1.Clinical Characteristics and Outcomes of Pediatric Macular Hole: A Retrospective Case Series Study
Myung Soo CHANG ; Christopher Seungkyu LEE ; Suk Ho BYEON ; Sung Soo KIM ; Yong Joon KIM
Journal of the Korean Ophthalmological Society 2026;67(6):183-192
Purpose:
To evaluate the clinical characteristics, etiologies, and treatment outcomes of pediatric macular holes (MHs).
Methods:
The medical records of pediatric patients under 18 years of age diagnosed with MHs at Severance Hospital between January 2005 and December 2022 were retrospectively reviewed. Data regarding etiology, MH diameter, treatment methods, and both visual and anatomical outcomes were analyzed.
Results:
Among 15 patients (16 eyes), traumatic MHs were identified in 7 cases (46.7%), while non-traumatic causes included Stargardt disease, familial exudative vitreoretinopathy, and vitreomacular traction. No statistically significant differences were observed between the traumatic and non-traumatic groups in terms of age, MH diameter, or initial and final best-corrected visual acuity (BCVA). However, there was a significant difference in sex distribution, with all traumatic cases occurring in males, whereas only 3 of the 9 non-traumatic eyes were male (p = 0.01). Surgical intervention was performed in 13 eyes, achieving anatomical closure in 62.5% (10 eyes). The three eyes without closure (37.5%) were all non-traumatic cases. BCVA (logMAR) significantly improved from a median of 1.00 preoperatively to 0.70 postoperatively (p = 0.013). Among the three eyes that did not undergo surgery, one demonstrated spontaneous closure, and another achieved closure following medical treatment.
Conclusions
Pediatric MHs may arise from various ocular conditions beyond trauma. Surgical intervention was effective, particularly for traumatic MHs, while non-traumatic cases demonstrated a lower closure rate. In some instances, spontaneous or medically induced closure occurred without surgical management. Further multicenter studies with larger cohorts are warranted to establish definitive management guidelines for pediatric MHs.
2.Clinical Features and Prognosis of MEK Inhibitor–associated Retinopathy: A Case Series
Tae Hwan KIM ; Christopher Seungkyu LEE ; Suk Ho BYEON ; Sung Soo KIM ; Yong Joon KIM
Journal of Retina 2026;11(1):50-59
Purpose:
To investigate the clinical characteristics, onset timing, and anatomical and functional outcomes of MEK inhibitor–associated retinopathy (MEKAR) in Korean patients receiving systemic MEK inhibitor therapy.
Methods:
This retrospective study included 16 patients diagnosed with MEKAR between January 2011 and August 2025. Best-corrected visual acuity (BCVA), central macular thickness (CMT), subfoveal choroidal thickness (CT), and optical coherence tomography (OCT) findings were evaluated at baseline, at MEKAR onset, and at final follow-up.
Results:
Mean age was 57.8 ± 10.6 years, with a male predominance (68.8%). Colorectal cancer was the most common primary malignancy (56.3%), followed by lung cancer and malignant melanoma (18.7% each). MEKAR developed after a median of 3.3 weeks (IQR, 1.9–4.4 weeks) following therapy initiation, and the median time to initial improvement was 2.4 weeks (IQR, 1.3–8.1 weeks). At onset, 62.6% of patients reported ocular symptoms, while 37.4% were asymptomatic. OCT showed reversible retinal changes, most commonly ellipsoid zone thickening (68.8%) and focal subretinal fluid (43.8%), all of which resolved completely. CMT increased transiently at onset compared with baseline (p = 0.002) and normalized at final follow-up (p < 0.001), with no baseline–final difference (p = 0.489). CT remained stable (p = 0.159). BCVA was preserved, with a median of 0.00 logMAR at baseline, onset and final follow-up. Patients undergoing dose modification or interruption showed faster improvement than those continuing therapy (median, 9 vs. 81 days; p = 0.004). One patient showed multiple recurrent episodes, all of which resolved without visual deterioration.
Conclusions
MEKAR developed early after treatment initiation and followed a transient, fully reversible course with preserved visual function. Although dose modification accelerated anatomical recovery, long-term outcomes remained favorable even with continued therapy, supporting close monitoring and individualized management rather than routine interruption, particularly in mild or asymptomatic cases.
3.Intravitreal Anti-Vascular Endothelial Growth Factor Treatment for Choroidal Neovascularization in Choroidal Osteoma: A Pilot Study
Hyo Jin SEONG ; Christopher Seungkyu LEE
Journal of Retina 2026;11(1):13-19
Purpose:
To determine the long-term visual and anatomical outcomes, recurrence risk, and prognostic factors after intravitreal anti-vascular endothelial growth factor (VEGF) treatment for choroidal neovascularization (CNV) in eyes with choroidal osteoma.
Methods:
A retrospective review included patients diagnosed with choroidal osteoma and secondary CNV who received at least one intravitreal anti-VEGF injection at a single tertiary center between 2005 and 2023. Variables collected included demographics, baseline and final visual acuity, CNV location and type, imaging results, recurrence events, and adjunctive therapies. The main outcomes were change in visual acuity, proportion of eyes with final vision ≤20/200, and recurrence rate. Multivariable Firth-penalized logistic regression identified factors associated with poor prognosis.
Results:
Of 17 eyes (mean age 32.0 years, 58.8% female), 15 (88.2%) achieved anatomical control, but only four (23.5%) achieved visual acuity improvement of two or more lines. Recurrences were observed in 12 eyes (70.6%), with most occurring within the first year after treatment. Lower initial visual acuity was associated with a worse prognosis (aOR 4.49, 95% CI 0.99–596.72), and non-subfoveal CNV location (aOR 0.27, 95% CI 0.02–2.29) and type 2 CNV (aOR 0.23, 95% CI 0.01–2.20) tended to be associated with a better visual outcome.
Conclusions
Anti-VEGF treatment was effective in achieving anatomical stabilization in CNV associated with choroidal osteoma, but visual recovery was limited. Given the high risk of recurrence, particularly within the first year after treatment, individualized strategies and early and long-term follow-up are essential.
4.Coexisting Macular Hole and Uveal Melanoma: A Case Series and Literature Review
Yeji KIM ; So Hyun YU ; Yong Joon KIM ; Eun Young CHOI ; Sung Chul LEE ; Christopher Seungkyu LEE
Korean Journal of Ophthalmology 2025;39(2):170-180
Purpose:
To report five cases of macular hole (MH) coexisting with uveal melanoma (UM) and review the literature.
Methods:
Seventeen patients (5 new and 12 from previous reports) with coexisting MH and UM were reviewed. The patients were divided into two groups based on whether the MH was diagnosed before or after tumor treatment. The clinical features, pathogenesis, management options, and clinical outcomes were reviewed.
Results:
Of 505 patients with UM in our institution, 5 (1.0%) had a concurrent MH in the ipsilateral eye. The 17 patients reviewed had a mean age of 63.9 years at the time of MH diagnosis. Of 16 patients with available data on sex, 11 (64.7%) were female. There were no major differences in the demographic or clinical data of the groups. Of the 15 known tumor locations, 6 (35.3%) were juxtapapillary or macular. In patients who developed MH after UM treatment, the durations from tumor treatment (radiotherapy or transpupillary thermotherapy) to MH diagnosis were 3 to 56 months (median, 8.5 months). MH surgery was performed in nine eyes, and hole closure was achieved in seven eyes with postoperative data. The mean visual acuity showed a tendency of improvement after surgery. No intraocular or extraocular tumor dissemination associated with surgery was observed.
Conclusions
MH is observed in approximately 1% of patients with UM, either before or after tumor treatment. Of patients with coexisting MH and UM, MH surgery appears to be safe and effective in those with stable tumors and visual potential.
5.Coexisting Macular Hole and Uveal Melanoma: A Case Series and Literature Review
Yeji KIM ; So Hyun YU ; Yong Joon KIM ; Eun Young CHOI ; Sung Chul LEE ; Christopher Seungkyu LEE
Korean Journal of Ophthalmology 2025;39(2):170-180
Purpose:
To report five cases of macular hole (MH) coexisting with uveal melanoma (UM) and review the literature.
Methods:
Seventeen patients (5 new and 12 from previous reports) with coexisting MH and UM were reviewed. The patients were divided into two groups based on whether the MH was diagnosed before or after tumor treatment. The clinical features, pathogenesis, management options, and clinical outcomes were reviewed.
Results:
Of 505 patients with UM in our institution, 5 (1.0%) had a concurrent MH in the ipsilateral eye. The 17 patients reviewed had a mean age of 63.9 years at the time of MH diagnosis. Of 16 patients with available data on sex, 11 (64.7%) were female. There were no major differences in the demographic or clinical data of the groups. Of the 15 known tumor locations, 6 (35.3%) were juxtapapillary or macular. In patients who developed MH after UM treatment, the durations from tumor treatment (radiotherapy or transpupillary thermotherapy) to MH diagnosis were 3 to 56 months (median, 8.5 months). MH surgery was performed in nine eyes, and hole closure was achieved in seven eyes with postoperative data. The mean visual acuity showed a tendency of improvement after surgery. No intraocular or extraocular tumor dissemination associated with surgery was observed.
Conclusions
MH is observed in approximately 1% of patients with UM, either before or after tumor treatment. Of patients with coexisting MH and UM, MH surgery appears to be safe and effective in those with stable tumors and visual potential.
6.Coexisting Macular Hole and Uveal Melanoma: A Case Series and Literature Review
Yeji KIM ; So Hyun YU ; Yong Joon KIM ; Eun Young CHOI ; Sung Chul LEE ; Christopher Seungkyu LEE
Korean Journal of Ophthalmology 2025;39(2):170-180
Purpose:
To report five cases of macular hole (MH) coexisting with uveal melanoma (UM) and review the literature.
Methods:
Seventeen patients (5 new and 12 from previous reports) with coexisting MH and UM were reviewed. The patients were divided into two groups based on whether the MH was diagnosed before or after tumor treatment. The clinical features, pathogenesis, management options, and clinical outcomes were reviewed.
Results:
Of 505 patients with UM in our institution, 5 (1.0%) had a concurrent MH in the ipsilateral eye. The 17 patients reviewed had a mean age of 63.9 years at the time of MH diagnosis. Of 16 patients with available data on sex, 11 (64.7%) were female. There were no major differences in the demographic or clinical data of the groups. Of the 15 known tumor locations, 6 (35.3%) were juxtapapillary or macular. In patients who developed MH after UM treatment, the durations from tumor treatment (radiotherapy or transpupillary thermotherapy) to MH diagnosis were 3 to 56 months (median, 8.5 months). MH surgery was performed in nine eyes, and hole closure was achieved in seven eyes with postoperative data. The mean visual acuity showed a tendency of improvement after surgery. No intraocular or extraocular tumor dissemination associated with surgery was observed.
Conclusions
MH is observed in approximately 1% of patients with UM, either before or after tumor treatment. Of patients with coexisting MH and UM, MH surgery appears to be safe and effective in those with stable tumors and visual potential.
7.Coexisting Macular Hole and Uveal Melanoma: A Case Series and Literature Review
Yeji KIM ; So Hyun YU ; Yong Joon KIM ; Eun Young CHOI ; Sung Chul LEE ; Christopher Seungkyu LEE
Korean Journal of Ophthalmology 2025;39(2):170-180
Purpose:
To report five cases of macular hole (MH) coexisting with uveal melanoma (UM) and review the literature.
Methods:
Seventeen patients (5 new and 12 from previous reports) with coexisting MH and UM were reviewed. The patients were divided into two groups based on whether the MH was diagnosed before or after tumor treatment. The clinical features, pathogenesis, management options, and clinical outcomes were reviewed.
Results:
Of 505 patients with UM in our institution, 5 (1.0%) had a concurrent MH in the ipsilateral eye. The 17 patients reviewed had a mean age of 63.9 years at the time of MH diagnosis. Of 16 patients with available data on sex, 11 (64.7%) were female. There were no major differences in the demographic or clinical data of the groups. Of the 15 known tumor locations, 6 (35.3%) were juxtapapillary or macular. In patients who developed MH after UM treatment, the durations from tumor treatment (radiotherapy or transpupillary thermotherapy) to MH diagnosis were 3 to 56 months (median, 8.5 months). MH surgery was performed in nine eyes, and hole closure was achieved in seven eyes with postoperative data. The mean visual acuity showed a tendency of improvement after surgery. No intraocular or extraocular tumor dissemination associated with surgery was observed.
Conclusions
MH is observed in approximately 1% of patients with UM, either before or after tumor treatment. Of patients with coexisting MH and UM, MH surgery appears to be safe and effective in those with stable tumors and visual potential.
8.Coexisting Macular Hole and Uveal Melanoma: A Case Series and Literature Review
Yeji KIM ; So Hyun YU ; Yong Joon KIM ; Eun Young CHOI ; Sung Chul LEE ; Christopher Seungkyu LEE
Korean Journal of Ophthalmology 2025;39(2):170-180
Purpose:
To report five cases of macular hole (MH) coexisting with uveal melanoma (UM) and review the literature.
Methods:
Seventeen patients (5 new and 12 from previous reports) with coexisting MH and UM were reviewed. The patients were divided into two groups based on whether the MH was diagnosed before or after tumor treatment. The clinical features, pathogenesis, management options, and clinical outcomes were reviewed.
Results:
Of 505 patients with UM in our institution, 5 (1.0%) had a concurrent MH in the ipsilateral eye. The 17 patients reviewed had a mean age of 63.9 years at the time of MH diagnosis. Of 16 patients with available data on sex, 11 (64.7%) were female. There were no major differences in the demographic or clinical data of the groups. Of the 15 known tumor locations, 6 (35.3%) were juxtapapillary or macular. In patients who developed MH after UM treatment, the durations from tumor treatment (radiotherapy or transpupillary thermotherapy) to MH diagnosis were 3 to 56 months (median, 8.5 months). MH surgery was performed in nine eyes, and hole closure was achieved in seven eyes with postoperative data. The mean visual acuity showed a tendency of improvement after surgery. No intraocular or extraocular tumor dissemination associated with surgery was observed.
Conclusions
MH is observed in approximately 1% of patients with UM, either before or after tumor treatment. Of patients with coexisting MH and UM, MH surgery appears to be safe and effective in those with stable tumors and visual potential.
9.Analysis of Visual and Anatomical Outcomes with Biosimilar Intravitreal Injections for Neovascular Age-related Macular Degeneration: A Retrospective Cohort Study
Jehwi JEON ; Kyung Joo MAENG ; Suk Ho BYEON ; Sung Soo KIM ; Christopher Seungkyu LEE
Journal of Retina 2025;10(2):201-206
Purpose:
To evaluate the anatomical and visual effects of biosimilars in the treatment of wet age-related macular degeneration (AMD).
Methods:
We retrospectively reviewed patients with wet AMD treated with originator or biosimilar ranibizumab (CKD-701) or aflibercept (SB15) between June 2024 and February 2025 at Severance Eye Hospital. Clinical outcomes were assessed over six months using best corrected visual acuity (BCVA) and central macular thickness (CMT) measurements.
Results:
Among 272 patients, 91 received ranibizumab (54.9% originator, 45.1% biosimilar) and 181 received aflibercept (66.9% originator, 33.1% biosimilar). In the ranibizumab group, BCVA and CMT improvements were comparable between originator and biosimilar formulations, with no significant differences in injection number. In the aflibercept group, the biosimilar cohort received significantly fewer injections (3.63 [originator] vs. 3.11 [biosimilar], p = 0.006) and showed slightly inferior visual and anatomical outcomes, likely influenced by a smaller proportion of treatment-naïve patients and limited insurance coverage. No serious adverse events were observed in any group.
Conclusions
Biosimilars demonstrated acceptable efficacy and safety over six months. Broader use could improve accessibility, though further long-term data are needed.
10.Clinical Features and Prognosis of Paclitaxel-related Cystoid Macular Edema: A Case Series
Jin Yeong JIN YEONG ; Christopher Seungkyu LEE ; Suk Ho BYEON ; Sung Soo KIM ; Yong Joon KIM
Journal of Retina 2025;10(2):171-181
Purpose:
To describe the clinical characteristics and course of paclitaxel (PTX)-related cystoid macular edema (CME) Methods: Electronic medical records were retrospectively reviewed for seven patients diagnosed with PTX-related CME at a single center in Seoul, South Korea, between January 2011 and April 2025. Collected data included demographics, chemotherapy regimen details, and ophthalmologic findings such as best-corrected visual acuity (BCVA), fundus photography, optical coherence tomography, and, when available, fundus fluorescein angiography. Management strategies and treatment outcomes, including changes in BCVA and central macular thickness (CMT), were analyzed.
Results:
Seven patients were diagnosed with PTX-related CME, all with bilateral involvement. The mean interval from initiation of PTXbased chemotherapy to CME diagnosis was 42.7 weeks (median, 34.9 weeks; range, 24.1–78.7 weeks). Median BCVA improved from 0.40 LogMAR (IQR, 0.22–0.47) at baseline to 0.10 LogMAR (IQR, 0.00–0.24) at the final visit (p = 0.008), and the median CMT decreased from 617.0 μm (IQR, 345.25–696.50 μm) at baseline to 255.0 μm (IQR, 235.75–300.25 μm) at the final visit (p = 0.001). Among six patients who discontinued PTX, initial CME improvement was observed at a mean of 4.5 weeks (median, 4.1 weeks; range, 1.1–11.1 weeks) following cessation, and complete resolution was confirmed in five patients, at a mean of 12.8 weeks (median, 11.1 weeks; range, 9.0–17.1 weeks).One patient who was unable to discontinue PTX achieved delayed CME resolution and visual recovery 28 weeks after dose reduction and interval extension.
Conclusions
Favorable anatomical and visual outcomes of PTX-related CME were achieved following drug cessation. In cases where discontinuation was not feasible, gradual improvement in CME occurred after dose reduction and interval extension. Awareness of this potential ocular adverse event is important for both ophthalmologists and oncologists managing patients on PTX-based chemotherapy.

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