To investigate changes in the size of the population of patients who are receiving long-term, active treatment for neovascular age-related macular degeneration (AMD). This retrospective, observational study included 3,380 patients who received anti-vascular endothelial growth factor injections (3,974 eyes). The injections performed were divided into the following three groups: group 1, injections performed right after the initial diagnosis; group 2, injections performed <24 months; and group 3, injection performed ≥24 months. Time-dependent changes in the proportion of injections in each group were analyzed. The total number of injections markedly increased from 431 in the 1st quarter of 2014 to 1,323 in the 4th quarter of 2018. There were significant changes in the proportion of injections in each group over time (P < 0.001). The proportions of group 1, group 2, and group 3 in the 1st quarter of 2014 were 17.4%, 65.4%, and 17.2%, respectively. The proportions changed to 10.6%, 50.2%, and 39.5% in the 4th quarter of 2018, respectively. The marked increase in the proportions of group 3 may suggest an increase in the patient population that underwent long-term active treatment. The socioeconomic influence of this trend should be considered when establishing future strategies for neovascular AMD.

Tractional retinal detachment (TRD) causes visual loss in diabetes mellitus patients. Silicone oil can be used as a tamponade to repair retinal detachment; however, intrasilicone injection is challenging. We aimed to evaluate the effect of intrasilicone bevacizumab injection in TRD surgery. This was a single-hospital, retrospective, case-control study of 44 patients (46 eyes). We reviewed medical histories and ophthalmic examination results. We administered silicone oil to 26 eyes (group I), and a combination of silicone oil and intravitreal bevacizumab injection to 20 eyes (group II). The main outcome measures were the logarithm of the minimum angle of resolution (logMAR) visual acuity and central macular thickness. Mean change in logMAR visual acuity was larger (p = 0.029) in group II (−0.99 ± 0.73) than in group I (−0.56 ± 0.80), 12 months postoperatively. Compared to group I, group II exhibited a lower mean (471.54 ± 120.14 μm vs. 363.40 ± 59.57 µm, respectively; p = 0.001), and mean change (−22.39 ± 203.99 μm vs. −72.40 ± 139.35 µm, respectively; p = 0.027), in central macular thickness, 1 month postoperatively. Intrasilicone bevacizumab injection immediately after vitrectomy may rapidly reduce central macular thickness and increase final visual acuity. Prospective studies are necessary to demonstrate long-term safety and efficacy.

High myopia is defined as a refractive error with a spherical equivalent (SE) ≤-6.0 diopters (D). The prevalence of myopia has been reported to be as high as 80% in Asia and 22.9% in other regions of the world [1,2]. Because of its increasing prevalence in eastern and southeastern Asian countries, including Singapore, China, Taiwan, Japan, and the Republic of Korea, it has been an important public health problem in the past 50 to 60 years [3]. Although most refractive errors can be corrected with glasses or contact lenses, high myopia can cause irreversible retinal disorders such as chorioretinal atrophy, choroidal neovascularization, and macular retinoschisis due to Purpose: To evaluate the differences in individual segmental retinal layer thickness in adult patients with high myopia. Methods: This study compared the retinal layers of patients with high myopia (axial length of ≥26.0 mm) with those of normal controls using spectral-domain optical coherence tomography. The thicknesses of the retinal layers were compared using nine Early Treatment Diabetic Retinopathy Study subfields. Choroidal thickness was also measured in the subfoveal area. Results: We included 37 eyes with high myopia and 37 eyes of healthy subjects. The mean age was 42.95 and 47.73 years (p = 0.114), and the mean axial length was 27.28 and 24.47 mm (p < 0.001), respectively. The parafoveal areas (outer ring segment) of the ganglion cell layer and inner plexiform layer, all segmental areas except the subfoveal region of the inner nuclear layer, most segmental areas (inner superior, inner inferior, outer superior, outer temporal, and outer nasal) of outer plexiform layer, and most segmental areas (subfovea, inner temporal, inner inferior, inner nasal, outer temporal, and outer inferior) of outer nuclear layer were thinner in eyes with high myopia than in normal eyes (all p < 0.05). There were no statistically significant differences between the levels of photoreceptor layer, retinal pigment epithelium, and nerve fiber layer. The mean choroidal thickness was 153.81 ± 64.80 and 239.54 ± 44.28 μm in the high myopia and control groups, respectively, which were significantly different (p < 0.001). Conclusions: In high myopia without pathologic changes, there was a meaningful thinning of the retina and choroid, especially in most Early Treatment Diabetic Retinopathy Study subfield areas of the deep vascular complex, perifoveal area of the superficial vascular complex, and most areas of the outer nuclear layer in the outer retinal layer, which are associated with myopic axial elongation.

To analyze the changes in each retinal layer and the recovery of the ellipsoid zone (EZ) after full-thickness macular hole (FTMH) surgery. Patients who underwent surgery for FTMH were included. Spectral-domain optical coherence tomography (SD-OCT) was performed preoperatively and postoperatively at 1, 3, 6, 9, and 12 months. A total of 32 eyes were enrolled. Ganglion cell layer, inner plexiform layer, and inner nuclear layer showed significant reductions over time after surgery (P = 0.020, P = 0.001, and P = 0.001, respectively), but were significantly thicker than those of fellow eyes at 12 months postoperatively. The average recovery duration of the external limiting membrane (ELM), outer nuclear layer (ONL), and EZ was 1.5, 2.1, and 6.1 months, respectively. Baseline best-corrected visual acuity (BCVA) (P = 0.003), minimum linear diameter (MLD) (P = 0.025), recovery of EZ (P = 0.008), and IRL thickness (P < 0.001) were significant factors associated with changes in the BCVA. Additionally, axial length (P < 0.001), MLD (P = 0.020), and IRL thickness (P = 0.001) showed significant results associated with EZ recovery. The IRL gradually became thinner after FTMH surgery but was still thicker than that of the fellow eye at 12 months postoperatively. The recovery of ELM and ONL may be a prerequisite for the EZ recovery. The BCVA change was affected by baseline BCVA, MLD, recovery of EZ, and IRL thickness. Additionally, axial length, MLD, and IRL thickness were significantly associated with EZ recovery.