Purpose: To evaluate functional and anatomical outcomes, including vessel morphology parameters on swept-source optical coherence tomography angiography (SS-OCTA), in eyes with neovascular age-related macular degeneration (nAMD) switched to brolucizumab. Methods: This retrospective study included 37 eyes with nAMD that were switched from other anti–vascular endothelial growth factor (anti-VEGF) agents to intravitreal brolucizumab. Best-corrected visual acuity (BCVA), injection intervals, central subfield thickness (CST), pigment epithelial detachment (PED), and presence of retinal fluid were compared between baseline and 12 months after switch. SS-OCTA images were analyzed to quantify macular neovascularization (MNV) area, vessel density, fractal dimension (FD), and lacunarity. Results: Switching to brolucizumab significantly extended injection intervals and reduced CST, PED height and retinal fluid, while maintaining BCVA at 12 months. Quantitative OCTA analysis showed reductions in MNV area and FD following the switch. When compared with the preceding 12 months of other anti-VEGF therapy, FD still showed a significant reduction after brolucizumab treatment (p = 0.019). Intraocular inflammation occurred in one eye and resolved with topical corticosteroids. Conclusions Intravitreal brolucizumab demonstrated favorable anatomical improvements and maintained visual outcomes over 12 months. Quantitative OCTA biomarkers, particularly FD, may serve as imaging indicators of disease activity and treatment response in eyes with nAMD undergoing a therapy switch.

Purpose: This study aimed to quantitatively evaluate longitudinal changes in drusen area and volume over 36 months in South Korean patients and to identify the factors associated with these changes and the development of advanced age-related macular degeneration (AMD). Methods: In this retrospective study, 38 eyes from 38 patients diagnosed with drusen were analyzed. The drusen area and volume were measured using spectral-domain optical coherence tomography (SD-OCT; Cirrus 5000, Carl Zeiss Meditec) with an automated retinal pigment epithelium elevation map algorithm. To minimize bias from variable follow-up intervals, an annualized classification framework was adopted. Based on percentage change in drusen area within the 5-mm circle, eyes were categorized as progressed (increase >20%), stable (change within ±20%), or regressing (decrease >20%). Results: Both drusen area and volume increased significantly up to 24 months (area, p = 0.003; volume, p = 0.028) and then showed a modest decline at 36 months, remaining above baseline levels. No significant difference in the proportions of progressed, stable, or regressing eyes was observed across 12-month intervals or compared with baseline (all p > 0.05). A larger baseline 5-mm drusen area was significantly associated with the development of advanced AMD (adjusted odds ratio, 2.818; 95% confidence interval, 1.022–7.767; p = 0.045). Eyes that exhibited at least one episode of drusen regression showed a higher incidence of advanced AMD (36.8% vs. 5.3%, p = 0.042). Conclusions Drusen in South Korean patients demonstrated dynamic morphological remodeling over time. Drusen regression was not a benign phenomenon but rather a potential high-risk marker for progression to advanced AMD. These findings highlight the importance of population-specific, quantitative SD-OCT monitoring for early risk stratification in East Asian eyes.

Background and Objectives: Dupilumab is approved for the treatment of uncontrolled chronic rhinosinusitis with nasal polyps (CRSwNP) and has been shown to be relatively safe and effective in randomized controlled trials. As such, real-world effectiveness and safety data should be obtained.Subjects and Method We performed a retrospective review of patients with CRSwNP who received monthly treatment of dupilumab between January 2022 and June 2023. Reviewed for the study were the following: demographic data, comorbidities, the visual analogue scale (VAS) for nasal obstruction and sense of smell, identification scores of the Korean version Sniffin’ stikc II (KVSS II) test, nasal polyp score (NPS), and serum eosinophil count. Statistical analyses were performed for each clinical variable. Results: A total of 76 patients (49 male, 27 female) were included in this study. The VAS scores decreased from 7.17 at the baseline to 4.51 at month 6; the KVSS II identification scores increased from 6.71 to 8.47, and the NPS decreased from 3.82 to 0.44. The sino-nasal outcome test-22 scores decreased from 36.29 at the baseline to 8.22 at month 6. The correlations between all clinical variables were statistically significant. Conclusion Monthly treatment of dupilumab is effective and safe for patients with CRSwNP. Further research is required to determine the predictive parameters for treatment responses and adverse events.

Background and Objectives: Dupilumab is approved for the treatment of uncontrolled chronic rhinosinusitis with nasal polyps (CRSwNP) and has been shown to be relatively safe and effective in randomized controlled trials. As such, real-world effectiveness and safety data should be obtained.Subjects and Method We performed a retrospective review of patients with CRSwNP who received monthly treatment of dupilumab between January 2022 and June 2023. Reviewed for the study were the following: demographic data, comorbidities, the visual analogue scale (VAS) for nasal obstruction and sense of smell, identification scores of the Korean version Sniffin’ stikc II (KVSS II) test, nasal polyp score (NPS), and serum eosinophil count. Statistical analyses were performed for each clinical variable. Results: A total of 76 patients (49 male, 27 female) were included in this study. The VAS scores decreased from 7.17 at the baseline to 4.51 at month 6; the KVSS II identification scores increased from 6.71 to 8.47, and the NPS decreased from 3.82 to 0.44. The sino-nasal outcome test-22 scores decreased from 36.29 at the baseline to 8.22 at month 6. The correlations between all clinical variables were statistically significant. Conclusion Monthly treatment of dupilumab is effective and safe for patients with CRSwNP. Further research is required to determine the predictive parameters for treatment responses and adverse events.

Background and Objectives: Dupilumab is approved for the treatment of uncontrolled chronic rhinosinusitis with nasal polyps (CRSwNP) and has been shown to be relatively safe and effective in randomized controlled trials. As such, real-world effectiveness and safety data should be obtained.Subjects and Method We performed a retrospective review of patients with CRSwNP who received monthly treatment of dupilumab between January 2022 and June 2023. Reviewed for the study were the following: demographic data, comorbidities, the visual analogue scale (VAS) for nasal obstruction and sense of smell, identification scores of the Korean version Sniffin’ stikc II (KVSS II) test, nasal polyp score (NPS), and serum eosinophil count. Statistical analyses were performed for each clinical variable. Results: A total of 76 patients (49 male, 27 female) were included in this study. The VAS scores decreased from 7.17 at the baseline to 4.51 at month 6; the KVSS II identification scores increased from 6.71 to 8.47, and the NPS decreased from 3.82 to 0.44. The sino-nasal outcome test-22 scores decreased from 36.29 at the baseline to 8.22 at month 6. The correlations between all clinical variables were statistically significant. Conclusion Monthly treatment of dupilumab is effective and safe for patients with CRSwNP. Further research is required to determine the predictive parameters for treatment responses and adverse events.

Background and Objectives: Dupilumab is approved for the treatment of uncontrolled chronic rhinosinusitis with nasal polyps (CRSwNP) and has been shown to be relatively safe and effective in randomized controlled trials. As such, real-world effectiveness and safety data should be obtained.Subjects and Method We performed a retrospective review of patients with CRSwNP who received monthly treatment of dupilumab between January 2022 and June 2023. Reviewed for the study were the following: demographic data, comorbidities, the visual analogue scale (VAS) for nasal obstruction and sense of smell, identification scores of the Korean version Sniffin’ stikc II (KVSS II) test, nasal polyp score (NPS), and serum eosinophil count. Statistical analyses were performed for each clinical variable. Results: A total of 76 patients (49 male, 27 female) were included in this study. The VAS scores decreased from 7.17 at the baseline to 4.51 at month 6; the KVSS II identification scores increased from 6.71 to 8.47, and the NPS decreased from 3.82 to 0.44. The sino-nasal outcome test-22 scores decreased from 36.29 at the baseline to 8.22 at month 6. The correlations between all clinical variables were statistically significant. Conclusion Monthly treatment of dupilumab is effective and safe for patients with CRSwNP. Further research is required to determine the predictive parameters for treatment responses and adverse events.

Background and Objectives: Dupilumab is approved for the treatment of uncontrolled chronic rhinosinusitis with nasal polyps (CRSwNP) and has been shown to be relatively safe and effective in randomized controlled trials. As such, real-world effectiveness and safety data should be obtained.Subjects and Method We performed a retrospective review of patients with CRSwNP who received monthly treatment of dupilumab between January 2022 and June 2023. Reviewed for the study were the following: demographic data, comorbidities, the visual analogue scale (VAS) for nasal obstruction and sense of smell, identification scores of the Korean version Sniffin’ stikc II (KVSS II) test, nasal polyp score (NPS), and serum eosinophil count. Statistical analyses were performed for each clinical variable. Results: A total of 76 patients (49 male, 27 female) were included in this study. The VAS scores decreased from 7.17 at the baseline to 4.51 at month 6; the KVSS II identification scores increased from 6.71 to 8.47, and the NPS decreased from 3.82 to 0.44. The sino-nasal outcome test-22 scores decreased from 36.29 at the baseline to 8.22 at month 6. The correlations between all clinical variables were statistically significant. Conclusion Monthly treatment of dupilumab is effective and safe for patients with CRSwNP. Further research is required to determine the predictive parameters for treatment responses and adverse events.

The main aim of this video article is to demonstrate the combined use of O-arm navigation and unilateral biportal endoscopy (UBE) to manage far-out syndrome (FOS). In FOS there is entrapment and compression of the fifth lumbar nerve beyond the foramen and between L5 transverse process and the sacral ala at the lumbosacral junction. Conventional microscopic decompression using a paraspinal approach had been the gold standard for its management. However, the surgery is technically challenging due to the deep location of the pathology and intricate anatomy of extraforaminal space. There have been some published reports of unsatisfactory outcomes with microscopic decompression for FOS. We decided to integrate navigation with UBE to increase precision for the management of FOS. A 70-year-old female presented to us with chief complaint of left lower limb radiculopathy since 1 year. She also complained of numbness and paresthesias in her left leg and foot. She was unable to walk for more than 10 minutes due to pain. Her magnetic resonance imaging scan revealed compression of left L5 nerve root in the extraforaminal region. UBE decompression via paraspinal approach was performed for her under O-arm navigation. She experienced immediate relief of her symptoms in the postoperative period. O-arm-navigation-guided UBE is an effective and safer alternative to microsurgical decompression for the management of FOS. This video demonstrates the step-by-step implementation of O-arm navigation with endoscopy and its precise execution.

The main aim of this video article is to demonstrate the combined use of O-arm navigation and unilateral biportal endoscopy (UBE) to manage far-out syndrome (FOS). In FOS there is entrapment and compression of the fifth lumbar nerve beyond the foramen and between L5 transverse process and the sacral ala at the lumbosacral junction. Conventional microscopic decompression using a paraspinal approach had been the gold standard for its management. However, the surgery is technically challenging due to the deep location of the pathology and intricate anatomy of extraforaminal space. There have been some published reports of unsatisfactory outcomes with microscopic decompression for FOS. We decided to integrate navigation with UBE to increase precision for the management of FOS. A 70-year-old female presented to us with chief complaint of left lower limb radiculopathy since 1 year. She also complained of numbness and paresthesias in her left leg and foot. She was unable to walk for more than 10 minutes due to pain. Her magnetic resonance imaging scan revealed compression of left L5 nerve root in the extraforaminal region. UBE decompression via paraspinal approach was performed for her under O-arm navigation. She experienced immediate relief of her symptoms in the postoperative period. O-arm-navigation-guided UBE is an effective and safer alternative to microsurgical decompression for the management of FOS. This video demonstrates the step-by-step implementation of O-arm navigation with endoscopy and its precise execution.

The main aim of this video article is to demonstrate the combined use of O-arm navigation and unilateral biportal endoscopy (UBE) to manage far-out syndrome (FOS). In FOS there is entrapment and compression of the fifth lumbar nerve beyond the foramen and between L5 transverse process and the sacral ala at the lumbosacral junction. Conventional microscopic decompression using a paraspinal approach had been the gold standard for its management. However, the surgery is technically challenging due to the deep location of the pathology and intricate anatomy of extraforaminal space. There have been some published reports of unsatisfactory outcomes with microscopic decompression for FOS. We decided to integrate navigation with UBE to increase precision for the management of FOS. A 70-year-old female presented to us with chief complaint of left lower limb radiculopathy since 1 year. She also complained of numbness and paresthesias in her left leg and foot. She was unable to walk for more than 10 minutes due to pain. Her magnetic resonance imaging scan revealed compression of left L5 nerve root in the extraforaminal region. UBE decompression via paraspinal approach was performed for her under O-arm navigation. She experienced immediate relief of her symptoms in the postoperative period. O-arm-navigation-guided UBE is an effective and safer alternative to microsurgical decompression for the management of FOS. This video demonstrates the step-by-step implementation of O-arm navigation with endoscopy and its precise execution.