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.

Purpose: Intermediate age-related macular degeneration (AMD) is characterized by drusen, alterations in the retinal pigment epithelium, and various features of pigment epithelium detachment (PEDs) without exudation. With the advent of optical coherence tomography angiography (OCTA), non-exudative choroidal neovascularization (CNV) has recently been reported in eyes with intermediate AMD.This study investigated the frequency of subclinical, non-exudative CNV in eyes with intermediate AMD using OCTA. Methods: We retrospectively evaluated the optical coherence tomography (OCT) and OCTA images of 140 eyes (97 patients) with intermediate AMD. PEDs were divided into 4 types based on OCT. En-face OCTA and cross-sectional OCTA were performed to detect the presence of non-exudative CNV in eyes with intermediate AMD. Results: The frequency of subclinical non-exudative CNV was 13.8% (17 eyes) in eyes with intermediate AMD. Drusenoid PEDs accounted for 47% (66 eyes), shallow irregular PEDs for 20% (28 eyes), serous PEDs for 19% (26 eyes), and combined PEDs for 15% (20 eyes). Non-exudative CNV was observed only in eyes with shallow irregular PEDs. The frequency of non-exudative CNV in shallow irregular PEDs was 38.6%. Conclusions Subclinical non-exudative CNV was identified in 13.8% of eyes with intermediate AMD, which does not seem to be low.Therefore, OCTA may be necessary to evaluate patients with intermediate AMD, particularly those with shallow irregular PEDs.

Purpose: We sought to evaluate the time-dependent efficacy and safety of eplerenone for central serous chorioretinopathy. Methods: A systematic search was performed from inception to May 2023 in the Medline, EMBASE, and Cochrane literature databases to find randomized controlled trials that have administered oral eplerenone therapy to central serous chorioretinopathy patients. Results: Five randomized controlled trials were included in the final analysis. Among a total of 252 central serous chorioretinopathy patients, 134 were included in the eplerenone group and 118 were included in the control group. The best-corrected visual acuity was statistically significantly improved in the eplerenone group compared to the control group (95% confidence interval [CI], -0.08 to -0.02; p = 0.001). After meta-analysis was performed at each follow-up point, it was found that eplerenone statistically significantly improved the best-corrected visual acuity compared to the control group at 2 and 3 months after starting oral eplerenone therapy, but there was no statistically significant difference at 6 months. Subretinal fluid, chorioretinal thickness, central macular thickness, and complications showed no statistically significant differences between the eplerenone and control groups (p = 0.43, 0.67, 0.64, and 0.12, respectively). The difference in the risk of complications occurring between the eplerenone and control groups also didn’t show statistical significance (p = 0.12). Conclusions Although eplerenone is not superior to a control protocol when considering anatomical improvements, the best-corrected visual acuity seems to improve up to 3 months superiorly compared to in the control group when oral eplerenone therapy is administered for central serous chorioretinopathy. In addition, the complications of eplerenone are tolerable. Therefore, clinically short-term use of eplerenone up to 3 months in central serous chorioretinopathy patients can be considered.

BACKGROUND AND OBJECTIVES: This study was performed to investigate whether stem cell therapy enhances β cell function by meta-analysis with proper consideration of variability of outcome measurements in controlled trial of type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) patients. METHODS: A systematic search was performed from inception to January 2018 in PubMed, EMBASE, and Cochrane databases. β cell function was assessed by stimulated C-peptide, fasting C-peptide, normal glycosylated hemoglobin levels (HbA1C), and exogenous insulin dose patterns. The quality of the studies were assessed by both the Cochrane Collaboration's Risk of Bias (ROB) for Randomized controlled trials and the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) for non-randomized controlled trials. RESULTS: From the selected final 15 articles, total of 16 trials were analyzed. There were 6 T1DM trials (total 153 cases) and 10 T2DM trials (total 457 cases). In T2DM patients, the changes in stimulated C-peptide, HbA1c, and exogenous insulin dose versus baseline showed a favorable pattern with a significant heterogeneity in stem cell therapy. In T1DM, there was no significant difference between control group and stem cell therapy group in three indicators except for HbA1c. Most of the studies were rated as having high risk of bias in the quality assessment. CONCLUSIONS: The stem cell therapy for DM patients is not effective in T1DM but seems to be effective in improving the β cell function in T2DM. However the observed effect should be interpreted with caution due to the significant heterogeneity and high risk of bias within the studies. Further verification through a rigorously designed study is warranted.
Bias (Epidemiology) ; C-Peptide ; Diabetes Mellitus ; Diabetes Mellitus, Type 1 ; Diabetes Mellitus, Type 2 ; Fasting ; Hemoglobin A, Glycosylated ; Humans ; Insulin ; Population Characteristics ; Stem Cells