Retinitis pigmentosa is an inherited disease, in which mutations in different types of genes lead to the death of photoreceptors and the loss of visual function. Although retinitis pigmentosa is the most common type of inherited retinal dystrophy, a clear line of therapy has not yet been defined. In this review, we will focus on the therapeutic aspect and attempt to define the advantages and disadvantages of the protocols of different therapies. The role of some therapies, such as antioxidant agents or gene therapy, has been established for years now. Many clinical trials on different genes and mutations causing RP have been conducted, and the approval of voretigene nepavorec by the FDA has been an important step forward. Nonetheless, even if gene therapy is the most promising type of treatment for these patients, other innovative strategies, such as stem cell transplantation or hyperbaric oxygen therapy, have been shown to be safe and improve visual quality during clinical trials. The treatment of this disease remains a challenge, to which we hope to find a solution as soon as possible.

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.

Objectives: To evaluate the effects of orally administered combination of Bromelain 250 mg from Ananas comosus (L.) Merr. Jambs and 250 mg Diosmin mcgSMIN Plus on visual acuity and central macular thickness (CMT) in patients treated for cystoid center-involving diabetic macular edema (DME) with anti-VEGF intravitreal maintenance therapy (IVT). Methods: Forty patients with type 2 diabetes and center-involving DME, treated with a maintenance protocol based on anti-VEGF, were enrolled in this prospective case-control study. Group A (20 eyes) received one pill containing bromelain (250 mg) and diosmin mcgSMIN Plus (250 mg) twice a day for 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, the control group consisted of data from patients who were only observed during anti-VEGF therapy. Best-corrected visual acuity (BCVA) and central macular thickness (CMT) measurements were assessed at baseline, after two months, and after four months. Results: A statistically significant improvement in CMT 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. Conclusion: Orally administered combination of Bromelain 250 mg and 250 mg Diosmin mcgSMIN Plus has positive impact on central macular thickness in patients treated for cystoid center-involving diabetic macular edema (DME) with anti-VEGF intravitreal maintenance therapy.

Objectives: to evaluate the efficacy of 0.7 mg dexamethasone intravitreal implant in the treatment of patients with diabetic macular edema through mean retinal sensitivity (MRS), best corrected visual acuity (BCVA), central retinal thickness (CRT) and fixation stability. Methods: patients (n = 50) with DME, best corrected visual acuity (BCVA) of 0.1 logMAR, and central retinal thickness (CRT) of ≥300 μm determined by optical coherence tomography were treated with 0.7 mg slow-release dexamethasone, and endpoints were evaluated one and three months after the injection. Results: The best corrected visual acuity, BCVA, whose mean values at baseline were 0.42 logMAR, improved significantly post dexamethasone injection, with mean values of 0.20 logMAR at one month and 0.24 logMAR at three months. The mean central retinal thickness, CRT, was 463 µm at baseline increasing to 297 µm at one month, and 315 µm at three months. Mean retinal sensitivity (MRS) was 12.31 dB at baseline. In line with other parameters, MRS also showed significant improvement at one month after slow-release dexamethasone treatment, with a mean value of 15.35 Db and the improvement was sustained at three months after injection, with a mean value of 14.71 dB. Fixation stability was assessed using the area of the third BCEA ellipse. At baseline, patients had an ellipse area of 53.68 degrees. At one month after injection, patients showed an improvement, with a mean ellipse area of 5.23 degrees, which was maintained at three months, with a mean ellipse area of 4.13 degrees. Conclusions: The dexamethasone implant of 0.7 mg met the efficacy endpoint for improvement in MRS, BCVA, CRT and fixation stability.

Optogenetics is a field that emerged with the goal of studying the physiology of nerve cells by selectively expressing opsins—channel proteins that can be activated by light exposure. Once the methodology was established, several research groups sought to express these proteins in damaged nerve tissue to restore proper signal transmission. Over the years, numerous efforts have been made to restore vision in patients with chronic degenerative diseases, particularly retinitis pigmentosa, with clinical trials yielding encouraging results. However, significant challenges remain, such as the difficulty of delivering the signal to specific retinal cells and the complexity of replicating the physiological activation of the target cells. As research continues, optogenetics remains a promising yet evolving field. This review aims to highlight the therapeutic advantages of optogenetics over currently available strategies and to promote further scientific exploration of this emerging discipline.