article
(This article belongs to the Special Issue Organoids and Models from Stem Cells)
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16 pages, 472 KB  
Article
Exploring Concomitant Ophthalmic Comorbidities in Portuguese Patients with Inherited Retinal Diseases: A Comprehensive Clinical Study
by Rita Mesquita, Ana Marta, Pedro Marques-Couto, José Costa, Sérgio Estrela-Silva, Diogo Cabral, João Pedro Marques and Sara Vaz-Pereira
Genes 2025, 16(7), 743; https://doi.org/10.3390/genes16070743 - 26 Jun 2025
Viewed by 571
Abstract
Background/Objectives: Inherited retinal diseases (IRDs) are a heterogeneous group of rare eye disorders characterized by progressive photoreceptor degeneration, leading to severe visual impairment or even blindness. This study aims to investigate the prevalence, types, and clinical significance of ophthalmic comorbidities in Portuguese [...] Read more.
Background/Objectives: Inherited retinal diseases (IRDs) are a heterogeneous group of rare eye disorders characterized by progressive photoreceptor degeneration, leading to severe visual impairment or even blindness. This study aims to investigate the prevalence, types, and clinical significance of ophthalmic comorbidities in Portuguese patients with IRDs. Methods: This nationwide Portuguese population-based retrospective study was based on the IRD-PT registry (retina.com.pt). Statistical analysis was conducted using Microsoft® Excel® for Microsoft 365 and IBM SPSS Statistics version 29.0.2.0. Informed consent was obtained from all participants. Results: A total of 1531 patients (1254 families) from six centers were enrolled. The cohort consisted of 51% males, with a mean age of 45.8 ± 19.3 years and a mean age at diagnosis of 39.4 ± 19.5 years. Overall, ocular comorbidities were reported in 644 patients (42.1%). In 176 individuals (11.5%), multiple concurrent comorbidities were found. Cataract was the most common comorbidity (21.3%), followed by amblyopia (6.3%) and high myopia (5.9%). Statistically significant associations with ocular comorbidities were observed in isolated progressive IRDs. Specifically, AR RP was associated with cataract (p < 0.001), and gene analysis revealed several significant associations. CRB1 was statistically linked to epiretinal membrane (ERM) (p = 0.003), EYS with cataract (p = 0.001), PROM1 with choroidal neovascularization (CNV) (p = 0.0026), and USH2A with macular hole (p = 0.01). Patients with the RPE65 mutation in Leber congenital amaurosis were associated with ERM (p = 0.019). There was also a significant association between X-linked RP and high myopia (p < 0.001) and CNV in Best disease (p < 0.001); in syndromic IRDs, cataract, cystoid macular edema, and ERM were observed in Usher syndrome, p = 0.002, p = 0.002, and p = 0.005, respectively, and the MYO7A gene was linked to cataract (p = 0.041) and strabismus (p = 0.013); pseudoxanthoma elasticum was significantly associated with CNV (p = 0.002); and foveal hypoplasia was associated with anterior segment dysgenesis (p < 0.001). Conclusions: This study enhances the current understanding of ocular comorbidities in IRDs in Portuguese patients. Common findings were cataract, refractive error, and CME. Stationary IRDs and pattern dystrophies showed fewer concomitant comorbidities, supporting their classification as non-progressive or benign conditions. The significance of registries like IRD-PT cannot be overstated, particularly in the context of rare diseases. These databases serve multiple crucial functions in enabling detailed documentation of disease characteristics and long-term monitoring of disease progression. Full article
(This article belongs to the Special Issue Genetics in Retinal Diseases—2nd Edition)
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9 pages, 3702 KB  
Case Report
Bilateral Choroidal Detachment Following Pseudophakic Cystoid Macular Edema Treatment with Oral Acetazolamide
by Agnieszka Kudasiewicz-Kardaszewska, Małgorzata Ozimek, Tomasz Urbański and Sławomir Cisiecki
Life 2025, 15(5), 811; https://doi.org/10.3390/life15050811 - 19 May 2025
Viewed by 723
Abstract
Aim: This case report presents an unusual instance of bilateral choroidal effusion following the oral administration of acetazolamide for the treatment of pseudophakic cystoid macular edema (PCME). Case Presentation: An 87-year-old Caucasian man experienced sudden, painless vision loss in both eyes several days [...] Read more.
Aim: This case report presents an unusual instance of bilateral choroidal effusion following the oral administration of acetazolamide for the treatment of pseudophakic cystoid macular edema (PCME). Case Presentation: An 87-year-old Caucasian man experienced sudden, painless vision loss in both eyes several days after beginning treatment for PCME in his left eye. He had undergone uncomplicated cataract surgery in both eyes two months earlier. The treatment regimen included oral acetazolamide (250 mg twice daily) and topical pranoprofen, a nonsteroidal anti-inflammatory drug (NSAID). One week after the initiation of acetazolamide treatment, the patient suffered a marked decline in visual acuity. Bilateral choroidal effusion was diagnosed. Prompt discontinuation of acetazolamide and initiation of topical dexamethasone (1% hourly) and atropine (1% twice daily) resulted in rapid clinical improvement. Conclusions: Carbonic anhydrase inhibitors (CAIs) such as acetazolamide, although commonly used to manage intraocular pressure, can cause choroidal effusion—a rare but potentially sight-threatening complication. Ophthalmologists should exercise caution, particularly in elderly patients, and be alert to early signs of this adverse effect. Early diagnosis and prompt management are essential to prevent permanent visual damage. To our knowledge, this is the first reported case of bilateral choroidal detachment associated with acetazolamide in the context of PCME. Full article
(This article belongs to the Special Issue Vision Science and Optometry)
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21 pages, 7194 KB  
Article
Quality by Design (QbD)-Based Development of a Self-Nanoemulsifying Drug Delivery System for the Ocular Delivery of Flurbiprofen
by Ju-Hwan Jeong, Tae-Han Yoon, Si-Won Ryu, Min-Gyeong Kim, Gu-Hae Kim, Ye-Jin Oh, Su-Jeong Lee, Na-Woon Kwak, Kyu-Ho Bang and Kyeong-Soo Kim
Pharmaceutics 2025, 17(5), 629; https://doi.org/10.3390/pharmaceutics17050629 - 9 May 2025
Viewed by 830
Abstract
Objectives: In this study, Quality by Design (QbD) was used to develop an optimized self-nanoemulsifying drug delivery system (SNEDDS) as an ophthalmic formulation of flurbiprofen (FLU). Using a Box–Behnken design (BBD), an optimal SNEDDS composition was crafted, targeting enhanced corneal permeability and [...] Read more.
Objectives: In this study, Quality by Design (QbD) was used to develop an optimized self-nanoemulsifying drug delivery system (SNEDDS) as an ophthalmic formulation of flurbiprofen (FLU). Using a Box–Behnken design (BBD), an optimal SNEDDS composition was crafted, targeting enhanced corneal permeability and increased bioavailability of the drug. Methods: The levels of each factor(X) were established using a pseudo-ternary diagram, and the Box-Behnken design (BBD) was used to evaluate the components of oil (18.9 mg), surfactant (70.7 mg), and co-surfactant (10.0 mg) to optimize the SNEDDS formulation. The response(Y) considered were particle size, polydispersity index (PDI), transmittance, and stability. Transmission electron microscopy (TEM) and dynamic light scattering (DLS) were used to analyze the particle size and morphology. In vitro and ex vivo diffusion tests were conducted to assess drug flux and permeability. Result: Using a response optimization tool, the values of each X factor were optimized to achieve a small particle size (nm), a low polydispersity index (PDI), and high transmittance (%), resulting in a formulation prepared with 18.9 mg of oil, 70.7 mg of surfactant, and 10.0 mg of co-surfactant. The optimized SNEDDS exhibited a small particle size of 24.89 nm, a minimal PDI of 0.068, and a high transmittance of 74.85%. A transmission electron microscopy (TEM) analysis confirmed the presence of uniform spherical nanoemulsion droplets with an observed mean diameter of less than 25 nm, corroborating the dynamic light scattering (DLS) measurements. Furthermore, the SNEDDS demonstrated improved stability under the stress conditions of heating–cooling cycles, with no phase separation, creaming, or caking observed and no differences in its particle size, PDI, or transmittance. In vitro and ex vivo diffusion tests demonstrated that the flux of the optimized SNEDDS (2.723 ± 0.133 mg/cm2, 5.446 ± 0.390 μg/cm2) was about 2.5 and 4 times higher than that of the drug dispersion, and the initial diffusion was faster, which is suitable for the characteristics of eye drops. Conclusions: Therefore, the formulation of a flurbiprofen-loaded SNEDDS (FLU-SNE) was successfully optimized using the QbD approach. The optimized FLU-SNE exhibited excellent stability and enhanced permeability, suggesting its potential effectiveness in treating various ocular inflammations, including uveitis and cystoid macular edema. Full article
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9 pages, 400 KB  
Article
Diabetic Macular Edema in Maintenance Intravitreal Scheduling
by Enzo Maria Vingolo, Mattia Calabro, Simona Mascolo, Filippo Miccichè, Lorenzo Casillo, Stefano Lupo and Feliciana Menna
Pharmaceutics 2025, 17(5), 605; https://doi.org/10.3390/pharmaceutics17050605 - 2 May 2025
Viewed by 604
Abstract
Objectives: This study aimed to assess the impact of an oral formulation combining bromelain (250 mg) derived from Ananas comosus (L.) Merr. Jambs and diosmin mcgSMIN Plus (250 mg) on visual acuity and central retinal thickness (CRT) in patients undergoing anti-VEGF intravitreal maintenance [...] Read more.
Objectives: This study aimed to assess the impact of an oral formulation combining bromelain (250 mg) derived from Ananas comosus (L.) Merr. Jambs and diosmin mcgSMIN Plus (250 mg) on visual acuity and central retinal thickness (CRT) in patients undergoing anti-VEGF intravitreal maintenance therapy (IVT) for cystoid, center-involving diabetic macular edema (DME). Methods: A total of forty patients with type 2 diabetes and center-involving DME, all receiving anti-VEGF maintenance therapy, were prospectively enrolled in a case-control study. Group A (20 eyes) was administered one tablet containing 250 mg of bromelain and 250 mg of diosmin mcgSMIN Plus twice daily for a period of two months. Group B (20 eyes) was monitored without drug administration until the next IVT. After two months and IVT administration, the groups were switched. At the end of the study, the collected data were divided into two groups. The treatment group included data from patients who received the dietary supplement, and the control group consisted of data from patients who were only observed during anti-VEGF therapy. Best-corrected visual acuity (BCVA) and CRT measurements were assessed at baseline, after two months, and after four months. Results: A statistically significant improvement in CRT was observed in the treatment group compared to the control group during follow-up (p < 0.05). However, the improvement in BCVA was not statistically significant. Conclusions: Orally administered combination of bromelain 250 mg and 250 mg diosmin mcgSMIN Plus has positive impact on central retinal thickness in patients treated for cystoid center-involving diabetic macular edema (DME) with anti-VEGF intravitreal maintenance therapy. Full article
(This article belongs to the Section Drug Delivery and Controlled Release)
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11 pages, 4233 KB  
Case Report
Expanding the Clinical Spectrum of CRB1-Retinopathies: A Novel Genotype–Phenotype Correlation with Macular Dystrophy and Elevated Intraocular Pressure
by Ana Catalina Rodriguez-Martinez, Oliver R. Marmoy, Katrina L. Prise, Robert H. Henderson, Dorothy A. Thompson and Mariya Moosajee
Int. J. Mol. Sci. 2025, 26(7), 2836; https://doi.org/10.3390/ijms26072836 - 21 Mar 2025
Cited by 1 | Viewed by 776
Abstract
Biallelic pathogenic variants in the CRB1 gene are associated with severe retinal dystrophies, including early onset severe retinal dystrophy/Leber congenital amaurosis (EOSRD/LCA), retinitis pigmentosa (RP), cone–rod dystrophy (CORD), and macular dystrophy (MD). Despite growing research, scant genotype–phenotype correlations have been established. Here, we [...] Read more.
Biallelic pathogenic variants in the CRB1 gene are associated with severe retinal dystrophies, including early onset severe retinal dystrophy/Leber congenital amaurosis (EOSRD/LCA), retinitis pigmentosa (RP), cone–rod dystrophy (CORD), and macular dystrophy (MD). Despite growing research, scant genotype–phenotype correlations have been established. Here, we present two cases involving individuals that presented with cystoid macular oedema and high intraocular pressure, which were later diagnosed as CRB1-MD, demonstrating a mild and stable phenotype. Two unrelated patients of African heritage were included, a 7-year-old female (case 1) and a 25-year-old female (case 2), both presenting with ocular hypertension and cystoid macular oedema. Case 2 had a history of bilateral plateau iris, treated with laser iridotomy. Baseline visual acuity for case 1 was 0.66 logMAR in the right eye and 0.54 logMAR in the left eye. For case 2, visual acuity was recorded as 0.30 logMAR in both eyes. Genetic testing confirmed a homozygous c.2506C>A p.(Pro836Thr) variant in the CRB1 gene in both cases. Longitudinal follow-up over seven years revealed stable visual acuity, improvement of cystoid macular oedema, and effective intraocular pressure control with topical ocular hypotensive therapy. This study establishes a novel genotype–phenotype correlation between the c.2506C>A p.(Pro836Thr) variant and MD, suggesting a mild, stable disease course in homozygous cases. The findings also highlight a potential association of this variant with elevated IOP, expanding the clinical spectrum of CRB1-related ocular conditions. Early genetic diagnosis and regular ophthalmic monitoring are essential to optimise management and identify therapeutic opportunities in patients with mild CRB1-related phenotypes. Full article
(This article belongs to the Special Issue Retinal Degenerative Diseases: 2nd Edition)
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10 pages, 344 KB  
Article
Safety of One-Piece Hydrophilic Acrylic Intraocular Lenses in the Ciliary Sulcus
by Tal Sharon, Naama Lippin, Veronika Yehezkeli, Nimrod Dar, Avner Belkin and Ehud I. Assia
J. Clin. Med. 2025, 14(6), 1972; https://doi.org/10.3390/jcm14061972 - 14 Mar 2025
Cited by 1 | Viewed by 1007
Abstract
Background/Objectives: this study aims to assess the safety of ciliary sulcus-placed hydrophilic acrylic intraocular lenses (IOLs). Methods: In this retrospective cohort study, consecutive patients who underwent phacoemulsification with implantation of IOLs into the ciliary sulcus without suture fixation between 2014 and 2016 [...] Read more.
Background/Objectives: this study aims to assess the safety of ciliary sulcus-placed hydrophilic acrylic intraocular lenses (IOLs). Methods: In this retrospective cohort study, consecutive patients who underwent phacoemulsification with implantation of IOLs into the ciliary sulcus without suture fixation between 2014 and 2016 at the Meir Medical Center were included. Clinical outcomes were compared between one-piece (1P) hydrophilic acrylic IOLs (Seelens AF, Hanita Lenses, Kibbutz Hanita, Israel) and three-piece hydrophobic acrylic IOLs with PMMA haptics (3P) (MA60AC, Alcon Laboratories, USA). Results: Thirty-eight eyes met the inclusion criteria and had ciliary sulcus IOLs implanted, twenty-three eyes with 1P hydrophilic (60.52%) and fifteen (39.47%) with 3P hydrophobic IOLs. Mean follow-up was 47.36 ± 7.25 months for the 1P group and 46.54 ± 9.82 months for the 3P group (p = 0.87). The mean peak IOP was higher in the 3P group (p = 0.038). No differences in the incidence of anterior uveitis or cystoid macula edema (CME) were detected between the groups (p > 0.05). None of the patients in our study developed uveitis, bleeding episodes, or required treatment for increased intraocular pressure, and no patient was diagnosed with uveitis-glaucoma-hyphema (UGH) syndrome. Post-operative corrected distance visual acuity (CDVA) was similar between the groups (p = 0.66). Conclusions: Hydrophilic IOLs can be safely placed in the ciliary sulcus and are non-inferior to the implantation of three-piece hydrophobic IOLs in the sulcus. In our cohort, with an average follow-up of approximately four years, no UGH was diagnosed, and none of the lenses were explanted. Full article
(This article belongs to the Section Ophthalmology)
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17 pages, 963 KB  
Systematic Review
Incidence, Pathogenesis, Risk Factors, and Treatment of Cystoid Macula Oedema Following Cataract Surgery: A Systematic Review
by Lorenzo Ferro Desideri, Kirupakaran Arun, Enrico Bernardi, Nicola Sagurski and Rodrigo Anguita
Diagnostics 2025, 15(6), 667; https://doi.org/10.3390/diagnostics15060667 - 10 Mar 2025
Cited by 1 | Viewed by 2463
Abstract
Background/Objectives: Cystoid macular edema (CMO) is a common complication that follows cataract surgery, presenting management challenges due to the lack of standardized treatment guidelines and the potential for spontaneous resolution. This study aimed to evaluate various treatment modalities for post-operative CMO, including topical [...] Read more.
Background/Objectives: Cystoid macular edema (CMO) is a common complication that follows cataract surgery, presenting management challenges due to the lack of standardized treatment guidelines and the potential for spontaneous resolution. This study aimed to evaluate various treatment modalities for post-operative CMO, including topical non-steroidal anti-inflammatory drugs (NSAIDs), periocular steroids, and intravitreal injections. Methods: A systematic review of the literature was conducted to assess the efficacy of different treatment approaches for post-operative CMO. Studies evaluating topical NSAIDs, periocular steroids, intravitreal triamcinolone acetonide (TCA), dexamethasone implants (Ozurdex), and intravitreal bevacizumab were included. The main outcomes assessed included improvements in vision, resolution of CMO, recurrence rates, and safety profile. Results: Topical NSAIDs, particularly ketorolac and diclofenac, showed effectiveness in acute CMO, while their efficacy in chronic cases was variable. Periocular steroids, including retrobulbar TCA and sub-Tenon injections, demonstrated significant improvements in vision and the resolution of CMO, especially in cases resistant to topical therapy. Intravitreal TCA and dexamethasone implants exhibited variable effects on CMO resolution and recurrence rates, with some studies reporting sustained improvements over 12 months. The role of intravitreal bevacizumab as initial therapy remains unclear, although it may be considered in cases unresponsive to steroids. Conclusions: Topical NSAIDs, often combined with periocular steroids, serve as first-line therapy, with periocular steroids offering additional efficacy in resistant cases. Further research is needed to establish optimal treatment algorithms and improve outcomes for patients with post-operative CMO Full article
(This article belongs to the Section Clinical Diagnosis and Prognosis)
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9 pages, 432 KB  
Article
Association Between Contrast Sensitivity and Ganglion Cell–Inner Plexiform Layer Thickness After Resolution of Macular Edema Due to Branch Retinal Vein Occlusion
by Tomoya Murakami, Fumiki Okamoto, Takeshi Matsueda, Yoshimi Sugiura, Shohei Morikawa, Yoshifumi Okamoto, Takahiro Hiraoka and Tetsuro Oshika
J. Clin. Med. 2025, 14(5), 1507; https://doi.org/10.3390/jcm14051507 - 24 Feb 2025
Viewed by 788
Abstract
Background/Objectives: We sought to assess the relationship between contrast sensitivity (CS) and optical coherence tomography (OCT) findings, including ganglion cell–inner plexiform layer (GCIPL) thickness, in eyes with cystoid macular edema, secondary to branch retinal vein occlusion (BRVO-CME), treated with intravitreal ranibizumab (IVR). Methods [...] Read more.
Background/Objectives: We sought to assess the relationship between contrast sensitivity (CS) and optical coherence tomography (OCT) findings, including ganglion cell–inner plexiform layer (GCIPL) thickness, in eyes with cystoid macular edema, secondary to branch retinal vein occlusion (BRVO-CME), treated with intravitreal ranibizumab (IVR). Methods: This prospective study included 44 patients with BRVO-CME who underwent treatment with IVR (three monthly injections and pro re nata) and were followed up for 12 months. We collected data on CS, best-corrected visual acuity (BCVA), and OCT findings (ellipsoid zone [EZ] and external limiting membrane status [ELM], central foveal thickness [CFT], and average GCIPL thickness) at the time of the final visit when macular edema was resolved. Multiple regression analysis was used to evaluate the relationship between visual functions and OCT findings, age, and lens status. Results: Multiple regression analysis revealed that lower GCIPL thickness was significantly associated with worse CS (β = 0.008; 95% CI, 0.002–0.014; p = 0.011), whereas this was not the case with BCVA. Lower CFT and mild cataracts were also associated with worse CS (CFT: β = 0.003; 95% CI, 0.001–0.004; p = 0.001; mild cataract: β = −0.182; 95% CI, −0.286–−0.078; p = 0.001) and worse BCVA (CFT: β = −0.002; 95% CI, −0.003–−0.001; p < 0.001; mild cataract: β = 0.079; 95% CI, 0.008–0.150; p = 0.029). Conclusions: GCIPL thickness may serve as a valuable biomarker for CS in eyes with BRVO-CME following IVR treatment. Full article
(This article belongs to the Section Ophthalmology)
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15 pages, 992 KB  
Article
Comparative Functional and Morphological Data of Different IOL Dislocation Treatment Methods
by Renata Vaiciuliene, Ugne Rumelaitiene, Martynas Speckauskas and Vytautas Jasinskas
J. Clin. Med. 2025, 14(5), 1462; https://doi.org/10.3390/jcm14051462 - 21 Feb 2025
Cited by 1 | Viewed by 617
Abstract
Background: This study compared the visual and morphological outcomes between iris fixation and anterior chamber intraocular lens (ACIOL) implantation for late spontaneously dislocated intraocular lens (IOL)–capsular bag complexes in a tertiary reference center in Lithuania. Methods: A prospective observational study was conducted between [...] Read more.
Background: This study compared the visual and morphological outcomes between iris fixation and anterior chamber intraocular lens (ACIOL) implantation for late spontaneously dislocated intraocular lens (IOL)–capsular bag complexes in a tertiary reference center in Lithuania. Methods: A prospective observational study was conducted between 2017 and 2019 involving 80 patients (83 eyes) with late spontaneous IOL–capsular bag dislocation. Patients underwent repositioning and fixation of the dislocated IOL to the iris (IF group) or IOL exchange with an ACIOL implant (ACIOL group). Pre- and postoperative assessments included best-corrected distance visual acuity (BCDVA), intraocular pressure (IOP), corneal endothelial cell density (ECD) and macular thickness (evaluating whether cystoid macular edema (CME) had occurred). Results: Both groups showed a significant improvement in BCDVA, with a more remarkable improvement in the IF group (median: 0.1 logMAR) than in the ACIOL group (median: 0.3 logMAR), p = 0.001. Corneal astigmatism increased significantly in the ACIOL group (p < 0.001) but remained stable in the IF group. IOP management outcomes were better in the IF group as fewer eyes required additional glaucoma treatment. ECD decreased in both groups, but the decrease was significantly greater in the ACIOL group (p < 0.001). Postoperative CME occurred in 4.4% of IF eyes and 39% of ACIOL eyes (p = 0.01). Conclusions: The iris fixation of late dislocated IOL–capsular bag complexes is a safe and minimally invasive technique that offers better visual outcomes, less astigmatism and fewer complications than ACIOL exchange. Full article
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10 pages, 1215 KB  
Article
Radial Peripapillary Capillary Vessel Density as a New Biomarker in Pseudophakic Cystoid Macular Edema
by Michele Rinaldi, Gilda Cennamo, Marina Concilio, Alessandro Aurilia, Antonio Alfano, Emilia Chiara Russo and Ciro Costagliola
J. Clin. Med. 2025, 14(5), 1454; https://doi.org/10.3390/jcm14051454 - 21 Feb 2025
Viewed by 583
Abstract
Background/Objectives: Our aim was to investigate the vessel density (VD) of the radial peripapillary capillary (RPC) plexus in eyes with early pseudophakic cystoid macular edema (PCME) and controls using OCT angiography (OCTA). Methods: Patients with PCME and controls underwent structural OCT to [...] Read more.
Background/Objectives: Our aim was to investigate the vessel density (VD) of the radial peripapillary capillary (RPC) plexus in eyes with early pseudophakic cystoid macular edema (PCME) and controls using OCT angiography (OCTA). Methods: Patients with PCME and controls underwent structural OCT to assess the retinal nerve fiber layer (RNFL) and central macular thickness (CMT) and 6 × 6 mm2 macular OCTA to record the superficial (SVP), deep (DVP) vascular plexus, and choriocapillaris. A scan area of 4.5 × 4.5 mm2 was centered on the optic disk to analyze the RPC plexus VD. Fluorescein angiography was performed in PCME patients. Results: Data from 30 PCME and 30 control eyes, matched for age, were analyzed. The mean CMT was larger in PCME eyes than in control eyes (450 ± 6.5; 243 ± 3.5 micron, p < 0.001). The mean RNFL thickness was significantly greater in terms of global thickness in the PCME group compared to the control group (103 ± 5.2; 91 ± 2.5 micron, p < 0.001). The PCME group had a statistically significant increase in the VD of the RPC in the whole image, peripapillary region, and inside disk compared to the control group (p < 0.001). There was no difference in SVP (p = 0.660) or DVP (p = 0.480) VD between the two groups. A significant correlation was found between the average RNFL thickness and the VD of the RPC (p < 0.05). Conclusions: Eyes with PCME showed increased VD of the RPC and a correlation between this parameter and RNFL thickness; the VD of the RPC shows potential as a reliable non-invasive biomarker for the early diagnosis of PCME. Full article
(This article belongs to the Section Ophthalmology)
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20 pages, 3942 KB  
Article
Twelve-Month Outcomes and Optical Coherence Tomography (OCT) Biomarkers After Intravitreal Dexamethasone Implantation in Pseudophakic Eyes with Post-Vitrectomy Cystoid Macular Edema (CME)—Refractory to Medical Therapy
by Francesco Pignatelli, Alfredo Niro, Giuseppe Addabbo, Pasquale Viggiano, Giacomo Boscia, Maria Oliva Grassi, Francesco Boscia, Cristiana Iaculli, Giulia Maria Emilia Clima, Antonio Barone and Ermete Giancipoli
Diagnostics 2025, 15(2), 147; https://doi.org/10.3390/diagnostics15020147 - 10 Jan 2025
Cited by 1 | Viewed by 1174
Abstract
Background: In this study, we evaluated the incidence of cystoid macular edema (CME) after pars plana vitrectomy (PPV) for different retinal pathologies and assessed the role of optical coherence tomography (OCT) biomarkers in guiding treatment decisions in post-surgical CME patients who were [...] Read more.
Background: In this study, we evaluated the incidence of cystoid macular edema (CME) after pars plana vitrectomy (PPV) for different retinal pathologies and assessed the role of optical coherence tomography (OCT) biomarkers in guiding treatment decisions in post-surgical CME patients who were refractory to medical therapy over a follow-up period of 12 months. Methods: Medical records of consecutive pseudophakic patients, who underwent PPV for different retinal pathologies, were retrospectively evaluated in this single-center, uncontrolled study. The incidence of post-PPV CME was assessed. Eyes with post-PPV CME in the first 2 months after surgery, with available clinical and OCT data for 12 months after surgery, were included in the evaluation. The mean best-corrected visual acuity (BCVA; logMAR), mean central macular thickness (CMT; μm) change, and response to different treatments [medical therapy and intravitreal dexamethasone (DEX) implant] were evaluated 1, 3, 6, 9, and 12 months after PPV. The impact of OCT biomarkers on the exposure to DEX implants was assessed. Adverse events, potentially related to the treatment, were investigated as well. Results: Of the 346 pseudophakic patients (352 eyes) who participated in this study, 54 (54 eyes) developed CME within the first 2 months after PPV (incidence of 15.3%). Among them, 48 patients were deemed eligible for the 12-month analysis. Preoperative mean BCVA (1.44 ± 0.99 logMAR) significantly improved to 0.32 ± 0.37 logMAR after 12 months (p < 0.001). The mean baseline CMT of 347 (±123.5) μm significantly decreased to 290 μm (±80.4; p = 0.003) by the end of the follow-up. Twenty-five eyes (52%) required one or more DEX implants for CME, due to being refractory to topical therapy. Significant correlations were found between the mean CMT values at various time points. Additionally, patients who required DEX implants at months 3 and 9 were more likely to present intraretinal fluid (IRF), disorganization of inner retinal layers (DRIL), disorganization of outer retinal layers (DROL), and hyper-reflective foci (HRF) at 1-month OCT. Five patients experienced a slight increase in intraocular pressure (IOP), which was successfully managed with topical medication. Conclusions: Topical therapy alone can be a valuable option for post-PPV CME in approximately 50% of patients. Significant visual recovery and macular thickness reduction at 12 months demonstrated that DEX implants can be a safe and effective second-line treatment for pseudophakic patients with post-PPV CME and who are refractory to medical therapy. Early post-surgical OCT biomarkers may indicate a more severe CME that might benefit from the steroid implant. Full article
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12 pages, 2465 KB  
Article
Comparative Study of Adalimumab, Infliximab and Certolizumab Pegol in the Treatment of Cystoid Macular Edema Due to Behçet’s Disease
by Nuria Barroso-García, José Luis Martín-Varillas, Iván Ferraz-Amaro, Lara Sánchez-Bilbao, Adrián Martín-Gutiérrez, Alfredo Adán, Inés Hernanz-Rodríguez, Emma Beltrán-Catalán, Miguel Cordero-Coma, David Díaz-Valle, Marisa Hernández-Garfella, Lucía Martínez-Costa, Manuel Díaz-Llopis, José M. Herreras, Olga Maíz-Alonso, Ignacio Torre-Salaberri, Antonio Atanes-Sandoval, Santos Insúa, Raquel Almodóvar-González, Patricia Fanlo, Juan Ramón De Dios Aberasturi, Ángel García-Aparicio, Sergio Rodríguez-Montero, Vega Jovaní, Patricia Moya-Alvarado, Eva Peña Sainz-Pardo, Vanesa Calvo-Río, Rosalía Demetrio-Pablo, José Luis Hernández and Ricardo Blancoadd Show full author list remove Hide full author list
J. Clin. Med. 2024, 13(23), 7388; https://doi.org/10.3390/jcm13237388 - 4 Dec 2024
Cited by 1 | Viewed by 1842
Abstract
Background: The leading cause of blindness due to non-infectious uveitis is cystoid macular edema (CME). Behçet’s disease (BD) is one of the most commonly conditions related to CME. Objectives: To compare the effectiveness and safety of adalimumab (ADA), infliximab (IFX) and certolizumab (CZP) [...] Read more.
Background: The leading cause of blindness due to non-infectious uveitis is cystoid macular edema (CME). Behçet’s disease (BD) is one of the most commonly conditions related to CME. Objectives: To compare the effectiveness and safety of adalimumab (ADA), infliximab (IFX) and certolizumab (CZP) in refractory CME due to BD. Methods: Multicenter study of BD-CME patients with no response to glucocorticoids (GCs) and at least one conventional immunosuppressive drug. At baseline, all patients presented CME, defined by OCT > 300 µ. The effectiveness of ADA, IFX and CZP was assessed over a 2-year period from baseline using the following ocular parameters: macular thickness (µm), visual acuity (BCVA), anterior chamber (AC) cells and vitritis. Mixed-effects regression models were applied. Results: a total of 50 patients (75 eyes) were studied (ADA = 25; IFX = 15 and CZP = 10). No significant differences in demographic parameters were found among the three groups. However, individuals in the CZP group had a significantly extended time from diagnosis to treatment onset (72 (36–120) months, p = 0.03) and had received a higher number of biological therapies (1.7 ± 1.1) compared to the ADA and IFX groups. Within the CZP group, ADA and IFX were previously administrated in seven patients. After 2 years of follow-up, a rapid and sustained reduction in macular thickness was noted in all three groups with no significant differences between them. Additionally, enhancements in BCVA, AC cells and vitritis were also observed. No serious adverse events were reported in the CZP group, although one isolated case of bacteremia was documented in the ADA group. ADA, IFX and CZP appear to be effective and safe treatments for refractory CME in BD. CZP seems to remain effective even in patients with an insufficient response to ADA and/or IFX. Conclusions: ADA, IFX and CZP appear to be effective and safe treatments for refractory CME in BD. CZP seems to remain effective even in patients with an insufficient response to ADA and/or IFX. Full article
(This article belongs to the Section Ophthalmology)
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9 pages, 3363 KB  
Article
Retinal Thickness Change Following Cataract Surgery in Eyes with Epiretinal Membranes
by Barbara Wienerroither, Georgios Mylonas, Clemens Bernhart, Franz Prager, Guenal Kahraman and Michael Amon
J. Clin. Med. 2024, 13(22), 6781; https://doi.org/10.3390/jcm13226781 - 11 Nov 2024
Viewed by 1107
Abstract
Purpose: To investigate intraretinal changes and central millimeter thickness (CMMT) after successful uncomplicated cataract surgery in patients with asymptomatic epiretinal membrane (ERM). Design: prospective, single-center, interventional case series. Methods: Thirty eyes from 26 patients with cataract and ERM (ERM group) and fifteen consecutive [...] Read more.
Purpose: To investigate intraretinal changes and central millimeter thickness (CMMT) after successful uncomplicated cataract surgery in patients with asymptomatic epiretinal membrane (ERM). Design: prospective, single-center, interventional case series. Methods: Thirty eyes from 26 patients with cataract and ERM (ERM group) and fifteen consecutive eyes with senile cataract with a healthy macula (control group) were included. Best-corrected visual acuity (BCVA) and optical coherence tomography (OCT) as well as biomicroscopy were performed at baseline, one week, one month and three months after cataract surgery. OCT raster scans were further analyzed regarding CMMT and structural changes in the retinal morphology. Results: The baseline mean visual acuity improved significantly three months after cataract surgery in both groups (p < 0.05). CMMT in the ERM group was 342 (±53 μm) at baseline and increased significantly to 356 (±57) μm after three months (p < 0.05). One patient in the ERM group developed temporary cystoid macular edema one week after cataract surgery that resolved under topical treatment within three months. CMMT in the control group increased significantly three months after cataract surgery as well but no structural changes in the retinal morphology were observed in this group. Conclusions: This study provides evidence that cataract surgery in eyes with asymptomatic pre-existing ERM can be considered as safe and effective, resulting in good visual acuity outcomes. However, an increase in CMMT and temporary mild changes in retinal morphology may occur. Full article
(This article belongs to the Section Ophthalmology)
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13 pages, 2773 KB  
Article
Macular Alterations in a Cohort of Caucasian Patients Affected by Retinitis Pigmentosa
by Marcella Nebbioso, Elvia Mastrogiuseppe, Eleonora Gnolfo, Marco Artico, Antonietta Moramarco, Fabiana Mallone, Samanta Taurone, Annarita Vestri and Alessandro Lambiase
Diagnostics 2024, 14(21), 2409; https://doi.org/10.3390/diagnostics14212409 - 29 Oct 2024
Viewed by 964
Abstract
Objectives: Our objective was to investigate the prevalence of macular complications detected by spectral-domain optical coherence tomography (SD-OCT) in a large Caucasian cohort of RP patients, highlight the major alterations in chorioretinal structure, and compare the macular structural changes in eyes affected by [...] Read more.
Objectives: Our objective was to investigate the prevalence of macular complications detected by spectral-domain optical coherence tomography (SD-OCT) in a large Caucasian cohort of RP patients, highlight the major alterations in chorioretinal structure, and compare the macular structural changes in eyes affected by retinal dystrophies with those in healthy controls. Methods: This was an observational, retrospective, and cross-sectional study. Three hundred and seven patients with RP were consecutively enrolled and underwent clinical assessment. In particular, SD-OCT images were used to ascertain the morphology of the posterior pole of patients with RP by evaluating the residual ellipsoid zone (EZ), the volume and thickness of the outer nuclear layer (ONLT), and subfoveal choroid thickness (SCT). At the same time, the pathological finding that the patients’ vision was reduced under treatment was analyzed. Results: A total of 436 eyes of 218 patients with RP were studied. Considering all of the eyes studied, 103 had cystoid macular edema (CME) (23.62%), 123 (28.21%) had vitreomacular traction (VMT), and 199 (45.75%) had epiretinal membranes (ERMs). There were also 12 (2.75%) cases of lamellar macular holes (LMHs), of which 3 (1.38% of all patients) cases were bilateral. Only 137 eyes (31.42%) did not have the above-mentioned alterations. SCT was significantly reduced compared to that of the control group (193.03 µm ± 67.90 SD vs. 295 µm ± 69.04 SD), while the foveal central macular thickness (FCMT) was greater (270.91 μm ± 74.04 SD vs. 221 µm ± 37.25 SD). Conclusions: This research highlights the high incidence of macular complications. The results of our study indicate the importance of regular monitoring of RP patients and early intervention to avoid further complications in this group of subjects with severe visual field impairment to avoid further central vision loss. Full article
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