PURPOSE: We prospectively investigated clinical changes and long-term outcomes after administration of the drugs recommended by the Age-Related Eye Disease Study-2 to patients with intermediate age-related macular degeneration (AMD). METHODS: This prospective multicenter study enrolled 79 eyes of 55 patients taking lutein and zeaxanthin. The primary endpoint was contrast sensitivity; this was checked every 12 months for a total of 36 months after treatment commenced. The secondary endpoints were visual acuity, central macular thickness, and drusen volume; the latter two parameters were assessed using spectral domain optical coherence tomography. RESULTS: The mean patient age was 72.46 ± 7.16 years. Contrast sensitivity gradually improved at both three and six cycles per degree. The corrected visual acuity was 0.13 ± 0.14 logMAR and did not change significantly over the 36 months. Neither the central macular thickness nor drusen volume changed significantly. CONCLUSIONS: Contrast sensitivity markedly improved after treatment, improving vision and patient satisfaction. Visual acuity, central retinal thickness, and drusen volume did not deteriorate. Therefore, progression of AMD and visual function deterioration were halted.
Contrast Sensitivity ; Eye Diseases ; Humans ; Lutein ; Macular Degeneration ; Patient Satisfaction ; Prospective Studies ; Retinaldehyde ; Tomography, Optical Coherence ; Visual Acuity ; Zeaxanthins

Spherical neural mass (SNM) is a mass of neural precursors that have been used to generate neuronal cells with advantages of long-term passaging capability with high yield, easy storage, and thawing. In this study, we differentiated neural retinal progenitor cells (RPCs) from human induced pluripotent stem cells (hiPSC)-derived SNMs. RPCs were differentiated from SNMs with a noggin/fibroblast growth factor-basic/Dickkopf-1/Insulin-like growth factor-1/fibroblast growth factor-9 protocol for three weeks. Human RPCs expressed eye field markers (Paired box 6) and early neural retinal markers (Ceh-10 homeodomain containing homolog), but did not photoreceptor marker (Opsin 1 short-wave-sensitive). Reverse transcription polymerase chain reaction revealed that early neural retinal markers (Mammalian achaete-scute complex homolog 1, mouse atonal homolog 5, neurogenic differentiation 1) and retinal fate markers (brain-specific homeobox/POU domain transcription factor 3B and recoverin) were upregulated, while the marker of retinal pigment epithelium (microphthalmia-associated transcription factor) only showed slight upregulation. Human RPCs were transplanted into mouse (adult 8 weeks old C57BL/6) retina. Cells transplanted into the mouse retina matured and expressed markers of mature retinal cells (Opsin 1 short-wave-sensitive) and human nuclei on immunohistochemistry three months after transplantation. Development of RPCs using SNMs may offer a fast and useful method for neural retinal cell differentiation.
Animals ; Cell Differentiation ; Humans* ; Immunohistochemistry ; Induced Pluripotent Stem Cells ; Methods ; Mice ; Neurons ; Photoreceptor Cells, Vertebrate ; Polymerase Chain Reaction ; Retina ; Retinal Pigment Epithelium ; Retinaldehyde* ; Reverse Transcription ; Stem Cells* ; Transcription Factors ; Up-Regulation

The aim of this study was to investigate the acute effects of ethanol administration on pattern-reversal visual evoked potential (VEP) and multifocal electroretinography (mfERG). Fifteen healthy subjects with no ocular or general disease were recruited. VEP (0.25° pattern sizes) and mfERG with 19 elements in two recording segments were performed before ethanol administration to obtain baseline for each participant. A few days later, the participants visited again for VEP and mfERG measurements after ethanol administration. Ethanol (0.75 g/kg) was administered orally over the course of 30 minutes. VEP and blood alcohol concentration were evaluated one hour after ethanol administration, and mfERG was conducted after pupil dilation. The Wilcoxon signed-rank test was used to compare parameter changes after randomized eye selection. The mean blood alcohol concentration was 0.034% ± 0.05% by volume. VEP revealed a P100 latency delay (109.4 ± 5.3; 113.1 ± 8.2; P = 0.008) after alcohol administration. The P1 implicit time of ring 1 on mfERG showed a trend of shortening after alcohol administration (37.9 ± 1.0; 37.2 ± 1.5; P = 0.048). However, the changes did not show statistical significance after Bonferroni correction. In conclusion, orally administrated ethanol (0.75 g/kg) appears to suppress the central nervous system, but it is not clear whether alcohol intake affects the retina.
Adult ; *Alcohol Drinking ; Electroretinography ; Evoked Potentials, Visual/*physiology ; Female ; Humans ; Male ; Retina/physiology

PURPOSE: The relationship between central serous chorioretinopathy associated with retinal macrovessel remains controversial due to its rareness. We report a case of central serous chorioretinopathy diagnosed by spectral domain optical coherence tomography (SD-OCT) in a patient with a retinal macrovessel that improved spontaneously. CASE SUMMARY: A 36-year-old healthy male patient visited our clinic complaining of blurred vision in his left eye. Fundus examination of the left eye revealed central serous chorioretinopathy with retinal macrovessel in the macular area. Fundus fluorescent angiography showed an ink blot-shaped leakage, which was not clearly distinguishable due to a retinal macrovessel. Serous retinal detachment under the neurosensory retina was identified on OCT. A small pigment epithelial detachment was observed and considered as a leaking point. However, no visible exudates appeared to be leaking around the retinal macrovessel. CONCLUSIONS: Central serous chorioretinopathy with a retinal macrovessel in a Korean patient was evaluated by SD-OCT. When compared with typical cases, no differences were observed in this case and no significant associations between central serous chorioretinopathy and retinal macrovessel were shown.
Angiography ; Central Serous Chorioretinopathy ; Exudates and Transudates ; Eye ; Humans ; Ink ; Male ; Retina ; Retinal Detachment ; Retinaldehyde ; Tomography, Optical Coherence ; Vision, Ocular

PURPOSE: To compare clinical outcomes between intravitreal bevacizumab (IVB) monotherapy and combined therapy with half-fluence rate verteporfin photodynamic therapy (PDT) for occult choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD). METHODS: Medical records were reviewed in consecutive patients who underwent IVB monotherapy or combined therapy with PDT for occult CNV secondary to AMD and had a 12-month follow-up period. After 3 consecutive monthly IVB injections, both groups were eligible for additional IVB injections when necessary. Best-corrected visual acuity (BCVA), central macular thickness (CMT), and number of additional IVB injections were compared between the groups. RESULTS: Thirty-nine eyes underwent IVB monotherapy (IVB group) and 25 eyes underwent combined therapy (PDT+IVB group). Mean BCVA improved significantly in the PDT+IVB group (p = 0.046) and not in IVB group (p = 0.213). A significant reduction in mean CMT occurred in both groups (p < 0.001). The mean number of additional IVB injections was 1.6 +/- 1.33 in the IVB group and 0.5 +/- 1.01 in the PDT+IVB group (p = 0.001). There were no serious complications. CONCLUSIONS: Combined therapy with half-fluence rate PDT improved BCVA and reduced the number of additional IVB injections in the eyes with occult CNV secondary to AMD.
Antibodies, Monoclonal, Humanized ; Choroid* ; Choroidal Neovascularization* ; Eye ; Follow-Up Studies ; Humans ; Macular Degeneration* ; Medical Records ; Photochemotherapy* ; Porphyrins ; Triazenes ; Visual Acuity ; Bevacizumab

PURPOSE: To report a case of delayed sealing of full-thickness macular hole associated with diabetic retinopathy after vitrectomy with silicone oil tamponade. CASE SUMMARY: A 63-year-old woman visited our clinic complaining of decreased visual acuity in her left eye. Fundoscopy showed a full-thickness macular hole with vitreomacular traction in the left eye and bilateral proliferative diabetic retinopathy. The patient underwent uncomplicated phacoemulsification and pars plana vitrectomy with silicone oil tamponade because her vision in the contralateral eye was only light perception. She was unable to maintain a prone position postoperatively due to anterior chamber hyphema. At 1.5 months after surgery, vitreomacular traction was removed but the hole was not sealed as observed on optical coherence tomography. Approximately 3 months after vitrectomy, the macular hole was sealed with minimal subfoveal fluid. At 6 months after vitrectomy, the macular hole was closed completely with no subfoveal fluid.
Anterior Chamber ; Diabetic Retinopathy ; Eye ; Female ; Humans ; Hyphema ; Light ; Phacoemulsification ; Prone Position ; Retinal Perforations ; Silicone Oils ; Tomography, Optical Coherence ; Traction ; Vision, Ocular ; Visual Acuity ; Vitrectomy

PURPOSE: To evaluate a simplified method to measure peripapillary choroidal thickness using commercially available, three-dimensional optical coherence tomography (3D-OCT). METHODS: 3D-OCT images of normal eyes were consecutively obtained from the 3D-OCT database of Korea University Medical Center On the peripapillary images for retinal nerve fiber layer (RNFL) analysis, choroidal thickness was measured by adjusting the segmentation line for the retinal pigment epithelium to the chorioscleral junction using the modification tool built into the 3D-OCT image viewer program. Variations of choroidal thickness at 12 sectors of the peripapillary area were evaluated. RESULTS: We were able to measure the peripapillary choroidal thickness in 40 eyes of our 40 participants, who had a mean age of 41.2 years (range, 15 to 84 years). Choroidal thickness measurements had strong inter-observer correlation at each sector (r = 0.901 to 0.991, p < 0.001). The mean choroidal thickness was 191 +/- 62 microm. Choroidal thickness was greatest at the temporal quadrant (mean +/- SD, 210 +/- 78 microm), followed by the superior (202 +/- 66 microm), nasal (187 +/- 64 microm), and inferior quadrants (152 +/- 59 microm). CONCLUSIONS: The measurement of choroidal thickness on peripapillary circle scan images for RNFL analysis using the 3D-OCT viewing program was highly reliable and efficient.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Choroid/*anatomy & histology ; Databases, Factual ; Female ; Humans ; Imaging, Three-Dimensional/*methods/statistics & numerical data ; Male ; Middle Aged ; Observer Variation ; Retina/*anatomy & histology ; Tomography, Optical Coherence/*methods/statistics & numerical data ; Young Adult

PURPOSE: To report a case of secondary macular hole formed after phacoemulsification in a vitrectomized eye which was treated with macular hole surgery. CASE SUMMARY: A 53-year-old man with a history of pars plana vitrectomy developed a cataract in his left eye. Uncomplicated cataract surgery involving phacoemulsification with posterior chamber intraocular lens implantation was performed. At his routine 3-month post-operative visit, he reported metamorphopsia. Fundus examinations and optical coherence tomography revealed a cystoid macular edema and a full thickness macular hole. He underwent repair of the macular hole including internal limiting membrane peeling and gas injection. Three months later, post-operative examinations showed anatomical closure of the macular hole. CONCLUSIONS: When performing cataract surgery, even in a previously vitrectomized eye, clinicians should be aware of the possibility of cystoid macular edema. A thorough pre- and post-operative assessment, including fundus examinations and optical coherence tomography must be carefully performed in order to detect a macular hole associated with cystoid macular edema. And prompt treatment is required when a macular hole is detected.
Cataract ; Eye ; Humans ; Lens Implantation, Intraocular ; Macular Edema ; Membranes ; Middle Aged ; Phacoemulsification ; Retinal Perforations ; Tomography, Optical Coherence ; Vision Disorders ; Vitrectomy

PURPOSE: To report a case of secondary macular hole formed after phacoemulsification in a vitrectomized eye which was treated with macular hole surgery. CASE SUMMARY: A 53-year-old man with a history of pars plana vitrectomy developed a cataract in his left eye. Uncomplicated cataract surgery involving phacoemulsification with posterior chamber intraocular lens implantation was performed. At his routine 3-month post-operative visit, he reported metamorphopsia. Fundus examinations and optical coherence tomography revealed a cystoid macular edema and a full thickness macular hole. He underwent repair of the macular hole including internal limiting membrane peeling and gas injection. Three months later, post-operative examinations showed anatomical closure of the macular hole. CONCLUSIONS: When performing cataract surgery, even in a previously vitrectomized eye, clinicians should be aware of the possibility of cystoid macular edema. A thorough pre- and post-operative assessment, including fundus examinations and optical coherence tomography must be carefully performed in order to detect a macular hole associated with cystoid macular edema. And prompt treatment is required when a macular hole is detected.
Cataract ; Eye ; Humans ; Lens Implantation, Intraocular ; Macular Edema ; Membranes ; Middle Aged ; Phacoemulsification ; Retinal Perforations ; Tomography, Optical Coherence ; Vision Disorders ; Vitrectomy

PURPOSE: To investigate systemic factors associated with central serous chorioretinopathy (CSC). METHODS: We retrospectively reviewed the medical records of 113 Korean patients who were diagnosed with CSC and who underwent history taking with a specialized questionnaire for CSC. They were matched for age and gender at a ratio of 1 : 3 to 339 normal controls. Normal controls were consecutively selected from a database at the Health Promotion Center. General characteristics and medical histories were compared between the two groups. The statistical analyses used included independent t-test, Mann-Whitney test, Fisher's exact test, and multivariate logistic regression analysis. RESULTS: There were 90 men and 23 women in the CSC group, and the male-female ratio for both groups was 3.9 : 1. The mean age of the patients was 45.6 years. In multivariate analysis, hypertension (odds ratio [OR], 2.327; 95% confidence interval [CI], 1.349-4.013), use of medicinal plants (OR, 2.198; 95% CI, 1.193-4.049), sleep disturbances (OR, 1.732; 95% CI, 1.096-2.739), and snoring (OR, 1.727; 95% CI, 1.058-2.820) were strongly associated with CSC. CONCLUSIONS: Hypertension, sleep disturbance, snoring, and medicinal plant use were identified as factors associated with CSC. Expanded history taking, including systemic factors and culture-specific behavior related to stress or fatigue such as use of medicinal plants, will be helpful in identifying Korean patients at an increased risk for CSC.
Asian Continental Ancestry Group ; Case-Control Studies ; Central Serous Chorioretinopathy/*epidemiology/*etiology ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Questionnaires ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Factors ; Statistics, Nonparametric