This study aims to report a case of rapid progression of cataract to mature stage after intravitreal dexamethasone implantation for macular edema due to branch retinal vein occlusion. A 59-year-old Korean male with complaints of sudden metamorphopsia and reduced visual acuity for three days in the left eye was referred to our clinic. Ophthalmological investigations included fundus photography, fluorescein angiography, and optical coherence tomography. In the left eye, branch retinal vein occlusion with macular edema was observed. We performed intravitreal dexamethasone implantation in the left eye three times within a period of one year. One week after the third intravitreal dexamethasone implantation, grade 1 posterior subcapsular opacity and raised intraocular pressure were observed in the left eye. Three weeks later, mature cataract was observed in the left eye. We performed cataract surgery along with intravitreal ranibizumab injection in the left eye. The procedure was uneventful, and the visual acuity improved postoperatively. Posterior subcapsular cataract developed due to intravitreal dexamethasone implantation can progress rapidly to mature stage. Therefore, short-term follow-up examinations may be necessary for early diagnosis and treatment of this complication.

Autologous serum eye drops are considered to be safe and efficient for the treatment of dry eyes associated with Sjögren syndrome (SS). The purpose of this study was to compare the clinical efficacies of autologous serum eye drops in the management of primary and secondary SS. Patients with primary (n = 20; 35 eyes) and secondary (n = 14; 27 eyes) SS dry eye were included. Serum concentrations of proinflammatory cytokines [tumor necrosis factor α, interleukin (IL)-1β, IL-6, and IL-8] were measured by a multiplex immunobead assay. The ocular symptom scores, ocular staining grades, and tear break-up time were evaluated before and after 4 weeks of 50% autologous serum eye drop application. At enrollment, patients with secondary SS had higher serum proinflammatory cytokine levels (tumor necrosis factor α, IL-1β, IL-6, and IL-8) than patients with primary SS (P < 0.01). After 4 weeks of autologous serum eye drop treatment, patients with primary SS had significantly improved ocular symptoms (P < 0.01), ocular surface staining grades (P < 0.01), and tear break-up time (P < 0.05). However, patients with secondary SS had no improvement (P > 0.05). Our results suggest that autologous serum eye drops might not be effective for the treatment of secondary SS because of elevated serum proinflammatory cytokine levels.

Purpose: We evaluate a matrix metalloproteinase-9 (MMP-9) point-of-care immunoassay (InflammaDry) as a prognostic tool for topical cyclosporine treatment. Methods: A total of 20 healthy subjects and 40 patients meeting >3 dry eye disease (DED) criteria (ocular surface disease index [OSDI] score ≥ 12, tear film breakup time [TBUT] ≤10 seconds, Schirmer I test result ≤10 mm/5 minutes, corneal staining ≥1) were included. DED patients were treated with topical cyclosporine ophthalmic emulsion 0.05% twice daily for 1 month. The InflammaDry test was used to grade MMP-9 levels in the tear film. Treatment response was monitored using the OSDI score, TBUT, and Schirmer, corneal staining, and InflammaDry tests. Results: Of the eyes, 18 (22.5%) were negative, 29 (36.3%) trace-positive, 16 (20.0%) weak-positive, 11 (13.8%) positive, and six (7.5%) strong-positive for MMP-9 at baseline. MMP-9 levels correlated with OSDI (P = 0.049), TBUT (P = 0.001), corneal staining (P = 0.002), and Schirmer test (P = 0.027) results. MMP-9–positive patients displayed decreased post-treatment MMP-9 levels (P = 0.001) and corneal staining score (P < 0.001), improved OSDI score (P < 0.001), and increased TBUT (P < 0.001) and Schirmer (P = 0.009) test values. Conclusions: Semiquantitative MMP-9 grading correlated well with DED symptoms and signs, and could be used to predict patient status and monitor treatment response. MMP-9–positive patients responded more favorably to topical cyclosporine than did MMP-9–negative patients. Thus, the InflammaDry test may inform decisions regarding initiating topical cyclosporine treatment. Translational Relevance: Semiquantitative MMP-9 could be used to predict patient status and monitor treatment response.

To compare the objective assessment of lens density by 2 systems (double-pass Optical Quality Analysis System and Pentacam Scheimpflug) in eyes with age-related nuclear cataract. Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea. Cross-sectional study. In eyes with age-related nuclear cataract, the objective lens density (0 to 100 points) was determined using the Scheimpflug system while subjective grading was achieved using the Lens Opacities Classification System III (LOCS III). The objective scatter index (OSI) (0 to 25) was assessed using the double-pass system. This study enrolled 47 patients (70 eyes). The mean OSI was 4.08 ± 2.22 (SD), and the mean Scheimpflug-measured lens density was 16.44 ± 4.36; the 2 parameters were correlated (r = 0.764, P<.01). There was a positive linear correlation between the OSI and LOCS III grading scores for nuclear opalescence and nuclear color (r = 0.772 and r = 0.752, respectively; P<.01). The cumulated dissipated energy (CDE) was strongly correlated with the OSI (r = 0.768) and Scheimpflug-measured lens density (r = 0.753). The OSI based on the double-pass system was correlated with the Scheimpflug-measured lens density, subjective lens grading, and CDE. The OSI may improve the preoperative evaluation of nuclear cataract and help predict phacodynamics in cataract surgery.

Purpose: To evaluate the efficacy and safety of a novel topical cyclosporin A 0.05% nanoemulsion in comparison with a conventional emulsion in primary Sjögren’s syndrome dry eyes. Methods: Prospective, randomized, double-blinded study was conducted. Results: Corneal and conjunctival staining score was improved in both groups, with a faster change noted in the nanoemulsion group at 12 weeks (p < 0.05). Tear film break-up time was significantly improved in the nanoemulsion group at 12 weeks (p < 0.05), while ocular surface disease index score was improved in both groups without a difference at 12 weeks. Schirmer I value and goblet cell grade did not change in both groups. IL-6 and MMP-9 were significantly decreased in both groups at 12 weeks. Conclusions: Both nanoemulsion and conventional cyclosporin A improved ocular signs, symptoms, and conjunctival inflammation. However, the novel cyclosporin A nanoemulsion showed faster improvement of ocular surface staining scores than the conventional emulsion.