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Purpose: To report the 1-year results of intravitreal ranibizumab (IVR) injections for neovascular age-related macular degeneration (nAMD) in patients with good baseline visual acuity (VA). Methods: Thirty-six eyes of 36 patients with nAMD with best-corrected VAs (BCVAs) >0.6 (equal to 0.22 in the logarithm of the minimum angle of resolution unit) were enrolled. IVR was the primary treatment; additional treatment was administered as needed. BCVAs and central retinal thickness (CRT) were measured periodically. Results: The mean number of injections at month 12 was 3.3. The mean BCVAs were 0.11 ± 0.02 at baseline and 0.12 ± 0.03 at month 12, which did not significantly differ. The mean CRT significantly improved from 320 ± 15 to 254 ± 12 μm at month 12 (p < 0.01). Photodynamic therapy was applied in 2 cases because of frequent recurrences. Conclusions: IVR maintained VA and improved morphological changes in wet AMD with good baseline VA. © 2014 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Neovascularization in response to tissue injury consists of the dual invasion of blood (hemangiogenesis) and lymphatic (lymphangiogenesis) vessels. We reported recently that 21-nt or longer small interfering RNAs (siRNAs) can suppress hemangiogenesis in mouse models of choroidal neovascularization and dermal wound healing independently of RNA interference by directly activating Toll-like receptor 3 (TLR3), a double-stranded RNA immune receptor, on the cell surface of blood endothelial cells. Here, we show that a 21-nt nontargeted 5iRNA suppresses both hemangiogenesis and lymphangiogenesis in mouse models of neovascularization induced by corneal sutures or hindlimb ischemia as efficiently as a 21-nt 5iRNA targeting vascular endothelial growth factor-A. In contrast, a 7-nt nontargeted siRNA, which is too short to activate TLR3, does not block hemangiogenesis or lyniphangiogenesis in these models. Exposure to 21-nt 5iRNA, which we demonstrate is not internalized unless cell-permeating moieties are used, triggers phosphorylation of cell surface TLR3 on lymphatic endothelial cells and induces apoptosis. These findings introduce TLR3 activation as a method of jointly suppressing blood and lymphatic neovascularization and simultaneously raise new concerns about the undesirable effects of siRNAs on both circulatory systems. [ABSTRACT FROM AUTHOR]

This case study details a 41-year-old male patient with Freeman-Sheldon syndrome (FSS) who presented with ocular hypertension. The intraocular pressure (IOP) in his right eye progressively increased over time, leading to visual field loss, culminating in a diagnosis of juvenile-onset open-angle glaucoma (JOAG). Despite conventional medical therapies, adequate IOP control was not achieved, necessitating his referral to Nagoya City University Hospital. The patient underwent minimally invasive glaucoma surgery (MIGS), specifically trabeculotomy using the Kahook Dual Blade (KDB). Postoperative outcomes were favorable, with the IOP decreasing from approximately 40 to 10 mmHg and remaining consistently below 15 mmHg over a 27-month follow-up period. This case represents the first documented instance of glaucoma in a patient with FSS successfully managed with MIGS, highlighting the long-term efficacy and safety of this surgical intervention., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Yoshida et al.)

We report a case of a 78-year-old man presenting with uncertain visual field loss, ultimately identified as posterior polar hemispheric choroidal dystrophy (PPHCD) using ultra-widefield fundus autofluorescence (FAF) and optical coherence tomography angiography (OCTA). The patient initially reported blurred vision in the left eye and had a previous diagnosis of suspected bilateral normal tension glaucoma based on optic nerve head excavation and static perimetry measurements. Detailed examination revealed suspicious retinal atrophy. Notably, the patient had a tigroid fundus, which complicated the correlation between visual field defect and chorioretinal atrophy. Ultra-widefield FAF highlighted mosaic/patchy hypofluorescent areas, emphasizing this atrophy. OCTA images confirmed choriocapillaris loss in the hemispheric choroidal atrophy and parafoveal atrophy. The combination of these imaging techniques enabled a definitive diagnosis of PPHCD. Long-term follow-up and continued investigation with these imaging modalities may hold promise for a better understanding of disease progression and management in similar cases., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Takano et al.)

Purpose: The ultra-wide field scanning laser ophthalmoscope (Optos 200Tx, Optos, Scotland, UK) provides retinal images of 200 degrees in a single capture which covers more than 80% of the retina. Fluorescein angiography with Optos 200Tx is useful to visualize the microcirculations of peripheral retina. It allows to evaluate peripheral pathology more precisely than conventional fundus photography. The purpose of this study was to evaluate the fluorescein angiography findings of eyes in diabetic retinopathy patients by using ultra-wide field fluoresrein angiography., Subjects and Methods: Ultra-wide field fluoresrein angiography was performed on 154 eyes of 77 patients with diabetic retinopathy. We divided the fundus into three zones, the posterior pole, the mid-periphery and the far-periphery. Capillary non-perfusion areas and retinal neovascularization in each zone were evaluated., Results: One hundred thirty eyes (84%) exhibited capillary non-perfusion areas. Ten eyes (7.7%) were found to have a capillary non-perfusion area only in the far-periphery. Seventy two eyes (47%) exhibited retinal neovascularization. Retinal neovascularization was observed most in the mid-periphery (58 eyes; 81%); 8 eyes (11%) were found to have retinal neovascularization in the far-periphery., Conclusion: Ultra-wide field fluorescein angiography revealed the microcirculatory disturbance in the peripheral retina of diabetic patients not evident by conventional fundus photography and it was useful for evaluating the status of the diabetic retinopathy.

Purpose: To assess the efficacy and outcomes of PASCAL laser versus conventional laser for panretinal photocoagulation (PRP) in the treatment of diabetic retinopathy., Methods: A retrospective chart review of 26 eyes at Nagoya City University Hospital which had undergone PRP with a follow-up of at least 6 months. The study endpoints were change in visual outcome, central retinal thickness (CRT), laser setting parameters, and total number of PRP and complications., Results: Ten eyes of conventional laser-treated patients and 16 eyes of PASCAL-treated patients were reviewed. There were significant differences in the laser treating parameters between the PASCAL laser treatment and conventional laser treatment in power, duration, number of sessions and total spot counts including additional treatments (p < 0.01). Among the patients who had undergone PRP in the PASCAL group there was an average of 4195 spots, larger than the conventional laser group (p < 0.0001). There were no significant differences between PASCAL group and conventional laser group in complications and in ability to prevent visual loss and CRT., Conclusion: Our data suggested that PASCAL laser might need tighter spacing and more total spot counts to achieve an effect equal to traditional conventional laser treatment.

Purpose: The difference in preferences and trends of treatment in each country are important to plan an international interventional clinical study in eastern Asia. Accordingly, we compared the preferences and trends in treatment of diabetic retinopathy in Korea and Japan., Methods: We obtained answers to questionnaires (49 questions) from 91 ophthalmologists of the Korean Retina Society and 120 ophthalmologists of the Japanese Society of Ophthalmic Diabetology in June/July, 2012. Some of the questions were modified from The Preferences and Trends (PAT) survey of American Society of Retina Specialists., Results: The first choice for a patient with vision of 20/25, clinically significant diabetic macular edema and clear evidence of intraretinal fluid on spectral domain OCT were intravitreal anti-vascular endothelial growth factor agent (31%) in Korea and sub-Tenon steroid (22%) in Japan. The management for a patient with refractory neovascular glaucoma who has closed angle and persistent intraocular pressure elevation (>50 mmHg) were glaucoma drainage implant surgery (74%) in Korea and trabeculectomy (57%) in Japan., Conclusion: There were differences in preferences and trends of treatment for diabetic retinopathy between Korea and Japan. The differences need to be considered when planning international clinical studies.

Purpose: To investigate the incidence of posterior subcapsular cataract after topical administration of triamcinolone acetonide., Methods: A retrospective, case-control study was conducted in 44 phakic eyes of 38 paients who underwent administration of triamcinolone acetonide. The mean age was 64 +/- 10.4 (39-89). Only posterior sub-Tenon injection was performed. Evaluation of posterior subcapsular cataract was performed by slit lamp microscopy, and risk factors of the posterior subcapsular cataract progression were studied., Results: Eight eyes (18%) had posterior subcapsular cataract progression in the 12 months after triamcinolone acetonide injection. Five eyes (11%) required cataract surgery. The mean time to the cataract progression was 8.8 +/- 3.7 months. There was no significant difference in the posterior cataract progression between the frequency of injection, the causes of disease, and the age (p = 0.3806, 0.6561, 0.7470)., Conclusion: The progression of posterior subcapsular cataract is an important complication in the long-term topical administration of triamcinolone acetonide.

A 32-year-old Japanese male visited our hospital on May 20, 2004 because of ventricular premature contractions detected at a regular medical check up. He had been asymptomatic with adequate exercise capacity. However, echocardiography findings and Holter monitoring showed impaired left ventricular systolic function associated with left ventricular dilation and non-sustained ventricular tachycardia on June 26. Coronary angiography did not show significant stenosis. Different types of non-sustained ventricular tachycardia could be induced by an electrophysiologic test, but not sustained ventricular tachycardia. The physical findings, such as enlargement of the nose, lips, hands and feet, suggested endocrinologic abnormalities, and growth hormone and somatomedin-C levels were elevated. Therefore, the final diagnosis was cardiomyopathy caused by acromegaly.

Purpose: We investigated the incidence and risk factors of intraocular pressure (IOP) elevation following triamcinolone administration for macular disorders., Methods: Intravitreal or posterior sub-Tenon's injections of triamcinolone acetonide were conducted on 119 eyes with macular disorders. The change in IOP was followed for all cases. Risk factors for IOP elevation were examined regarding causal disease, history of vitrectomy, methods of injection, frequency of injection, refractive power, and age., Result: The difference between the mean baseline IOP (13.0 +/- 2.9 mmHg) and the maximum mean IOP (21.5 +/- 9.8 mmHg) was statistically significant (p< 0.0001). The final mean IOP was 15.1 +/- 3.6 mmHg. Forty-one eyes (34.5%) had IOP elevation over 21 mmHg during the follow-up. Fifty-nine eyes (49.6%) showed pressure elevation of over 5 mmHg. One eye (1%) required trabeculotomy to control the IOP. Risk factors for the IOP elevation included younger age, high myopia, no history of vitrectomy, and multiple injections., Conclusion: Careful follow-up of the IOP is required after triamcinolone acetonide injections.