To evaluate 1-year outcomes of loading phase treatment followed by a treat-and-extend (TAE) regimen with intravitreal aflibercept 8 mg for neovascular age-related macular degeneration (nAMD). Retrospective, interventional case series. We retrospectively studied 83 eyes of 80 consecutive patients with treatment-naïve nAMD, assessing best-corrected visual acuity (BCVA), foveal thickness (FT), central choroidal thickness (CCT), total number of injections over 1 year, and intended injection interval at the last visit. Sixty eyes (72.3%) completed the 1-year aflibercept 8mg treatment. Their BCVA improved significantly, with significant reductions in FT and CCT, for up to 1 year. The total number of injections was 6.5±0.7, and the intended injection interval at the last visit was 13.4±3.3 weeks. Of the 23 eyes (27.7%) failing to complete the 1-year treatment, 9 (10.8%) developed non-infectious intraocular inflammation (IOI) associated with retinal vasculitis during the loading phase, leading to treatment discontinuation. Moreover, 7 eyes (8.4%) were switched to intravitreal brolucizumab due to persistent exudation with an 8-week interval of aflibercept 8mg injections in the maintenance phase. The remaining 7 eyes (8.4%) dropped out. Loading phase treatment followed by a TAE regimen with intravitreal aflibercept 8 mg appears to be effective for improving visual acuity and ameliorating exudative changes in eyes with nAMD. However, there might be cases in which exudative changes cannot be adequately controlled with injections of aflibercept 8 mg. Moreover, careful monitoring is required due to the potential development of IOI associated with retinal vasculitis during the loading phase.

To investigate the association between genetic variants susceptible to exudative age-related macular degeneration (AMD) and the treatment response to as-needed intravitreal brolucizumab (IVBr) therapy. Interventional study METHODS: This retrospective study included 103 treatment-naïve eyes with exudative AMD. All eyes received three monthly IVBr injections (6.0 mg/0.05 mL) followed by a pro re nata regimen for 12 months. Seven major AMD-associated single nucleotide polymorphisms-ARMS2 A69S (rs10490924), CFH I62V (rs800292), CFH rs1329428, C2-CFB-SKIV2L rs429608, C3 rs2241394, CETP rs3764261, and ADAMTS9 rs6795735-were genotyped using TaqMan assays. The requirement for retreatment, the number of additional injections, and visual outcomes were compared across genotypes. Of the 103 patients, 68 (66.0%) required additional injections. The T allele of ARMS2 A69S was significantly more frequent in the retreatment group than in the retreatment-free group (65.0% vs. 42.9%, p = 1.9 × 10⁻3) and remained independently associated with retreatment after adjustment for age, sex, and baseline visual acuity (p = 3.0 × 10⁻3). Eyes with the TT genotype required significantly more additional injections than those with the TG or GG genotypes (2.4 ± 1.7 vs. 1.3 ± 1.6 and 1.3 ± 1.5, respectively; p = 5.0 × 10⁻3). Kaplan-Meier analysis demonstrated a significant difference in retreatment-free survival among ARMS2 genotypes (p = 4.1 × 10⁻4). Visual outcomes did not differ across any genotypes. ARMS2 A69S may serve as a predictor of recurrence and number of additional injections in as-needed brolucizumab therapy for exudative AMD.

To compare physician-assessed and patient-reported outcomes quantified with the Japanese Ocular Surface Disease Index (J-OSDI) following the treatment of bacterial blepharitis and to evaluate the utility of the J-OSDI. Multicenter prospective observational study. Physicians assessed symptoms and findings, calculating clinical total scores at baseline (T0), 7(T1) and 14 (T2) days post-treatment with 1% azithromycin ophthalmic solution, and 1 month after discontinuation (T3). Patients self-reported symptoms using the J-OSDI at these times. The J-OSDI score trends and differences in temporal changes between the J-OSDI and clinical total scores were analyzed by use of a linear mixed-effects model. Forty-six eyes (46 patients; mean age, 71.8 years) were studied. The J-OSDI scores decreased significantly post-treatment for all the patients, with similar trends for both anterior and posterior blepharitis. For all the patients, the slope difference between the J-OSDI and clinical total scores was not significant in the T0-T1 period (P = .219), meaning that the J-OSDI scores reflected the clinical results, whereas it was significant in the T1-T2 (P = .004) and T2-T3 (P <.001) periods. The within-subject correlation between the 2 scores was 0.525 (95% CI 0.401-0.631). For anterior blepharitis, the slope differences were significant across all the periods, but for posterior blepharitis, no significant differences were observed in the T0-T1 or T1-T2 (P = .205, 0.06, respectively) periods, although significant differences were noted in the T2-T3 period (P = .018). The J-OSDI trajectory often diverges from physician-rated changes. Whilst the J-OSDI does not assess treatment response in anterior blepharitis, it may be partially reflective of improvement in posterior blepharitis.

To determine the frequency of peripapillary retinoschisis (PRS), lamina cribrosa defect (LCD), peripapillary intrachoroidal cavitation (PICC), and prelaminar schisis (PLS) in primary open-angle glaucoma (POAG) eyes and investigate their association with axial length (AXL). Retrospective cross-sectional METHODS: Optical coherence tomography scans of 263 POAG eyes were reviewed for PRS, LCD, PICC, and PLS. The frequency of each optic nerve head (ONH) abnormality was compared between eyes with and without high myopia (HM), defined as AXL >26mm. Associations with AXL were assessed using univariable and multivariable logistic regression, adjusting for gender, age, intraocular pressure, visual field mean deviation, circumpapillary retinal nerve fiber layer thickness and Bruch's membrane opening (BMO) area. PRS, LCD, PICC, and PLS were observed in 11.8%, 31.6%, 18.3%, and 55.1% of all POAG eyes, respectively. 77.2% exhibited at least one abnormality, and 31.2% had multiple abnormalities. PRS, LCD, and PICC were more frequent in HM eyes (p=0.001, 0.016 and <0.001, respectively) and associated with longer AXL in univariable analysis (p<0.001). Multivariable analysis showed that PRS significantly associated with longer AXL (p<0.001) and that LCD and PICC significantly associated with larger BMO area (p=0.009, <0.001). PLS was more frequent in eyes without HM (p=0.026) and significantly associated with shorter AXL (p=0.005). ONH abnormality was common in myopic POAG eyes with substantial overlaps. PRS, LCD and PICC were associated with longer AXL and myopic ONH structural change while PLS was associated with shorter AXL. These findings will be a foundation for further studies exploring their functional relevance.

To investigate differences in work styles and career satisfaction between women and men physicians in the retina subspecialty in Japan using a questionnaire survey. Cross-sectional study. A web-based questionnaire was sent as an e-mail link to all 3,027 current members of the Japanese Retina and Vitreous Society in August 2023 with responses collected anonymously in September 2023. The questionnaire consisted of 4 main categories: baseline characteristics, job satisfaction, life events and career advancement, and suitability as a retina specialist and workplace gender equality. Valid responses were received from 614 members, representing a response rate of 20.3%. One-fifth of men (19.0%) were "very satisfied" with their job, much higher than the same for women (7.5%) (P < 0.001). Furthermore, there was a significant difference between men and women who "strongly agreed" or "agreed" that life events were an impediment to one's career (44.3% vs 74.9%) (P < 0.001). There was also a significant difference between men and women who answered "strongly agree" when asked whether they felt they were suited to work in the retina subspecialty (31.0% vs 13.4%) (P < 0.001). Our study identified and quantified marked differences in work style and career satisfaction between women and men. Such differences highlight gender-based challenges in the retina subspecialty that could be improved in order to enhance career satisfaction and career longevity of women retina specialists in Japan.

To evaluate the safety and efficacy of a novel double-encircling continuous suture technique for the surgical repair of complete (360°) cyclodialysis. Retrospective interventional case series. Medical records of seven consecutive eyes from seven patients with complete cyclodialysis treated at the University of Tokyo Hospital between 2022 and 2025 were retrospectively reviewed. The extent of cyclodialysis and postoperative anatomical outcomes were assessed using anterior segment optical coherence tomography (OCT). Intraocular pressure (IOP) and best-corrected visual acuity (BCVA) were recorded both pre- and post-operatively. The surgical technique consisted of placing two laps of encircling continuous 10-0 polypropylene sutures at 3-4 mm and 2-3 mm posterior to the limbus. In phakic eyes, phacoemulsification with intraocular lens and capsular tension ring implantation were performed concurrently. Four men and three women with a mean age of 43.6 ± 25.4 years were included. Cyclodialysis resulted from blunt trauma (n = 3) or surgical complications (n = 4). Preoperative IOP ranged from 2 to 8 mmHg, and hypotonic maculopathy was observed in all cases. Postoperatively, anatomical reattachment of the ciliary body and resolution of hypotony were achieved in six of seven eyes (85.7%). All eyes demonstrated improved BCVA, though the improvement depended on comorbid conditions such as glaucoma, pathologic myopia, and bullous keratopathy. IOP transiently elevated postoperatively, and additional glaucoma surgery was necessary in two cases with a history of glaucoma. Reproducible safety and efficacy were confirmed for the double-encircling continuous suture technique in repairing complete cyclodialysis, yielding anatomical success and functional improvement.

Meesmann corneal dystrophy (MCD) is a rare autosomal dominant corneal disorder characterized by recurrent epithelial erosions. While secondary corneal amyloidosis (SCA) is well-documented in chronic inflammatory disorders, its occurrence in MCD has not been previously described. Here we first report a case of concurrent MCA and SCA, the diagnosis was confirmed through clinical evaluation, Anterior segment optical coherence tomography, in vivo laser confocal microscopy, and histopathological examination. Genetic testing identified a novel KRT12 mutation (c.1292G>C, p.R431P) in both the patient and her affected father, though the father exhibited no signs of SCA. SCA may develop as a rare complication in patients with long-standing MCD, potentially complicating the diagnosis.

To determine whether the effect of three muscle surgery for moderate to large angle exotropia can be better predicted by surgical dosage, or by pre-operative exotropia angle. We examined cases where identical surgical dose was performed for a wide range of preoperative angles 30 to 55Δ. Retrospective, interventional case study. Patients with exotropia 30-55Δ who underwent bilateral lateral rectus (BLR) muscle recession 7 mm and 4 mm unilateral medial rectus (UMR) muscle plication between 2014 and 2024 were included. Surgical effect was analyzed by linear regression against the amount of preoperative exotropia, as well as total millimeters of recession and plication. Success was defined as less than 10Δ exotropia or 5Δ esotropia. Thirty-four patients were included with 32 ± 27 (standard deviation, SD) years mean age. Mean preoperative exotropia at distance was 42 ± 6Δ (range 30-55Δ), and 40 ± 16Δ (range 6-70Δ) at near. Surgical effect varied from 29Δ to 75Δ, averaging 42 ± 10Δ, giving a mean dose response of 2 ± 1Δ/mm. Linear regression showed that average surgical effect was equal to pre-operative deviation, accounting for 34-36% of variation in surgical effect. Success rate of this operation for all exotropia angles was 76% at 2 months mean followup. Surgical effect for moderate to large angle exotropia does not strongly depend on surgical dose, so that successful outcomes measured 2months post-operatively are obtained by performing a numerically identical procedure regardless of the pre-operative angle exceeding 30Δ. Since outcome is attributable more to the biological response than to amount of surgery, pre-operative measurements require onlysufficient precision to confirm that the angle is moderate to large.

This study aimed to identify the incidence and risk factors of corneal disorders (CDs) and lacrimal passage obstruction (LPO) caused by S-1 chemotherapy. Multicenter prospective cohort study. This study included patients who were administered S-1 for the first time and underwent ophthalmic evaluations for 1 year during the treatment. CD was defined as an increase of >2 points in the National Eye Institute classification. LPO was defined as an abnormality in lacrimal irrigation. Risk factors were identified via univariate and multivariate analyses. This study enrolled 126 men and 49 women with a mean age of 68.1 (30-87) years. Over a mean follow-up of 169.6 ± 127.3 days, the incidence rates of CD and LPO were 24.6% and 14.0%, with 1-year cumulative incidence rates of 37.0% and 25.9%, respectively. The risk factors for CD were no previous use of eye drops (hazard ratio [HR] 3.45, p = 0.0955) and tear breakup time over 5 s prior to S-1 chemotherapy (HR 1.86, p = 0.0535). The risk factors for LPO were male sex (HR 5.00, p = 0.0311), primary tumor other than gastric cancer (HR 2.27, p = 0.0666), previous use of eye drops for dry eye (HR 21.16, p = 0.0035), and previous visual disturbance (HR 2.89, p = 0.0303). The high incidence of CD and LPO among patients undergoing S-1 chemotherapy warrants close monitoring of those with identified risk factors, especially within the first six months of chemotherapy.

To investigate the role of choroidal thickness (CT) in primary angle-closure disease (PACD). Retrospective study. This retrospective observational study included fifty-one eyes-thirteen with acute primary angle-closure (APAC) with resolved glaucoma attack, twelve with primary angle-closure suspect (PACS), and twenty-six age- and sex-matched controls. Two blinded observers independently measured CT using swept-source optical coherence tomography (SS-OCT) at the subfovea and eight peripheral locations following the Margolis and Spaide method. In addition to routine ophthalmic examinations, the axial length (AL), anterior chamber depth (ACD), and lens vault (LV) were analyzed. Multivariable regression was used to identify associated factors, and the most effective parameters for discriminating PACD were investigated. Subfoveal CT (SFCT) was significantly greater in the APAC (293.4±103.7µm) and PACS (283.8±71.9µm) groups than in the control group (210.8±77.2µm; p<0.05). AL and age were each independently negatively associated with SFCT (p<0.05). The CT/AL ratio was significantly greater in both PACD groups than in the control group. This ratio demonstrates superior discriminatory performance compared with absolute CT values in distinguishing eyes affected by PACD from normal eyes. The combination of ACD and LV yielded the highest diagnostic performance (area under the curve: 0.96), with a similar level of performance observed for the combination of the AL and the CT/AL ratio (area under the curve: 0.93). Compared with normal eyes, eyes affected by PACD exhibit increased CT and a significantly higher CT/AL ratio. The CT/AL ratio, a novel anatomical index, may provide a normalized metric reflecting choroidal expansion relative to globe size and may serve as a potential structural marker for PACD risk assessment.