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Purpose: To compare the subfoveal choroidal vascularity indices (CVIs) of treatment-naïve patients with central retinal vein occlusion (CRVO) with controls.Methods: Twenty-one eyes of 21 treatment-naïve CRVO patients and 42 age- and sex-matched control eyes (of 42 subjects) lacking any retinal disease were included. The subfoveal CVIs were measured using ImageJ software.Results: The mean subfoveal CVI in eyes with treatment-naïve CRVO at the initial visit was significantly higher than that of control eyes (0.6464 ± 0.0326 vs. 0.6209 ± 0.0434 respectively; p = 0.024). In contrast, no significant difference in the mean subfoveal CVI was found between CRVO eyes 6 months after initial diagnosis and control eyes (0.6311 ± 0.0600 vs. 0.6209 ± 0.0434 respectively; p = 0.238). Of the 21 eyes with CRVO, 18 (85.7%) received intravitreal injections (bevacizumab, ranibizumab, aflibercept, or triamcinolone) and four (19.0%) underwent panretinal photocoagulation.Conclusions: The subfoveal CVI of eyes with treatment-naïve CRVO at the initial visit was significantly higher than that of control eyes, but decreased by 6 months. Further studies are needed to determine whether CRVO treatments such as intravitreal injection or panretinal photocoagulation affect choroid hemodynamics.

Human corneal-endothelial cells (hCEnCs) are located on the inner layer of the cornea. Injury to CEnCs leads to permanent corneal edema, requiring corneal transplantation. NADPH oxidase 4 (NOX4) has been reported to be implicated in the pathogenesis of CEnCs diseases. Thus, we investigated the role of NOX4 in CEnCs in this study. In an animal study, siRNA for NOX4 (siNOX4) or plasmid for NOX4 (pNOX4) was introduced into the corneal endothelium of rats by electroporation, using a square-wave electroporator (ECM830, Havard apparatus) to decrease or increase the expression of NOX4, respectively, and the rat corneas were cryoinjured through contact with a metal rod of 3 mm diameter frozen in liquid nitrogen for 10 min. The immunofluorescence staining of NOX4 and 8-OHdG showed that the levels of NOX4 and 8-OHdG were decreased in the siNOX4 group compared to the siControl, and increased in the pNOX4 group compared to the pControl at one week after treatment. Without cryoinjury, corneal opacity was more severe, and the density of CEnCs was lower, in pNOX4-treated rats compared to pControl. After cryoinjury, the corneas were more transparent, and the CEnC density was higher, in siNOX4-treated rats. The hCEnCs were cultured and transfected with siNOX4 and pNOX4. The silencing of NOX4 in hCEnCs resulted in a normal cell shape, higher viability, and higher proliferation rate than those transfected with the siControl, while NOX4 overexpression had the opposite effect. NOX4 overexpression increased the number of senescent cells and intracellular oxidative stress levels. NOX4 overexpression increased ATF4 and ATF6 levels, and nuclear translocation of XBP-1, which is the endoplasmic reticulum (ER) stress marker, while the silencing of NOX4 had the opposite effect. Additionally, the mitochondrial membrane potential was hyperpolarized by the silencing of NOX4, and depolarized by NOX4 overexpression. The LC3II levels, a marker of autophagy, were decreased by the silencing of NOX4, and increased by NOX4 overexpression. In conclusion, NOX4 plays a pivotal role in the wound-healing and senescence of hCEnCs, by modulating oxidative stress, ER stress, and autophagy. The regulation of NOX4 may be a potential therapeutic strategy for regulating the homeostasis of CEnCs, and treating corneal-endothelial diseases.

Purpose: To evaluate the changes in retinal function after anatomical resolution of central serous chorioretinopathy by multifocal electroretinography. Design: Prospective observational study. Methods: Thirty-two eyes of 32 patients with unilaterally resolved central serous chorioretinopathy were prospectively studied. Serial multifocal electroretinography examinations were performed at the initial visit for active central serous chorioretinopathy, the time of anatomical resolution (resolved central serous chorioretinopathy), and 3, 6, and 12 months after resolution. The peak amplitudes of the first kernel responses were analysed and compared with those in 27 age-matched normal controls. Results: Compared with controls, N1 amplitudes of ring 1–4 and P1 amplitudes of ring 1–3 showed statistically significant reductions at 12 months after the resolution of central serous chorioretinopathy (p

Purpose: This study evaluated the short-term safety of resident-performed intravitreal injections.Methods: We retrospectively reviewed the medical records of 503 patients (503 eyes) treated for the first time in our hospital from January 2018 to October 2020 via intravitreal bevacizumab, ranibizumab, aflibercept, or triamcinolone acetonide injections by residents or retina specialists. In terms of short-term ophthalmic complications, patients were followed-up 1 day, 1 week, and 1 month after injection.Results: A total of 503 eyes of 503 patients were included. Intravitreal injections were given to 211 and 292 eyes by residents (the resident group) and retina specialists (the retina specialist group), respectively. There were no between-group differences in baseline characteristics except in terms of the indications for injection. Intraocular pressure elevation >5 mmHg occurred in two eyes (0.95%) in the resident group and five (1.71%) in the retina specialist group, but the difference was not statistically significant. Subconjunctival hemorrhage occurred in 29 eyes (13.74%) of the resident group and 32 eyes (10.96%) of the retina specialist group; again, the difference was not statistically significant. No case of noninfectious endophthalmitis occurred in the resident group but two (0.68%) cases occurred in the retina specialist group; again, the difference was not significant. There were two (0.95%) cases of infectious endophthalmitis in the resident group and one (0.34%) case in the retina specialist group; again, the difference was not significant. No corneal erosion, traumatic lens damage, vitreous hemorrhage, or retinal tearing or detachment were noted in either group.Conclusions: Resident-performed intravitreal injections appear to be safe.

Purpose: To assess if alternate treatment with intravitreal anti-vascular endothelial growth factor (VEGF) and corticosteroid injections can improve visual and anatomical outcomes of treatment-naiv...

To evaluate the efficacy and safety of intravitreal dexamethasone (DEX) implant in retinitis pigmentosa patients with cystoid macular edema (CME).In this randomized, noncontrolled, paired-eye, single crossover clinical trial, one eye of retinitis pigmentosa patients with bilateral CME with central macular thickness of250 µm was randomized to intravitreal DEX implant while the fellow eye was observed. Both eyes were started on topical dorzolamide. At Month 6, DEX implant was eligible for both eyes when CME was250 µm. Patients were followed up until Month 12. Primary outcome measures were the central macular thickness and best-corrected visual acuity changes from baseline at Month 2.Fourteen patients with bilateral RP-CME were included. Study eyes showed significant central macular thickness decrease (median, -147.5 µm; P = 0.001) and best-corrected visual acuity improvement (median, +6 letters; P = 0.001) at Month 2, but not at Month 6. Intravitreal DEX implant at Month 6 produced comparable efficacy to baseline treatment in 11 fellow eyes and 12 study eyes. Topical dorzolamide did not show significant therapeutic efficacy. During 12 months, elevated intraocular pressure of21 mmHg and cataract progression were observed in 14.3% and 40.0% of study eyes.Intravitreal DEX implant can both reduce macular thickness and improve vision in RP-CME, while repeated injection is required.

Purpose The purpose of this study is to investigate the alienation and the overcoming process of the physical activity participation of people with Adventitious Visual Impairment(AVI) Methods 21 Adults with AVI were recruited and one on one semi-structured interview was conducted. Ground theory was used to analyze the data. Member check, peer debriefing was conducted to enhance the trustworthiness of this study. Results As a result, a total of 203 concepts were derived. This consisted of 21 subcategories and the common themes of the subcategories were categorized into nine categories. Specific results are as follows. First, the physical activity of people with AVI was directly affected by the sports facilities, physical activity programs, and professional instructor. This causal condition resulted in the loss of leisure experience in the context of the busy daily life and the depressed psychological state. Second, due to the perceived need of health care and the positive involvement of others, people with AVI came to expect the effect of exercise. Third, people with AVI participated in physical activity again as a tool to achieve the purpose of health improvement. This type of physical activity has a limitation that it can not guarantee the continuity of physical activity due to the limitation that it does not contain autonomy and interest of people with AVI. Conclusions Based on these results, the following suggestions were made. First, it is necessary to improve the environment for ensuring participation in physical activity of people with AVI. Moreover education and promotion of the effects and values of the exercise should be carried out for people with AVI and their guardians. Second, it is necessary to diversify physical activity types and reconstruct existing exercise programs.

To investigate the clinical findings, natural course, and pigment development of patients with retinitis pigmentosa (RP) sine pigmento using multimodal imaging.We reviewed the medical records of 810 consecutive patients with RP and assessed serial ultra-widefield fundus photography, fundus autofluorescence, and optical coherence tomography images. Electrophysiological and visual field analysis findings were also reviewed.Of the 774 patients with RP who met the inclusion criteria, 88 were diagnosed with RP sine pigmento, with a prevalence of 11.4%. The mean age of the patients was 35.57 years compared with 49.83 years for patients with typical RP. Fifty-nine patients (67%) demonstrated minimal color change, whereas 29 (33%) presented with grayish flecks in the retinal pigment epithelium on fundus photography. All patients with RP sine pigmento had abnormalities on fundus autofluorescence, and the commonest fundus autofluorescence findings were punctate or reticular hypoautofluorescence. Of the 62 patients without pigmentation at the first visit and at the follow-up visits, 14 (22.6%) had developed pigmentation at their follow-up visit, with an average time of 3.92 years. Most patients retained a visual acuity of ≥20/50 within the age of 50 years.Diagnosing RP sine pigmento based solely on ophthalmoscopic findings is more difficult than in more typical cases. Multimodal imaging can provide insights into the clinical characteristics to facilitate the diagnosis, classification, and follow-up of patients.

Purpose. To evaluate whether treatment with intravitreal corticosteroid and anti-vascular endothelial growth factor (VEGF) injections alternately can improve treatment outcomes of macular edema (ME) caused by retinal vein occlusion (RVO). Methods. This dual-center retrospective study included 112 eyes with treatment-naïve ME secondary to RVO that were alternately treated with intravitreal corticosteroid and anti-VEGF injections (33 eyes, alternate group) or treated only with intravitreal anti-VEGF injections (79 eyes, anti-VEGF group) on a pro re nata basis. Results. During the 12-month follow-up period, the alternate group achieved a visual acuity gain of 0.39 logMAR, while the anti-VEGF group achieved a gain of 0.21 logMAR ( P = 0.042 ). The alternate group demonstrated a reduction in the central macular thickness of 229.9-μm, while the anti-VEGF group achieved a reduction of 220.1 μm ( P = 0.887 ). The alternate group required an average of 5.2 injections, while the anti-VEGF received 4.2 injections ( P < 0.001 ). In a propensity score-matched cohort to compensate for the differences in the injection numbers between the two groups, the alternate group achieved a better visual acuity gain than the anti-VEGF group at month 12 (0.39 logMAR vs. 0.17 logMAR, P = 0.048 ). Conclusions. In ME secondary to RVO, treatment with intravitreal corticosteroid and anti-VEGF injections alternately resulted in a more favorable visual outcome compared with intravitreal anti-VEGF monotherapy.

Background. To analyze the microbiological causes of infectious endophthalmitis on an isolated island over ten years. Methods. A retrospective review of the medical records of 49 eyes clinically diagnosed with infectious endophthalmitis between January 2009 and December 2018 was done. The subjects were recruited from a single tertiary referral center on Jeju Island. The baseline characteristics of all subjects were investigated, and a culture examination was performed. The isolated pathogens were analyzed to determine how their microbiological features differed from those in regions with different geographical conditions. Results. Of the 49 eyes, causative microorganisms were identified in 27 eyes (55.1%). Bacteria were found in 24 cases and fungi in 3 cases. Among the exogenous causes, Staphylococcus species (Staphylococcus aureus, S. epidermidis, and S. hominis) were the most common pathogens (7 cases). Achromobacter xylosoxidans was the second most common causative pathogen (4 cases) followed by Moraxella species (3 cases). The most frequent endogenous origin was due to Klebsiella pneumoniae (6 cases). The subjects were divided into two groups according to the treatment results and analyzed for predisposing factors related to visual outcomes. The presence of diabetes mellitus ( P = 0.038) and initial visual acuity ( P ≤ 0.001) were significant predisposing factors for visual outcomes. Conclusion. The causative microorganisms of endogenous endophthalmitis on Jeju Island were not different from those reported previously. However, isolated exogenous microorganisms were different from those reported in other studies from inland areas. A high incidence and atypical clinical features of Achromobacter xylosoxidans and Moraxella in exogenous endophthalmitis were observed, reflective of the distinct climatic features of Jeju Island: high humidity and temperature. Therefore, considering the causative microorganisms of exogenous endophthalmitis, it may be assumed that the causative microorganisms of exogenous endophthalmitis and its clinical manifestations differ according to the region.

Human corneal endothelial cells (hCECs) are restricted in proliferative capacity in vivo. Reduction in the number of hCEC leads to persistent corneal edema requiring corneal transplantation. This study demonstrates the functions of SIRT1 in hCECs and its potential for corneal endothelial regeneration. Cell morphology, cell growth rates and proliferation-associated proteins were compared in normal and senescent hCECs. SIRT1 was activated using the CRISPR/dCas9 activation system (SIRT1a). The plasmids were transfected into CECs of six-week-old Sprague&ndash, Dawley rats using electroporation and cryoinjury was performed. Senescent cells were larger, elongated and showed lower proliferation rates and lower SIRT1 levels. SIRT1 activation promoted the wound healing of CECs. In vivo transfection of SIRT1a promoted the regeneration of CECs. The proportion of the S-phase cells was lower in senescent cells and elevated upon SIRT1a activation. SIRT1 regulated cell proliferation, proliferation-associated proteins, mitochondrial membrane potential, and oxidative stress levels. In conclusion, corneal endothelial senescence is related with a decreased SIRT1 level. SIRT1a promotes the regeneration of CECs by inhibiting cytokine-induced cell death and senescence. Gene function activation therapy using SIRT1a may serve as a novel treatment strategy for hCEC diseases.

Purpose We report a case of diabetic papillopathy (DP) treated with intravitreal bevacizumab injections and evaluated for disc vessel changes using swept-source optical coherence tomography angiography (SS-OCTA). Observations A 52-year-old man was referred with a 1-week history of acute painless decreased vision in both eyes (OU). His best-corrected visual acuity (BCVA) was 20/40 in the right eye (OD) and 20/100 in the left eye (OS). Fundus examination showed swollen optic discs with superficial radially oriented telangiectatic vessels, peripapillary splinter hemorrhages, and hard exudates OU. On SS-OCTA, B-scan images displayed blood flow signals in the thickened retinal nerve fiber layer (RNFL) of the optic disc and superficial RNFL slab images displayed radially oriented telangiectatic vessels OU. Laboratory tests revealed previously unknown diabetes, and we diagnosed the patient with DP OU. Two weeks after an intravitreal injection of bevacizumab OS, the disc swelling, radially oriented telangiectatic vessels, and peripapillary splinter hemorrhages had decreased OS. The superficial RNFL slab OS also depicted decreased radially oriented telangiectatic vessels. However, OD showed no interval changes. Two weeks after an intravitreal bevacizumab injection OD, improved BCVA, decreased disc swelling, radially oriented telangiectatic vessels, and peripapillary splinter hemorrhages were observed OU. The superficial RNFL slab also showed decreased radially oriented telangiectatic vessels OU. Conclusions and importance This case showed that bevacizumab is a useful treatment option for DP as they resolve underlying optic nerve capillary vasculopathy. SS-OCTA demonstrated resolved superficial telangiectatic vessels of the optic disc which has not been previously described.

Objective To analyze the clinical characteristics of and treatment outcomes for orbital apex lesions according to their pathological diagnosis and identify clinical characteristics that could aid in their differential diagnosis. Design Retrospective analysis design was used for this study. Setting The study was conducted in a single tertiary institution. Participants Patients with pathologically confirmed lesions centered in the orbital apex who were admitted between January 2011 and December 2015. Main Outcome Measures Clinical characteristics, including demographics, predisposing factors, presenting symptoms, radiological findings, intraoperative findings, biopsy results, and treatment outcomes. Results Nine patients with invasive fungal sinusitis, six with inflammatory pseudotumor, and six with neoplastic or tumorous lesions were enrolled. The most common presenting symptom was orbital pain or headache, followed by ophthalmoplegia and vision loss, which exhibited overall recovery rates of 62.5% and 33.3%, respectively, after definitive treatment. The prognosis was worse for patients with invasive fungal sinusitis. There was no significant difference in age, underlying medical conditions, absolute neutrophil count, C-reactive protein level, and radiological findings among the three groups. Grossly necrotic tissues around the orbital apex area at biopsy were more frequently found in patients with invasive fungal sinusitis than in the other patients. In most cases, pain ameliorated after surgical intervention. There were no surgery-related morbidities. Conclusions Lesions centered in the orbital apex included invasive fungal sinusitis, inflammatory pseudotumor, and tumorous lesions. However, clinical features that clearly differentiated chronic invasive fungal sinusitis from inflammatory pseudotumor could not be identified. Our findings suggest that prompt biopsy is warranted for timely diagnosis, symptom relief, and early implementation of definitive treatment.

Punctate inner choroidopathy (PIC) is a relatively uncommon idiopathic inflammatory multifocal chorioretinopathy, which occurs at the level of the outer retina, retinal pigment epithelium (RPE), and inner choroid. PIC was first described in 1984 by Watzke and colleagues in a series of 10 young myopic women who presented with blurred central vision, photopsia, and paracentral scotomas (Watzke et al. 1984). PIC is considered one of the “white dot syndromes” and is reported as having a considerable overlap with acute zonal occult outer retinopathy (Gass 2003; Ahnood et al. 2017; Francis et al. 2005). The development of various imaging modalities has led to a better understanding of PIC, but whether PIC is truly a separate disease entity or simply a subset of the so-called PIC/MCP spectrum is still controversial (Jampol and Becker 2003; Spaide et al. 2013).

This study describes the methods and results of superparamagnetic iron oxide nanoparticle (SPION) labeling and magnetic resonance imaging (MRI) tracking of human embryonic stem cell-derived photoreceptor precursors transplanted into the subretinal space of Royal College of Surgeons rats. SPION labeling and MRI tracking provide information about the biodistribution of transplanted photoreceptor precursors, which is necessary for improving the functional benefits of cell therapy for degenerative retinal diseases.

Purpose To investigate the effect of COL8A2 repression on corneal endothelial cells (CECs) in vitro and in vivo. Methods Cultured human CECs (hCECs) were transfected with COL8A2 siRNA (siCOL8A2), and the cell viability and proliferation rate were measured. The expression of cell proliferation-associated molecules was evaluated by Western blotting and real-time reverse transcription PCR. Cell shape, Wingless-INT (WNT) signaling, and mitochondrial oxidative stress were also measured. For in vivo experiments, siCOL8A2 was transfected into rat CECs (rCECs), and corneal opacity and corneal endothelium were evaluated. Results After transfection with siCOL8A2, COL8A2 expression was reduced (80%). Cell viability, cell proliferation rate, cyclin D1 expression, and the number of cells in the S-phase were reduced in siCOL8A2-treated cells. The cell attained a fibroblast-like shape, and SNAI1, pSMAD2, and β-catenin expression, along with mitochondrial mass and oxidative stress levels, were altered. Corneal opacity increased, and the CECs were changed in rats in the siCOL8A2 group. Conclusions COL8A2 is required to maintain normal wound healing and CEC function.

Vitelliform macular dystrophy (VMD) is a group of macular dystrophy characterized by the subretinal accumulation of yellow yolk-like materials which predominantly affect the macula. Best vitelliform macular dystrophy is among the most common autosomal dominant (AD) retinal dystrophy, caused by mutations in the BEST1 gene. Since first identification of BEST1 gene in 1998, molecular biology and pathophysiology of BEST1 gene and vitelliform macular dystrophy were studied. Recent advances in genetic analysis have described over 200 different human BEST1 mutations to date, associated with a broad spectrum of ocular diseases, called bestrophinopathy. However, the genotype-phenotype correlation in VMD is largely unexplored. Genetic test is clinically important in the diagnosis of VMD because the clinical features of VMD are similar to those of exudative age-related macular degeneration (AMD), choroidal neovascularization (CNV), or central serous chorioretinopathy (CSC). Here, in addition to describing the clinical characteristics of VMD, this chapter focuses on the clinical genetics of BEST1 gene in VMD.

Purpose. To demonstrate the long-term effectiveness of vitrectomy for intermediate uveitis (IU) and to determine whether complete control of inflammation before vitrectomy is necessary.Methods. This retrospective study included 66 eyes of 66 patients with IU who underwent vitrectomy for vitreoretinal complications. Eyes were followed for at least 12 months after vitrectomy. The degree of inflammation control and visual acuity were compared before and after vitrectomy. These parameters were compared according to the presence of complete inflammation control before surgery.Results. The indications of vitrectomy included epiretinal membrane (26 eyes), vitreous opacity (21 eyes), and tractional retinal detachment (12 eyes), among others. Uveitic attacks did not occur in 44 of the 66 patients after vitrectomy. The numbers of uveitis attacks, local steroid injections, and systemic medications significantly decreased, and vision meaningfully improved after vitrectomy. These parameters did not differ significantly, regardless of the presence of preoperative inflammation.Conclusions. This study showed that vitrectomy is a good modality to manage vitreoretinal complications associated with IU, even if complete control of intraocular inflammation is not achieved before vitrectomy.

Purpose To determine the outcome of a reduced amount of medial rectus (MR) muscle recession in esotropes with cerebral palsy (CP) and to compare the surgical response with that of normal controls. Design Retrospective cohort study. Participants Thirty esotropes with CP and 60 age-matched esotropes without CP who underwent a unilateral or bilateral MR muscle recession. Methods The surgical amount of MR muscle recession was reduced by 1 mm per muscle in patients with CP. Main Outcome Measures Success rates, surgical response, cumulative probabilities of success, and factors affecting surgical responses evaluated by generalized linear mixed models. Results In patients with CP, the initial success rate was higher ( P = 0.037) and the rate of undercorrection was lower ( P = 0.037) compared with patients without CP. At the final visit, success rates were not significantly different between both groups. However, the rate of overcorrection was higher ( P = 0.003) compared with patients without CP. The rate of overcorrection per person-year during follow-up was 11% in patients with CP and 2% in patients without CP. Patients with CP showed a greater surgical response than did those without CP, at about 1.3 prism diopters per millimeter of MR muscle recession ( P Conclusions Even with the reduced amount of recession, esotropes with CP showed a greater surgical response to MR muscle recession than did those without CP, and the incidence of late overcorrection was significantly higher compared with that of patients without CP. Financial Disclosure(s) The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Purpose This study evaluated changes in choroidal vascularity after half-fluence photodynamic therapy (HF-PDT) in patients with central serous chorioretinopathy (CSC) using swept-source optical coherence tomography (SS-OCT) en face imaging. Methods This retrospective comparative case series included 50 eyes of 25 patients with unilateral CSC who underwent HF-PDT and 50 age-and sex-matched normal healthy control eyes. En face SS-OCT images of the choriocapillaris, Sattler’s layer, and Haller’s layer were converted into binary images. The vascular proportions were defined as the percentage of the area of vascular lumen against the area of the 3.0-mm-diameter circular area. The main outcome measures were the vascular proportions before HF-PDT and at 6 weeks, 6 months, and 12 months after HF-PDT. Results At baseline, the vascular proportions in the CSC eyes were significantly greater than those in the control eyes in all layers (choriocapillaris: 51.8% ± 15.5% vs. 41.3 ± 18.7%, P = 0.018; Sattler’s: 58.6% ± 13.4% vs. 49.7% ± 15.7%, P = 0.017; Haller’s: 65.3% ± 15.3% vs. 53.0% ± 13.4%, P = 0.001). In the CSC eyes, the vascular proportion in the choriocapillaris significantly decreased at 6 weeks (36.6% ± 16.9%, P < 0.001), 6 months (34.0% ± 12.3%, P < 0.001), and 12 months (34.8% ± 17.6%, P < 0.001) after HF-PDT compared with baseline. The vascular proportions in Sattler’s and Haller’s layers did not show a significant decrease at 6 weeks (Sattler’s: 49.7% ± 17.3%, P = 0.052 and Haller’s: 58.3% ± 12.9%, P = 0.558) but decreased significantly at 6 months (Sattler’s: 48.9% ± 12.4%, P < 0.001 and Haller’s: 57.7% ± 15.7%, P = 0.027) and 12 months after HF-PDT from the baseline values (Sattler’s: 45.8% ± 10.4%, P < 0.001 and Haller’s: 56.8% ± 15.7%, P < 0.001). Conclusion After HF-PDT, the choriocapillaris showed the earliest decrease in vascular proportion of en face images, Sattler’s and Haller’s layers showed later decreases. The temporal differences in the response of each layer may reflect the pathophysiology of CSC and the therapeutic mechanism of HF-PDT.

PURPOSE To determine surgical responses and outcomes of bilateral lateral rectus (BLR) recession in exotropes with cerebral palsy (CP) and to compare the results with exotropes without CP. METHODS Forty-one exotropes with CP and 82 age- and type (intermittent or constant)-matched exotropes without CP who underwent BLR recession by one surgeon (J-M.H.) were evaluated. Main outcome measures were surgical responses, factors affecting surgical response, success rates, cumulative probabilities of success and recurrence, and drifts of ocular alignment towards exodeviation after surgery (exodrift). RESULTS The surgical responses of BLR recession were not significantly different between both groups (p = 0.136). After a mean follow-up period of 2 years, success rates showed no significant difference between the two groups (p = 1.000). The cumulative probabilities of success and recurrence were not significantly different between the two groups (p = 0.770 and 0.754, respectively). The rate of recurrence per person-year during follow-up was 16.7% in patients with CP and 20.2% in patients without CP. The amount of exodrift showed no significant difference between both groups (p = 0.118). CONCLUSIONS Exotropes with CP showed a similar surgical response, an amount of exodrift, cumulative success and recurrence rates after BLR recession compared to exotropes without CP.

To evaluate the clinical significance of the change in central macular thickness (CMT) measured 1 h after intravitreal bevacizumab injection (IVB) for macular edema (ME) secondary to diabetic retinopathy or retinal vein occlusion (RVO).Retrospective case series.Thirty eyes with ME treated with IVB.A single IVB (1.25 mg/0.5 mL) was administered in 14 eyes with diabetic macular edema (DME) and 16 eyes with ME secondary to RVO. CMT was measured using spectral-domain optical coherence tomography before injection and again 1 hour and 1 month after injection.Statistically significant CMT reduction was observed at both time points. CMT declined from 542.3 ± 127.7 µm at baseline to 516.9 ± 123.4 µm 1 hour after injection (p0.001) and to 345.5 ± 110.0 µm at 1 month after injection (p0.001). The reduction in CMT 1 hour after injection was significantly correlated with the reduction in CMT observed at 1 month after injection, with respect to both absolute (r = 0.515, p = 0.004) and relative changes (r = 0.454, p = 0.012). The 15 eyes that had larger 1-hour CMT reductions also showed larger 1-month CMT reductions (242.9 ± 133.8 µm and 43.4% ± 16.5%) when compared with 15 eyes with smaller 1-hour CMT reductions (148 ± 130.6 µm and 25.0% ± 18.3%). This trend was the same for absolute and relative changes (p = 0.037 and 0.008).The 1-month response of ME to IVB can be predicted by checking CMT 1 hour after injection.

PURPOSE: To compare the clinical outcomes of transscleral fixation of a posterior chamber intra-ocular lens (PC IOL) in the ciliary sulcus or pars plana.SETTING: Department of Ophthalmology, Seoul National University College of Medicine, Seoul,South Korea.DESIGN: Comparative case series.METHODS: This retrospective chart review comprised eyes having ciliary sulcus or pars planafixation of a 3-piece foldable acrylic PC IOL between January 2003 and August 2010. Thepostoperative corrected distance visual acuity (CDVA), efficacy index, safety index, endothelialcell count (ECC), and complication rates in the 2 groups were compared.RESULTS:Theciliarysulcusgroupcomprised38eyesandtheparsplanagroup,56eyes.Therewasno significant between-group difference in the postoperative CDVA, efficacy index, safety index, orECC. The mean spherical equivalent difference was larger in the ciliary sulcus group. Intraocularlens dislocation and pupillary capture of the IOL optic occurred more frequently in the ciliarysulcus group (PZ.001 and PZ.041, respectively). However, retinal detachment, IOLdecentration or tilt, cystoid macular edema, secondary glaucoma, and vitreous hemorrhage didnot differ significantly between the 2 groups.CONCLUSION: The pars plana location for PC IOL transscleral fixation was as safe and effective asthe ciliary sulcus location.Financial Disclosure: No author has a financial or proprietary interest in any material or methodmentioned.J Cataract Refract Surg 2011; 37:1439–1446 Q 2011 ASCRS and ESCRSThere are 2 major options to treat aphakia or to use incases of surgery complicated by severe zonular dis-ruption or posterior capsule rupture. The options areanterior chamber intraocular lens (AC IOL) implanta-tion and posterior chamber IOL (PC IOL) transscleralfixation.

Purpose To evaluate the test-retest reliability and validity of the new automated computerized distance visual acuity and stereoacuity test for children, which uses an interactive video game. Design Retrospective, observational case series. Methods A total of 102 children aged between 3 and 7 years underwent the Snellen visual acuity test, the Distance Randot Stereotest, and the new automated computerized distance visual acuity and stereoacuity test. The test-retest reliability and validity of the automated computerized tests were assessed and compared with the Snellen visual acuity test and the Distance Randot Stereotest with frequency distributions of the differences, Bland-Altman plots, and Deming regression. Results The automated computerized distance visual acuity test had high test-retest reliability (95% limits of agreement ±0.18 logMAR, 90.0% of the differences within 0.2 logMAR) and acceptable validity as compared with the Snellen visual acuity chart (95% limits of agreement ±0.27 logMAR, 81.3% of the differences within 0.2 logMAR). The automated computerized distance stereoacuity test had high test-retest reliability (95% limits of agreement ±0.29 log arc second, 95.1% of the differences within 0.3 log arc second) and acceptable validity as compared with the Distance Randot Stereotest (95% limits of agreement ±0.35 log arc second, 93.9% of the differences within 0.3 log arc second). Conclusions The new automated computerized distance visual acuity and stereoacuity test, which uses an interactive video game, has good reliability and acceptable validity compared with the Snellen visual acuity chart and the Distance Randot Stereotest.