Purpose: This study aimed to evaluate the long-term effects of intravitreal brolucizumab (IVB) injections on peripapillary retinal nerve fiber layer (RNFL) thickness in patients with polypoidal choroidal vasculopathy (PCV). Methods: This retrospective case series included 11 eyes from 11 patients with PCV who were switched to IVB treatment due to persistent fluid accumulation despite prior anti-vascular endothelial growth factor (VEGF) therapy. RNFL thickness was measured using spectral-domain optical coherence tomography at baseline and 1, 3, 6, 9, and 12 months post-IVB injection. The data were compared to baseline data of treated eyes and untreated fellow eyes. Results: A significant decrease in RNFL thickness was observed in the inferior temporal sector of the treated eyes at 1 month post-IVB injection compared to baseline (p = 0.029). However, this difference was not significant at subsequent follow-up points. No significant long-term changes were noted in global RNFL thickness or other RNFL sectors compared to baseline. Additionally, there were no significant differences in RNFL thickness between IVB-treated and -untreated fellow eyes at any follow-up visit. Central macular thickness decreased significantly from baseline over the 12-month study period, but BCVA did not significantly differ from baseline at any time point. Conclusions Long-term use of IVB in PCV patients does not lead to significant changes in RNFL thickness in treated eyes relative to untreated fellow eyes. The initial decrease in RNFL thickness in the inferior temporal sector may be due to a reduction in macular edema rather than neurotoxicity caused by anti-VEGF treatment. These findings suggest that IVB treatment for PCV does not have a detrimental impact on RNFL thickness over 12 months.

Acupuncture is recognized as a component of alternative medicine and is increasingly used worldwide. Many studies have shown the various effects of acupuncture around the eyes for ophthalmologic or nonophthalmologic conditions. For ophthalmologic conditions, the effect of acupuncture on dry eye syndrome, glaucoma, myopia, amblyopia, ophthalmoplegia, allergic rhinoconjunctivitis, blepharospasm, and blepharoptosis has been reported. Recently, several studies on dry eye syndrome have been reported and are in the spotlight. However, given the variety of study designs and reported outcomes of periocular acupuncture, research is still inconclusive, and further studies are required. In addition, although a systematic and reliable safety assessment is required, to the best of our knowledge, there have been no reports of a literature review of ocular complications resulting from periocular acupuncture. This review collected cases of ocular injury as severe adverse events from previously published case reports of periocular acupuncture. A total of 14 case reports (15 eyes of 14 patients) of adverse events published between 1982 and 2020 were identified. This review article provides a summary of the reported cases and suggestions for the prevention and management of better visual function prognosis.

Purpose: To investigate the long-term effects of intravitreal anti-vascular endothelial growth factor injection on choroidal thickness and its correlation with visual acuity (VA) in neovascular age-related macular degeneration (nAMD). Methods: This retrospective study evaluated VA, central macular thickness (CMT), and subfoveal choroidal thickness (SFCT) using spectral domain optical coherence tomography at baseline, followed by assessments for up to five years post-injection. Comparisons were made between nAMD and fellow eyes, as well as between baseline and post-injection values within each group. A multiple regression model was used to analyze factors influencing final VA, including baseline VA, age, sex, number of injections, nAMD subtype, baseline CMT and SFCT, and final CMT and SFCT. Results: A total of 57 patients was included in this study. VA improved significantly in nAMD eyes up to one year after injection and then declined. Compared to fellow eyes, nAMD eyes had significantly poorer VA over the entire follow-up. In nAMD eyes, SFCT decreased significantly at each annual follow-up visit (p < 0.001 at every visit). The SFCT of nAMD and fellow eyes showed no significant difference at baseline and after one year. However, a significant difference was observed from the second year onward. Final VA significantly correlated only with baseline VA (standardized coefficients Beta = 0.380, p = 0.011). Conclusions The SFCT of nAMD eyes significantly decreased each year, becoming thinner than fellow eyes from the second year on.Throughout follow-up, nAMD eyes had poorer VA than fellow eyes and final VA of nAMD eyes correlated only with baseline VA.

Purpose: To evaluate the short-term ophthalmic side effects of bilateral same-day intravitreal bevacizumab injections. Methods: We retrospectively analyzed patients who underwent intravitreal bevacizumab injection in both eyes on the same day from January 2015 to June 2019. The patients were followed up at 1 day, 1 week, and 1 month after the injection. Results: A total of 281 patients (153 males and 128 females) and 562 eyes were included in the study, and 950 bilateral same-day intravitreal bevacizumab injections were performed. The mean age of patients was 58.87 ± 13.44 years. The most common cause of bilateral injection was that of complications due to diabetic retinopathy, which accounted for 66.3%, followed by age-related macular degeneration at 22.2%, retinal vein occlusion at 5.1%, and central serious chorioretinopathy at 2.1%. There were 0 cases of endophthalmitis after 950 injections, 13 cases of subconjunctival hemorrhage, and 17 patients with a temporary elevation of intraocular pressure. There were 11 patients with acute intraocular inflammation after bilateral injection, but none in both eyes. Patients with acute intraocular inflammation were followed up at short-term intervals until they improved. All patients showed complete improvement within 2 weeks after injection. Comparing the patients’ condition before and after injection, visual acuity improved (p < 0.001). Conclusions In terms of the frequency of short-term ophthalmic adverse events, bilateral same-day intravitreal bevacizumab injection is a safe procedure with fewer side effects and is more convenient for both the patient and the doctor.

Purpose: To compare the long-term changes in surgically induced astigmatism (SIA) in patients who underwent 23-gauge sutureless vitrectomy and cataract surgery together with patients who underwent cataract surgery only. Methods: We retrospectively reviewed SIA changes for 1 year after surgery in patients who received only cataract surgery using phacoemulsification (group 1) and patients who underwent 23-gauge sutureless vitrectomy and cataract surgery together (group 2). Flat keratometry (K1), steep keratometry (K2), and astigmatism axis were measured with automatic keratometry before and after the surgery. Vector analysis was used to calculate SIA at 1, 3, 6, and 12 months postoperatively. We then examined whether the SIA values at each time point were different between the two groups. Results: A total of 86 eyes were included in this study (group 1, n = 45; group 2, n = 41). The mean SIA values calculated at 1, 3, 6, and 12 months after surgery in group 1 were 0.83 ± 0.37, 0.69 ± 0.39, 0.60 ± 0.33, and 0.59 ± 0.33, respectively. In group 2, the values were 0.82 ± 0.47, 0.69 ± 0.38, 0.62 ± 0.28, and 0.61 ± 0.30, respectively. Over time, SIA decreased in both groups (all p < 0.001). There was no significant difference in the mean SIA between the two groups at each follow-up time point after surgery (p = 0.296, p = 0.728, p = 0.361, and p = 0.356, respectively). Conclusions When 23-gauge sutureless vitrectomy and cataract surgery were performed together, the astigmatism change caused by surgery did not show a significant difference compared with that of the group who received cataract surgery only. Thus, 23-gauge sutureless vitrectomy may not significantly affect corneal astigmatism.

Purpose: To evaluate the short-term ophthalmic side effects of bilateral same-day intravitreal bevacizumab injections. Methods: We retrospectively analyzed patients who underwent intravitreal bevacizumab injection in both eyes on the same day from January 2015 to June 2019. The patients were followed up at 1 day, 1 week, and 1 month after the injection. Results: A total of 281 patients (153 males and 128 females) and 562 eyes were included in the study, and 950 bilateral same-day intravitreal bevacizumab injections were performed. The mean age of patients was 58.87 ± 13.44 years. The most common cause of bilateral injection was that of complications due to diabetic retinopathy, which accounted for 66.3%, followed by age-related macular degeneration at 22.2%, retinal vein occlusion at 5.1%, and central serious chorioretinopathy at 2.1%. There were 0 cases of endophthalmitis after 950 injections, 13 cases of subconjunctival hemorrhage, and 17 patients with a temporary elevation of intraocular pressure. There were 11 patients with acute intraocular inflammation after bilateral injection, but none in both eyes. Patients with acute intraocular inflammation were followed up at short-term intervals until they improved. All patients showed complete improvement within 2 weeks after injection. Comparing the patients’ condition before and after injection, visual acuity improved (p < 0.001). Conclusions In terms of the frequency of short-term ophthalmic adverse events, bilateral same-day intravitreal bevacizumab injection is a safe procedure with fewer side effects and is more convenient for both the patient and the doctor.

Purpose: To compare the long-term changes in surgically induced astigmatism (SIA) in patients who underwent 23-gauge sutureless vitrectomy and cataract surgery together with patients who underwent cataract surgery only. Methods: We retrospectively reviewed SIA changes for 1 year after surgery in patients who received only cataract surgery using phacoemulsification (group 1) and patients who underwent 23-gauge sutureless vitrectomy and cataract surgery together (group 2). Flat keratometry (K1), steep keratometry (K2), and astigmatism axis were measured with automatic keratometry before and after the surgery. Vector analysis was used to calculate SIA at 1, 3, 6, and 12 months postoperatively. We then examined whether the SIA values at each time point were different between the two groups. Results: A total of 86 eyes were included in this study (group 1, n = 45; group 2, n = 41). The mean SIA values calculated at 1, 3, 6, and 12 months after surgery in group 1 were 0.83 ± 0.37, 0.69 ± 0.39, 0.60 ± 0.33, and 0.59 ± 0.33, respectively. In group 2, the values were 0.82 ± 0.47, 0.69 ± 0.38, 0.62 ± 0.28, and 0.61 ± 0.30, respectively. Over time, SIA decreased in both groups (all p < 0.001). There was no significant difference in the mean SIA between the two groups at each follow-up time point after surgery (p = 0.296, p = 0.728, p = 0.361, and p = 0.356, respectively). Conclusions When 23-gauge sutureless vitrectomy and cataract surgery were performed together, the astigmatism change caused by surgery did not show a significant difference compared with that of the group who received cataract surgery only. Thus, 23-gauge sutureless vitrectomy may not significantly affect corneal astigmatism.