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To determine the relationship between the center of the foveal avascular zone (FAZ) and the center of the foveal photoreceptors in eyes with a history of retinopathy of prematurity (ROP). To accomplish this, we reviewed the medical records of patients with ROP who were examined at the ROP Clinic of the Tokyo Women's Medical University Hospital. We studied 43 eyes of 23 children with ROP and 67 eyes of 36 control children without any fundus abnormalities. The optical coherence tomography angiographic (OCTA) en face images were used to measure the size and location of the foveal avascular zone (FAZ), and cross-sectional OCT images to measure the central retinal thickness (CRT). Our results showed that the size of the FAZ was significantly smaller in the ROP group (0.200 ± 0.142 mm2) than in the control group (0.319 ± 0.085 mm2; P < 0.01). The CRT was significantly thicker in the ROP group (228 ± 30 µm) than in the control group (189 ± 13 µm; P < 0.01). The mean length of the foveal bulge was not significantly different between the two groups. The actual distance of the misalignment between the center of the FAZ and the center of the photoreceptors was significantly greater in the ROP group (50.4 ± 29.5 µm) than in the control group (39.6 ± 21.9 µm; P = 0.001). The correlations between the actual distance of misalignment and the size of the FAZ, CRT, and length of the foveal bulge in both groups were not significant. Despite the significant misalignment in eyes with a history of ROP, the center of the foveal photoreceptors was consistently located within the narrow FAZ which indicates that the development of the FAZ and photoreceptor formation are interrelated. [ABSTRACT FROM AUTHOR]

Purpose: To assess 6-month outcomes of switching from aflibercept to faricimab in eyes with refractory neovascular age-related macular degeneration (nAMD) previously requiring monthly injections. Methods: This multicenter retrospective study examined nAMD eyes receiving monthly aflibercept injections switched to faricimab administered monthly up to 4 injections followed by injections at a minimum of 2-month intervals as per drug labeling. Data regarding age, sex, number of previous injections, treatment intervals, and best-corrected visual acuity (BCVA) were collected. Central retinal thickness (CRT), subfoveal choroidal thickness (SFCT), and maximal pigment epithelial detachment (PED) height were measured by optical coherence tomography. Results: The study included 130 eyes of 124 patients. At 6 months, 53 eyes (40.8%) continued on faricimab treatment (Group 1), while 77 eyes (59.2%) discontinued faricimab for various reasons (Group 2) the most common being worse exudation. There were no significant differences between the two groups at baseline. In Group 1, CRT and SFCT significantly decreased at 1 month (P = 0.013 and 0.008), although statistical significance was lost at 6 months (P = 0.689 and 0.052). BCVA and maximal PED height showed no significant changes; however, mean treatment intervals were extended from 4.4 ± 0.5 weeks at baseline to 8.7 ± 1.7 weeks at 6 months (P < 0.001) in Group 1. No clear predictors of response were identified. Conclusion: Switching from aflibercept to faricimab allowed for extension of treatment intervals from monthly to bimonthly in roughly 40% of eyes, suggesting that faricimab may be considered in refractory nAMD cases. [ABSTRACT FROM AUTHOR]

Retinal Müller glia have a capacity to regenerate neurons in lower vertebrates like zebrafish, but such ability is extremely limited in mammals. In zebrafish, Müller glia proliferate after injury, which promotes their neurogenic reprogramming while inhibiting reactive gliosis. In mammals, however, how the cell cycle affects the fate of Müller glia after injury remains unclear. Here, we focused on the expression of proneural transcription factors, Ngn2 and Ascl1, and a gliosis marker glial fibrillary acidic protein (GFAP) in rat Müller glia after N-methyl-N-nitrosourea (MNU)-induced photoreceptor injury and analyzed the role of Müller glia proliferation in the regulation of their expression using retinal explant cultures. Thymidine-induced G1/S arrest of Müller glia proliferation significantly hampered the expression of Ascl1, Ngn2, and GFAP, and release from the arrest induced their upregulation. The migration of Müller glia nuclei into the outer nuclear layer was also shown to be cell cycle-dependent. These data suggest that, unlike the situation in zebrafish, cell cycle progression of Müller glia in mammals promotes both neurogenic reprogramming and reactive gliosis, which may be one of the mechanisms underlying the limited regenerative capacity of the mammalian retina. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate 1-year efficacy, durability, and safety of faricimab among patients from Asian countries in the TENAYA/LUCERNE trials of neovascular age-related macular degeneration (nAMD). Methods: Treatment-naïve patients with nAMD were randomly assigned (1:1) to faricimab 6.0 mg up to every 16 weeks (Q16W), based on disease activity at weeks 20 and 24, or aflibercept 2.0 mg Q8W. The primary endpoint was change in best-corrected visual acuity (BCVA) from baseline averaged over weeks 40, 44, and 48. Results: In the pooled TENAYA/LUCERNE trials, there were 120 (9.0%) and 1209 (91.0%) patients in the Asian (faricimab n = 61; aflibercept n = 59) and non-Asian country (faricimab n = 604; aflibercept n = 605) subgroups, respectively. In the Asian country subgroup, mean BCVA change from baseline at the primary endpoint visits was 7.1 (95% CI, 4.3–9.8) letters with faricimab and 7.2 (4.4–10.0) letters with aflibercept. In non-Asian country patients, mean vision gains were 6.1 (5.2–7.1) and 5.7 (4.8–6.7) letters with faricimab and aflibercept, respectively. At week 48, 59.6% of Asian country patients in the faricimab group achieved Q16W dosing (vs. 43.9% non-Asian) and 91.2% achieved ≥ Q12W dosing (vs. 77.5% non-Asian). Central subfield thickness reductions were similar between the subgroups, with meaningful and similar reductions from baseline observed at the primary endpoint visits and over time. Faricimab was well tolerated in both subgroups, with an acceptable safety profile. Conclusion: Consistent with the global TENAYA/LUCERNE findings, faricimab up to Q16W showed sustained visual and anatomical benefits in patients with nAMD from Asian and non-Asian countries. Trial registration: ClinicalTrials.gov identifier: NCT03823287 (TENAYA); NCT03823300 (LUCERNE). Date of registration: January 30, 2019. [ABSTRACT FROM AUTHOR]

To determine the clinical properties of pachychoroid neovasculopathy (PNV) that differ from conventional neovascular age-related macular degeneration (nAMD) and suggest that they are different clinical entities. To accomplish this, we reviewed the medical records of 100 consecutive patients diagnosed with nAMD. All of the patients were Japanese, and their mean age was 75.5 years. There were 72 men and 28 women. For the bilateral cases, only the right eye was analyzed. An eye was diagnosed with PNV when a macular neovascularization (MNV) was detected just above the dilated choroidal vessels. The Indocyanine green angiographic (ICGA) and en face optical coherence tomographic (OCT) images were used to assess the vertical symmetry of the medium and large choroidal vessels. The subfoveal choroidal thickness (SCT) was also measured manually in the OCT images. After reclassification, there were 29 (29%) patients with typical nAMD (25 with type 1 MNV, 4 with type 2 MNV), 43 (43%) with PNV, 21 (21%) with polypoidal choroidal vasculopathy, and 7 (7%) with retinal angiomatous proliferation. Of the 43 PNV, 17 (39.5%) had polypoidal lesions and 26 (60.5%) had no polypoidal lesions. The percentage of eyes with vertical asymmetry of the medium and large choroidal vessels was significantly greater in the 35 PNV (81.4%) than in the 16 non-PNV (28.1%; P < 0.01) cases. The mean SCT was significantly thicker in the PNV eyes than in the non-PNV eyes (298 ± 96 μm vs. 228 ± 82 μm; P < 0.01). The response of PNV to anti-vascular endothelial growth factor treatments was better than that of non-PNV eyes [higher dry macula rate after the loading period (90.9% vs. 59.1%), fewer total number of injections (11.0 ± 2.9 vs. 13.4 ± 3.2), and longer treatment intervals for the anti-VEGF therapy (8.4 ± 3.1 vs. 13.4 ± 3.2 weeks) at 2 years (all P < 0.01)]. These differences in the morphology and response to anti-VEGF treatments suggest that PNV is a separate clinical entity to conventional nAMD. [ABSTRACT FROM AUTHOR]

Mammalian Müller glia express transcription factors and cell cycle regulators essential for the function of retinal progenitors, indicating the latent neurogenic capacity; however, the role of these regulators remains unclear. To gain insights into the role of these regulators in Müller glia, we analyzed expression of transcription factors (Pax6, Vsx2 and Nfia) and cell cycle regulators (cyclin D1 and D3) in rodent Müller glia, focusing on their age- and cell cycle-related expression patterns. Expression of Pax6, Vsx2, Nfia and cyclin D3, but not cyclin D1, increased in Müller glia during development. Photoreceptor injury induced cell cycle-associated increase of Vsx2 and cyclin D1, but not Pax6, Nfia, and cyclin D3. In dissociated cultures, cell cycle-associated increase of Pax6 and Vsx2 was observed in Müller glia from P10 mice but not from P21 mice. Nfia levels were highly correlated with EdU incorporation suggesting their activation during S phase progression. Cyclin D1 and D3 were transiently upregulated in G1 phase but downregulated after S phase entry. Our findings revealed previously unknown links between cell cycle progression and regulator protein expression, which likely affect the cell fate decision of proliferating Müller glia. [ABSTRACT FROM AUTHOR]

Background/purpose: Observation of choroidal thickness after anti-vascular endothelial growth factor (VEGF) therapy may be important for the ideal management of neovascular age-related macular degeneration (AMD). This study investigated changes in subfoveal choroidal thickness (SCT) during loading doses of intravitreal injections of brolucizumab in eyes with neovascular AMD. Methods: This study included 73 eyes of 72 patients with neovascular AMD at five university hospitals in Japan. All 73 eyes underwent three monthly 6.0 mg intravitreal injections of brolucizumab at baseline, 1 month, and 2 months. The SCT at 3 months was evaluated using optical coherence tomography. Results: The 73 eyes were classified into the treatment-naïve group (43 eyes) and the switched group (30 eyes) that were switched from other anti-VEGF treatments. After three intravitreal injections of brolucizumab, SCT significantly decreased from 236.5 ± 98.8 µm at baseline to 200.4 ± 98.3 µm at 3 months (percent of baseline 84.7%, P < 0.001) in the treatment-naïve group. In the switched group, SCT also significantly decreased from 229.0 ± 113.2 μm at baseline to 216.9 ± 110.2 μm at 3 months (percent of baseline 94.7%, P = 0.039), although the decrease was not as marked compared to that of the treatment-naïve group. Conclusion: Intravitreal injections of brolucizumab for neovascular AMD significantly reduced the SCT in both the treatment-naïve and switched groups. Brolucizumab may cause significant anatomic changes in the choroid, particularly in treatment-naïve AMD eyes, possibly more than that previously reported for other anti-VEGF agents. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to compare the morphology of the central and peripheral choroid of eyes with central serous chorioretinopathy (CSC) to that of normal eyes using ultra-widefield optical coherence tomography (UWF-OCT). Methods: We reviewed the medical records of 29 eyes of 25 patients (23 men, 2 women; average age 44.4 years) with CSC and 34 eyes of 22 healthy subjects (19 men, 3 women; average age, 49.5 years) with normal eyes. The images obtained by a prototype swept source UWF-OCT (Topcon, Tokyo, Japan) of about 31.5-mm wide and a depth of 10.9 mm were analyzed. The choroidal thickness was measured for each sector of the eye using the conventional automated layer analysis method. The local morphological differences were quantified by the maximum steepness (µm/deg) which was obtained by differentiating the changes in the choroidal thickness from the periphery to the fovea. Only the vertical scans were evaluated to avoid the influence of the optic disc. Results: The choroid was thicker in the macular area than the peripheral area in both normal and CSC eyes. The choroid at the subfovea was significantly thicker in the CSC eyes than that of the normal eyes (P < 0.0001); however, the difference at the periphery was not significant. The mean of the maximum steepness of the choroidal thickness was 20.8 ± 3.8 µm/deg in the CSC eyes which was significantly steeper than the 16.0 ± 4.6 µm/deg in healthy eyes (P < 0.0001). Conclusion: The choroid in CSC eyes has a steeper slope around the posterior pole. UWF-OCT can be used to evaluate the abnormalities of the choroidal structures from the posterior pole to the periphery in eyes with CSC. [ABSTRACT FROM AUTHOR]

Purpose: To elucidate the clinical characteristics of eyes with dry age-related macular degeneration (AMD) in Japan. Study design: Retrospective. Methods: We performed a nationwide survey of dry AMD. A questionnaire on dry AMD was sent to 3,801 major hospitals and eye clinics nationwide. Whenever both eyes met the diagnostic criteria, only the eye with more advanced geographic atrophy was included. Results: In the current survey, 81 patients (81 eyes) with dry AMD were included. Of the 81 patients, 56 (69.1%) were men, and the mean age of the patients was 76.6 ± 8.4 (range, 54–94) years. Twenty-four patients (29.6%) had a history of smoking. The decimal best corrected-visual acuity (BCVA) was equal to or better than 0.7 in 25 eyes (30.9%), but worse than 0.1 in 17 eyes (21.0%). The mean BCVA was 0.62 ± 0.59 in logarithm of the minimum angle of resolution. Lesion size (the greatest linear dimension of the largest geographic atrophy) was ≥ 2 disc diameter in 33 eyes (40.7%) and < 1 disc diameter in 21 eyes (25.9%). Soft drusen was observed in 27 eyes (33.3%), and reticular pseudodrusen was observed in 31 eyes (38.3%). Of the 81 patients, the other eye was diagnosed as dry AMD in 26 eyes (32.1%), neovascular AMD in 16 eyes (19.8%), and intermediate AMD in 18 eyes (22.2%). Conclusion: Dry AMD in the Japanese population has characteristics of male predominance, older age, high prevalence of reticular pseudodrusen, and high bilaterality. [ABSTRACT FROM AUTHOR]

Purpose: To determine the characteristics of eyes with treatment-naïve quiescent choroidal neovascularization (CNV) detected by optical coherence tomography angiography (OCTA). Methods: Thirty-eight eyes of 37 treatment-naïve consecutive patients (30 men, 7 women, average 69.8 years) were studied. Quiescent CNVs were detected by OCTA (RTVue XR Avanti, Optovue, Fremont, CA) in all eyes. Swept-source OCT (SS-OCT; DRI-OCT, Topcon, Japan) confirmed the absence of exudation. The symptoms, visual acuity, CNV size, and status of the fellow eye were evaluated. Patients were followed longitudinally and the length of follow-up period and development of exudation were recorded for each patient. We also investigated patients' medical records from their referral hospitals in search of prior exudation. Results: All eyes with quiescent CNV were diagnosed at the initial visit with sub-retinal pigment epithelium CNVs, i.e., type 1 CNV, from the OCT and OCTA images. Prior exudation was confirmed in 15 eyes (39.5%) from their medical records of the referral hospitals. Symptoms were present in 18 eyes (47.3%). An exudative CNV was present in 12 of the fellow eyes. Exudation developed in 12 eyes (31.6%) during an average follow-up period of 25.1 months. One-half of the eyes had a prior exudation. The CNV at the baseline in eyes that developed exudation during the follow-up period was larger than eyes without exudation; however, the difference was not significant (0.59±0.47 vs 0.48±0.32 mm2, P = 0.50). Conclusion: Quiescent CNVs will develop exudation in approximately 30% of the eyes during a mean 2-year follow-up period. These findings must be remembered when investigating quiescent CNVs that could not be distinguished from eyes with former active CNV and naturally deactivate CNV. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the efficacy and safety of intravitreal aflibercept (IVT-AFL) versus IVT-AFL plus rescue photodynamic therapy (IVT-AFL + rPDT) in the subgroup of Japanese patients with polypoidal choroidal vasculopathy (PCV) enrolled in the PLANET study. Study design: A 96-week, double-masked, sham-controlled phase-3b/4 randomized clinical trial conducted at multiple centers from May 2014 to August 2016. Patients and methods: Patients with PCV (BCVA 73-24 ETDRS letters [20/40–20/320 Snellen]) received 3 initial monthly doses of IVT-AFL 2 mg. At week 12, the patients were randomly assigned 1:1 to IVT-AFL + sham PDT or IVT-AFL + rPDT. Patients not requiring rescue received IVT-AFL every 8 weeks; those requiring rescue received IVT-AFL monthly plus sham/active PDT. Following week 52, the treatment intervals could be extended > 8 weeks. Results: The baseline demographics for the 159 Japanese patients were balanced. At week 96, the mean BCVA change was + 9.7 (IVT-AFL) versus + 9.5 letters (IVT-AFL + rPDT) (least-squares mean difference of − 0.3; 95% CI, − 3.7 to 3.1); the mean central subfield thickness reduction was − 148.0 µm versus − 145.9 µm. Overall, 17.1% of the patients required rescue PDT. At week 96, 25.0% (IVT-AFL) and 37.9% (IVT-AFL + rPDT) of the patients had complete polyp regression; 84.1% (IVT-AFL) and 88.4% (IVT-AFL + rPDT) of the patients had no evidence of active polyps. The mean number of injections (weeks 52–96) were 4.6 (IVT-AFL) and 4.5 (IVT-AFL + rPDT). Overall, 36.0% (IVT-AFL) and 33.8% (IVT-AFL + rPDT) of the patients experienced ocular treatment-emergent adverse events. Conclusion: IVT-AFL monotherapy was efficacious for the treatment of Japanese patients with PCV, and the addition of rescue PDT did not show additional benefits. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the development and rate of growth in macular atrophy after intravitreal injections of aflibercept (IVAs) for neovascular age-related macular degeneration (AMD) over a 2-year period. Study design: Retrospective, interventional, consecutive case series. Methods: This study included 94 eyes of 92 patients with treatment-naïve AMD involving the foveal center treated with IVAs at 3 university hospitals in Japan. The patients underwent IVAs bimonthly after 3 initial monthly doses in the first year. The protocol was converted to a treat-and-extend regimen in the second year. The incidence and growth rate of macular atrophy were quantified based on hypoautofluorescence detected by fundus autofluorescence images. Additionally, possible background factors related to the development and rate of growth of macular atrophy were investigated. Results: Of 94 eyes, 39 (41.5%) had typical AMD and 55 (58.5%) had polypoidal choroidal vasculopathy. Ten eyes (10.6%) had macular atrophy at the baseline. Of the remaining 84 eyes, 14 (16.7%) had developed new macular atrophy at 2 years, the square root of the growth rate of atrophy was 0.52 mm/year. In multivariate analyses, a poorer best-corrected visual acuity (P = 0.01) and the presence of intraretinal fluid (P = 0.04) at baseline were found to be the independent predictors for the development of macular atrophy. No factors were found that were significantly related to the growth rate of the macular atrophy. Conclusions: Our study determined the incidence and rate of growth of macular atrophy after IVAs for neovascular AMD in clinical settings. Eyes with vision reduction and intraretinal fluid at the baseline develop macular atrophy more frequently after IVAs for neovascular AMD. [ABSTRACT FROM AUTHOR]

Graph Dear Editor, We report short-term data on the development of intraocular inflammation (IOI) after intravitreal brolucizumab injection for exudative age-related macular degeneration (AMD) in Japanese patients in this letter. However, among 101 Japanese patients enrolled in the HAWK study, the rates were 2- to 3-fold higher; IOI in 12.9%, retinal vasculitis in 9.9%, and retinal vascular occlusion in 4.95% [[5]]. Of 127 eyes, 12 (9.4%) developed IOI consisting of anterior chamber cells and/or vitreous cells, with retinal vasculitis documented in 4 eyes (3.1%) and retinal vascular occlusion in 2 eyes (1.6%) (Table 1). [Extracted from the article]

Purpose: To determine the effects of averaging five en face optical coherence tomography angiographic (OCTA) images on the quality of the images in eyes with a choroidal neovascularization (CNV). Methods: Twenty-seven eyes of 25 patients (18 men, 7 women; average age 71.0 years) with a CNV were examined by OCTA (OCT HS-100, Canon. Japan). A 3 × 3-mm image including the CNV was recorded and automatically segmented between the retinal outer layers. Analyses were performed on a single image (S-image) and the average of five single images of the same area (A-images). The region of the CNV was selected by ImageJ, and the peak signal-to-noise ratio (PSNR), the vascular density (VD), fractal dimension (FD), and the noise component using band pass filter (BPF) processing of the S- and A-images of each case were compared. Results: The average PSNR for the A-images was 14.0 which was significantly higher than the 12.2 for the S-images (P < 0.01). However, the average VD was 33.6% for the S-images and 34.8% for the A-images (P > 0.1). The average FD was 1.67 for the S-images and 1.54 for the A-images (P < 0.01). The mean luminance difference obtained by subtracting the luminance of the A-image from the S-image after BPF processing was 10.41 ± 14.66 db which was positive for all eyes. Conclusions: The better quality of the A-images of a CNV and absence of a significant difference in the vascular density indicates that the improvement was due to the removal of the same signal levels of the noise component and blood vessels. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate and compare the intrachoroidal structures of eyes with typical neovascular age-related macular degeneration (AMD) with those of eyes with polypoidal choroidal vasculopathy (PCV).Study design: Retrospective and comparative case series.Methods: Eighty-four treatment-naïve eyes of 84 patients (22 women and 62 men) with typical neovascular AMD or PCV located in the subfoveal region were studied. Cross-sectional images of the retina and choroid were obtained by swept-source optical coherence tomography (SS-OCT). The horizontal SS-OCT images were analyzed by a manual delineation technique and by a binarization method.Results: Thirty-nine eyes with typical neovascular AMD and 45 eyes with PCV were studied. Although the subfoveal choroidal thickness (SCT) did not differ significantly between the 2 subtypes (255.1 ± 86.7 µm in typical neovascular AMD and 289.2 ± 116.5 µm in PCV, P = 0.29), the ratio of the large choroidal vessel layer (LCVL) thickness to the SCT was significantly larger in the eyes with PCV than in the eyes with typical neovascular AMD (0.863 ± 0.084 vs 0.803 ± 0.125, P = 0.023). The binarization method did not find significant differences in the choroidal structure between the 2 subtypes. Multivariate logistic regression analyses found the ratio of the LCVL thickness to the SCT to be the only significantly different factor between typical neovascular AMD and PCV (P = 0.035).Conclusion: The intrachoroidal structures of typical neovascular AMD and PCV eyes differ significantly. In eyes with PCV, there seemed to be a greater dilation of the large choroidal vessels. [ABSTRACT FROM AUTHOR]

Purpose: To determine factors predictive of visual outcomes in eyes treated with intravitreal aflibercept injections (IAIs) for typical neovascular age-related macular degeneration (AMD) or polypoidal choroidal vasculopathy (PCV).Study design: Retrospective, multicenter, institutional, consecutive, interventional case series.Methods: One hundred nine eyes (107 patients) with treatment-naïve neovascular AMD at 3 university hospitals were studied. After a loading phase of 3 monthly 2.0-mg IAIs, injections were administered every 2 months. The baseline clinical characteristics were investigated in relation to the 12-month visual outcomes. Changes in the mean best-corrected visual acuity (BCVA) were measured at 12 months after initiation of aflibercept therapy.Results: Forty-five eyes (41.3%) had typical neovascular AMD, and 64 eyes (58.7%) had PCV. The changes in the mean BCVA at 12 months compared with baseline did not differ significantly (P =.737) between the 2 groups. Stepwise analysis showed that larger gains in the BCVA at 12 months were associated with poor BCVA (P <.001), no pigment epithelial detachment (P =.004), and subretinal fluid (P =.039) at baseline in eyes with typical neovascular AMD; larger gains in the BCVA were associated with poorer BCVA (P <.001), presence of choroidal vascular hyperpermeability (CVH) (P =.013), and subretinal fluid (P =.044) at baseline in eyes with PCV.Conclusions: Although poorer BCVA and the presence of subretinal fluid predicted larger gains in BCVA in both subtypes treated with aflibercept, eyes with typical neovascular AMD had greater improvement if no pigment epithelial detachment was present, while eyes with PCV had greater improvement if CVH was present. [ABSTRACT FROM AUTHOR]

Purpose: To assess the usefulness of spectral domain optical coherence tomography (SD-OCT) and fundus autofluorescence (FAF) findings in cytomegalovirus (CMV) retinitis.Study design: Observational case series.Methods: Thirteen eyes of 11 human immunodeficiency virus (HIV)-positive patients with CMV retinitis underwent full ophthalmologic examinations, SD-OCT, and 4 eyes of 4 patients underwent FAF. FAF images included short-wavelength autofluorescence (SW-AF) and near-infrared autofluorescence (IR-AF). CMV retinitis was classified into proposed categories of acute, subacute, remission, and recurrent; the acute stage was further subdivided into initial, early, and late stages.Results: In the initial stage, vertical structural disruption of all retinal layers was observed by SD-OCT, and FAF showed hyperautofluorescence on SW-AF and hypoautofluorescence on IR-AF. In the early stage, SD-OCT showed significant retinal thickening; cells and debris from the retinal surface to the vitreous; enlarged vessels with/without thickened vessel walls; and highly complicated serous retinal detachment. In the late to subacute stage, features observed included rhegmatogenous retinal detachment with shrinking posterior hyaloid membrane and waving from the ellipsoid zone to the retinal pigment epithelium. In remission, FAF findings were hypoautofluorescence on SW-AF and hyperautofluorescence on IR-AF.Conclusion: Although the number of examined eyes was limited, SD-OCT and FAF provide new information in various stages of CMV retinitis in patients with HIV infection that is not obtainable by conventional examination and which may be of great benefit when screening for the initial stage of CMV retinitis. [ABSTRACT FROM AUTHOR]

Emergence of male dimorphism within a species is the evolutionary process of disruptive selection. In squids, two types of male mating behaviour, known as alternative reproductive tactics (ARTs), are causally associated with adult body size. Males inseminate promiscuously with the same females; large 'consort' males internally, and small 'sneaker' males externally. Previously we found that in Heterololigo bleekeri, sneaker (but not consort) spermatozoa are able to swarm by sensing self-emitted CO. This suggests that a swarming trait might have arisen in sneakers as a 'sperm cooperation' strategy among sibling sperm in order to compete with consort males, or as a consequence of adaptation to external fertilization. To address these possibilities, we examined six species where three patterns of insemination are present, namely, only internal, only external, or both ARTs. In three species that employ both ARTs ( H. bleekeri, Loligo reynaudii and Uroteuthis edulis), sneaker spermatozoa always exhibited self-swarming capacity. In Idiosepius paradoxus and Todarodes pacificus, which use only external insemination, spermatozoa formed a swarm. However, in Euprymna morsei, which use only internal insemination, sperm were unable to swarm. These results suggest that the self-swarming trait is likely to be linked to the mode of insemination rather than the alternative strategy used by sneaker males. Thus we propose a new hypothesis in which cooperative sperm behaviour has evolved not only through kin selection against sperm competition risks, but also through adaptation to the insemination/fertilization environment. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to determine the changes in the luminal and stromal areas of the choroid in eyes with Vogt-Koyanagi-Harada disease by optical coherence tomography (OCT). Methods: A retrospective observational study. Choroidal images were recorded by enhanced depth imaging (EDI-OCT) at the baseline, and at 1 week and 1 month after initiating steroid therapy. The EDI-OCT images were converted to binarized images, and the luminal areas and the stromal areas were measured separately. Results: Thirty-two eyes of 16 patients were enrolled, and 16 eyes of 10 patients had suitable images for the binarization analyses. The ratio of the luminal areas to the choroidal areas was 0.60 ± 0.03 at the baseline, 0.67 ± 0.04 at 1 week, and 0.66 ± 0.04 at 1 month. There was a significant increase from the baseline at 1 week ( P < 0.01) but not from 1 week to 1 month. Although both the stromal and luminal areas were reduced, the percent reduction of the stromal areas (56.5 ± 7.2 %) was significantly greater than that of the luminal areas (42.5 ± 12.6 %) at 1 week ( P < 0.01). Conclusions: A significant decrease of the choroidal area was detected in eyes with Vogt-Koyanagi-Harada disease at 1 week after beginning steroid therapy. The decrease was more evident in the stromal area than in the luminal area. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was clarify the efficacy of combination therapy of intravitreal ranibizumab (IVR) injections and photodynamic therapy (PDT) in patients with symptomatic retinal angiomatous proliferation (RAP) over 24 months. Methods: We retrospectively reviewed 37 naïve eyes of 31 patients treated with three consecutive monthly IVR injections (0.5 mg/0.05 ml) and PDT and followed for at least 24 months. Results: The mean logarithm of the minimum angle of resolution best-corrected visual acuity levels improved significantly ( P < 0.0001) from 0.63 at baseline to 0.39 at 24 months. Geographic atrophy (GA) involving the fovea developed in nine (24 %) eyes, with a significant ( P = 0.036) decrease in VA at 24 months and a high (100 %) prevalence of reticular pseudodrusen (RPD) at baseline. Complete occlusion of the retinal-retinal anastomosis seen in 35 eyes was achieved in 33 eyes at month 24. The central retinal thickness decreased significantly ( P < 0.0001) from 415 to 129 μm at 24 months. The mean number of treatments during 24 months was 2.5 PDT and 5.5 IVR injections. Conclusions: Combination therapy comprising IVR injections and PDT is generally effective in maintaining or improving VA and retinal morphology within 2 years in eyes with RAP, except for eyes with baseline RPD, which are likely to develop GA in the fovea resulting in reduced VA. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to report a case of acute zonal occult outer retinopathy (AZOOR) with spontaneous remission that was followed up using adaptive optics scanning laser ophthalmoscopy (AO-SLO). Methods: The right eye of a 31-year old myopic man diagnosed with AZOOR was followed up. The patient underwent a full ophthalmologic examination, spectral-domain optical coherence tomography (SD-OCT), multifocal electroretinography (mfERG) and imaging with prototype AO-SLO systems (Canon Inc) at the first visit, 1 month after, and 2 months after. Images focused on the photoreceptor layer were recorded in the area, and a montage of AO-SLO images was created. Results: The patient presented with acute onset of a blind spot and photopsia in his right eye. On AO-SLO, focal dark areas could be observed on the right eye but not on the left eye at the first examination (cone density 8,589/mm, mosaic regularity of cone photoreceptors 38.5 %, cone spacing 0.567). The dark areas on AO-SLO corresponded to areas of disrupted inner segments and outer segments (IS/OS) line or ellipsoid of the IS and abnormal area in mfERG. After 1 and 2 months, his symptoms tended to disappear gradually without any treatment. IS/OS line and mfERG could be nearly normalized. Furthermore, normal cone mosaic could be observed in areas where some focal dark spots could be observed at the first examination (cone density 10,112/mm, mosaic regularity of cone photoreceptors 39.9 %, cone spacing 0.606). Conclusion: AO-SLO is a useful tool of diagnosis and follow-up of AZOOR. This study might suggest reversible cone damage could occur in some cases of AZOOR with spontaneous remission. [ABSTRACT FROM AUTHOR]

Background: To clarify the long-term efficacy of photodynamic therapy (PDT) in patients with symptomatic polypoidal choroidal vasculopathy (PCV). Methods: We retrospectively reviewed 60 naive eyes of 59 patients (45 men, 14 women; mean age, 73.8 years) treated with full-fluence PDT (PDT group) and followed for at least 60 months. Retreatment was either antivascular endothelial growth factor (VEGF) therapy or intravitreal triamcinolone acetonide if PDT alone was ineffective (supplemental retreatment group). Results: The mean logarithm of the minimum angle of resolution best-corrected visual acuity (BCVA) levels at baseline and 60 months were 0.66 and 0.71, respectively. The mean change at 60 months was a decrease of 0.50 line. In the PDT group (36 eyes), the mean BCVAs at baseline and month 60 were 0.73 and 0.68, respectively ( p = 0.60). In the supplemental retreatment group (24 eyes), the mean BCVAs at baseline and month 60 were 0.55 and 0.74, respectively ( p = 0.076). The percentage of eyes with decreased BCVA at the time of the additional anti-VEGF treatment was significantly ( p = 0.031) higher than at month 60. The risk factors identified by multiple regression analysis with a significant decrease in BCVA at month 60 were a large greatest linear dimension (GLD), classic choroidal neovascularization at baseline, and a hemorrhage over the arcade vessels after PDT. Conclusions: The efficacy of PDT for PCV depends on the GLD. Twenty-four of the 60 eyes needed additional treatment other than only PDT during 60 months of follow-up. Additional anti-VEGF treatment may help maintain the BCVA of patients with exudative or anatomic recurrence. [ABSTRACT FROM AUTHOR]

Background: To clarify the efficacy of combined therapy with intravitreal ranibizumab injections and photodynamic therapy (PDT) in patients with symptomatic polypoidal choroidal vasculopathy (PCV). Methods: We retrospectively reviewed 57 treatment-naïve eyes of 57 patients. Thirty-two patients were treated with standard fluence PDT (PDT group), and 25 patients were treated with three consecutive monthly intravitreal injections of ranibizumab and standard fluence PDT (ranibizumab plus PDT group). All patients were followed for at least 24 months. Results: In the ranibizumab plus PDT group, the mean best-corrected visual acuity (BCVA) levels of decimal (logMAR equivalent) significantly improved from 0.30 (0.52) at baseline to 0.55 (0.26) at 24 months ( P < 0.001). In the PDT group, the BCVA levels stabilized from 0.26 (0.58) at baseline to 0.25 (0.60) at 24 months. The mean changes in the BCVA in the ranibizumab plus PDT group and the PDT group were improvement of 2.63 lines and decline of 0.16 lines respectively ( P = 0.010). The mean number of PDTs at 24 months in the ranibizumab plus PDT group and the PDT group were 1.4 and 2.6 respectively. Increased subretinal hemorrhages were seen in eight (18.0 %) eyes, all of which were belonging to the PDT group. Conclusions: Combined intravitreal ranibizumab and PDT was significantly more effective in maintaining and improving VA for PCV patients compared with PDT monotherapy over 24 months. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate changes in choroidal thickness adjacent to the area of laser application after photodynamic therapy (PDT) in patients with polypoidal choroidal vasculopathy (PCV) using enhanced depth imaging spectral-domain optical coherence tomography. Methods: Masked observers measured the choroidal thickness at the subfovea and superior, inferior and temporal areas adjacent to the area of laser application before, 2 days, 1 week and 1 and 3 months after treatment. Results: Thirty-seven patients with PCV treated with PDT with verteporfin were included. The mean subfoveal choroidal thickness decreased significantly ( P < 0.001) from 256 ± 115 μm at baseline to 207 ± 111 μm at 3 months; the mean outside choroidal thickness including the superior, inferior and temporal areas decreased significantly ( P < 0.001) from 240 ± 92 μm at baseline to 209 ± 86 μm at 3 months. Conclusion: PDT affected not only the subfoveal choroid, but also the choroid outside the area of laser application in PCV. [ABSTRACT FROM AUTHOR]

Purpose: To clarify the efficacy of a combination of intravitreal anti-vascular endothelial growth factor (VEGF) injections and photodynamic therapy (PDT), over 24 months, for patients with symptomatic retinal angiomatous proliferation (RAP). Methods: We retrospectively reviewed 13 treatment-naïve eyes of 12 patients (7 men, 5 women; age range (mean), 63-92 (77) years) treated with intravitreal bevacizumab (IVB) plus PDT as initial treatment. Retreatment was performed with IVB plus PDT until February 2009 or intravitreal ranibizumab and PDT from March 2009. Results: Mean best-corrected visual acuity (BCVA) significantly improved from 0.26 at baseline to 0.40 at 24 months ( P = 0.013). The mean improvement in BCVA at 24 months from baseline was 1.79 lines. The central retinal thickness decreased significantly from 431 to 142 microns at 24 months ( P < 0.0001). Complete occlusion of the retinal-retinal anastomosis was achieved in seven of the 10 eyes at 24 months. The mean number of PDT treatments during 24 months was 2.8 and the mean number of injections was 3.4. Geographic atrophy was seen in four eyes without significant decline of VA at 24 months. Conclusion: Combined anti-VEGF and PDT for RAP patients effectively maintained or improved VA and reduced exudation, without severe adverse events, over 24 months. [ABSTRACT FROM AUTHOR]

Purpose: Idiopathic macular telangiectasia (MacTel) is classified into aneurysmal telangiectasia (type 1), perifoveal telangiectasia (type 2) and occlusive telangiectasia (type 3). Most instances of telangiectasia in Western countries are type 2. This study reports clinical and demographic features of MacTel in Japanese patients. Methods: Newly diagnosed patients with MacTel were examined retrospectively. All patients underwent fluorescein angiography and optical coherence tomography. Results: Thirty-four eyes of 27 patients with MacTel were included. Twenty eyes of 20 patients (74.1%) had type 1, ten eyes of five patients (18.5%) had type 2, and four eyes of two patients (7.4%) had type 3. Foveal capillary dilatation and microaneurysms were observed in all except for one eye of early stage type 2 MacTel. Optical coherence tomography revealed cystoid macular edema in type 1, temporal foveal thinning and a loss of boundary between the inner and outer segments of photoreceptors in type 2, and thinning of all retinal layers around the fovea in type 3. Conclusion: The most frequent among our patients was aneurysmal MacTel, whereas perifoveal MacTel was not common. Although the clinical characteristics were similar, the most common type was different from that in Western countries. [ABSTRACT FROM AUTHOR]

Purpose: To compare the genomic contribution of the ARMS2/HTRA1 region of chromosome 10q26 to typical neovascular age-related macular degeneration (nAMD) (also known as typical exudative AMD) and to polypoidal choroidal vasculopathy (PCV) Methods: DNA samples were prepared from 84 patients with typical nAMD, 181 patients with PCV, and 276 control participants. All of the 18 haplotype-tagging single-nucleotide polymorphisms (SNPs) derived from the HapMap data and the potential functional variant, rs11200638, which extended the ARMS2/HTRA1 region by 85.2 kb, were genotyped. Associations were tested using single-SNP and haplotype analyses. Results: Statistically significant associations were found for six of the 19 SNPs with both typical nAMD and PCV ( P < 1 × 10), peaking at a segment containing three of the SNPs: rs3793917, rs10490924, and rs11200638 ( P < 10). Six common haplotypes were inferred from the nine SNPs spanning 33 kb, which included the six SNPs associated with both phenotypes. Among the six common haplotypes, one showed a positive association with typical nAMD, and two, including the one mentioned above, were associated with PCV. In addition, they corresponded to the risk alleles rs10490924 and rs11200638. Conclusions: The association pattern and haplotype estimation in the ARMS2/HTRA1 region of Japanese patients with PCV were very similar to those of Japanese patients with typical nAMD. The polymorphisms responsible for nAMD and PCV may be located in this region or in the strong linkage disequilibrium of rs10490924 and rs11200638. [ABSTRACT FROM AUTHOR]

When we classified neovascular exudative age-related macular degeneration (AMD) into three types of polypoidal choroidal vasculopathy (PCV), typical AMD, and retinal angiomatous proliferation (RAP) in our previous study, we reported 5.5% had the combined cases, such as one eye had PCV and the other eye had typical AMD. We examined the clinical characteristics of these combined cases in the current study. All cases underwent fluorescein and indocyanine green angiography (FA and ICGA) at the initial examination. All PCV cases were diagnosed definitively based on characteristic aneurysmal lesions seen on ICGA. Follow-up examinations also were conducted to determine whether polypoidal lesions had developed in the eyes with typical AMD. Among 349 patients with neovascular AMD, 20 (5.7%) had one eye with PCV and the other eye with typical AMD. The average age was 73 years. The mean best-corrected visual acuity levels at the initial examination in eyes with PCV and typical AMD were 0.20 and 0.43, respectively ( p = 0.09). All subgroups of classic and occult CNV were observed in the eyes with typical AMD on FA. During the follow-up period (average, 21.7 months), PCV developed in ten eyes with typical AMD at the initial examination. Although some cases might include different stages of progression or probable cases of PCV, the combined cases in which one eye has PCV and the other eye has typical AMD suggest that those clinical entities are not independent and possibly overlap. [ABSTRACT FROM AUTHOR]

To investigate whether pan-retinal photocoagulation (PRP) affects vitreous levels of cytokines and macular thickening in patients with high-risk proliferative diabetic retinopathy (PDR). Fourteen patients with bilateral high-risk PDR—which requires pars plana vitrectomy (PPV)—but without a history of retinal photocoagulation participated in this study. Before PPV, one eye received PRP, and the other eye did not. The concentrations of cytokines of vascular endothelial growth factor (VEGF), stromal derived factor-1 (SDF-1), interleukin-6 (IL-6) and regulated upon activation, normal T-cell expressed and secreted (RANTES) were measured in each vitreous sample obtained at PPV. Macular thickness obtained by optical coherence tomography was also monitored during clinical course. After the PRP, macular thickness in PRP-pretreated eye showed temporal increase. Vitreous levels of IL-6 and RANTES in PRP pre-treated eye were significantly higher than levels in control eyes ( p = 0.013, p = 0.033). Although macular thickness in control was correlated to vitreous levels of VEGF and IL-6 ( p = 0.022, p = 0.003), that in PRP-pretreated eye was closely correlated to IL-6 and RANTES ( p = 0.002, p = 0.011). After the PPV, macular thickness in both eye groups improved, and there was no significant difference between both eye groups 3 months after the PPV. In patients with high-risk PDR, PRP cause temporal worsening of macular edema linked with pro-inflammatory cytokines of IL-6 and RANTES, but not with VEGF and SDF-1. Thus, PRP-induced macular edema was caused by inflammation, while visual prognosis after PPV was not influenced by pretreatment of PRP. [ABSTRACT FROM AUTHOR]

We successfully established a novel ovarian granulosa tumor cell line (HSOGT). The tumor tissue of the ovary was derived from a 25 year-old Japanese woman under her consent. The cell line was maintained for over 14 months, subcultured more than 73 times, and had a population doubling time of 18.9 hours. Phase contrast microscopy displayed a pavement-like arrangement without contact inhibition. The chromosome number showed a wide distribution of aneuploidy and the mode was 83; many marker chromosomes were observed. The HSOGT was also successfully xenotransplanted into nude mice. The cell line produced estradiol and has preserved some characters of granulosa cells with stable growth in vitro. We firmly believe that this cell line will be a most useful tool for endocrinological investigation of human granulosa cells. [ABSTRACT FROM AUTHOR]

A novel cell line, designated SMOV-1, was established from the ascitic fluid of a woman with ovarian cancer. This report describes the process of establishment and characterization of this cell line. The case involved a woman who had undergone a surgical intervention, due to a serous papillary adenocarcinoma of the ovary. She received the combination chemotherapy of PAC (cisplatin +doxorubicin+cyclophosphamide) 6 times after the surgery. However, as a result of malignant pleural effusion during chemotherapy, she died 7 months after surgery. Before surgery, ascitic fluid was removed from the patient for cell culture, after obtaining her consent. The cells were successfully subcultured, and designated SMOV-1. The cell line gave a pavement-stone pattern, without contact inhibition. SMOV-1 could also be transplanted into nude mice, and the tissue showed reconstruction of the original tumor. The chromosome number of the SMOV-1 cells was 57, and the DNA index was 2.28. The population-doubling time of the SMOV-1 cells was 61.4 hours. Cultured SMOV-1 cells were still capable of producing the tumor-associated antigens CA 125, CA 19-9, and sTn (sialosyl-Tn). We propose that this novel cell line is of possible use for the investigation of drug resistance in ovarian cancer. [ABSTRACT FROM AUTHOR]

Optical coherence tomography angiography (OCTA) seems not to image the choroidal blood flow pattern in the normal individual because of the OCT light attenuation. Our purpose in the current study was to visualize the large choroidal blood flow pattern after subtraction of the choriocapillaris projection artifact in normal eyes non-invasively by swept source (SS) OCTA. Sixty-one eyes of 45 individuals (19 men, 26 women) without ocular disease were examined by SS-OCTA (AngioPlex Elite 9000, Zeiss, Germany). A 12 × 12 mm macular area was scanned. Subfoveal choroidal thickness (SCT) was measured, and the choroidal blood flow pattern in a slab of 30 µm width at one-half of SCT was analyzed. In examining the choroidal blood flow pattern, a slab that was between 30 to 60 µm posterior to the retinal pigment epithelium, in which the choriocapillaris blood flow was most clearly imaged, was used for the subtraction of the projection artifacts from the choriocapillaris on the stromal area of choroid. The ratio (%) of the choroidal blood flow area in the whole choroidal region was calculated after binarization. Thirty-four eyes of 27 individuals (12 men, 15 women) were also examined by spectral domain OCTA (SD-OCTA). After the subtraction, the middle and large choroidal blood flow were clearly visible in SS-OCTA in all eyes. The mean SCT was 297 ± 61 µm, and the mean ratio of the choroidal blood flow area was 27.3 ± 8.2%, which was significantly correlated with SCT (R = 0.738, P < 0.01). SD-OCTA did not show the choroidal blood flow pattern. In conclusion, removal of the projection artifacts of choriocapillaris can make the choroidal blood flow visible in SS-OCTA of normal eyes. Because the ratio of choroidal blood flow area was correlated with SCT, the choroidal blood flow might be an important factor related to the choroidal thickness. [ABSTRACT FROM AUTHOR]

Purpose: To compare choroidal thickness and volume in eyes with central serous chorioretinopathy (CSC) and healthy control eyes over a wide area of the fundus using ultra-widefield optical coherence tomography (UWF-OCT).Thirty-three eyes of 29 patients with CSC and 36 eyes of 21 healthy controls were examined retrospectively. Choroidal images were obtained with a prototype UWF-OCT device with a field of view of 105° or approximately 31.5-mm wide by 10.9-mm deep. Choroidal thickness and volume were measured in the images of 12 radial scans (every 15°) from the horizontal scan. The “new index” of the extent of focal choroidal protrusion was defined as the maximum steepness of choroidal thickness (MSCT).Choroidal volume in CSC eyes was significantly larger than in control eyes within the central 50° (P < 0.001). However, there was no significant difference in choroidal volume in the peripheral 50 to 105° (P = 0.071). The MSCTs were significantly steeper in CSC eyes than in control eyes at scan lines 1, 6, 7, 8, and 10 (P < 0.01, P < 0.001, P < 0.05, P < 0.01, P < 0.05).The choroid in CSC eyes was thickened only at the posterior pole, and its protrusion was significant mainly in the vertical direction. Focal choroidal thickening at the posterior pole, which we speculate includes congenital scleral changes, may affect the pathophysiology of CSC.Methods: To compare choroidal thickness and volume in eyes with central serous chorioretinopathy (CSC) and healthy control eyes over a wide area of the fundus using ultra-widefield optical coherence tomography (UWF-OCT).Thirty-three eyes of 29 patients with CSC and 36 eyes of 21 healthy controls were examined retrospectively. Choroidal images were obtained with a prototype UWF-OCT device with a field of view of 105° or approximately 31.5-mm wide by 10.9-mm deep. Choroidal thickness and volume were measured in the images of 12 radial scans (every 15°) from the horizontal scan. The “new index” of the extent of focal choroidal protrusion was defined as the maximum steepness of choroidal thickness (MSCT).Choroidal volume in CSC eyes was significantly larger than in control eyes within the central 50° (P < 0.001). However, there was no significant difference in choroidal volume in the peripheral 50 to 105° (P = 0.071). The MSCTs were significantly steeper in CSC eyes than in control eyes at scan lines 1, 6, 7, 8, and 10 (P < 0.01, P < 0.001, P < 0.05, P < 0.01, P < 0.05).The choroid in CSC eyes was thickened only at the posterior pole, and its protrusion was significant mainly in the vertical direction. Focal choroidal thickening at the posterior pole, which we speculate includes congenital scleral changes, may affect the pathophysiology of CSC.Results: To compare choroidal thickness and volume in eyes with central serous chorioretinopathy (CSC) and healthy control eyes over a wide area of the fundus using ultra-widefield optical coherence tomography (UWF-OCT).Thirty-three eyes of 29 patients with CSC and 36 eyes of 21 healthy controls were examined retrospectively. Choroidal images were obtained with a prototype UWF-OCT device with a field of view of 105° or approximately 31.5-mm wide by 10.9-mm deep. Choroidal thickness and volume were measured in the images of 12 radial scans (every 15°) from the horizontal scan. The “new index” of the extent of focal choroidal protrusion was defined as the maximum steepness of choroidal thickness (MSCT).Choroidal volume in CSC eyes was significantly larger than in control eyes within the central 50° (P < 0.001). However, there was no significant difference in choroidal volume in the peripheral 50 to 105° (P = 0.071). The MSCTs were significantly steeper in CSC eyes than in control eyes at scan lines 1, 6, 7, 8, and 10 (P < 0.01, P < 0.001, P < 0.05, P < 0.01, P < 0.05).The choroid in CSC eyes was thickened only at the posterior pole, and its protrusion was significant mainly in the vertical direction. Focal choroidal thickening at the posterior pole, which we speculate includes congenital scleral changes, may affect the pathophysiology of CSC.Conclusions: To compare choroidal thickness and volume in eyes with central serous chorioretinopathy (CSC) and healthy control eyes over a wide area of the fundus using ultra-widefield optical coherence tomography (UWF-OCT).Thirty-three eyes of 29 patients with CSC and 36 eyes of 21 healthy controls were examined retrospectively. Choroidal images were obtained with a prototype UWF-OCT device with a field of view of 105° or approximately 31.5-mm wide by 10.9-mm deep. Choroidal thickness and volume were measured in the images of 12 radial scans (every 15°) from the horizontal scan. The “new index” of the extent of focal choroidal protrusion was defined as the maximum steepness of choroidal thickness (MSCT).Choroidal volume in CSC eyes was significantly larger than in control eyes within the central 50° (P < 0.001). However, there was no significant difference in choroidal volume in the peripheral 50 to 105° (P = 0.071). The MSCTs were significantly steeper in CSC eyes than in control eyes at scan lines 1, 6, 7, 8, and 10 (P < 0.01, P < 0.001, P < 0.05, P < 0.01, P < 0.05).The choroid in CSC eyes was thickened only at the posterior pole, and its protrusion was significant mainly in the vertical direction. Focal choroidal thickening at the posterior pole, which we speculate includes congenital scleral changes, may affect the pathophysiology of CSC. [ABSTRACT FROM AUTHOR]