1.Pregnancy and Retinal Disorders: Pathophysiology, Clinical Features, and Management
Minsub LEE ; Hyeong Min KIM ; Hyungwoo LEE ; Hyewon CHUNG
Journal of Retina 2026;11(1):1-12
During pregnancy, various physiological and metabolic changes occur throughout the female body, including in the retina. In particular, women at high risk, such as those with gestational diabetes or pregnancy-induced hypertension, often present with ocular symptoms.The major retinal disorders associated with pregnancy include diabetic retinopathy, hypertensive retinopathy, central serous chorioretinopathy, and retinal vascular occlusions. In this review, we provide an in-depth overview of recent studies investigating the impact of pregnancy on the retina and highlight the importance of retinal screening in pregnant women.
2.Harada-like Syndrome in a Chronic Hepatitis B Carrier: Case Report
Journal of Retina 2026;11(1):90-95
Purpose:
To report a case of Harada-like syndrome occurring in a patient with chronic hepatitis B and compensated liver cirrhosis.Case summary: A 66-year-old man with hepatitis B surface antigen positivity and Child-Pugh A cirrhosis presented with a two- to three-day history of decreased vision in the right eye. Best-corrected visual acuity was 0.5 in the right eye and 1.0 in the left eye. Slit-lamp examination showed no anterior chamber or vitreous inflammation. Optical coherence tomography revealed a thicker choroid in the right eye in comparison to the left, along with choroidal folds and multifocal subretinal fluid (SRF) in the right eye. Wide-field fundus imaging revealed bilateral cotton-wool spots and serous retinal detachment in the right eye, while the left eye had no SRF. Fluorescein angiography demonstrated multifocal leakage and pooling, and Indocyanine green angiography revealed hypocyanescent spots consistent with choroidal inflammation in the right eye. Neurological symptoms such as headache, tinnitus, or meningismus were absent throughout the entire follow-up period, and infectious serologic tests were all negative. The patient was treated with oral prednisolone 50 mg/ day without antiviral prophylaxis, which was tapered to 25 mg over four weeks. Patient’s SRF and cotton-wool spots gradually resolved with visual improvement, and no hepatitis B virus (HBV) reactivation or systemic complications occurred.
Conclusions
This case represents the first reported instance of Harada-like syndrome in a chronic carrier of HBV. The findings suggest a potential immunologic link between persistent HBV infection and melanocyte-targeted autoimmunity.
3.A Case of Long-term Follow-up After Vitrectomy of Epiretinal Membrane with Coats Disease: Case Report
Journal of Retina 2026;11(1):83-89
Purpose:
To report a stable long-term course after vitrectomy of epiretinal membrane associated with Coats disease.Case summary: A 60-year-old female patient visited our clinic for visual discomfort. She was diagnosed with an epiretinal membrane and macular edema associated with Coats disease. Vitrectomy, epiretinal membrane peeling, inner limiting membrane peeling, phacoemulsification with posterior chamber intraocular lens implantation and laser photocoagulation were performed. Two months after vitrectomy, uncorrected visual acuity (VA) improved to 0.5, and four months later, VA improved to 0.8. There continued to be gradual improvement, and at 13 months, few exudates were observed in the macula, and VA was measured as 1.0. At 21 months postoperative, new telangiectatic lesions and macular edema were found, so laser photocoagulation and intravitreal bevacizumab injection were performed again. One month later, due to decreased VA to 0.4 and increased subretinal fluid, fluorescein angiography was done, followed by laser photocoagulation and intravitreal bevacizumab injection. At 2 years postoperatively, subretinal fluid and intraretinal fluid were absorbed, macular edema decreased, and VA was restored to 1.0.
Conclusions
In an epiretinal membrane associated with Coats disease, vitrectomy can be an effective treatment method. However, continuous follow-up and appropriate treatment are required even after surgery
4.Simultaneous Occurrence of Retinal and Choroidal Macrovessels in Two Individual Patients: Case Reports
Jeong Hwa SHIN ; Jaeryung OH ; So Min AHN
Journal of Retina 2026;11(1):75-82
Purpose:
We report two individual rare cases of the simultaneous occurrence of retinal and choroidal macrovessels.Case summary: The first case involved a 39-year-old male who presented with a two-week history of metamorphopsia in his right eye.At the initial visit, visual acuity was 1.0 in both eyes. A choroidal macrovessel transversing the macula was observed in the right eye, and a vascular loop in the inferior retinal arcade and a retinal macrovessel crossing the macula were identified in the left eye. Optical coherence tomography (OCT) revealed bilateral pachyvessels and subretinal fluid in the right macula, which persisted after two months. The second case involved a 36-year-old male with a six-month history of decreased vision in his left eye. At the initial visit, visual acuity was 0.1 in the right eye and 1.0 in the left eye. Subretinal fluid and retinal macrovessel were observed in the left macula. Two months later, the subretinal fluid resolved spontaneously. At a seven-year follow-up, OCT demonstrated pachyvessels in both eyes.
Conclusions
Although retinal and choroidal macrovessels originated from distinct embryologic vascular systems and are unlikely to share a direct developmental pathway, both cases showed bilateral pachyvessels. Dysregulation of vascular signaling factors such as vascular endothelial growth factor and angiopoietin, which are involved in both retinal and choroidal vascular development, may contribute to the formation of these abnormal macrovessel structures.
5.Adalimumab Treatment for Refractory Ocular Toxocariasis: Case Report
Kyeung Min KIM ; Seung Woo CHOI ; Se Joon WOO
Journal of Retina 2026;11(1):69-74
Purpose:
We evaluated the therapeutic efficacy of adalimumab in patients with refractory ocular toxocariasis (OT).Case summary: Three patients with recurrent OT who experienced frequent relapses or intolerance to corticosteroids and immunosuppressants were treated with adalimumab. All three achieved improved control of intraocular inflammation, a marked reduction in relapse rate (from 2.48 to 0.14 per year), and complete discontinuation of systemic corticosteroids and immunosuppressants by the final follow-up. No adverse events were observed during adalimumab treatment. Cases 1 (bilateral panuveitis), 2 (intermediate uveitis), and 3 (neuroretinitis) each demonstrated clinical improvement or stabilization following adalimumab initiation, with remission sustained for 30–62 months.
Conclusions
Adalimumab is effective in controlling inflammation and preventing recurrence in patients with refractory OT unresponsive to conventional therapy. It may offer a viable steroid-sparing option for managing chronic inflammation in OT.
6.Asymmetric Visual Outcomes in Bilateral Non-Neovascular Serous Pigment Epithelial Detachments: Case Report
Journal of Retina 2026;11(1):64-68
Purpose:
We report a unique case of bilateral non-neovascular serous pigment epithelial detachments (nnSPEDs) in a single patient that resolved through two different mechanisms—an extrafoveal retinal pigment epithelium (RPE) tear and spontaneous collapse—resulting in asymmetric visual outcomes.Case summary: A 78-year-old male was followed for bilateral nnSPEDs. The right eye developed an RPE tear outside the fovea, which led to the resolution of the nnSPED and a visual acuity improvement from 20/30 to 20/25. In contrast, the left eye underwent spontaneous collapse of the nnSPED without an RPE tear, resulting in a decrease in visual acuity from 20/30 to 20/70 and associated photoreceptor damage.
Conclusions
This case demonstrates that the resolution of an nnSPED via a timely, extrafoveal RPE tear can lead to a favorable functional outcome by draining sub-RPE fluid before irreversible photoreceptor damage occurs. In contrast, spontaneous collapse may represent a late-stage event following significant RPE and photoreceptor injury. The mechanism, timing, and location of nnSPED resolution are critical in determining the final visual prognosis.
7.Kyrieleis Plaques Associated with Ocular Toxoplasmosis: Case Report
Moon Young CHOI ; Jae Pil SHIN
Journal of Retina 2026;11(1):60-63
Purpose:
We report two cases of Kyrieleis plaques associated with ocular toxoplasmosis.Case summary: A 65-year-old man presented with decreased vision in the right eye. Fundus examination showed vitreous inflammation and small peripheral retinochoroiditis. Serologic testing revealed elevated Toxoplasma gondii immunoglobulin G (IgG) titers. Other infectious or autoimmune causes were excluded. The patient was treated with oral sulfamethoxazole/trimethoprim. During work-up, multiple segmental whitish opacities developed along retinal arteries, consistent with Kyrieleis plaques. These gradually regressed as inflammation subsided. A 66-year-old man presented with unilateral vitritis and peripheral chorioretinal atrophic lesion. Laboratory tests were positive for T. gondii IgG and negative for other infectious or inflammatory markers. The patient received oral sulfamethoxazole/trimethoprim and showed gradual improvement. Segmental periarterial opacifications appeared during recovery but resolved completely with inflammation control.
Conclusions
Recognition of this distinctive but benign finding is essential to distinguishing it from retinal artery emboli or occlusion, preventing unnecessary systemic work-up, and supporting the appropriate management of inflammatory ocular diseases.
8.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.
9.A Prospective Cross-sectional Screening Using Non-mydriatic Fundus Photography and Optical Coherence Tomography in Patients on Tamoxifen Therapy
Sang Cheol YANG ; Jun Young LEE ; Dong Seon KIM ; Tae Yeon KIM ; Young Hwan JEONG ; Bo Hyun PARK ; IkSoo BYON ; Sung Who PARK
Journal of Retina 2026;11(1):44-49
Purpose:
To determine the prevalence of tamoxifen retinopathy and assess the utility of a screening protocol using non-mydriatic fundus photography and optical coherence tomography (OCT).
Methods:
Between May and October 2024, patients on tamoxifen therapy at a breast surgery clinic were offered screening including non-mydriatic fundus photography and OCT. Among those who consented, 290 patients (580 eyes) were included after excluding other retinal diseases. We investigated tamoxifen duration, cumulative dose, central retinal thickness, BMI, underlying diseases, menopausal status, and history of chemotherapy, hormone therapy, or oral contraceptives.
Results:
All patients were taking 20 mg of tamoxifen daily. The mean treatment duration was 55.7 ± 29.5 months for those treated longer than two years (n = 193), with a mean BMI of 22.1 ± 3.0 kg/m2. Systemic comorbidities included dyslipidemia (n = 27, 14.0%), hypertension (n = 19, 9.8%), diabetes mellitus (n = 13, 6.7%), and cardiovascular disease (n = 4, 2.1%). Additionally, patient histories included chemotherapy (n = 84, 43.7%), postmenopausal status (n = 56, 29.1%), hormone therapy (n = 52, 27.0%), and oral contraceptive use (n = 14, 7.2%). Tamoxifen retinopathy was not observed in any of the patients.
Conclusions
In this cross-sectional study, the prevalence of tamoxifen retinopathy, as assessed by non-mydriatic fundus photography and OCT in this study, was 0%, which is lower than previously reported rates (0.9%–12%). Although specialized examination by an ophthalmologist, including a dilated fundus examination and OCT remains the diagnostic gold standard, practical constraints can limit its routine clinical use. Our study evaluated a screening protocol performed without ophthalmologist intervention. However, we found that limitations in image quality compromised the detection of subtle lesions, such as crystalline deposits. Consequently, this approach may be insufficient to serve as a primary screening strategy.
10.Four-point Scleral Fixation using the Single-loop Suture Technique for Posterior Chamber Intraocular Lens Implantation: Long-Term Follow-up Results
Myung Ae KIM ; Moon Young CHOI ; Hyun Sub OH
Journal of Retina 2026;11(1):36-43
Purpose:
To investigate results of the single-loop suture scleral fixation technique with long-term follow-up.
Methods:
This retrospective study analyzed patients who underwent scleral fixation using the single-loop suture technique between January 2010 and June 2024 with a minimum follow-up period of one year. Ophthalmic outcomes and complications including polypropylene suture type and re-operation rates were evaluated.
Results:
A total of 215 eyes in 201 patients were included. Polypropylene suture types used included 10-0 in 52.1% (112 of 215), 9-0 in 44.2% (95 of 215), and 3.7% (8 of 215) remained unconfirmed. The re-operation rate was 22.3% (25 of 112) with 10-0 polypropylene, 1.1% (1 of 95) with 9-0 polypropylene, and 12.1% (26 of 215) in total. Intraocular lens repositioning was needed in 0.9% (2 of 215). Postoperative intraocular pressure (IOP) elevation occurred in 51.6% (83 of 161) of patients without baseline glaucoma history; 94.0% (78 of 83) of cases were well controlled with glaucoma medication and 44.6% (37 of 83) were able to discontinue it.
Conclusions
Single-loop suture scleral fixation is a safe and effective surgical technique with a low incidence of serious complications.This technique leads to stable lens centering with a low rate of lens repositioning. Polypropylene suture type can affect the re-operation rate. Close monitoring of IOP is recommended.

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