Age-Related Macular or Retinal Degeneration?

PARP inhibition preserves cone photoreceptors in rd2 retina

The rd2 mouse model, characterized by a mutation in the Prph2 gene, exhibits abnormal development of photoreceptor outer segments, resulting in progressive retinal degeneration. While the correlation between poly-ADP-ribose polymerase (PARP) activity and the degeneration of rod photoreceptors is established in the rd2 model, the specific mechanism driving cone degeneration in this model remains unclear. Furthermore, it is yet to be determined whether inhibiting PARP activity can effectively impede the degeneration of cone photoreceptors in this context. We demonstrated that PARP inhibitors Olaparib, BMN-673, and 3-aminobenzamide (3AB), effectively reduced photoreceptor cell loss in the rd2 retina. Notably, rd2 retinas exhibited decreased cone density, but treatment with PARP inhibitors significantly protected cone photoreceptors. The PARP inhibitors, particularly BMN-673, demonstrated a significant protective effect as evidenced by increased rhodopsin expression within the outer segment and a concurrent decrease in Müller cell activity indicated by GFAP expression. The treatment also resulted in significant changes for markers of oxidative stress, such as glutathione (GSH), and oxidized glutathione (GSSG). Notably, the administration of PARP inhibitors also reduced CD9 expression (extracellular vesicle marker), which were significantly increased within the outer nuclear layer (ONL) in the rd2 retinas. Among PARP inhibitors, BMN-673 demonstrated the highest efficacy in preserving photoreceptors, particularly benefiting cone cells.

The Impact of Social Support on Postoperative Recovery in Retinal Detachment Surgery

Background and Objectives: Retinal detachment is a severe ophthalmological condition requiring urgent surgical intervention and comprehensive postoperative management. This study aimed to evaluate the impact of perceived social support (PSS) on postoperative adherence, pain management, and reintervention rates in patients undergoing retinal detachment surgery. It was hypothesized that higher levels of PSS would be associated with better postoperative outcomes, particularly in adherence and anxiety management. Materials and Methods: A prospective observational study was conducted with 166 patients at a tertiary hospital between 2022 and 2024. Sociodemographic and clinical data were collected, and PSS was assessed using the Medical Outcomes Study (MOS) questionnaire (Cronbach's alpha = 0.96). The primary outcomes included adherence to postoperative recommendations, reintervention rates, additional analgesic use, and local complications. Given the non-normal distribution of key variables, non-parametric statistical analyses were performed, with significance set at p < 0.05. Results: PSS scores were consistently high (median: 5; IQR: 4.7-5.0). Adherence rates were excellent (100% at 7 and 15 days; 99.04% at 30 days). Reintervention rates remained low (0.5%, 1.0%, and 1.5% at 7, 15, and 30 days, respectively). The need for additional analgesia decreased significantly over time (46.43% at 7 days vs. 13.33% at 30 days; p = 0.041). Preoperative anxiety was significantly associated with higher postoperative analgesic consumption (median STAI score: 38 [IQR: 34-42], p = 0.041). A significant relationship was found between higher preoperative anxiety levels and greater postoperative analgesic use (p = 0.041). However, no significant associations were found between PSS and major clinical outcomes such as reintervention or complications. Conclusions: These findings suggest that PSS may influence adherence to postoperative recommendations, although its direct impact on clinical outcomes remains uncertain. The significant association between higher preoperative anxiety and increased postoperative analgesic consumption highlights the need for psychosocial and educational interventions in RD surgical care. These results support a multidisciplinary approach incorporating psychosocial support alongside surgical treatment to optimize patient outcomes.

[Multifocal electroretinography in the diagnosis and monitoring of early and intermediate stages of age-related macular degeneration]

Multifocal electroretinography is a valuable diagnostic method for the objective localization and quantitative assessment of functional disorders of the central retina in age-related macular degeneration. It is used to detect early changes, monitor the course of the disease and treatment outcomes. In many cases, multifocal electroretinography is a more sensitive method for detecting functional disorders at the early/intermediate stage of age-related macular degeneration compared to morphological (optical coherence tomography) and subjective (visual acuity, perimetry) testing methods.

Sialic Acid Mimetic Microglial Sialic Acid-Binding Immunoglobulin-like Lectin Agonism: Potential to Restore Retinal Homeostasis and Regain Visual Function in Age-Related Macular Degeneration

Age-related macular degeneration (AMD), a leading cause of visual loss and dysfunction worldwide, is a disease initiated by genetic polymorphisms that impair the negative regulation of complement. Proteomic investigation points to altered glycosylation and loss of Siglec-mediated glyco-immune checkpoint parainflammatory and inflammatory homeostasis as the main determinant for the vision impairing complications of macular degeneration. The effect of altered glycosylation on microglial maintained retinal para-inflammatory homeostasis and eventual recruitment and polarization of peripheral blood monocyte-derived macrophages (PBMDMs) into the retina can explain the phenotypic variability seen in this clinically heterogenous disease. Restoring glyco-immune checkpoint control with a sialic acid mimetic agonist targeting microglial/macrophage Siglecs to regain retinal para-inflammatory and inflammatory homeostasis is a promising therapeutic that could halt the progression of and improve visual function in all stages of macular degeneration.

Advancements in the treatment of geographic atrophy: focus on pegcetacoplan in age-related macular degeneration

Geographic atrophy (GA) is a progressive form of age-related macular degeneration characterized by the degeneration of retinal pigment epithelial cells and photoreceptor death. The dysregulation of the complement cascade has been implicated in GA progression. This review provides a comprehensive overview of the pathophysiology of age-related macular degeneration and GA, discusses current therapeutic options, and focuses on the recent breakthrough drug, pegcetacoplan (SYFOVRE). Pegcetacoplan is a complement inhibitor that selectively targets the C3 complement protein, effectively modulating complement activation. Clinical trials, including the OAKS and DERBY studies, have demonstrated the efficacy of SYFOVRE in reducing the growth of GA lesions compared to placebo. The FDA approval of SYFOVRE as the first and only definitive therapy for GA marks a significant milestone in the management of this debilitating condition. The review also explores potential future treatment strategies, including immune-modulating agents and ocular gene therapy. While SYFOVRE offers new hope for GA patients, further research is needed to evaluate its long-term benefits, safety profile, and optimal treatment regimens.