Background: How HLA-A26 modulates Behçet’s disease ocular lesions such as iridocyclitis and retinochorioiditis has not been scrutinized. Methods: Ministry of Health, Labour and Welfare of Japan provided us a database of Behçet’s disease patients who were registered from 2003 to 2014. We selected patients who satisfied International Criteria for Behçet’s Disease and whose data for HLA-A26 was available. Results. Eligible 557 patients consisting of 238 men (42.7%) and 319 women (57.3%), whose median age was 38 years old (interquartile range (IQR) 29-47) were analyzed. Prevalence of general ocular lesions, iridocyclitis, retinochorioiditis, and chronic lesions were 43.1%, 30.7%, 34.1%, and 17.4%, respectively. The prevalence of ocular lesions was higher among HLA-A26 carriers compared to that among HLA-A26 non-carriers with odds ratio (OR) of 2.5 (95% confidence interval (95% CI) 1.8-3.5, P < 0.001) for general ocular lesions, OR of 2.5 (95% CI 1.7-3.6, P < 0.001) for iridocyclitis, OR of 2.8 (95% CI 1.9-4.0, P < 0.001) for retinochorioiditis, and OR of 2.7 (95% CI 1.7-4.3, P < 0.001) for “chronic ocular lesion following iridocyclitis or retinochorioiditis.” The HLA-A26 had a similar impact on ocular lesions between HLA-B51 positive and negative cases (Breslow-Day test, P > 0.05). However, the HLA-A26 had a larger impact on iridocyclitis for men compared to women (Breslow-Day test, P = 0.040). The male HLA-A26 carriers had higher risk of iridocyclitis with OR of 3.4 (95%CI 2.0-5.9, P <0.001), while the OR for women was 1.5 (95%CI 0.9-2.6, P = 0.146). Conclusion: HLA-A26 carriers had higher risk for iridocyclitis and retinochorioiditis. However, the impact was more prominent for men.

Background/Objectives: Meibomian gland dysfunction (MGD)-related dry eye aggravates postoperative visual outcomes in cataracts. Diffractive trifocal intraocular lenses (IOLs) decrease contrast sensitivity (CS). Intense pulsed light (IPL) improves tear film stability and ocular surface conditions in MGD-related dry eyes. We investigated the effect of preoperative MGD-related dry eye treatment combining manual meibomian gland expression (MGX) with IPL (IPL-MGX) on visual outcomes post-cataract surgery with diffractive trifocal IOL implantation. Methods: In this single-center, prospective, and open-label study, we enrolled 67 patients (134 eyes) with MGD-related dry eye undergoing cataract surgery on both eyes. Preoperatively, IPL-MGX was performed on one eye (IPL-MGX group) but not the contralateral eye (control group). Tear break-up time, high-order aberrations, and central superficial punctate keratopathy (C-SPK) were assessed. CS and corrected distance visual acuity were analyzed. Differences between groups were analyzed at 1 week, 1 month, and 3 months postoperatively. Results: The IPL-MGX group showed greater mean tear break-up time and lower mean high-order aberration and C-SPK values after preoperative IPL treatment and postoperatively (all p < 0.01). Postoperative CS was higher in the IPL-MGX group at 1 week (all spatial frequencies) (p < 0.01 [cpd = 2.9, 4.5, 7.1, and 10.2] and p < 0.05 [cpd = 1.1 and 1.8]); 1 month [2.9–10.2 cpd] (p < 0.01); and 3 months [4.5–10.2 cpd] (p < 0.01 [cpd = 10.2] and p < 0.05 [cpd = 4.5 and 7.1]) postoperatively. Mean corrected distance visual acuity was higher in the IPL-MGX group only postoperatively (p < 0.01). Conclusions: Preoperative MGD-related dry eye treatment using IPL-MGX enhances tear film stability, ocular surface conditions, and visual outcomes, potentially improving postoperative vision quality and patient satisfaction.

Objective: This research seeks to investigate the effects of preoperative intense pulsed light with manual meibomian expression (IPL-MGX) on the refractive accuracy of cataract surgery on dry eyes with meibomian gland dysfunction (MGD-related dry eyes). Methods: Fifty-six MGD-related dry eye cases planned for cataract surgery were analyzed. IPL-MGX (four times at 2-week intervals) was performed before preoperative examination. Axial length (AL), anterior chamber depth (ACD), corneal curvature (mean-K), tear break-up time (TBUT), superficial punctate keratopathy in the central cornea (C-SPK), corneal higher-order aberrations (HOAs), and predicted postoperative spherical equivalent (P-SE) were evaluated pre- and post-IPL-MGX. The postoperative subjective spherical equivalent (S-SE) was evaluated after one month. The absolute difference between the S-SE and P-SE was considered an indication of P-SE accuracy. Changes in all the variables were assessed before and after IPL-MGX treatment. Results: No significant differences were observed in AL or ACD (p = 0.85, 0.56). The differences in mean-K, TBUT, C-SPK, and HOAs were significant (p < 0.01). P-SE accuracy based on post-IPL-MGX data was significantly higher than that based on pre-IPL-MGX data (p < 0.01). P-SE accuracy was within 0.25 diopters (D) in 14.3% of pre- and 55.4% of post-IPL-MGX, within 0.5D in 55.4% of pre- and 92.9% of post-IPL-MGX, within 0.75D in 98.2% of pre- and post-IPL-MGX, and within 1.0D in 98.2% of pre- and 100% of post-IPL-MGX. In the range of 0.25 and 0.5 D, the accuracy of P-SE was significantly higher in post-IPL-MGX (p < 0.01). Conclusions: Preoperative IPL-MGX considerably improved the predicted postoperative refraction accuracy in patients with MGD-related dry eye undergoing cataract surgery.

Nocturnal and circadian intraocular pressure (IOP) fluctuations are important issues in glaucoma treatment. Ripasudil 0.4% eye drops, a new glaucoma medication, lowers IOP by increasing aqueous humor outflow through the trabecular meshwork. We aimed to compare differences between circadian IOP fluctuations measured using a contact lens sensor (CLS) before and after administering 0.4% ripasudil eye drops adjunctively to patients with primary open-angle glaucoma (POAG) and normal tension glaucoma (NTG). Patients with POAG (n = 1) and NTG (n = 5) underwent 24 h IOP monitoring with a CLS before and after administering ripasudil eye drops every 12 h (8 a.m., 8 p.m.) for 2 weeks without discontinuing currently used glaucoma medications. No vision-threatening adverse event occurred. The reduction in IOP fluctuation and the reduction in the SD of IOP in 24 h, awake time and sleep time did not reach statistical significance. The baseline office-hour IOP, which was measured using Goldmann applanation tonometry (GAT), ranged in the low teens, and the reduction in office-hour IOP also did not show a significant difference. Further study is necessary to evaluate whether the low baseline IOP with less IOP reduction relates to attenuated IOP fluctuation reduction.

Background: Diabetic macular edema (DME) is a leading cause of vision loss in working-age adults. Faricimab, a bispecific antibody targeting VEGF and Ang-2, has been shown to reduce treatment burden by enabling extended injection intervals. However, real-world, long-term data from Japanese populations are limited. Purpose: To evaluate the two-year efficacy and safety of intravitreal faricimab for DME in a real-world clinical setting in Japan. Methods: This retrospective observational study was conducted at the International Goodwill Hospital, Yokohama, Japan. Patients with DME who were followed for two years after initiating intravitreal faricimab. Outcome measures included central subfield thickness (CST), best-corrected visual acuity (BCVA), macular fluid resolution, and recurrence. Changes were evaluated using nonparametric tests and survival analysis. Results: We analyzed 9 patients (16 eyes) with DME who were followed for two years after initiating intravitreal faricimab. A four-injection loading phase was omitted in all but one case, with a median of one initial injection. CST decreased from 332.3 μm to 267.0 μm (p = 0.069), and BCVA remained stable (0.49 to 0.55 logMAR, p = 0.2081). Complete macular fluid resolution occurred in 87.5% of eyes, with a median resolution time of 6 months. Recurrence occurred in 37.5% of eyes during follow-up, with a median time to recurrence of 9 months. Among eyes on fixed dosing (n = 11), 72.7% achieved a final injection interval of ≥ 12 weeks. Intraretinal fluid (IRF) significantly decreased (p = 0.0078), and chronic cystoid changes were associated with limited CST reduction (p = 0.016). No treatment-related adverse events were reported. Conclusion: Faricimab demonstrated favorable anatomical outcomes and extended injection intervals over two years in a real-world setting, despite the omission of a loading phase in most cases. These findings support its practical utility of faricimab for DME management in Japan.

Background: Retinal vein occlusion (RVO) is the second most common retinal vascular disease and a major cause of visual impairment due to macular edema (ME). Faricimab, a novel bispecific antibody targeting both VEGF-A and angiopoietin-2, has shown promise in clinical trials; however, real-world data on its efficacy and safety for ME secondary to RVO (RVO-ME) remain limited. Objective: To evaluate the short-term efficacy and safety of intravitreal faricimab for RVO-ME in a real-world Japanese clinical setting, and to explore associations between baseline optical coherence tomography (OCT) biomarkers and treatment outcomes. Methods: This retrospective observational study was conducted at the International Goodwill Hospital, Yokohama, Japan, and included 23 eyes with RVO-ME treated with intravitreal faricimab. Changes in best-corrected visual acuity (BCVA, logMAR) and central subfield thickness (CST) over 3 months were assessed. Baseline OCT biomarkers were analyzed for associations with visual and anatomical responses. Subgroup analyses compared treatment-naïve and previously treated eyes. Results: The median number of injections was 1, and 52.2% of eyes achieved complete resolution of macular fluid. Median BCVA improved significantly from 0.40 to 0.22 logMAR (p = 0.0025), and median CST decreased from 352 μm to 194 μm (p < 0.001). Greater CST reduction was observed in treatment-naïve eyes (p = 0.048) and in eyes with chronic cyst (p = 0.015). No OCT biomarker was significantly associated with BCVA improvement. No ocular or systemic adverse events were observed. Conclusion: Intravitreal faricimab was effective and well-tolerated for RVO-ME in this real-world study. Even a single injection frequently led to anatomical and functional improvement. These results support the clinical utility of faricimab and suggest a potential role for OCT biomarkers in predicting treatment response.