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Rationale Granulomatosis with polyangiitis (GPA) is a rare systemic autoimmune disease of unknown etiology. GPA affects multiple ocular tissues, most commonly the orbit, conjunctiva, cornea, and sclera. Retinal and choroidal manifestations are rare in GPA, but they often include choroidal neovascularization (CNV). Patient concerns A 36-year-old man was diagnosed with GPA. He had been taking oral steroid treatment for 8 years. He experienced disease recurrence and the dose of oral prednisolone was increased after steroid pulse therapy. Fundus examination showed small retinal pigment epithelial detachment and serous retinal detachment (SRD). Optical coherence tomography (OCT) revealed a protruded lesion inside the SRD. Fluorescein angiography (FA) showed a small, dot-shaped fluorescein leakage in the SRD, and indocyanine green fluorescein fundus angiography showed choroidal vascular hyperpermeability that was consistent with the hyperfluorescence seen with FA. We had to determine whether the protruded lesion inside the SRD was CNV secondary to the inflammation due to GPA or whether it was central serous chorioretinopathy (CSC)-like condition caused by high-dose steroid treatment. Diagnoses We confirmed that the SRD was due to CSC but not CNV because the protruded lesion examined by B-scan OCT angiography (OCTA) showed no blood flow. Interventions We decided to reduce the dose of steroid. Outcomes Since the reduction of steroids, no sign of worsening in the protruded lesions with SRD has been observed. Lessons We therefore propose the effectiveness of this advanced function of OCTA for the examination of blood flow signal images to detect CNV.

To evaluate, using pupillography, the difference between eyes affected by age-related macular degeneration and their contralateral normal eyes with regard to the mean relative afferent pupillary defect (RAPD) score. Also, to ascertain any correlations between this difference in RAPD score and differences in visual acuity or age-related macular degeneration (AMD) dimensions. Measurements were made using the RAPDx pupillographer (Konan Medical, Nishinomiya, Japan), which analyzes pupil response to light stimulation. Both best corrected visual acuity (converted to logMAR) and greatest linear dimension (GLD; calculated on the basis of fluorescence angiography images) were measured. The correlations between RAPD difference and logMAR difference, and GLD difference were then analyzed. The study included 32 patients (18 men, 14 women; mean age = 74.8 ± 9.7 years) who had AMD in 1 eye and a normal fundus in the contralateral eye. Mean resting pupil diameter, mean latency onset of constriction, mean velocity of constriction, and recovery were not significantly different in AMD eyes compared with normal eyes. The mean amplitude of constriction was smaller (P = 0.028), and the mean latency of maximum constriction was shorter (P = 0.0013) in AMD eyes than in normal eyes. Regarding RAPD scores, there was a significant correlation between visual acuity difference and RAPD score differences of both amplitude (P

To characterize the total retinal blood flow determined by laser speckle flowgraphy (LSFG) of healthy subjects. This prospective cross-sectional study was conducted at the Nagoya University Hospital. One hundred fifteen right eyes of 115 healthy subjects (mean age: 39.4 ± 16.1 years) were studied. The total blood flow in the retinal arteries and veins around the optic nerve head was measured separately using the total retinal flow index (TRFI), which represents blood flow volume. The lumen diameters of the retinal vessels determined by LSFG and by adaptive optics (AO) camera were compared. The images obtained by LSFG and AO camera were merged, and the distribution of the mean blur rates (MBRs), which represent the velocities of the erythrocytes, was evaluated on the images. The mean TRFI in veins (1812 ± 445, arbitral units) was significantly higher than that in arteries (1455 ± 348, arbitral units; P