Diabetic retinopathy (DR) is one of the leading causes of blindness globally. Retinal neuronal abnormalities occur in the early stage in DR. Therefore, maintaining retinal neuronal activity in DR may prevent vision loss. Previously, pemafibrate, a novel selective peroxisome proliferator-activated receptor alpha modulator, was suggested as a promising drug in hypertriglyceridemia. However, the role of pemafibrate remains obscure in DR. Therefore, we aimed to unravel systemic and retinal changes by pemafibrate in diabetes. Adult mice were intraperitoneally injected with streptozotocin (STZ) to induce diabetes. After STZ injection, diet supplemented with pemafibrate was given to STZ-induced diabetic mice for 12 weeks. During the experiment period, body weight and blood glucose levels were examined. Electroretinography was performed to check the retinal neural function. After sacrifice, the retina, liver, and blood samples were subjected to molecular analyses. We found pemafibrate mildly improved blood glucose level as well as lipid metabolism, boosted liver function, increased serum fibroblast growth factor21 level, restored retinal functional deficits, and increased retinal synaptophysin protein expression in STZ-induced diabetic mice. Our present data suggest a promising pemafibrate therapy for the prevention of early DR by improving systemic metabolism and protecting retinal function.

This study examines the role of violet light (VL) in preventing myopia progression, addressing a critical need in urban environments where VL exposure is limited. Recent research suggests that VL, within the 360–400 nm wavelength range, may reduce myopia risk. To investigate, we conducted spectroscopic measurements in various settings across Tokyo, quantifying VL irradiance in natural sunlight. The results showed high VL levels outdoors, averaging 583 μW/cm² on sunny days and 271 μW/cm² on cloudy days, leading to a weighted annual average of approximately 310 μW/cm². In contrast, indoor environments lacked VL due to UV-blocking materials in windows, glasses, and lighting. This deficiency may contribute to the rising incidence of myopia, particularly in urban areas with reduced outdoor exposure. Our findings highlight the need for innovative solutions to mitigate VL deficiency indoors, such as optimizing architectural designs and artificial lighting to better incorporate VL. This study provides foundational insights for future interventions aimed at reducing myopia risk through improved indoor light environments.

We report a case of ocular siderosis caused by a subretinal iron foreign body. A 30-year-old male construction worker injured by a small piece of shrapnel while working visited an eye clinic for decreased vision in left eye on day X, and was subsequently referred to our hospital with a diagnosis of vitreous hemorrhage on day X+1. Although a penetrating foreign body was suspected, no obvious wound or intraocular foreign body was found even after the hemorrhage subsided. On X+3 months, a rhegmatogenous retinal detachment was found and a lens-sparing vitrectomy was performed. A black elevated subretinal lesion was noted intraoperatively but not removed because it was considered to be a blood clot. The postoperative course was stable with best corrected visual acuity (BCVA) recovering to 20/16. However, the BCVA decreased to 20/30 on X+11 months with the subretinal lesion turning reddish brown. The electroretinogram also showed a significant attenuation of all stimuli. Siderosis was considered to have developed due to the subretinal foreign body. On X+14 months, we performed a combined phaco-vitrectomy to remove the foreign body. Analysis revealed iron as the main component of the foreign body. However, the postoperative electroretinogram remained unchanged, and the BCVA was 20/63 without improvement. We experienced a case of a subretinal iron foreign body being mistaken for a blood clot. Even if the vision stays stable, ocular siderosis may occur over the long term if a subretinal iron foreign body remains. Therefore, surgical removal should be actively considered when a subretinal iron foreign body is suspected.

To report a rare case of a full-thickness macular hole (FTMH) that underwent spontaneous closure on two separate occasions following vitrectomy and intraocular lens (IOL) scleral fixation. A 58-year-old man, who had undergone IOL scleral fixation and vitrectomy for a dislocated IOL, developed an FTMH (minimum diameter: 21 μm) in the left eye approximately one year post-surgery. While awaiting surgical intervention, the macular hole closed spontaneously two months after its discovery. Two years and nine months later, the FTMH recurred (minimum diameter: 180 μm) and closed spontaneously again within four weeks. Optical coherence tomography (OCT) confirmed the presence of epiretinal proliferation (EP) at the macular surface during both occurrences. Small-diameter FTMHs that form after vitrectomy, particularly those with associated EP, may have the potential for spontaneous closure. This case indicates that short-term observation may be a reasonable management option for select cases of small post-vitrectomy macular holes before proceeding with further surgery.