Sung Jae Yang

1. Glaucoma is one of the leading causes of irreversible blindness worldwide and is characterised by the progressive degeneration of retinal ganglion cells (RGCs) (Lee and Mackey 2022; Qi et al. 20...

Objective To evaluate prognostic factors associated with good response to intravitreal bevacizumab (IVB) treatment in central serous chorioretinopathy (CSC) patients. Methods We retrospectively reviewed ninety-four eyes of 94 CSC patients who received intravitreal bevacizumab injection(IVB) (0.05 ml, 1.25 mg) as a first line treatment. Patients were divided into two groups as good responders and poor responders based on optical coherence tomography (OCT) findings 1 month after the first injection of intravitreal bevacizumab. Good responders were defined as complete resolution of subretinal fluid (SRF) on OCT 1 month after IVB. We compared baseline visual acuity, duration of symptoms, angiographic findings on fluorescein angiography, central retinal thickness (CRT), macular volume (MV),subfoveal choroidal thickness (SFCT) between two groups. Results 42 eyes were included as good responder and 52 eyes as poor responders. Mean age was 47.8±7.4 year old ingood responders and 50.6±7.8 year old in poor responders. Baseline visual acuity (logMAR) was better in good responders than poor responders, 0.19±0.19 and 0.29±0.19 respectively (p=0.015). SFCT was significantly thicker in good responders than poor responders 419.7±103.2㎛ and 376.0±99.0㎛ respectively (p=0.040). Prevalence of chronic cases was higher in poor responders (33/52) than good responders (15/42), (p=0.012). There was no statistical significance in age, sex, CRT, MVbetween two groups. Conclusion Intravitreal injection of bevacizumab can be potential option for the treatment of CSC patients, especially in case of recent onset, better baseline visual acuity with thicker choroid on OCT.

Purpose of review Ocular involvement in sarcoidosis is present in up to 80% of patients and is frequently manifested before diagnosis of the underlying systemic disease. Considering the therapeutic consequences, early diagnosis of the underlying disease is advantageous in patients presenting with ocular inflammation. There are several ocular findings suggestive of underlying sarcoidosis, such as granulomatous keratic precipitates, iris nodules, cells in the vitreous humor known as snowballs and snowbanks, and retinal periphlebitis. High suspicion is crucial for the diagnosis of sarcoidosis. This review on ocular sarcoidosis will mainly focus on new diagnostic and treatment modalities. Recent findings Recent studies found possible new diagnostic indicators for the diagnosis of ocular sarcoidosis which include not only serum profiles but also vitreous sample analysis. Ophthalmologic imaging techniques have improved to investigate the ocular structure in detail. Results from recent uveitis clinical trials have included sarcoidosis as an underlying cause and have reported positive results. Summary The diagnosis of ocular sarcoidosis can be challenging in some cases. High suspicion is important to diagnose ocular sarcoidosis with various laboratory and ophthalmic tools. There are many possible options for the treatment of ocular sarcoidosis including various biologic agents.

This study aimed to investigate the levels of aqueous humour cytokines in the eyes of patients with central serous chorioretinopathy (CSC), who received an intravitreal injection of bevacizumab, and to evaluate the differences in cytokine levels between bevacizumab responders and non-responders. Aqueous humour samples were collected from 39 eyes of 39 patients with CSC and 25 eyes of 25 control patients undergoing cataract surgery and were analysed using Multiplex bead assays. We compared the cytokine levels in patients with CSC (responders and non-responders) and control subjects. After intravitreal injections of bevacizumab in patients with CSC, we evaluated the changes in visual acuity and optical coherence tomographic parameters. Significantly increased levels of interferon gamma-induced protein (IP-10) were detected in the aqueous humour of eyes from patients with CSC compared to controls (p = 0.036). Vascular endothelial growth factor (VEGF) levels were significantly higher in bevacizumab responders than in non-responders (p = 0.021). The concentrations of the other cytokines investigated did not differ significantly between patients with CSC and control subjects or between responders and non-responders. The results of the present study suggest that IP-10 and VEGF may contribute to the pathogenesis of CSC. It is clear that intravitreal bevacizumab was helpful in some of the patients with CSC, who showed higher levels of VEGF in the aqueous humour. However, the true effect and the rationale of anti-VEGF injection treatment in patients with CSC remain to be elucidated. Our results suggest that patients with CSC may be more susceptible to VEGF and/or other cytokines than the normal population.

The aim was to evaluate changes in choroidal thickness, intraocular pressure (IOP) and other parameters of optical coherence tomography, such as central foveal thickness (CFT), macular volume, peripapillary retinal nerve fibre layer (RNFL) thickness after haemodialysis (HD). Thirty-four eyes of 34 chronic renal failure patients (9 eyes with diabetic patients) who underwent haemodialysis in the Dialysis Unit of Gangneung Asan Hospital were included. CFT, macular volume, peripapillary RNFL and choroidal thickness were measured before and after haemodialysis by optical coherence tomography (OCT, Spectralis; Heidelberg Engineering). Changes in the IOP were evaluated with Goldmann applanation tonometry before and after haemodialysis. The average choroidal thickness decreased significantly, from 233.1 ± 77.5 μm to 219.1 ± 76.8 μm (paired t-test, p < 0.001). This change correlated with the amount of body weight lost (Pearson's correlation coefficient = 0.348, p = 0.044). The mean IOP decreased from 15.1 ± 2.6 mmHg to 13.9 ± 2.2 mmHg after haemodialysis (paired t-test, p = 0.03). The change in macular volume and the small decrease in CFT (214.0 ± 21.0 μm to 213.8 ± 21.8 μm) were not significant. The measured overall change in RNFL thickness from 93.6 ± 15.5 μm to 94.7 ± 14.6 μm was not significant. Haemodialysis can affect various ocular parameters, particularly choroidal thickness and IOP.