Major ocular cancers are currently amenable to conservative treatment. The main limitations of conservative treatment lie in the inability to limit the onset of metastatic disease or to avoid irreversible loss of visual function due to poor knowledge of the side effects of the therapy itself. It is also essential to be able to have surveys that can also diagnose and functionally monitor the characteristics of each process that leads to the loss of visual function. At the same time, it appears essential to identify those at risk for metastatic disease within the treated population by evaluating factors intrinsic to the neoplasm and systemic. Only in this way will it be possible to proceed with the selection of subjects to be sent to adjuvant therapy or to undergo targeted follow-up. The use of local and systemic drugs can lead to ocular changes, hitherto little known. The development of new non-invasive diagnostic techniques could help in the early diagnosis of these alterations, and the restoration of normal ocular structure and function.

Toxicology

The development of new diagnostic techniques in ophthalmology has made it possible to study the different ocular pathologies in a more in-depth and less invasive way, bringing to light new knowledge on the etiology and the correlation between morphological and functional damage of the eye. In recent years, non-invasive ocular diagnostics, applied to both the posterior and anterior segment of the eye, has led to a finer, more precise and earlier diagnosis of pathology, consequently allowing earlier intervention with better results. In addition, the visual system, and the eye in particular, is an ideal model for the study of toxic effects, as a consequence of diseases of other organs or systems or of different therapeutic interventions. At the ocular level, the microcirculation (the retinal one is similar to the cerebral one) and the different components of the nervous system (both central - the ganglion fibers of the retina - and peripheral - the corneal innervation) can be studied non-invasively and in vivo. From these premises derive the first applications of in vivo ocular toxicology aimed at the study of both systemic diseases and modern therapeutic approaches.

Objectives

The objectives of the line can be summarised in the ongoing research and in the new research lines planned with:

1) Increased overall survival, reduced visual impairment and improved quality of life in patients with intraocular and systemic neoplastic and degenerative diseases, identification of innovative and targeted diagnostic and prognostic techniques.

2) Analysis of the biochemical composition of intraocular fluids in intraocular neoplastic and degenerative diseases.

3) Identification of new imaging techniques and clinical biomarkers for a more targeted approach to oncological and degenerative eye diseases, also through screening programmes and the use of artificial intelligence systems.

4) Correlation of morphological parameters with the different neuroinflammatory profiles and pathology- or patient-specific glial activity identified through the qualitative and quantitative study of the expression of specific protein and biochemical factors present in the aqueous humor of subjects suffering from intraocular or systemic neoplastic/degenerative diseases compared with healthy controls.

5) Understanding of the pathophysiological mechanisms of these pathologies in order to identify effective therapeutic approaches with limited side effects.

6) Identification of biomarkers of disease in genetic neurodegenerative diseases (e.g. neurofibromatosis, von Hippel Lindau) and in neoplastic diseases related to them (e.g. Optic Nerve Glioma, haemangioblastoma) to integrate the current diagnostic approach to these diseases to achieve earlier patient management.

7) Study of ocular surface modifications in patients suffering not only from neoplastic and degenerative diseases of the anterior but also posterior segment and from toxicity secondary to oncological treatment or in systemic diseases with predominantly neurological involvement such as amyloidosis.