Scar formation can cause the failure of glaucoma filtration surgery. We investigated the effect of AR12286, a selective Rho-associated kinase inhibitor, on myofibroblast transdifferentiation and intraocular pressure assessment in rabbit glaucoma filtration surgery models. Cell migration and collagen contraction were used to demonstrate the functionality of AR12286-modulated human conjunctival fibroblasts (HConFs). Polymerase chain reaction quantitative analysis was used to determine the effect of AR12286 on the production of collagen Type 1A1 and fibronectin 1. Cell migration and collagen contraction in HConFs were activated by TGF-β1. However, compared with the control group, rabbit models treated with AR12286 exhibited higher reduction in intraocular pressure after filtration surgery, and decreased collagen levels at the wound site in vivo. Therefore, increased α-SMA expression in HConFs induced by TGF-β1 could be inhibited by AR12286, and the production of Type 1A1 collagen and fibronectin 1 in TGF-β1-treated HConFs was inhibited by AR12286. Overall, the stimulation of HConFs by TGF-β1 was alleviated by AR12286, and this effect was mediated by the downregulation of TGF-β receptor-related SMAD signaling pathways. In vivo results indicated that AR12286 thus improves the outcome of filtration surgery as a result of its antifibrotic action in the bleb tissue because AR12286 inhibited the TGF-β receptor-related signaling pathway, suppressing several downstream reactions in myofibroblast transdifferentiation.

Rationale: Preoperative embolization of brain tumors has been widely used to minimize hemorrhaging during surgery, but anastomosis between vessels is sometimes overlooked and complications can occur. Herein we describe a case of rare complications of central retinal artery occlusion (CRAO) and posterior ciliary artery occlusion after embolization of the middle meningeal artery. Patient concerns: A 48-year-old woman experienced acute, painless loss of vision in her left eye during embolization of the middle meningeal artery for meningioma. Diagnosis: The patient was diagnosed with CRAO and posterior ciliary artery occlusion based on indirect ophthalmoscopy, optical computed tomography of the macula, and fundus angiography. Interventions: Ocular massage, oral acetazolamide, and topical brimonidine eyedrops were administered. Outcomes: Visual acuity decreased from hand motion to no light perception within 2 months. Optic disc atrophy with retinal thinning was evident after 2 to 4 months. Lessons: The blood supply and any collateral vessels of the ophthalmic artery should be vigilantly scrutinized to prevent complications during embolization of the middle meningeal artery that may lead to a poor visual outcome.

To present a case of anterior capsular contraction syndrome with hyperopic shift two weeks after an uncomplicated combined cataract surgery and pars plana vitrectomy. A 55-year-old man, with no known risk factors, who developed anterior capsular contraction syndrome with hyperopic shift two weeks after an uncomplicated combined cataract surgery and pars plana vitrectomy. Hyperopic shift was caused by posterior displacement of the intraocular lens with anterior flexion of the haptics. Manual peeling of the anterior capsule using the can-opener approach and microscissors successfully restored vision and corrected refractive errors. Anterior capsular contraction syndrome is a complication of cataract surgery and is known to be affected by zonular weakness, pre-existing systemic and ocular conditions, intraocular lens materials, and intraoperative complications. Careful maneuver with surgery or laser can effectively restore vision and correct refraction.

Spectral-domain optical coherence tomography is widely used in maculopathy, including diabetic macular edema (DME). Bacillary layer detachment (BALAD) is a novel optical coherence tomography finding, defined as the separation of the intraretinal layer between the inner segment myoids and ellipsoids. A total of 161 treatment-naïve eyes with centrally involved DME that underwent 3 monthly loading doses of anti-vascular endothelial growth factor (anti-VEGF) intravitreal injections were enrolled and analyzed retrospectively. BALAD was found in 6.2% of eyes with concurrent subretinal fluid (SRF). All eyes were divided into 3 groups: no either group had neither SRF or BALAD; the SRF only group had SRF but no BALAD; and the BALAD group had both SRF and BALAD. A significant increase in baseline central foveal thickness (CFT) in the BALAD group was observed (no either vs SRF only vs BALAD, baseline CFT: 387.6 ± 74.29 vs 440.6 ± 106.79 vs 642.0 ± 188.86; P < .01). Total resolution of BALAD was noted after anti-VEGF therapy, along with a significant decrease in CFT in all groups (CFT decrease: 82.4 ± 87.07 vs 187.6 ± 138.88 vs 252.1 ± 127.63; P < .01). Eyes with BALAD tended to have the worst baseline visual acuity (baseline logarithm of the minimum angle of resolution VA: 0.76 ± 0.353 vs 0.63 ± 0.303 vs 1.15 ± 0.300; P = .046) but showed the most improvement after treatment (logarithm of the minimum angle of resolution VA change: −0.14 ± 0.235 vs −0.22 ± 0.275 vs −0.27 ± 0.250; P = .079). After resolution of BALAD, all eyes in the BALAD group exhibited ellipsoid zone and/or interdigitation zone disruption corresponding to the BALAD area. BALAD is a novel optical coherence tomography finding associated with a spectrum of diseases including DME. With anti-VEGF therapy, total resolution of BALAD and a significant decrease in CFT can be obtained. However, ellipsoid zone/interdigitation zone disruption tended to develop.