Purpose: To compare disease severity between preperimetric primary open-angle glaucoma (POAG) patients with and without deep-layer microvasculature dropout. Materials and Methods: Ninety-four eyes of 94 preperimetric POAG patients with β-zone parapapillary atrophy (βPPA) were categorized according to the presence of deep-layer microvasculature dropout defined as a complete loss of microvasculature within the choroid or scleral flange on optical coherence tomography angiography. Parameters representing disease severity, that is, visual field (VF) mean deviation (MD), global and sectoral (6-sector) retinal nerve fiber layer (RNFL) thickness, and other factors including age, focal lamina cribrosa (LC) defect, width of βPPA with and without Bruch membrane (BM) (βPPA+BM and βPPA−BM), and optic disc hemorrhage were compared between eyes with and without dropout. Results: Deep-layer microvasculature dropout was observed in 33 preperimetric POAG eyes (35.1%). Eyes with dropout had significantly thinner RNFL in all areas except the inferonasal sector, worse VF MD, and higher prevalence of focal LC defect, and larger βPPA−BM (P<0.05), whereas the 2 groups did not differ in age, disc hemorrhage, or βPPA+BM width (P>0.05). In the multivariable logistic regression, worse VF MD [odds ratio (OR), 1.485; P=0.045], thinner RNFL (OR, 1.141; P<0.001), and higher prevalence of focal LC defect (OR, 6.673; P<0.001) were significantly associated with dropout. Conclusions: Deep-layer microvasculature dropout was observed in a considerable number of preperimetric POAG eyes, and worse disease severity was associated with dropout. Future studies elucidating the pathogenic role of deep-layer microvasculature dropout in the development and progression of glaucoma are warranted.

Purpose: To investigate changes in corneal anterior high-order aberration (HOA) and contrast sensitivity (CS) before and after epiblepharon surgery. Methods: A retrospective observational analysis of the degree of corneal erosion, HOAs and CS was conducted in the OD and OS, respectively, before and after epiblepharon surgery. The correlations between corneal erosion, HOAs, and CS were analyzed. Results: Forty-nine patients were included in the study. Among the anterior HOAs, total HOA, coma, and trefoil showed significant improvement after surgery (P = 0.003, P = 0.009, and P = 0.018, respectively). In the CS test, there was a significant improvement in CS after surgery at 1.1 cycles per degree (cpd) under photopic conditions, regardless of glare. Preoperative correlation analysis between HOAs and corneal erosion showed a significant positive correlation with total HOA (P = 0.001) and coma (P = 0.001). Preoperative correlation analysis between CS and corneal erosion showed a significant negative correlation at 1.1 cpd with glare under photopic conditions (P = 0.049). A negative correlation was also observed between CS under mesopic and photopic conditions and total HOA both before and after surgery. Conclusion: Significant improvement in corneal anterior HOAs and CS at 1.1 cpd under photopic conditions was observed after epiblepharon surgery. Total HOA of anterior cornea showed a negative correlation with CS. A decrease in HOAs and recovery of corneal erosion after epiblepharon surgery will help improve CS.

Purpose: To investigate the use of second AREDS2 formula in patients with intermediate or advanced age-related macular degeneration.Methods: A prospective survey was conducted between December 2019 and July 2020. The questionnaire consisted of 24 questions on demographics, disease perception, and formula intake.Results: The survey included 100 patients (males, 56%; age [>60 years], 89%). We found that 66%, 84%, and 93% of patients had a good understanding of their disease, had stopped smoking, and were aware of the need for antioxidant supplements; 58% of patients were aware of the supplement they were prescribed, and 63.8% (37% of total) were using the AREDS2 formula. Only 8% of patients had knowledge regarding the supplement ingredients, and 91% consumed the supplement daily. Patients with long disease duration used supplements less frequently (p < 0.05). Older patients and those with a low education level had a limited perception of the disease (p < 0.05).Conclusions: In this prospective survey, some patients consumed supplements other than the AREDS2 formula. Further studies are required to determine ways to increase the use of the AREDS2 formula.

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