Progress in Retinal and Eye Research最新文献

{"title":"Optical coherence tomography in the management of diabetic macular oedema","authors":"Simon KH. Szeto ,&nbsp;Timothy YY. Lai ,&nbsp;Stela Vujosevic ,&nbsp;Jennifer K. Sun ,&nbsp;SriniVas R. Sadda ,&nbsp;Gavin Tan ,&nbsp;Sobha Sivaprasad ,&nbsp;Tien Y. Wong ,&nbsp;Carol Y. Cheung","doi":"10.1016/j.preteyeres.2023.101220","DOIUrl":"10.1016/j.preteyeres.2023.101220","url":null,"abstract":"<div><p><span>Diabetic macular oedema<span> (DMO) is the major cause of visual impairment<span> in people with diabetes. Optical coherence tomography (OCT) is now the most widely used modality to assess presence and severity of DMO. DMO is currently broadly classified based on the involvement to the central 1 mm of the macula into non-centre or centre involved DMO (CI-DMO) and DMO can occur with or without </span></span></span>visual acuity<span> (VA) loss. This classification forms the basis of management strategies of DMO. Despite years of research on quantitative and qualitative DMO related features assessed by OCT, these do not fully inform physicians of the prognosis and severity of DMO relative to visual function. Having said that, recent research on novel OCT biomarkers development and re-defined classification of DMO show better correlation with visual function and treatment response.</span></p><p>This review summarises the current evidence of the association of OCT biomarkers in DMO management and its potential clinical importance in predicting VA and anatomical treatment response. The review also discusses some future directions in this field, such as the use of artificial intelligence to quantify and monitor OCT biomarkers and retinal fluid and identify phenotypes of DMO, and the need for standardisation and classification of OCT biomarkers to use in future clinical trials and clinical practice settings as prognostic markers and secondary treatment outcome measures in the management of DMO.</p></div>","PeriodicalId":21159,"journal":{"name":"Progress in Retinal and Eye Research","volume":"98 ","pages":"Article 101220"},"PeriodicalIF":17.8,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71511957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of angle closure disease in the age of artificial intelligence: A review","authors":"Zhi Da Soh ,&nbsp;Mingrui Tan ,&nbsp;Monisha Esther Nongpiur ,&nbsp;Benjamin Yixing Xu ,&nbsp;David Friedman ,&nbsp;Xiulan Zhang ,&nbsp;Christopher Leung ,&nbsp;Yong Liu ,&nbsp;Victor Koh ,&nbsp;Tin Aung ,&nbsp;Ching-Yu Cheng","doi":"10.1016/j.preteyeres.2023.101227","DOIUrl":"10.1016/j.preteyeres.2023.101227","url":null,"abstract":"<div><p><span>Primary angle closure glaucoma is a visually debilitating disease that is under-detected worldwide. Many of the challenges in managing primary angle closure disease (PACD) are related to the lack of convenient and precise tools for clinic-based disease assessment and monitoring. Artificial intelligence (AI)- assisted tools to detect and assess PACD have proliferated in recent years with encouraging results. Machine learning (ML) algorithms that utilize clinical data have been developed to categorize angle </span>closure eyes by disease mechanism. Other ML algorithms that utilize image data have demonstrated good performance in detecting angle closure. Nonetheless, deep learning (DL) algorithms trained directly on image data generally outperformed traditional ML algorithms in detecting PACD, were able to accurately differentiate between angle status (open, narrow, closed), and automated the measurement of quantitative parameters. However, more work is required to expand the capabilities of these AI algorithms and for deployment into real-world practice settings. This includes the need for real-world evaluation, establishing the use case for different algorithms, and evaluating the feasibility of deployment while considering other clinical, economic, social, and policy-related factors.</p></div>","PeriodicalId":21159,"journal":{"name":"Progress in Retinal and Eye Research","volume":"98 ","pages":"Article 101227"},"PeriodicalIF":17.8,"publicationDate":"2023-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71485529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endpoints for clinical trials in ophthalmology","authors":"Leopold Schmetterer ,&nbsp;Hendrik Scholl ,&nbsp;Gerhard Garhöfer ,&nbsp;Lucas Janeschitz-Kriegl ,&nbsp;Federico Corvi ,&nbsp;SriniVas R. Sadda ,&nbsp;Felipe A. Medeiros","doi":"10.1016/j.preteyeres.2022.101160","DOIUrl":"10.1016/j.preteyeres.2022.101160","url":null,"abstract":"<div><p>With the identification of novel targets, the number of interventional clinical trials in ophthalmology has increased. Visual acuity has for a long time been considered the gold standard endpoint for clinical trials, but in the recent years it became evident that other endpoints are required for many indications including geographic atrophy and inherited retinal disease. In glaucoma the currently available drugs were approved based on their IOP lowering capacity. Some recent findings do, however, indicate that at the same level of IOP reduction, not all drugs have the same effect on visual field progression. For neuroprotection trials in glaucoma, novel surrogate endpoints are required, which may either include functional or structural parameters or a combination of both. A number of potential surrogate endpoints for ophthalmology clinical trials have been identified, but their validation is complicated and requires solid scientific evidence. In this article we summarize candidates for clinical endpoints in ophthalmology with a focus on retinal disease and glaucoma. Functional and structural biomarkers, as well as quality of life measures are discussed, and their potential to serve as endpoints in pivotal trials is critically evaluated.</p></div>","PeriodicalId":21159,"journal":{"name":"Progress in Retinal and Eye Research","volume":"97 ","pages":"Article 101160"},"PeriodicalIF":17.8,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1350946222001203/pdfft?md5=8e7f3f55817357e608bc5c11daea7ccc&pid=1-s2.0-S1350946222001203-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10472562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From randomised controlled trials to real-world data: Clinical evidence to guide management of diabetic macular oedema","authors":"Pierre-Henry Gabrielle ,&nbsp;Hemal Mehta ,&nbsp;Daniel Barthelmes ,&nbsp;Vincent Daien ,&nbsp;Vuong Nguyen ,&nbsp;Mark C. Gillies ,&nbsp;Catherine P. Creuzot-Garcher","doi":"10.1016/j.preteyeres.2023.101219","DOIUrl":"10.1016/j.preteyeres.2023.101219","url":null,"abstract":"<div><p>Randomised clinical trials (RCTs) are generally considered the gold-standard for providing scientific evidence for treatments' effectiveness and safety but their findings may not always be generalisable to the broader population treated in routine clinical practice. RCTs include highly selected patient populations that fit specific inclusion and exclusion criteria. Although they may have a lower level of certainty than RCTs on the evidence hierarchy, real-world data (RWD), such as observational studies, registries and databases, provide real-world evidence (RWE) that can complement RCTs. For example, RWE may help satisfy requirements for a new indication of an already approved drug and help us better understand long-term treatment effectiveness, safety and patterns of use in clinical practice. Many countries have set up registries, observational studies and databases containing information on patients with retinal diseases, such as diabetic macular oedema (DMO). These DMO RWD have produced significant clinical evidence in the past decade that has changed the management of DMO. RWD and medico-administrative databases are a useful resource to identify low frequency safety signals. They often have long-term follow-up with a large number of patients and minimal exclusion criteria. We will discuss improvements in healthcare information exchange technologies, such as blockchain technology and FHIR (Fast Healthcare Interoperability Resources), which will connect and extend databases already available. These registries can be linked with existing or emerging retinal imaging modalities using artificial intelligence to aid diagnosis, treatment decisions and provide prognostic information. The results of RCTs and RWE are combined to provide evidence-based guidelines.</p></div>","PeriodicalId":21159,"journal":{"name":"Progress in Retinal and Eye Research","volume":"97 ","pages":"Article 101219"},"PeriodicalIF":17.8,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1350946223000587/pdfft?md5=917c14928a76d6684eaa6820451c6d59&pid=1-s2.0-S1350946223000587-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66784259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The pre-Descemet's layer (Dua's layer, also known as the Dua-Fine layer and the pre-posterior limiting lamina layer): Discovery, characterisation, clinical and surgical applications, and the controversy","authors":"Harminder S. Dua ,&nbsp;Rui Freitas ,&nbsp;Imran Mohammed ,&nbsp;Darren S.J. Ting ,&nbsp;Dalia G. Said","doi":"10.1016/j.preteyeres.2022.101161","DOIUrl":"10.1016/j.preteyeres.2022.101161","url":null,"abstract":"<div><p>The pre-Descemet's layer/Dua's layer, also termed the Dua-Fine layer and the pre-posterior limiting lamina layer, lies anterior to the Descemet's membrane in the cornea, is 10 μm (range 6–16) thick, made predominantly of type I and some type VI collagen with abundant elastin, more than any other layer of the cornea. It has high tensile strength (bursting pressure up to 700 mm of Hg), is impervious to air and almost acellular. At the periphery it demonstrates fenestrations and ramifies to become the core of the trabecular meshwork, with implications for intraocular pressure and glaucoma. It has been demonstrated in some species of animals.</p><p>The layer has assumed considerable importance in anterior and posterior lamellar corneal transplant surgery by improving our understanding of the behaviour of corneal tissue during these procedures, improved techniques and made the surgery safer with better outcomes. It has led to the innovation of new surgical procedures namely, pre-Descemet's endothelial keratoplasty, suture management of acute hydrops, DALK-triple and Fogla's mini DALK.</p><p>The discovery and knowledge of the layer has introduced paradigm shifts in our age old concepts of Descemet's membrane detachment, acute corneal hydrops in keratoconus and Descemetoceles, with impact on management approaches. It has been shown to contribute to the pathology and clinical signs observed in corneal infections and some corneal dystrophies. Early evidence suggests that it may have a role in the pathogenesis of keratoconus in relation to its elastin content. Its contribution to corneal biomechanics and glaucoma are subjects of current investigations.</p></div>","PeriodicalId":21159,"journal":{"name":"Progress in Retinal and Eye Research","volume":"97 ","pages":"Article 101161"},"PeriodicalIF":17.8,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1350946222001215/pdfft?md5=a70dbcd5811aec9179e2fef22e02ebb3&pid=1-s2.0-S1350946222001215-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9080188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The genetics and disease mechanisms of rhegmatogenous retinal detachment","authors":"Birgit M. Govers ,&nbsp;Ramon A.C. van Huet ,&nbsp;Susanne Roosing ,&nbsp;Sander Keijser ,&nbsp;Leonoor I. Los ,&nbsp;Anneke I. den Hollander ,&nbsp;B. Jeroen Klevering","doi":"10.1016/j.preteyeres.2022.101158","DOIUrl":"10.1016/j.preteyeres.2022.101158","url":null,"abstract":"<div><p>Rhegmatogenous retinal detachment (RRD) is a sight threatening condition that warrants immediate surgical intervention. To date, 29 genes have been associated with monogenic disorders involving RRD. In addition, RRD can occur as a multifactorial disease through a combined effect of multiple genetic variants and non-genetic risk factors. In this review, we provide a comprehensive overview of the spectrum of hereditary disorders involving RRD. We discuss genotype-phenotype correlations of these monogenic disorders, and describe genetic variants associated with RRD through multifactorial inheritance. Furthermore, we evaluate our current understanding of the molecular disease mechanisms of RRD-associated genetic variants on collagen proteins, proteoglycan versican, and the TGF-β pathway. Finally, we review the role of genetics in patient management and prevention of RRD. We provide recommendations for genetic testing and prophylaxis of at-risk patients, and hypothesize on novel therapeutic approaches beyond surgical intervention.</p></div>","PeriodicalId":21159,"journal":{"name":"Progress in Retinal and Eye Research","volume":"97 ","pages":"Article 101158"},"PeriodicalIF":17.8,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1350946222001185/pdfft?md5=3c19118a48af3c4fda7c893f2d972f86&pid=1-s2.0-S1350946222001185-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10847257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the contribution of ARMS2 and HTRA1 genetic risk factors in age-related macular degeneration","authors":"Yang Pan ,&nbsp;Yingbin Fu ,&nbsp;Paul N. Baird ,&nbsp;Robyn H. Guymer ,&nbsp;Taraprasad Das ,&nbsp;Takeshi Iwata","doi":"10.1016/j.preteyeres.2022.101159","DOIUrl":"10.1016/j.preteyeres.2022.101159","url":null,"abstract":"<div><p><span><span>Age-related macular degeneration (AMD) is the leading cause of severe irreversible central vision loss in individuals over 65 years old. Genome-wide association studies (GWASs) have shown that the region at chromosome 10q26, where the age-related </span>maculopathy susceptibility (</span><em>ARMS2/LOC387715</em><span>) and HtrA serine peptidase 1 (</span><em>HTRA1</em>) genes are located, represents one of the strongest associated loci for AMD. However, the underlying biological mechanism of this genetic association has remained elusive. In this article, we extensively review the literature by us and others regarding the <em>ARMS2/HTRA1</em><span><span><span> risk alleles and their functional significance. We also review the literature regarding the presumed function of the ARMS2 protein and the molecular processes<span> of the HTRA1 protein in AMD pathogenesis in vitro and in vivo, including those of transgenic mice overexpressing HtrA1/HTRA1 which developed </span></span>Bruch's membrane (BM) damage, </span>choroidal neovascularization<span> (CNV), and polypoidal choroidal vasculopathy (PCV), similar to human AMD patients. The elucidation of the molecular mechanisms of the </span></span><em>ARMS2</em> and <em>HTRA1</em><span><span> susceptibility loci has begun to untangle the complex biological pathways underlying AMD pathophysiology, pointing to new testable paradigms for </span>treatment.</span></p></div>","PeriodicalId":21159,"journal":{"name":"Progress in Retinal and Eye Research","volume":"97 ","pages":"Article 101159"},"PeriodicalIF":17.8,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10454125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consensus and controversies in the science of endophthalmitis management: Basic research and clinical perspectives","authors":"Taraprasad Das ,&nbsp;Joveeta Joseph ,&nbsp;Matthew P. Simunovic ,&nbsp;Andrzej Grzybowski ,&nbsp;Kuan-Jen Chen ,&nbsp;Vivek Pravin Dave ,&nbsp;Savitri Sharma ,&nbsp;Patrick Staropoli ,&nbsp;Harry Flynn Jr.","doi":"10.1016/j.preteyeres.2023.101218","DOIUrl":"10.1016/j.preteyeres.2023.101218","url":null,"abstract":"<div><p>Infectious endophthalmitis<span><span> is a severe intraocular infection caused by bacteria, or less commonly by fungi. It can occur after penetrating eye procedures, trauma, or the spread of infection from contiguous structures or via emboli from distant organs. Because of the time-critical nature of the treatment, </span>endophthalmitis<span> is treated with the clinical diagnosis and modified by the microbiological report of the intraocular contents. The current strategy for managing endophthalmitis relies on pre-clinical literature, case series, and one large multi-center randomized clinical trial on post-cataract surgery endophthalmitis. Culture-susceptibility of the microorganisms from undiluted vitreous guides the definitive treatment in non-responsive cases. Strategies to reduce the incidence of endophthalmitis after penetrating eye procedures have been developed concurrently with refined means of treatment.</span></span></p><p>Despite these advances, outcomes remain poor for many patients. Although consensus articles have been published on managing endophthalmitis, treatment patterns vary, and controversies remain. These include (1) the use of newer methods for early and precise microbiological diagnosis; (2) the choice of intravitreal antibiotics; (3) the need for systemic therapy; (4) early and complete vitrectomy. Here, we review the current consensus and address controversies in diagnosing and managing endophthalmitis. This review is intended to familiarize physicians and ophthalmologists with different aspects of endophthalmitis management to make informed decisions.</p></div>","PeriodicalId":21159,"journal":{"name":"Progress in Retinal and Eye Research","volume":"97 ","pages":"Article 101218"},"PeriodicalIF":17.8,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41211034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurovascular dysfunction in glaucoma","authors":"Luis Alarcon-Martinez ,&nbsp;Yukihiro Shiga ,&nbsp;Deborah Villafranca-Baughman ,&nbsp;Jorge L. Cueva Vargas ,&nbsp;Isaac A. Vidal Paredes ,&nbsp;Heberto Quintero ,&nbsp;Brad Fortune ,&nbsp;Helen Danesh-Meyer ,&nbsp;Adriana Di Polo","doi":"10.1016/j.preteyeres.2023.101217","DOIUrl":"10.1016/j.preteyeres.2023.101217","url":null,"abstract":"<div><p>Retinal ganglion cells, the neurons that die in glaucoma, are endowed with a high metabolism requiring optimal provision of oxygen and nutrients to sustain their activity. The timely regulation of blood flow is, therefore, essential to supply firing neurons in active areas with the oxygen and glucose they need for energy. Many glaucoma patients suffer from vascular deficits including reduced blood flow, impaired autoregulation, neurovascular coupling dysfunction, and blood-retina/brain-barrier breakdown. These processes are tightly regulated by a community of cells known as the neurovascular unit comprising neurons, endothelial cells, pericytes, Müller cells, astrocytes, and microglia. In this review, the neurovascular unit takes center stage as we examine the ability of its members to regulate neurovascular interactions and how their function might be altered during glaucomatous stress. Pericytes receive special attention based on recent data demonstrating their key role in the regulation of neurovascular coupling in physiological and pathological conditions. Of particular interest is the discovery and characterization of tunneling nanotubes, thin actin-based conduits that connect distal pericytes, which play essential roles in the complex spatial and temporal distribution of blood within the retinal capillary network. We discuss cellular and molecular mechanisms of neurovascular interactions and their pathophysiological implications, while highlighting opportunities to develop strategies for vascular protection and regeneration to improve functional outcomes in glaucoma.</p></div>","PeriodicalId":21159,"journal":{"name":"Progress in Retinal and Eye Research","volume":"97 ","pages":"Article 101217"},"PeriodicalIF":17.8,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41146037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors, clinical features and treatment of Behçet's disease uveitis","authors":"Zhenyu Zhong,&nbsp;Guannan Su,&nbsp;Peizeng Yang","doi":"10.1016/j.preteyeres.2023.101216","DOIUrl":"10.1016/j.preteyeres.2023.101216","url":null,"abstract":"<div><p><span><span><span>Behçet's disease is a </span>systemic vasculitis<span><span><span> frequently associated with intraocular inflammation. Recent findings identified independent clinical clusters in Behçet's disease, each involving distinct combinations of affected organs. Ocular Behçet's disease, mainly manifested as uveitis, is characterized as an independent cluster with a low likelihood of association with other system involvements, such as intestinal, cardiovascular, or </span>central nervous system. A prevailing theory suggests that the pathogenesis of the disease is multifactorial, where a variety of genetic and infectious agents may interact with each other to cause the disease. Among sporadic cases, the </span>human leukocyte antigen (HLA) genes, including HLA-B51, HLA-A26, HLA-B15, and HLA-B5701, have been found to be a key component conferring </span></span>genetic susceptibility<span>. Outside the HLA region, a set of susceptibility variants are identified, closely related to interleukin (IL)-23/IL-17 pathway, tumor necrosis factor<span> (TNF) signaling, and pattern recognition receptor systems. Microbial infections, such as </span></span></span><span><em>Streptococcus sanguinis</em></span>, <span><em>Mycobacterium tuberculosis</em></span><span><span><span><span>, and Herpes simplex virus (HSV), are linked to play the triggering of disease in immunogenetically predisposed individuals. Clinically, due to the notable relapsing-remitting course of ocular Behçet's disease, the prevention of recurrent attack would be the primary </span>treatment goal. Combination of corticosteroids and </span>immunomodulatory drugs, such as anti-TNF agents, </span>interferon<span><span>, and conventional immunosuppressants (e.g. </span>cyclosporine<span>, azathioprine), have been the mainstream regimen for the disease. Future research may focus on comparing the effectiveness of immunomodulatory drugs and identifying the most suitable subgroups for a specific drug on the basis of the knowledge of the molecular heterogeneity of the disease.</span></span></span></p></div>","PeriodicalId":21159,"journal":{"name":"Progress in Retinal and Eye Research","volume":"97 ","pages":"Article 101216"},"PeriodicalIF":17.8,"publicationDate":"2023-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41169708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}