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To measure changes in axial length before and after trabeculectomy with noncontact, partial coherence laser interferometry and identify patient factors that lead to the development of hypotony maculopathy and axial length shortening in 25 eyes with intraocular pressure (IOP) ≤6 mmHg at 4 weeks after mitomycin C-augmented trabeculectomy. A retrospective comparative case series. Hypotony maculopathy was identified with both ophthalmoscopy and spectral-domain optical coherence tomography. Axial length and IOP were serially measured pre- and postoperatively. Logistic regression analysis was performed to identify factors associated with the presence of hypotony maculopathy at 4 weeks after trabeculectomy and multiple regression analysis to identify factors associated with axial length changes. Ten eyes exhibited hypotony maculopathy, whereas the remaining 15 did not. Patients with hypotony maculopathy were significantly younger (47.7 ± 6.2 years) compared with those without it (63.3 ± 9.6 years, P = 0.0002, unpaired t test). The percent reduction of axial length after trabeculectomy was significantly larger in the former group (5.91 ± 2.76 %) compared with the latter group (1.51 ± 0.91 %) (P = 0.0001, Mann–Whitney U test). Multivariate analyses showed that only age was associated with the presence of hypotony maculopathy, with an odds ratio of 0.82 (P = 0.0075), when age, sex, type of glaucoma, lens status, percent changes in axial length and IOP before and after trabeculectomy, and central corneal thickness were included as independent variables (R 2 = 0.543, P = 0.003). Age-dependent axial length reduction is a risk factor for the development of hypotony maculopathy after trabeculectomy.

To evaluate the long-term effects of photodynamic therapy (PDT) on typical neovascular age-related macular degeneration (tAMD) and polypoidal choroidal vasculopathy (PCV). This was a multicenter prospective study of 139 eyes from 136 patients (tAMD: 74 eyes; PCV: 65 eyes) who underwent PDT as the initial treatment. The change in best-corrected visual acuity (BCVA), predictive factors for the BCVA at 60 months, frequency of recurrence, and mean recurrence period were analyzed. The pre-PDT BCVA and greatest linear dimension (GLD) did not differ between the two groups. The mean BCVA (logMAR) was significantly improved at 6 months post-initial PDT (post-PDT) in the PCV group (−0.11, P = 0.0091). However, at 60 months post-PDT, the mean BCVA was significantly worse than baseline in the tAMD (+0.21, P = 0.0035) and PCV (+0.21, P = 0.0076) groups. Pre-PDT BCVA, age, and GLD were the factors significantly associated with the BCVA at 60 months post-PDT. Although the frequency of recurrence did not significantly differ between the two phenotype groups, the mean recurrence period was significantly longer in the PCV group than in the tAMD group (15.7 vs. 8.6 months, P = 0.0020). PDT may not have benefits for visual acuity in cases of tAMD and PCV over 5 years of follow-up.

Methanol is a highly toxic substance used as an industrial solvent and automotive antifreeze. Human consumption of methanol may result in severe visual disturbances. Because optical coherence tomography (OCT) is very useful for evaluating retinal edema and nerve fiber swelling, we used OCT to examine a patient with methanol-induced retinal toxicity. A 37-year-old man who drank industrial alcohol (100 ml/day) for 4 days. The retinal profiles were evaluated by OCT and fluorescein angiography during the course of treatment. OCT demonstrated peripapillary nerve fiber swelling and accumulation of intraretinal fluid in the acute phase. In the chronic phase, the retinal thickness was diffusely decreased. Steroid pulse therapy was not effective, and his visual acuity was 6/200 OD and 4/100 OS 2 years after the event. OCT was very useful for evaluating the severity of the retinal edema and the temporal changes in the retinal profile. Jpn J Ophthalmol 2006;50:239–241 © Japanese Ophthalmological Society 2006

Neovascular glaucoma (NVG) occurring after branch retinal artery occlusion (BRAO) might not be as rare as previously thought. We report a case of unilateral NVG after BRAO. A 72-year-old man with chronic heart failure suffered from BRAO in the left eye. Funduscopic examination showed retinal edema and many cotton wool spots in the superotemporal retina. Five weeks later, he had increased blurring of vision due to a second BRAO in the inferotemporal retina of the left eye. Three days later, he felt pain and had severe visual loss in the left eye. In the presence of angle neovascularization, intraocular pressure (IOP) in the left eye rose to 35 mmHg. Immediate focal photocoagulation to the affected retina diminished the neovascularization and lowered the IOP. It is possible for NVG to occur as a complication of BRAO. Jpn J Ophthalmol 2005;49:388–390 © Japanese Ophthalmological Society 2005