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Purpose To retrospectively evaluate the short-term efficacy of omidenepag isopropyl (EYBELIS 0.002%) by assessing its intraocular pressure (IOP)-lowering capability and safety in patients with normal-tension glaucoma (NTG). Patients and Methods Fifty-four NTG patients (54 eyes) who were newly administrated with omidenepag isopropyl were enrolled in the study. The subjects comprised 22 men and 32 women, and the mean age of the subjects was 55.0 ± 14.1 years. The mean deviation value using the Humphrey visual field test program (30-2 SITA Standard) was -5.03 ± 3.38 dB. The following data were retrieved from the medical records and used for retrospective analyses: IOP at baseline 1-2 months and 3-4 months after administration. The frequency of non-responder patients who had less than 10% IOP reduction was evaluated. Patients were observed for adverse reactions and dropouts at each time point. Results IOP at baseline, after 1-2 months and after 3-4 months was 15.7 ± 2.6 mmHg, 13.5 ± 2.3 mmHg, and 13.6 ± 2.4 mmHg, respectively. There was a significant decrease in IOP after administration (p

Purpose To investigate the short-term intraocular pressure-lowering efficacy and safety of switching from a fixed combination of latanoprost/timolol to a fixed combination of latanoprost/carteolol. Patients and Methods The subjects were 30 eyes of 30 adult patients with primary open-angle glaucoma, normal-tension glaucoma, or ocular hypertension who were using a latanoprost-/timolol-fixed combination with insufficient intraocular pressure-lowering efficacy or adverse reactions. The subjects were switched from once-daily latanoprost/timolol to once-daily latanoprost/carteolol with no washout interval. Intraocular pressure, tear film break-up time, corneal epithelial defects, conjunctival hyperemia, blood pressure, and pulse rate were measured and compared before and 1 and 3 months after switching. Patients were monitored for adverse reactions at each visit, and dropouts were recorded. Results The mean intraocular pressure at 1 month (15.9±3.1 mmHg) and 3 months (16.3±3.8 mmHg) was not significantly different from that at baseline (16.1±3.1 mmHg). The tear film break-up time and corneal epithelial defects were significantly improved after switching (p

Purpose: To evaluate the relationship between the macular vessel density and photopic negative response (PhNR) amplitude of focal electroretinograms (ERGs) in patients with early-stage normal tension glaucoma (NTG). Materials and Methods: This prospective cross-sectional study included a total of 42 subjects with early-stage NTG. Optical coherence tomography angiography was used to measure macular vessel density, and focal ERGs were elicited by a white light stimulus (30 cd/m2) with background light (1.5 cd/m2). The amplitude of the PhNR was measured from the peak of the b-wave to the PhNR trough. Mean visual field sensitivity was measured by the Humphrey Field Analyzer (HFA) program central 10-2. Spearman's coefficients were used to evaluate the correlation between the macular vessel density, PhNR amplitude, mean deviation (MD) of the HFA 10-2, retinal nerve fiber layer (RNFL) thickness, and ganglion cell complex (GCC) thickness measured by spectral domain-optical coherence tomography. Results: The mean MD of the HFA 10-2 was -2.0 ± 3.2 dB. The PhNR amplitude significantly correlated with the macular vessel density (r = 0.420, P = 0.006), but not with the MD, GCC thickness, or RNFL thickness. The macular vessel density significantly correlated with the MD (r = 0.364, P = 0.018) and RNFL thickness (r = 0.369, P = 0.016), but not with GCC thickness (r = 0.266, P = 0.089). Conclusions: Macular vessel density significantly correlated with PhNR amplitude in patients with early-stage NTG, suggesting that microvascular alterations are associated with functional changes recorded by focal ERG in very early-stage glaucoma.

Seiji Takagi,1–3 Michiko Mandai,1,4 Noriko Miyamoto,1,2 Akihiro Nishida,1,2 Yasuhiko Hirami,1,2 Hirofumi Uyama,1,2 Midori Yamamoto,1,2 Masayo Takahashi,1,2,4 Goji Tomita,3 Yasuo Kurimoto1,2 1Department of Ophthalmology, Kobe City Medical Center General Hospital, 2Department of Translational Research, Division of Ophthalmology, Institute of Biomedical Research and Innovation, Kobe, Hyogo, 3Department of Ophthalmology, Toho University Ohashi Medical Center, Meguro-ku, Tokyo, 4RIKEN Center for Developmental Biology, Kobe, Hyogo, Japan Purpose: The purpose of this study was to investigate the occurrence of outer retinal tubulation (ORT) among patients with different types of choroidal neovascularization (CNV) over time. Materials and methods: In this retrospective chart review, disease type was classified as typical age-related macular degeneration (t-AMD), polypoidal choroidal vasculopathy (PCV), retinal angiomatous proliferation (RAP), or myopic CNV (mCNV). Spectral domain-optical coherence tomography (SD-OCT) images were evaluated for the appearance of ORT and subretinal fibrosis and fluid. Furthermore, the association of the presence of ORT with clinical data and OCT findings was investigated. Results: Among the 136 eyes studied, the overall rates of occurrence of ORT were 7.8%, 18.8%, and 31.6% after 12, 24, and 36months from baseline, respectively. Among patients with t-AMD, RAP, and mCNV, the occurrence of ORT increased soon after the initial visit. Incontrast, among patients with PCV, the occurrence of ORT increased slowly over time. Patients with and without ORT – ORT(+) and ORT(-) groups, respectively – differed significantly in terms of sex ratio and presence of intraretinal fluid at the initial visit and presence of subretinal fibrosis at 3years from baseline. The ORT(+) group exhibited lower visual acuity (VA; 0.67±0.43) than that of the ORT(-) group (0.41±0.36; P

Background: To evaluate the incidence and cause of iatrogenic retinal breaks (RBs) and postoperative retinal detachment (RD) in cases of idiopathic macular hole (MH) and epiretinal membrane (ERM). Methods: We analyzed 79 eyes with MH and 41 eyes with ERM, the relationship between the incidence of RBs and RD, and the frequency of posterior vitreous detachment (PVD) and lattice degeneration (LD). Results: The incidence of RBs related to the operation was significantly higher in eyes with MH. The frequency of PVD was significantly higher in eyes with ERM. The frequency of LD did not differ between groups. In the MH group, the incidence of RBs related to the operation was high in eyes without PVD, but with LD. We observed four cases of RD in the MH group. Conclusion: The MH group had higher incidence of RBs related to the operation, especially in eyes without PVD or with LD.

Purpose. To evaluate the effects of topically administered iganidipine hydrochloride, a novel water-soluble Ca2+-channel blocker, on optic nerve head (ONH) circulation in Dutch rabbits and cynomolgus monkeys. Methods. ONH tissue blood velocity (NBONH) was determined using the laser speckle method. In rabbits, NBONH was measured for 90 minutes before and after a single igani-dipine administration, or before and after twice-daily administrations for 21 days (0.03%). In monkeys, NBONH was measured before and after twice-daily administrations of iganidipine for 7 days (0.03 or 0.1%). Results. Iganidipine (0.03% solution) significantly increased NBONH by 8 to 10% in treated eyes after a single administration (p < 0.05) or by 18 to 35% after 7-, 14-, or 21-day twice-daily administration in rabbits (p < 0.05). In monkeys, 0.03% and 0.1% iganidipine significantly increased NBONH in treated eyes by 20 and 41% after 7-day (p < 0.05) twice-daily administration, respectively. Conclusion. Topical iganidipine significa...

Background Latanoprost 0.005% + timolol maleate 0.5% combined eyedrops were recently made available in Japan. We prospectively investigated the intraocular pressure (IOP)-lowering effect, visual preservation effect, and adverse reactions of a one-year administration of this fixed combination. Methods The subjects included 162 eyes from 162 patients diagnosed with either primary open-angle glaucoma or ocular hypertension and using an unfixed combination of latanoprost 0.005% and timolol maleate 0.5%. The unfixed combination was discontinued and replaced with the latanoprost 0.005% + timolol maleate 0.5% fixed combination with no washout period. IOP was measured before (baseline) and 3, 6, 9, and 12 months after the change. The mean deviation value of Humphrey field analysis was compared. Adverse reactions were examined at every follow-up. Results No significant differences were found between mean IOP values obtained at baseline (mean ± standard deviation, 15.2 ± 3.3 mmHg) 3 months (15.1 ± 3.2 mmHg), 6 months (15.3 ± 3.1 mmHg), 9 months (15.3 ± 3.1 mmHg), and 12 months (15.1 ± 3.2 mmHg) after the change from the unfixed to the fixed combination of eyedrops (P = 0.212). In addition, no significant differences were observed between mean deviation values obtained at baseline (−9.11 ± 6.94 dB) and 12 months (−10.08 ± 7.24 dB) after the change (P = 0.114). Thirty-one patients discontinued the fixed combination within 12 months of replacement, due to an insufficient IOP decrease (20 patients, 12.3%) and adverse reactions (11 patients, 6.8%). Conclusion Following replacement of two eyedrop medications (latanoprost 0.005% and timolol maleate 0.5%) by one fixed combination (latanoprost 0.005% + timolol maleate 0.5%), IOP and visual field were preserved. However, 20% of the patients discontinued the new treatment because of an insufficient IOP decrease and complaints of adverse reactions.

Kenji Inoue1, Kei Noguchi1, Masato Wakakura1, Goji Tomita21Inouye Eye Hospital, 2Second Department of Ophthalmology, Toho University School of Medicine, Tokyo, JapanBackground: The purpose of this study was to evaluate the effects of topical nipradilol monotherapy for 5 years on intraocular pressure, visual field performance, and optic disk topography.Methods: Thirty patients with normal tension glaucoma were monitored for intraocular pressure every 1–3 months. A Humphrey visual field test and measurement of optic disk configuration using the Heidelberg retina tomograph II was done after every year of treatment and the results compared with those before treatment. Visual field performance was also evaluated by trend and event analysis.Results: The mean intraocular pressure ± standard deviation after 3 years of nipradilol treatment (14.1 ± 2.0 mmHg) and after 5 years of nipradilol treatment (13.7 ± 2.1 mmHg) was significantly lower than that before treatment (17.0 ± 1.8 mmHg, P< 0.0001). Heidelberg retina tomograph II parameters, such as mean cup depth and height variation contour after treatment, were significantly increased compared with those before treatment. Visual field performance worsened in eight eyes by trend analysis and eight eyes by event analysis.Conclusion: Nipradilol monotherapy was effective in reducing intraocular pressure over at least 5 years without worsening of optic disk topography. Furthermore, mean cup depth and height variation contour were also significantly improved. However, visual field performance worsened in 16.0% of patients with normal tension glaucoma.Keywords: nipradilol, intraocular pressure, Heidelberg retina tomograph II, trend analysis, event analysis