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Purpose: To evaluate the visual outcomes of three different treatments for macular edema associated with a branch retinal vein occlusion. Methods: A 1-year, non-randomized study was conducted at 21 ophthalmological institutes in Japan. All of the patients received one of three treatments: medication per-oral (PO), photocoagulation (PC) or pars plana vitrectomy (PPV). Retinal hemorrhage that was lower than that shown in reference photographs was considered an inclusion criteria. Results: Ninety-eight patients were studied. Twenty-six (26.5%) patients were in the PO, 37 (37.8%) in the PC and 35 (35.7%) in the PPV group. The mean best-corrected visual acuity (BCVA) improved significantly after 1 year in all groups ( P < 0.001). There was no significant difference among those groups in the degree of the BCVA improvement. However, the BCVA in the PPV group improved significantly at 6 months, significantly earlier than in the other two groups. The BCVA at entry in the PPV group was significantly worst among patients whose eyes had a BCVA of ≥0.7 at 1 year ( P < 0.05). Conclusions: PPV had a slight advantage over PC and PO, although the improvement to the BCVA did not differ significantly following any of the three treatments. [ABSTRACT FROM AUTHOR]

Background: Pro re nata (PRN) regimen using anti-vascular endothelial growth factor (VEGF) agent is popular for the treatment of diabetic macular edema (DME). We investigated the influence of waiting time (WT) and interval between the date of recurrence of edema and re-injection on treatment efficacy. Methods: This retrospective study conducted at 7 sites in Japan enrolled patients who received intravitreal injection of ranibizumab (IVR) and aflibercept (IVA) in 1+PRN regimen. Enrolled patients were divided into 2 groups: prompt group (less than 1 week) and deferred group (3 weeks or more). Central retinal thickness (CRT) and best corrected visual acuity (BCVA) were measured every month for 1 year. Results: CRT in the deferred group was significantly higher than that in the prompt group at 2, 5, 6, 7, and 12 months (p < 0.05). BCVA in the prompt group was significantly better than that in the deferred group at 7, 10, and 12 months (p < 0.05). Conclusion: The prompt group was superior in anatomical and functional improvement of DME in anti-VEGF therapy than the deferred group. Our data suggests that shorter WT is recommended for better visual prognosis in the treatment for DME. [ABSTRACT FROM AUTHOR]

Background: To describe a retrospective study of macular retinoschisis that developed long after the onset of retinal artery occlusion (RAO) using optical coherence tomography (OCT).Methods: We describe changes in macular findings and visual acuity (VA) of 29 patients (21 males and 8 females, mean age: 66.1 ± 16.9 years) with RAO (18 branch RAOs [BRAOs] and 11 central RAOs [CRAOs] who visited Osaka Medical College Hospital over an 8-year period based on a medical chart review.Results: The mean VA (logMAR) increased from 1.06 ± 1.08 (CRAO: 2.04 ± 0.99; BRAO: 0.37 ± 0.40) at the first visit to 0.71 ± 0.87 (CRAO: 1.46 ± 0.86; BRAO: 0.18 ± 0.30) at the final visit. Macular OCT revealed swelling or hyper-reflectivity of the inner retina in the early phase of RAO and retinal thinning in the late phase. Among the 29 patients, two patients (a patient with BRAO and a patient with CRAO) developed macular retinoschisis about 1 year after RAO onset. The VA of the patient with BRAO was 20/300 at the first visit, and it improved to 20/25 two days after onset following eye massage and anterior chamber paracentesis. However, his VA worsened, declining from 20/25 to 20/50, and retinoschisis occurred 13 months after RAO onset. The patient with CRAO showed macular changes including small cystoids at the first follow-up visit more than 3 weeks after onset and developed retinoschisis 11 months after the first visit. In addition, two patients with BRAO and one patient with CRAO developed macular changes including small cystoids 3 weeks after onset, with the BRAO complicated by retinal vein occlusion. In the CRAO patient, the cystoid macular edema was resolved 1 month after the first visit.Conclusions: Macular retinoschisis is unusual, but a possible complication of RAO that can develop long after the onset of the occlusion, potentially resulting in renewed VA deterioration. [ABSTRACT FROM AUTHOR]

Introduction: In cases of persistent pupillary membrane (PPM), the eye is usually slightly microphthalmic and emmetropia or hyperopia is often present, yet severe myopia is reportedly rare. Here we presented a case of PPM complicated by vitreomacular traction syndrome and posterior staphyloma due to severe myopia., Patient Concerns: This study involved a 63-year-old female patient who had been diagnosed with bilateral PPM at a local eye clinic and who was subsequently referred to our department for a more detailed examination due to a recent decrease of visual acuity., Diagnoses: Slit-lamp microscopy examination revealed bilateral PPM. The ocular fundus revealed peripapillary conus and myopic change in both eyes. Optical coherence tomography examination revealed no particular abnormalities in the right eye, yet did show findings indicative of vitreomacular traction syndrome in the left eye., Interventions: In both eyes, we performed surgical removal of the PPM, phacoemulsification aspiration, and intraocular lens implantation, yet in the patient's left eye, vitrectomy was also performed., Outcomes: After surgery, the patient's visual acuity improved in both eyes., Conclusion: The findings in this case show that when required, vitrectomy should be considered based upon the preoperative Optical coherence tomography findings for PPM.

Purpose: We investigate seasonal variations found in patients with central serous chorioretinopathy (CSC)., Methods: We retrospectively investigated 201 CSC patients at the Osaka Medical College Hospital from January 2011 to December 2016 and evaluated their seasonal and monthly distributions., Results: The study population comprised 149 males and 52 females. There were significant seasonal differences in the distribution of patients, with 62 cases in spring, 37 in summer, 59 in autumn, and 43 in winter, and the monthly prevalence of CSC was high in March (n = 24), April (n = 22), and November (n = 23). In addition, seasonal variation of serous retinal detachment (SRD) in the macula could be observed in 12 recurrent CSC cases., Conclusions: The prevalence of CSC development was the highest in spring. In addition, recurrent SRD in the macula showed seasonal variation in some CSC patients. As factors related to CSC, season and temperature might influence the pathophysiology of CSC., (© 2018 S. Karger AG, Basel.)

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.