Purpose. To evaluate the ability of Stratus optical coherence tomography (OCT; Carl Zeiss Meditec, Dublin, CA) with its internal normative database to discriminate between healthy eyes and eyes with a localized retinal nerve fiber layer (RNFL) defect not accompanied by a perimetric defect according to standard automated perimetry (SAP) (i.e., a preperimetric localized RNFL defect). methods. Data were retrospectively reviewed from 49 eyes of 49 subjects with preperimetric localized RNFL defects, and 49 healthy control eyes of 49 age-matched subjects, with classification into each group based primarily on red-free fundus photography results. The sensitivity and specificity of various OCT RNFL thickness parameters for identifying subjects with preperimetric localized RNFL defects was determined. In addition, the topographic relationship between the OCT-measured RNFL thickness and the localized RNFL defect location according to red-free fundus photography (i.e., the red-free RNFL defect) was examined. results. The sensitivity of the Stratus OCT RNFL thickness parameters ranged from 2.0% to 40.8%. The highest sensitivity was yielded using a criterion of ≥1 clock hour that were abnormal at the 5% level, which had a specificity of 85.7%. The OCT-measured RNFL thickness showed excellent topographic agreement with the red-free RNFL defect location. conclusions. Although the sensitivity of current Stratus OCT RNFL thickness parameters is low for preperimetric localized RNFL defects, it appears that OCT has the potential to recognize such defects. Further study is needed to develop new analytical methods that will increase OCT sensitivity for identifying preperimetric localized RNFL damage.

Intraocular foreign bodies (IOFBs) are critical ophthalmic emergencies that require urgent diagnosis and treatment to prevent blindness or globe loss. This study aimed to examine the various clinical presentations of IOFBs, determine the prognostic factors for final visual outcomes, establish diagnostic protocols, and update treatment strategies for patients with IOFBs. We retrospectively reviewed patients with IOFBs between 2005 and 2019. The mean age of the patients was 46.7 years, and the most common mechanism of injury was hammering (32.7%). The most common location of IOFBs was the retina and choroid (57.7%), and the IOFBs were mainly metal (76.9%). Multivariate regression analysis showed that poor final visual outcomes (<20/200) were associated with posterior segment IOFBs (odds ratio (OR) = 11.556, p = 0.033) and retinal detachment (OR = 4.781, p = 0.034). Diagnosing a retained IOFB is essential for establishing the management of patients with ocular trauma. To identify IOFBs, ocular imaging modalities, including computed tomography or ultrasonography, should be considered. Different strategies should be employed during the surgical removal of IOFBs depending on the material, location, and size of the IOFB.

To compare the clinical features and treatment outcomes of different types of vitreoretinal lymphoma (VRL) that presents primarily, secondarily, or concurrently in association with CNS lymphoma. We retrospectively reviewed the medical records of 53 patients with VRL pathologically confirmed between 2000 and 2014 in two of the largest tertiary hospitals in Korea. The proportions of primary, secondary, and concurrent VRL were 26%, 34%, and 40%, respectively. The primary VRL group had retinal infiltration most frequently (68%) among all groups and presented with the worst visual acuity at diagnosis (P = 0.035). The diagnostic delay was significantly shorter in patients with secondary VRL (1.4 months; P < 0.001). Median overall survival was 31 months in the entire cohort, and it was shortest in the concurrent VRL/CNS lymphoma group (18 months; P = 0.007). Ocular presentation and survival times may be different in VRL patients according to the association with CNS involvement.

Purpose To evaluate the safety and efficacy of Ahmed Glaucoma Valve implantation (AGVI) for the management of neovascular glaucoma (NVG) associated with proliferative diabetic retinopathy (PDR) in the vitrectomized eyes. Patients and Methods We reviewed the medical records of patients with NVG associated with PDR who underwent AGVI for intraocular pressure (IOP) control and compared the surgical outcome according to vitrectomy history. The main outcome measures were: postoperative IOP control, visual acuity, and complications. Success was defined as an IOP of ≤21 mm Hg and ≥6 mm Hg, without further glaucoma surgery or loss of light perception and devastating complications. Results A total of 73 patients (73 eyes) were included: 42 patients with vitrectomy history before AGVI (vitrectomized group) and 31 patients without vitrectomy history (nonvitrectomized group). The cumulative probabilities of success after AGVI were 89.9% and 83.8% after 1 year, 74.8% and 74.7% after 2 years, and 62.5% and 68.5% after 3 years for the vitrectomized group and the nonvitrectomized group, respectively (P=0.9309). Cox proportional hazards regression showed the intraocular silicone oil tamponade as a risk factor for the surgical failure (odds ratio=4.543, P=0.047). Final visual acuity improved or stabilized in 33 patients (78.6%) in the vitrectomized group and 18 patients (58.1%) in the nonvitrectomized group. Complications were comparable between the groups, but surgical interventions were needed for 5 patients (11.9%) in the vitrectomized group. Conclusion Despite some complications that necessitate surgical intervention, the AGVI is a safe and effective procedure that enables successful IOP control and vision preservation in patients with NVG associated with vitrectomy for the PDR.

Behçet’s disease (BD) is a chronic recurrent systemic inflammatory disorder of unknown etiology characterized by oral and genital ulcerations, skin lesions, and uveitis. The ocular involvement of BD, or Behçet’s uveitis (BU), is characterized by panuveitis or posterior uveitis with occlusive retinal vasculitis and tends to be more recurrent and sight threatening than other endogenous autoimmune uveitides, despite aggressive immunosuppression. Although pathogenesis of BD is unclear, researches have revealed that immunological aberrations may be the cornerstone of BD development. General hypothesis of BD pathogenesis is that inflammatory response is initiated by infectious agents or autoantigens in patients with predisposing genetic factors and perpetuated by both innate and acquired immunity. In addition, a network of immune mediators plays a substantial role in the inflammatory cascade. Recently, we found that the immunopathogenesis of BU is distinct from other autoimmune uveitides regarding intraocular effector cell profiles, maturation markers of dendritic cells, and the cytokine/chemokine environment. In addition, accumulating evidence indicates the involvement of Th17 cells in BD and BU. Recent studies on genetics and biologics therapies in refractory BU also support the immunological association with the pathogenesis of BU. In this review, we provide an overview of novel findings regarding the immunopathogenesis of BU.