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To investigate short-term treatment outcomes of intravitreal brolucizumab (IVBr) for treatment-naïve neovascular age-related macular degeneration (AMD) in a Japanese multicenter study.Retrospective case control study METHODS: The subjects were 58 eyes of 57 patients with neovascular AMD (43 men and 14 women, mean age 74.6 years) of whom 43 eyes of 42 patients completed initial loading of 3 monthly IVBr injections and were followed for more than 3 months. Best-corrected visual acuity (BCVA) changes, anatomical outcomes, and complications were investigated.Of the 43 eyes that completed loading doses, the AMD subtype was type 1 and type 2 macular neovascularization (MNV) in 51%, polypoidal choroidal vasculopathy (PCV) in 42%, and type 3 MNV in 7%. At 3 months after initiating treatment, BCVA significantly improved (P = 0.002) and central retinal thickness significantly decreased (P 0.0001). At 3 months, complete retinal and subretinal fluid resolution was achieved in 91% of all eyes and complete regression of polypoidal lesions was achieved in 82% of PCV eyes. Iritis occurred in 8 eyes of 8 patients (14%), but resolved using topical or subtenon corticosteroid injection without visual loss in all cases.IVBr for treatment-naïve neovascular AMD was effective in the short-term, achieving significantly improved BCVA, good retinal fluid resolution, and a high rate of polypoidal lesion regression. However, iritis was noted in 14% of patients which may limit use of this drug.

PURPOSE To elucidate clinical factors related to the presence of loculation of fluid (LOF) in the posterior choroid in central serous chorioretinopathy (CSC). DESIGN Retrospective, cross-sectional study. METHODS This single-center study included 158 eyes from 158 patients with CSC who were classified into LOF and non-LOF groups. The groups were compared for age, sex, spherical equivalent, axial length, subfoveal choroidal thickness (SCT), and scleral thickness. Using swept-source optical coherence tomography (OCT), we determined the presence of LOF based on B-scan and en face images. Scleral thickness was measured 6 mm posterior to the scleral spur in four directions using anterior segment OCT. RESULTS The 158 eyes were classified into 98 eyes in the LOF group and 60 eyes in the non-LOF group. In univariable analyses, the LOF group was younger (P = .01) and had a higher male ratio (P = .03) and greater SCT (P < .001) than the non-LOF group. All scleral thicknesses at the superior, temporal, inferior, and nasal points were greater in the LOF group than in the non-LOF group (426.2 μm vs. 395.1 μm, 445.7 μm vs. 414.9 μm, 459.2 μm vs. 428.8 μm, 445.4 μm vs. 414.3 μm, all P < .05). Multivariable analyses found that SCT (odds ratio [OR]: 1.02, 95% confidence interval [CI]: 1.01-1.02, P < .001) and mean scleral thickness (OR: 1.02, 95% CI: 1.02-1.03, P = .002) were significantly associated with the presence of LOF. CONCLUSION A thick choroid and thick sclera appeared to be related to the presence of LOF in CSC.

To investigate the prevalence of ciliochoroidal effusion (CE) in central serous chorioretinopathy (CSC) using anterior-segment optical coherence tomography and its association with the clinical features of CSC.Overall, 164 eyes of 164 patients with CSC and 51 eyes of 51 age- and sex-matched normal control participants were retrospectively examined. Anterior-segment optical coherence tomography was used to assess patients with CSC and control subjects for CE and scleral thickness. Central serous chorioretinopathy eyes were divided into two groups: eyes with CE (CE group) and eyes without CE (non-CE group). Scleral thickness was measured at the point that was 6 mm posterior to the scleral spur in four directions.Among the 164 eyes with CSC, 32 eyes (19.5%) displayed CE, and this proportion was significantly higher than that in control subjects (2.0%) (P = 0.001). Scleral thickness was significantly greater in the CE group compared with the non-CE group at all four directions (P0.05 for all). Multivariable analysis revealed that the mean scleral thickness (odds ratio: 1.01; 95% confidence interval: 1.00-1.02; P = 0.007) was significantly associated with the incidence of CE.Central serous chorioretinopathy may accompany fluid accumulation in the anterior segment more frequently than previously expected in association with thick sclera.

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.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.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.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.

Purpose To investigate the clinical and morphological factors related to asymmetric dilated vortex veins in central serous chorioretinopathy (CSC). Design Retrospective, comparative study. Participants One hundred fifty-eight eyes of 158 patients with CSC. Methods All CSC patients underwent ophthalmic examination and multimodal imaging, including measurements of axial length (AL), fluorescein angiography, indocyanine green angiography, swept-source optical coherence tomography (OCT), and anterior-segment OCT. Using en face OCT images at the level of the outer choroid, the eyes were divided into two groups: eyes with symmetric vortex veins (symmetry group) and those with asymmetric vortex veins (asymmetry group). Main Outcome Measures Clinical and morphological factors related to asymmetric vortex veins in CSC. Results Of the 158 eyes, 120 (75.9%) were classified into the asymmetry group and 38 (24.1%) into the symmetry group. The asymmetry group significantly showed greater spherical equivalent (-0.32 ± 1.78 diopters vs. -1.35 ± 2.64 diopters; P = 0.033), shorter AL (23.52 ± 0.86 mm vs. 24.10 ± 1.06 mm; P = 0.005), and greater subfoveal choroidal thickness (414.6 ± 105.3 μm vs. 360.4 ± 91.8 μm; P = 0.005) than the symmetry group. No significant differences existed between the two groups regarding the age, sex, and all scleral thicknesses at the superior, temporal, inferior, and nasal points. In the multivariable analyses, shorter AL (odds ratio, 0.56; 95% confidence interval, 0.36–0.88; P = 0.011) was found to be significantly associated with the presence of asymmetric vortex veins. Conclusions The asymmetric dilated vortex vein is a common finding in patients with CSC. Our results suggest that certain biometric factors, such as short AL, may be associated with developing asymmetric dilated vortex veins in CSC.

To evaluate scleral thickness in central serous chorioretinopathy (CSC) using anterior segment (AS) OCT.Retrospective, comparative study.Forty-seven eyes of 40 patients with CSC and 53 eyes of 47 age- and gender-matched normal control participants.Spherical equivalent, axial length, subfoveal choroidal thickness, and scleral thickness were compared between the CSC and control groups. Scleral thickness was measured by AS OCT 6 mm posterior to the scleral spur in 4 directions.Scleral thickness in CSC eyes.No differences were found between the 2 groups in age, gender, spherical equivalent, or axial length. Subfoveal choroidal thickness was significantly greater in CSC eyes than in normal control eyes (424.0 ± 101.4 μm vs. 324.3 ± 91.8 μm; P0.001). Scleral thickness was significantly greater in CSC eyes than in normal control eyes at the superior (429.4 ± 50.3 μm vs. 395.2 ± 55.4 μm; P = 0.005), temporal (447.7 ± 45.7 μm vs. 396.5 ± 64.1 μm; P0.001), inferior (455.7 ± 81.2 μm vs. 437.8 ± 46.9 μm; P = 0.022), and nasal (454.9 ± 44.7 μm vs. 416.6 ± 51.2 μm; P = 0.001) points.Scleral thickness measured by AS OCT was significantly greater in CSC eyes than in normal control eyes, although no differences were found in spherical equivalent or axial length. Thick sclera may have a role in the pathogenesis of CSC.