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Eye Diseases: Diagnosis and Management—2nd Edition
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Eye Diseases: Diagnosis and Management—2nd Edition

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: 28 February 2025 | Viewed by 16725

Special Issue Editor

Dr. Ramin Khoramnia

E-Mail Website
Guest Editor
Im Neuenheimer Feld 400, Eye Clinic, Heidelberg University Hospital, D-69120 Heidelberg, Germany
Interests: IOL; intravitreal injection; retina; presbyopia; macular diseases; cataract; refractive surgery; biomaterials; optics; diagnostic tools
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Ophthalmology has been at the forefront of medical innovation due to its unique demand for device-assisted diagnostics and microsurgery. In former times, imaging technology for ophthalmologists was limited to basic photography, low-resolution ultrasound, and microscopy. These diagnostic techniques are highly dependent on the skills and experiences of the examiner and, therefore, show high interobserver variability in sensitivity and specificity. The use of modern devices not only allows the earlier detection of eye diseases but also enables ophthalmologists to offer more individualized treatment to their patients. The use of modern diagnostic instruments generates a large amount of data. In view of the high number of patients, these data can hardly be evaluated in everyday routine clinical practice. For this reason, the automated evaluation of the obtained results will become increasingly important. Ophthalmologists today have access to numerous drugs and medical devices that have revolutionized the treatment of common and rare eye diseases. As such, patients can be offered the best possible treatment, especially in terms of safety and functional outcomes. 

In this Special Issue, we are looking for research results including new findings in the diagnosis and management of eye diseases. Our goal is to address, amongst others, diagnostic imaging (optical diagnosis), molecular pathology diagnosis (biomarkers), artificial intelligence diagnosis, and innovative treatment options in the field of ophthalmology. We are looking forward to receiving your invaluable work for this Special Issue.

Dr. Ramin Khoramnia
Guest Editor

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Published Papers (16 papers)

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Research

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13 pages, 2424 KiB  
Article
Comparison of Biomarkers Playing a Role in Pterygium Development in Pterygium and Recurrent Pterygium Tissues
by Özgür Eroğul and Serkan Şen
Diagnostics 2024, 14(23), 2619; https://doi.org/10.3390/diagnostics14232619 - 21 Nov 2024
Abstract
Background/Objectives: Pterygium is a nonneoplastic elastotic degeneration characterized by subepithelial growth. It manifests as an ocular lesion originating from the bulbar conjunctiva, extending to the corneal surface, and reaching the visual axis in some cases. Although the exact cause is unknown, prolonged exposure [...] Read more.
Background/Objectives: Pterygium is a nonneoplastic elastotic degeneration characterized by subepithelial growth. It manifests as an ocular lesion originating from the bulbar conjunctiva, extending to the corneal surface, and reaching the visual axis in some cases. Although the exact cause is unknown, prolonged exposure to ultraviolet radiation is considered the most significant contributing factor. Chronic irritation and actinic damage are likely responsible for the typical fibrovascular reactions observed in pterygium. Additionally, growth factors, cytokines, and matrix metalloproteinases play roles in the pathogenesis of pterygium. This study compared recurrent and primary pterygium cases at the molecular level to gain new insights into the etiology of pterygium. Methods: Total protein was extracted from surgical samples of patients with primary and recurrent pterygium, and the levels of transforming growth factor beta 1 (TGF-β1), interleukin-1 beta (IL-1β), interleukin-6 (IL-6), IL-8, and IL-10 were analyzed using the enzyme-linked immunosorbent assay technique. Target gene expression levels were analyzed using the ΔΔCt method after cDNA synthesis from isolated RNA, with normalization to GAPDH and quantification performed with SYBR Green PCR Master Mix. Results: Among the studied cytokines, IL-10 levels were higher in primary pterygium than in recurrent pterygium (722.0 ± 600.9/421.4 ± 266.8) (p = 0.0054). Other cytokines (IL-6, IL-8, IL-1β, and TGF-β1) were detected at similar levels in both primary and recurrent pterygium (p = 0.2986). Additionally, the TGF-β1 gene expression was found to be significantly upregulated in recurrent pterygium tissue compared to primary pterygium tissue (p = 0.034). Conclusions: This increase suggests that TGF-β1 may contribute to the recurrence mechanisms of pterygium through processes such as fibroblast activation and tissue remodeling. The higher levels of IL-10 in primary pterygium compared to recurrent pterygium indicate an enhanced early protective response aimed at limiting pterygium progression and controlling the inflammatory process. Full article
(This article belongs to the Special Issue Eye Diseases: Diagnosis and Management—2nd Edition)
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11 pages, 1889 KiB  
Article
Delayed Diagnosis and Misdiagnosis of Lacrimal Sac Tumors in Patients Presenting with Epiphora: Diagnosis, Treatment, and Outcomes
by Yu-Chen Chu and Chieh-Chih Tsai
Diagnostics 2024, 14(21), 2401; https://doi.org/10.3390/diagnostics14212401 - 28 Oct 2024
Viewed by 454
Abstract
Background/Objectives: Epiphora, or excessive tearing, is a common symptom often attributed to benign conditions such as dry eye or nasolacrimal duct obstruction. However, it can also be an early indicator of lacrimal sac tumors, which are frequently misdiagnosed or diagnosed late due to [...] Read more.
Background/Objectives: Epiphora, or excessive tearing, is a common symptom often attributed to benign conditions such as dry eye or nasolacrimal duct obstruction. However, it can also be an early indicator of lacrimal sac tumors, which are frequently misdiagnosed or diagnosed late due to their subtle presentation. This study aims to identify the clinical features that contribute to delays and misdiagnoses of lacrimal sac tumors in patients presenting with epiphora, with the goal of improving early detection and treatment outcomes. Methods: This retrospective study reviewed medical records from Taipei Veterans General Hospital between 2007 and 2023, focusing on patients who presented with epiphora and were later diagnosed with pathologically confirmed lacrimal sac tumors. Inclusion criteria were limited to cases that were initially misdiagnosed or had a delayed diagnosis, with imaging and clinical evaluations confirming tumor-related tear drainage obstruction. Patients with non-tumor causes of epiphora were excluded. Results: Eleven cases of lacrimal sac tumors were identified, including two benign and nine malignant tumors. The average duration from symptom onset to diagnosis was 22.4 months. Common symptoms included epiphora (100%), discharge (54.5%), and hemolacria (18.2%). Subtle clinical signs, such as asymmetry in the medial canthal region and non-tender swelling, were frequently noted. Despite receiving appropriate surgical and adjuvant treatments, the impact of delayed diagnosis was significant. Two patients succumbed to tumor-related disease; one developed lung metastasis 12 years after diagnosis, and another experienced recurrence during a six-year follow-up after undergoing extensive exenteration, adjuvant chemotherapy, and radiotherapy. Conclusions: Lacrimal sac tumors can present insidiously with symptoms often mistaken for benign conditions, leading to significant diagnostic delays. Thorough history taking, meticulous physical examination, and timely imaging are crucial for early detection. Increased clinician awareness and a high index of suspicion for lacrimal sac tumors in patients with atypical epiphora are essential to improve prognosis and reduce the risk of severe outcomes. Full article
(This article belongs to the Special Issue Eye Diseases: Diagnosis and Management—2nd Edition)
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11 pages, 538 KiB  
Article
The Usage of Different Hyaluronic-Acid-Containing Artificial Tears and the Treatment Outcome of Intense Pulsed Light Therapy for Dry Eye Disease: A Retrospective Cohort Study
by Chia-Yi Lee, Shun-Fa Yang, Yun-Chen Chen and Chao-Kai Chang
Diagnostics 2024, 14(16), 1796; https://doi.org/10.3390/diagnostics14161796 - 16 Aug 2024
Viewed by 678
Abstract
In this study, we aimed to investigate the effect of different hyaluronic acid (HA)-containing artificial tears on dry eye disease (DED) treatment in combination with intense pulsed light (IPL) therapy. A retrospective cohort study was conducted, and the participants received IPL therapy and [...] Read more.
In this study, we aimed to investigate the effect of different hyaluronic acid (HA)-containing artificial tears on dry eye disease (DED) treatment in combination with intense pulsed light (IPL) therapy. A retrospective cohort study was conducted, and the participants received IPL therapy and HA-containing artificial tears. There were 42 and 40 eyes in the 0.10% and 0.15% HA groups after selection, respectively. The main outcomes were the postoperative non-invasive tear break-up time (NITBUT), Schirmer II test results, ocular surface stain, and numbers of DED-related symptoms. A generalized linear model was utilized to produce the adjusted odds ratio (aOR) and 95% confidence interval (CI) of the main outcomes between groups. At the three-month follow-up, the NITBUT was significantly higher in the 0.15% HA group (p = 0.023), and the NITBUT recovery was also significantly better in the 0.15% HA group compared to the 0.10% HA group (p = 0.039). The multiple DED-related symptoms significantly correlated with no DED symptom improvement in both the 0.10% and 0.15% HA groups (both p < 0.05), while the low pre-treatment NITBUT was marginally related to no DED symptom improvement in the 0.10% HA group (p = 0.047). A low NITBUT and Schirmer II test result correlated with no DED symptom improvement in both the groups (all p < 0.05). In conclusion, the application of 0.10% and 0.15% HA-containing artificial tears revealed similar effects to IPL therapy for DED. Full article
(This article belongs to the Special Issue Eye Diseases: Diagnosis and Management—2nd Edition)
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7 pages, 1070 KiB  
Communication
Tear Film Conditions and Depression Symptoms in Persons with Obesity
by Anabel Sanchez-Sanchez, MaGuadalupe Leon-Verdin, Sabino Chavez-Cerda and Claudia Martinez-Cordero
Diagnostics 2024, 14(16), 1768; https://doi.org/10.3390/diagnostics14161768 - 14 Aug 2024
Viewed by 571
Abstract
Most persons with obesity who have undergone gastric bypass surgery present depressive symptoms. Depression and anxiety have been associated with tear film disorders. This study aimed to investigate whether there is a correlation between tear film conditions and depression symptoms in patients subjected [...] Read more.
Most persons with obesity who have undergone gastric bypass surgery present depressive symptoms. Depression and anxiety have been associated with tear film disorders. This study aimed to investigate whether there is a correlation between tear film conditions and depression symptoms in patients subjected to bariatric surgery. The participants completed a Patient Health Questionnaire to detect depression symptoms. The break-up time and Schirmer test were subsequently applied; the measurements were performed three times, and the average time was subsequently recorded. The results revealed that the Schirmer test score and PH-9 score were negatively correlated, but this was not the case for the break-up time test. Depression symptoms may correlate with lower tear production from the principal tear gland, but they may not have the same effect on meibomian gland production in adults undergoing bariatric surgery. In addition to routine control, bariatric surgery patients should be periodically evaluated by an ophthalmologist and/or psychologist who is aware of potential comorbidities. Furthermore, the observed association between depression symptoms and tear deficiencies highlights the importance of further investigations to gain a better understanding of these mechanisms. Full article
(This article belongs to the Special Issue Eye Diseases: Diagnosis and Management—2nd Edition)
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12 pages, 681 KiB  
Article
The Risk Factors for Myopia Undercorrection in Second-Generation (Visumax 800) Keratorefractive Lenticule Extraction Surgery: A Retrospective Case–Control Study
by Chia-Yi Lee, Shun-Fa Yang, Hung-Chi Chen, Ie-Bin Lian, Chin-Te Huang, Jing-Yang Huang and Chao-Kai Chang
Diagnostics 2024, 14(16), 1752; https://doi.org/10.3390/diagnostics14161752 - 12 Aug 2024
Viewed by 822
Abstract
In this study, we aim to evaluate the risk factors of myopia undercorrection in recipients of second-generation keratorefractive lenticule extraction (KLEx) surgery. A retrospective case–control study was performed, and patients who received second-generation KLEx surgery were enrolled. The cases with myopia undercorrection were [...] Read more.
In this study, we aim to evaluate the risk factors of myopia undercorrection in recipients of second-generation keratorefractive lenticule extraction (KLEx) surgery. A retrospective case–control study was performed, and patients who received second-generation KLEx surgery were enrolled. The cases with myopia undercorrection were matched to non-myopia undercorrection cases with a 1:4 ratio according to age, and a total of 22 and 88 eyes were categorized into the undercorrection and control groups, respectively. Demographic, refractive, topographic, and surgical data were collected preoperatively. A generalized linear model was operated to evaluate the potential risk factors for myopia undercorrection. The uncorrected distance visual acuity (UDVA) at three months postoperation was significantly better in the control group (p = 0.006), and residual myopia and SE were significantly higher in the undercorrection group during the whole follow-up period (all p < 0.001). The UDVA value showed a trend of improvement in the control group (p < 0.001), and the changes to SE and residual myopia were significantly lower in the control group (both p < 0.001). Regarding the risk factors for myopia undercorrection in the whole population and the high-myopia population, a higher manifest sphere power, higher steep keratometry (K), higher topographic cylinder, lower central corneal thickness (CCT) at apex, higher CCT difference and lower residual stromal thickness (RST) correlated to myopia undercorrection (all p < 0.05). In the low-myopia population, only higher myopia and lower RST correlated to myopia undercorrection (both p < 0.05). In conclusion, a high-sphere power and irregular topographic pattern correlated to myopia undercorrection after the second KLEx surgery, especially for individuals with high myopia. Full article
(This article belongs to the Special Issue Eye Diseases: Diagnosis and Management—2nd Edition)
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13 pages, 2365 KiB  
Article
An Innovative Virtual Reality System for Measuring Refractive Error
by Chin-Te Huang, Chien-Nien Lin, Shyan-Tarng Chen, Hui-Ying Kuo and Han-Yin Sun
Diagnostics 2024, 14(15), 1633; https://doi.org/10.3390/diagnostics14151633 - 29 Jul 2024
Viewed by 828
Abstract
In this study, we aimed to validate a novel light field virtual reality (LFVR) system for estimating refractive errors in the human eye. Fifty participants with an average age of 22.12 ± 2.2 years (range 20–30 years) were enrolled. The present study compared [...] Read more.
In this study, we aimed to validate a novel light field virtual reality (LFVR) system for estimating refractive errors in the human eye. Fifty participants with an average age of 22.12 ± 2.2 years (range 20–30 years) were enrolled. The present study compared spherical equivalent (SE) and focal line measurements (F1 and F2) obtained by the LFVR system with those obtained by established methods, including closed-field and open-field autorefractors, retinoscopy, and subjective refraction. The results showed substantial agreement between the LFVR system and the traditional methods, with intraclass correlation coefficients (ICC) for SE ranging from 82.7% to 86.7% (p < 0.01), and for F1 and F2 from 80.7% to 86.4% (p < 0.01). Intra-repeatability for F1 and F2 demonstrated strong agreement, with ICC values of 88.8% and 97.5%, respectively. These findings suggest that the LFVR system holds potential as a primary tool for refractive error measurement in optical care, offering high agreement and repeatability compared to conventional methods. Full article
(This article belongs to the Special Issue Eye Diseases: Diagnosis and Management—2nd Edition)
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12 pages, 778 KiB  
Article
The Degrees of Coronary Heart Disease and the Degrees of New-Onset Blepharitis: A Nationwide Cohort Study
by Chia-Yi Lee, Shun-Fa Yang, Yu-Ling Chang, Jing-Yang Huang and Chao-Kai Chang
Diagnostics 2024, 14(13), 1349; https://doi.org/10.3390/diagnostics14131349 - 25 Jun 2024
Cited by 1 | Viewed by 1105
Abstract
In this study, we aimed to evaluate the association between the severity of coronary heart disease (CHD) and the subsequent severity of blepharitis. This retrospective population-based cohort study was conducted using the National Health Insurance Research Database (NHIRD) of Taiwan. The participants with [...] Read more.
In this study, we aimed to evaluate the association between the severity of coronary heart disease (CHD) and the subsequent severity of blepharitis. This retrospective population-based cohort study was conducted using the National Health Insurance Research Database (NHIRD) of Taiwan. The participants with a CHD diagnosis were divided into mild CHD and severe CHD groups at a 1:2 ratio, according to whether percutaneous coronary intervention (PCI) was performed. The main outcomes were the development of blepharitis and severe blepharitis with the application of antibiotics. Cox proportional hazard regression was performed to obtain the adjusted hazard ratio (aHR) for blepharitis, with a 95% confidence interval (CI) between the groups. There were 22,161 and 15,369 blepharitis events plus 9597 and 4500 severe blepharitis episodes in the mild and severe CHD groups, respectively. The severe CHD group showed a significantly higher incidence of blepharitis development (aHR, 1.275; 95% CI: 1.051–1.912, p = 0.0285), whereas the incidence of severe blepharitis was not significantly different between the groups (aHR, 0.981; 95% CI: 0.945–1.020, p = 0.3453). The cumulative probability of blepharitis was significantly higher in the severe CHD group than in the mild CHD group (p < 0.001). In the subgroup analyses, the correlation between severe CHD and blepharitis was more significant in patients older than 70 years compared to the younger group (p = 0.0115). In conclusion, severe CHD is associated with a higher incidence of blepharitis than mild CHD, and this correlation is more prominent in individuals older than 70 years. Full article
(This article belongs to the Special Issue Eye Diseases: Diagnosis and Management—2nd Edition)
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15 pages, 584 KiB  
Article
Low Rate of Postoperative Pterygium Recurrence in Patients under Treatment with Low-Dose Oral Doxycycline for Chronic Blepharitis: A First Report
by Fiammetta Catania, Paolo Vinciguerra and Alessandra Di Maria
Diagnostics 2024, 14(7), 715; https://doi.org/10.3390/diagnostics14070715 - 28 Mar 2024
Viewed by 1027
Abstract
Purpose: Low doses of systemic doxycycline (LD-SD) inhibit angiogenesis and the expression of matrix metalloproteases, which are determinants of pterygium progression. This study aimed to compare the recurrence rate and visual outcome of pterygium excision in patients undergoing chronic treatment with LD-SD for [...] Read more.
Purpose: Low doses of systemic doxycycline (LD-SD) inhibit angiogenesis and the expression of matrix metalloproteases, which are determinants of pterygium progression. This study aimed to compare the recurrence rate and visual outcome of pterygium excision in patients undergoing chronic treatment with LD-SD for chronic refractory blepharitis and LD-SD-naive patients. Methods: A retrospective analysis of patients that underwent surgical excision and conjunctival graft apposition was conducted. Patients were divided in a TETRA group (under LD-SD treatment at the moment of surgery) and a control group. The main outcome was the rate of recurrence at 1 year postoperatively. Secondary outcomes were the comparisons of surface regularity, visual quality, and dry-eye symptoms at 6-week, 6-month, and 1-year follow-up in the two groups. Results: The TETRA group showed a significantly lower rate of 1-year recurrence both in primary (p = 0.034) and recurrent (p < 0.001) pterygia. The best corrected visual acuity (BCVA), astigmatic error, corneal total root mean square (RMS), and ocular surface disease index (OSDI) significantly reduced during the follow-up in both groups. The surface asymmetry index and high-order aberrations (HOAs) significantly reduced only in the TETRA group. The final BCVA was significantly higher, while the OSDI score and total RMS and HOAs were significantly lower in the TETRA group compared to the control. Conclusions: Patients under treatment with LD-SD showed a lower rate of recurrence at 1-year follow-up compared to controls. These patients also experienced higher BCVA and surface regularity and less dry-eye symptoms. Full article
(This article belongs to the Special Issue Eye Diseases: Diagnosis and Management—2nd Edition)
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12 pages, 781 KiB  
Article
The Extents of Coronary Heart Disease and the Severity of Newly Developed Dry Eye Disease: A Nationwide Cohort Study
by Chia-Yi Lee, Shun-Fa Yang, Jing-Yang Huang and Chao-Kai Chang
Diagnostics 2024, 14(6), 586; https://doi.org/10.3390/diagnostics14060586 - 10 Mar 2024
Viewed by 1375
Abstract
This study aimed to evaluate the potential association between coronary heart disease (CHD) severity and the subsequent dry eye disease (DED) with a different severity through the use of the National Health Insurance Research Database (NHIRD) of Taiwan. A retrospective cohort study was [...] Read more.
This study aimed to evaluate the potential association between coronary heart disease (CHD) severity and the subsequent dry eye disease (DED) with a different severity through the use of the National Health Insurance Research Database (NHIRD) of Taiwan. A retrospective cohort study was conducted. The CHD population was further divided into a severe CHD that had received coronary artery bypass graft (CABG) surgery group and a mild CHD that had received medicine group, then matched with a 1:2 ratio, and 29,852 and 14,926 CHD patients were put into the severe CHD and mild CHD groups, respectively. The primary outcomes were the development of DED and severe DED after CHD diagnosis. The Cox proportional hazards regression was used to produce the adjusted hazard ratio (aHR) and 95% confidence interval (CI) of DED and severe DED between groups. There were 3440 and 1276 DED cases in the mild CHD and severe CHD groups, respectively. And another 37 and 48 severe CHD events were observed in the mild and severe CHD groups, respectively. The incidence of severe DED in the severe CHD group was significantly higher compared to the mild CHD group (aHR: 5.454, 95% CI: 1.551–7.180, p = 0.0001). The cumulative probabilities of DED and severe DED were significantly higher in the severe CHD group than the mild CHD group (both p < 0.0001). In the subgroup analysis, the correlation between severe CHD and DED was higher in the patients aged older than 70 years (p < 0.0001). In conclusion, severe CHD is associated with a higher incidence of severe DED with a higher cumulative incidence. Full article
(This article belongs to the Special Issue Eye Diseases: Diagnosis and Management—2nd Edition)
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6 pages, 913 KiB  
Communication
Choroidal Hyperreflective Nodules Detected by Infrared Reflectance Images Are a Diagnostic Criterion for Neurofibromatosis Type 1 Patients Excluding Those with High Myopia
by Marta Orejudo de Rivas, Javier Mateo Gabás, Miguel Ángel Torralba Cabeza, Olivia Esteban Floría, Raquel Herrero Latorre, Eva Núñez Moscarda, Julia Aramburu Clavería, Guillermo Pérez Rivasés and Javier Ascaso Puyuelo
Diagnostics 2023, 13(7), 1348; https://doi.org/10.3390/diagnostics13071348 - 4 Apr 2023
Cited by 1 | Viewed by 1816
Abstract
Neurofibromatosis type 1 (NF1) is one of the central nervous system’s most common autosomal dominant conditions. The diagnosis is based on the clinical diagnostic criteria and/or a molecularly confirmed mutation in the NF1 gene. This study investigated the possibility of substantiating choroidal nodules [...] Read more.
Neurofibromatosis type 1 (NF1) is one of the central nervous system’s most common autosomal dominant conditions. The diagnosis is based on the clinical diagnostic criteria and/or a molecularly confirmed mutation in the NF1 gene. This study investigated the possibility of substantiating choroidal nodules as a diagnostic criterion for the disease, including patients affected with and without high myopia. A cross-sectional study was carried out in 60 eyes of 30 adult patients diagnosed with NF1. A total of 30 healthy individuals of equivalent age and sex served as control. The Spectralis HRA+OCT MultiColor (Heidelberg Engineering GmbH, Heidelberg, Germany) evaluated the presence of choroidal abnormalities with near-infrared reflectance imaging. Secondly, the presence of iridian Lisch nodules was evaluated by slit lamp examination. Near-infrared reflectance imaging showed the presence of choroidal hyperreflective nodules in 83% of the patients diagnosed with NF1, while these choroidal abnormalities were not observed in any control subject. The patients diagnosed with NF1 associated with high myopia were the only ones who did not present the characteristic choroidal disorders. Therefore, when excluding patients diagnosed with high myopia, choroidal nodules were more frequent than Lisch nodules in a statistically significant proportion. Hyperreflective nodules detected by near-infrared reflectance imaging are as regular as Lisch nodules or even significantly more frequent when excluding high myope patients. Our observation of the mutual exclusion of choroidal hyperreflective nodules and high myopia in the NF1 patients seems a novel and interesting remark. Full article
(This article belongs to the Special Issue Eye Diseases: Diagnosis and Management—2nd Edition)
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Review

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24 pages, 1218 KiB  
Review
Ocular and Periocular Tattoo Adverse Effects: A Review
by Kar Wai Alvin Lee, Lisa Kwin Wah Chan, Angela Wai Kay Lee, Cheuk Hung Lee, Jovian Wan and Kyu-Ho Yi
Diagnostics 2024, 14(19), 2150; https://doi.org/10.3390/diagnostics14192150 - 27 Sep 2024
Viewed by 490
Abstract
Background: Ocular and periocular tattoos, involving ink application to the eyeball or surrounding skin, have gained popularity as forms of self-expression. However, this trend raises significant concerns about potential complications that can adversely affect ocular health and esthetics. Awareness of these risks is [...] Read more.
Background: Ocular and periocular tattoos, involving ink application to the eyeball or surrounding skin, have gained popularity as forms of self-expression. However, this trend raises significant concerns about potential complications that can adversely affect ocular health and esthetics. Awareness of these risks is crucial for both patients and practitioners. Methods: A comprehensive literature review was conducted, focusing on studies discussing complications related to ocular and periocular tattooing. Relevant studies were identified through the MEDLINE, PubMed, and Ovid databases. The reviewed papers were evaluated based on study design, including blinding, sample size, control use, randomization, and objective endpoints, and classified according to the Oxford Center for Evidence-Based Medicine evidence hierarchy. Results: The review identified a wide range of complications, including immediate issues like bleeding, infections (conjunctivitis, endophthalmitis), and allergic reactions. Delayed reactions included granuloma formation, often requiring further treatment. The most serious risk identified was potential visual impairment due to improper technique or ink placement. Conclusions: With the growing trend in ocular and periocular tattooing, there is an urgent need for increased awareness of associated risks. It is crucial to ensure that only qualified professionals perform these procedures, emphasizing the importance of understanding ocular anatomy. Developing strict regulatory guidelines and prioritizing research on the long-term effects of these tattoos are essential for patient safety. A collaborative approach among healthcare providers, regulatory bodies, and educational institutions is needed to mitigate risks and promote best practices in cosmetic tattooing. Full article
(This article belongs to the Special Issue Eye Diseases: Diagnosis and Management—2nd Edition)
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16 pages, 241 KiB  
Review
Ocular Complication in Facial Aesthetic Laser and Light Treatments: A Comprehensive Review
by Kar Wai Alvin Lee, Lisa Kwin Wah Chan, Angela Wai Kay Lee, Cheuk Hung Lee, Jovian Wan and Kyu-Ho Yi
Diagnostics 2024, 14(18), 2006; https://doi.org/10.3390/diagnostics14182006 - 10 Sep 2024
Viewed by 583
Abstract
Background: The increasing popularity of laser- and light-based esthetic treatments for facial rejuvenation has raised concerns regarding ocular safety. Although these procedures are generally considered safe and effective, there is a growing body of evidence highlighting the potential for ocular complications. This review [...] Read more.
Background: The increasing popularity of laser- and light-based esthetic treatments for facial rejuvenation has raised concerns regarding ocular safety. Although these procedures are generally considered safe and effective, there is a growing body of evidence highlighting the potential for ocular complications. This review aims to systematically analyze the types and mechanisms of ocular injuries associated with such treatments, as well as to evaluate preventive measures and management strategies. Methods: A comprehensive literature search was conducted using databases including MEDLINE, PubMed and Ovid for relevant studies published on clinical trials, diagnosis and treatment. Some papers were further reviewed using a double-blinding approach, varying sample sizes, control usage, randomization usage and objective endpoint measurements. All studies were classified according to the Oxford Centre for evidence-based medicine evidence hierarchy. Result: Our review identified several types of ocular complications associated with facial laser or light treatments, including but not limited to conjunctival burns, corneal damage, retinal phototoxicity, and transient vision disturbances. The incidence of these complications varies significantly depending on the type of laser or light source employed, treatment parameters, and the anatomical proximity of the eyes to the treatment area. Factors such as inadequate protective measures, patient movement during the procedure, and the operator’s experience were found to contribute to the risk of ocular injury. Strategies such as the use of appropriate eye protection, careful patient positioning, and thorough pre-treatment assessments were highlighted as essential preventive measures. Conclusion: Ocular complications, though rare, represent a significant risk in facial esthetic laser and light treatments. This review underscores the importance of awareness among practitioners regarding the potential ocular hazards and the implementation of robust safety protocols. Future research is needed to establish standardized guidelines to minimize risks and enhance patient safety in esthetic dermatological practices. Continued education and improved protective strategies will be essential in safeguarding ocular health as the field of esthetic treatments continues to evolve. This comprehensive review serves as an essential resource for practitioners, informing them of ocular risks, management options, and the need for vigilance to mitigate complications in clinical practice. Full article
(This article belongs to the Special Issue Eye Diseases: Diagnosis and Management—2nd Edition)
33 pages, 3780 KiB  
Review
Diagnostic Techniques to Increase the Safety of Phakic Intraocular Lenses
by Tadas Naujokaitis, Gerd U. Auffarth, Grzegorz Łabuz, Lucy Joanne Kessler and Ramin Khoramnia
Diagnostics 2023, 13(15), 2503; https://doi.org/10.3390/diagnostics13152503 - 27 Jul 2023
Cited by 3 | Viewed by 1897
Abstract
Preoperative and postoperative diagnostics play an important role in ensuring the safety of patients with phakic intraocular lenses (pIOLs). The risk of endothelial cell loss can be addressed by regularly measuring the endothelial cell density using specular microscopy and considering the endothelial cell [...] Read more.
Preoperative and postoperative diagnostics play an important role in ensuring the safety of patients with phakic intraocular lenses (pIOLs). The risk of endothelial cell loss can be addressed by regularly measuring the endothelial cell density using specular microscopy and considering the endothelial cell loss rate and the endothelial reserve in accordance with the patient’s age when deciding whether to explant a pIOL. The anterior chamber morphometrics, including the anterior chamber depth and the distance between the pIOL and the endothelium, measured using Scheimpflug tomography and anterior segment optical coherence tomography (AS-OCT), can help to assess the risk of the endothelial cell loss. In patients undergoing posterior chamber pIOL implantation, accurate prediction of the vault and its postoperative measurements using AS-OCT or Scheimpflug tomography are important when assessing the risk of anterior subcapsular cataract and secondary glaucoma. Novel approaches based on ultrasound biomicroscopy and AS-OCT have been proposed to increase the vault prediction accuracy and to identify eyes in which prediction errors are more likely. Careful patient selection and regular postoperative follow-up visits can reduce the complication risk and enable early intervention if a complication occurs. Full article
(This article belongs to the Special Issue Eye Diseases: Diagnosis and Management—2nd Edition)
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7 pages, 1122 KiB  
Case Report
A Case of Refractory Vernal Keratoconjunctivitis Showing Improvement after the Administration of Upadacitinib for the Treatment of Atopic Dermatitis
by Yoshihito Mima, Eri Tsutsumi, Tsutomu Ohtsuka, Ippei Ebato, Yukihiro Nakata, Taro Kubota and Yuta Norimatsu
Diagnostics 2024, 14(12), 1272; https://doi.org/10.3390/diagnostics14121272 - 17 Jun 2024
Viewed by 1162
Abstract
Vernal keratoconjunctivitis is a persistent allergic ocular disease predominantly mediated by the T-helper 2 lymphocyte-associated immune response. The standard therapeutic approaches for vernal keratoconjunctivitis include topical corticosteroids and immunosuppressive eye drops. However, managing vernal keratoconjunctivitis with only topical treatments becomes challenging during seasonally [...] Read more.
Vernal keratoconjunctivitis is a persistent allergic ocular disease predominantly mediated by the T-helper 2 lymphocyte-associated immune response. The standard therapeutic approaches for vernal keratoconjunctivitis include topical corticosteroids and immunosuppressive eye drops. However, managing vernal keratoconjunctivitis with only topical treatments becomes challenging during seasonally exacerbated periods. Systemic treatments such as oral corticosteroids or cyclosporine may be alternative options. Recently, dupilumab’s efficacy in refractory vernal keratoconjunctivitis treatment has been documented. Here, we report a case of refractory vernal keratoconjunctivitis coexisting with atopic dermatitis that rapidly improved after upadacitinib administration. An 18-year-old Japanese woman presented with atopic dermatitis, vernal keratoconjunctivitis, and hay fever. In winter, the patient experienced widespread erythema and escalated itching, leading to significant discomfort and insomnia. Owing to the difficulty in maintaining her current regimen, upadacitinib (15 mg), a Janus kinase inhibitor was initiated. After upadacitinib administration, the treatment-resistant vernal keratoconjunctivitis and erythema improved. Upadacitinib is beneficial in severe cases of atopic dermatitis. Consequently, in our case, upadacitinib may offer therapeutic benefits for refractory vernal conjunctivitis by improving the T-helper 1/2 type immune response, autoimmunity, and oxidative stress. To our knowledge, this is the first report suggesting the potential utility of upadacitinib in managing severe vernal conjunctivitis. Full article
(This article belongs to the Special Issue Eye Diseases: Diagnosis and Management—2nd Edition)
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9 pages, 1649 KiB  
Brief Report
Three-Year Follow-Up Detecting Choroidal Neovascularization with Swept Source Optical Coherence Tomography Angiography (SS-OCTA) after Successful Half-Fluence Photodynamic Therapy for Chronic Central Serous Chorioretinopathy
by Olivia Esteban-Floría, Guillermo Pérez-Rivasés, Ana Honrubia-Grijalbo, Isabel Bartolomé-Sesé, María Dolores Díaz-Barreda, Ana Boned-Murillo, Pablo Cisneros-Arias, Javier Mateo-Gabás and Francisco-Javier Ascaso-Puyelo
Diagnostics 2023, 13(17), 2792; https://doi.org/10.3390/diagnostics13172792 - 29 Aug 2023
Viewed by 1312
Abstract
Purpose: To assess the clinical course, structural changes, and choroidal neovascularization detection by SS-OCTA in long-standing and resolved patients with chronic central serous chorioretinopathy (cCSC) after successful half-fluence photodynamic therapy (hf-PDT) treatment. Methods: Twenty-four eyes presenting with cCSC were examined with SS-OCTA [...] Read more.
Purpose: To assess the clinical course, structural changes, and choroidal neovascularization detection by SS-OCTA in long-standing and resolved patients with chronic central serous chorioretinopathy (cCSC) after successful half-fluence photodynamic therapy (hf-PDT) treatment. Methods: Twenty-four eyes presenting with cCSC were examined with SS-OCTA and were classified as choroidal neovascular (CNV) or non-choroidal neovascular (non-CNV) cCSC depending on the vascular pattern detected by SS-OCTA after one, two, and three years after hf-PDT. Two groups were compared based on the following clinical findings: demographic characteristics, time of clinical signs, best corrected visual acuity (BCVA), central retinal thickness (CRT), central choroidal thickness (CFT), subretinal fluid (SRF), flat, irregular pigment epithelial detachment (FIPED), and features of fluorescein angiography (FA) and vascular pattern by SS-OCTA. Results: All patients showed resolved cCSC during follow-up after hf-PDT. A total of 5 of 24 (20.8%) eyes showed a neovascular pattern by SS-OCTA. No differences between BCVA, CRT, SRF, FIPED, or FA features were found between both groups (p > 0.05). However, CFT and older age were associated with a neovascular pattern by SS-OCTA (p < 0.05) in follow-up. No signs of neovascular activity were detected by SS-OCT during follow-up in CNV cCSC patients, and no antiVEGF treatment was required for three-year follow-ups. Conclusions: Despite patients with cCSC showing a favorable clinical response after hf-PDT, lower foveal thickness and older age were associated with CNV patterns by SS-OCTA during follow-up. Full article
(This article belongs to the Special Issue Eye Diseases: Diagnosis and Management—2nd Edition)
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15 pages, 3395 KiB  
Systematic Review
Tear Cytokine Levels in Sicca Syndrome-Related Dry Eye: A Meta-Analysis
by Suad Aljohani and Ahoud Jazzar
Diagnostics 2023, 13(13), 2184; https://doi.org/10.3390/diagnostics13132184 - 27 Jun 2023
Cited by 4 | Viewed by 1491
Abstract
Sjogren’s syndrome (SS) is an autoimmune disease that affects exocrine glands, mainly salivary and lacrimal glands. Several studies have investigated cytokine profiles in tears in order to understand the pathogenesis of SS and find additional diagnostic markers. This systematic review and meta-analysis aimed [...] Read more.
Sjogren’s syndrome (SS) is an autoimmune disease that affects exocrine glands, mainly salivary and lacrimal glands. Several studies have investigated cytokine profiles in tears in order to understand the pathogenesis of SS and find additional diagnostic markers. This systematic review and meta-analysis aimed to analyze cytokines in tears of SS patients. A systematic literature search of the Cochrane, Medline via PubMed, Scopus, and Web of Science databases was conducted using key terms related to “Sjögren’s syndrome” and “tears” combined with “biomarker”, “cytokines”, “interleukin”, and “chemokines”, following PRISMA guidelines. Article selection was subjected to certain eligibility criteria. A total of 17 articles (from 1998 and 2022) were selected for the quantitative and qualitative analysis. When compared to controls, concentrations of IFN-γ, TNF-α, IL-1α, IL-1 Ra, IL-4, IL-6, IL-8, IL-10, IL-17, IL-21 and IL-22 were consistently higher; however, IL-23 was significantly lower in patients with SS compared to the controls. Tear levels of some cytokines were significantly elevated among SS groups compared to control groups. Therefore, these cytokines could be potential biomarkers of SS. However, standardization of sample collection and analytical methods is necessary in order to translate these findings into clinical practice. Full article
(This article belongs to the Special Issue Eye Diseases: Diagnosis and Management—2nd Edition)
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