To compare clinical outcomes between pars plana vitrectomy (PPV), scleral buckling (SB) and PPV+SB for Rhegmatogenous Retinal Detachment (RRD) in the Japan-RD Registry.

This is a nation-wide, multi-center, observational study based on the registry data between 2016 and 2017. The failure levels were defined as level 1 (a failure of RD repair), level 2 (remaining silicone oil), and level 3 (multiple surgeries to achieve reattachment). We compared cases treated by SB or PPV in the subgroup of simple RRD using multivariate Cox proportional hazard models.

A total of 2,775 cases were included. Overall, 6-months any levels of failure in total, SB, PPV, and PPV+SB were 9.2% (n=256), 6.9% (n=48), 8.2% (n=157), and 21.3% (n=51), respectively. Poor visual acuity at baseline in SB and Inferior RRD and larger retinal tear in PPV were associated with higher risk of failure. PPV was associated with higher chance of achieving primary success in cases with simple RDD especially for cases with superior RDD (adjusted hazard ratio 3.61, 95%CI 2.22 to 5.94, P<0.001).

In this nationwide study, surgical anatomic outcomes were equally successful in either SB or PPV. There were different baseline characteristics associated with primary success between SB and PPV.

In this nationwide study, surgical anatomic outcomes were equally successful in either SB or PPV. There were different baseline characteristics associated with primary success between SB and PPV.

To investigate the influence of age, gender and underlying disease on the optical coherence tomography (OCT) features of choroidal neovascularization (CNV) secondary to Inflammation (iCNV), myopia (mCNV) and age-related macular degeneration (AMD-CNV).

Demographic and clinical data of eyes with treatment naïve iCNV, mCNV and type 2 AMD-CNV were collected. OCT images were reviewed to determine the presence of pitchfork sign (PFS), pigment epithelial detachment (PED), subretinal fluid (SRF), intraretinal cysts (IRC), subretinal hyper reflective material (SHRM), atrophy and outer retinal disruption (ORD) graded 1 to 4. The influence of demographics and underlying etiology on OCT signs was investigated.

185 eyes from 179 patients were enrolled. The mean[SD] age was 36[±14.4], 62[±18] and 77[±8] for the iCNV, mCNV and AMD-CNV respectively (p<0.001). Multiple linear regression showed that the presence of PFS was negatively associated with age (p<0.0001) regardless of underlying disease. By contrast the SRF, PED, IRC and the ORD were all positively influenced by age regardless of gender and underlying disease (all p<0.01). Logistic regression showed that none of the OCT signs increased the likelihood for diagnosis of iCNV. By contrast, absence of SRF was suggestive for mCNV and presence of PED and SRF was suggestive for AMD-CNVs.

The age of the patient had a significant effect on the OCT appearance of the CNV, particularly the presence of a PFS, regardless of the underlying etiology. The absence of SRF was suggestive for a diagnosis of mCNV. The presence of SRF and PED was suggestive for AMD-CNVs.

The age of the patient had a significant effect on the OCT appearance of the CNV, particularly the presence of a PFS, regardless of the underlying etiology. The absence of SRF was suggestive for a diagnosis of mCNV. The presence of SRF and PED was suggestive for AMD-CNVs.

Comparing the anatomical and functional outcomes of vitrectomy, silicone oil endotamponade without cyclopexy (VEWOC) and with cyclopexy (VEWC) in patients with traumatic cyclodialysis clefts and severe ocular comorbidities.

A total of 55 patients (55 eyes) with traumatic cyclodialysis clefts were divided into VEWOC and VEWC groups according to the surgery undergone. Besides the cyclodialysis clefts, all study eyes had one or more additional conditions caused by severe ocular trauma cataract, lens dislocation, vitreous hemorrhage, retinal detachment, choroidal detachment, maculopathy, suprachoroidal hemorrhage, sub-retinal hemorrhage, or proliferative vitreoretinopathy. The minimum postoperative follow-up period for all patients was six months. The main measures of outcome were rate of successful anatomical repair, intraocular pressure (IOP), and best-corrected visual acuity (BCVA).

Both the VEWOC group (33 eyes) and the VEWC group (22 eyes) showed significant improvement in postoperative BCVA and IOP athe vitrectomy procedure in such cases.

To evaluate the neovascular age-related macular degeneration (nAMD) course after endophthalmitis.

Multicenter, retrospective series.

From 4/2013-10/2018, 196,598 intravitreal anti-VEGF injections were performed, with 75 cases of endophthalmitis (incidence 0.0381%). There was no association between intravitreal anti-VEGF drug (p=0.29), anesthetic method (p=0.26), povidone concentration (p=0.22), or any intra-procedure variable and endophthalmitis incidence. Seventy-two patients (96%) were treated with intravitreal tap & inject (vs 3 with pars plana vitrectomy). After endophthalmitis resolution, 17 patients (22.7%) were not re-treated for nAMD (inactive disease – 10 cases; follow-up 115±8.4 weeks). Patients required less frequent anti-VEGF injections post-infection (7.4±0.61 weeks vs 11.5±1.8 weeks; p=0.004). LogMAR visual acuity (VA) pre-infection was 0.585±0.053 (∼20/77). It worsened with endophthalmitis (1.67±0.08, ∼20/935; p<0.001) and again on POD1 (1.94±0.064, Count Fingers; p<0.001), but improved after re-initiating nAMD therapy (1.02±0.11, ∼20/209; p<0.001). Better VA on post-endophthalmitis week 1 (p=0.002) and reinitiation of nAMD treatment (p=0.008) were associated with better final VA, streptococcal culture with worse VA (p=0.028). The post-endophthalmitis treatment interval was associated with the anti-VEGF drug (aflibercept = ranibizumab > bevacizumab; p<0.001).

Patients with nAMD required fewer injections after endophthalmitis, suggesting a biological change in disease activity. nAMD became quiescent in 13.3% of eyes. Most achieved better outcomes with anti-VEGF reinitiation.

Patients with nAMD required fewer injections after endophthalmitis, suggesting a biological change in disease activity. nAMD became quiescent in 13.3% of eyes. Most achieved better outcomes with anti-VEGF reinitiation.

To evaluate the efficacy of posterior scleral contraction (PSC) to treat myopic foveoschisis (MF).

The records of MF patients treated with PSC were reviewed. During PSC, a cross-linked fusiform strip from allogeneic sclera was used and designed axial length (AL) shortening amount was around 2.0∼3.0mm based on preoperative AL. The middle part of the strip was placed at posterior pole of the eye. After few aqueous humors were released, the strip was tightened to contract posterior sclera and shorten AL. Clinical data were collected at pre-operation (op) and post-op follow-ups for 12 months.

Twenty-four eyes were collected. The AL at pre-op, post-op 1-week, 3-month, 6-month and 12-month were 29.84±1.24, 27.39±1.32, 27.73±1.23, 27.86±1.26, and 27.91±1.29mm. There was no AL difference between post-op 6-month and 12-month (P=0.242). The accumulated MF reattachment rate at post-op 1-week, 3-month, 6-month, and 12-month were 8.3%, 16.7%, 50.5% and 95.8%. The best-corrected visual acuity (BCVA) at post-op 6-month and 12-month were 0.71±0.39 (Snellen acuity 20/80) and 0.64±0.37 (Snellen acuity 20/63), improving significantly compared to pre-op (P=0.006 and <0.001).

The PSC was effective to treat MF. The AL stabilized after post-op 6-month and MF reattached gradually with improved visual acuity up to post-op 12-month.

The PSC was effective to treat MF. The AL stabilized after post-op 6-month and MF reattached gradually with improved visual acuity up to post-op 12-month.

To describe the intra- and postoperative morphological and functional outcomes after autologous neurosensory retinal flap transplantation (ART) for high myopia-related refractory macular hole (MH).

This prospective interventional study enrolled 5 eyes of 5 patients (age range 54-84 years) with highly myopic refractory MH who underwent ART. All cases were evaluated with intraoperative optical coherence tomography (OCT) and postoperative OCT, OCT angiography, and microperimetry for at least 6 months postoperatively.

Intraoperatively, the MH was covered by an ART flap with a persistent small subretinal space that was filled with the ART flap after 4-6 days. OCT discriminated the original from the transplanted retina. The mean basal diameter of the original MH decreased from 1504 ± 684 μm preoperatively to 1111 ± 356 μm postoperatively. The best-corrected visual acuity improved in 2 cases, was stable in 2 cases, and deterioration in 1 case. Microperimetry demonstrated no obvious postoperative changes in the fixation points and the absolute scotoma corresponding to the base of MHs with chorioretinal atrophy. In 2 eyes, choroidal neovascularization (CNV) developed beneath the transplanted retinas.

Transplanted tissue was in a fixed position by 1 week postoperatively with a decreased diameter of the original MH. Postoperative fixation points were on the original retina at the MH edge. Since CNV may develop, detailed monitoring is required.

Transplanted tissue was in a fixed position by 1 week postoperatively with a decreased diameter of the original MH. Postoperative fixation points were on the original retina at the MH edge. Since CNV may develop, detailed monitoring is required.

The purpose of this study was to evaluate the efficacy and safety of direct oral anticoagulants vs. warfarin for portal vein thrombosis treatment.

This was a single-center, retrospective study. Adult patients initiated on a direct oral anticoagulant or warfarin for treatment of a new portal vein thrombosis were included. The primary failure outcome was the absolute difference in recurrent thromboembolic events 90 days following initiation of a direct oral anticoagulant vs. warfarin. The primary safety outcome was the absolute difference in bleeding events 90 days following initiation of a direct oral anticoagulant vs. warfarin. Descriptive statistics, Fisher’s exact, and Student’s t-tests were utilized as appropriate.

Thirty-three patients were included. Thirteen (39.4%) patients received direct oral anticoagulants, and 20 (60.6%) received warfarin. None of the patients receiving direct oral anticoagulants experienced a primary failure event compared to four receiving warfarin (P < 0.001). None of the patients receiving direct oral anticoagulants experienced a primary safety event vs. one receiving warfarin (P < 0.001).

Direct oral anticoagulants appear to be effective and safe in the treatment of portal vein thrombosis and in preventing recurrent thromboembolic events. Future studies with larger sample sizes are warranted to confirm direct oral anticoagulants’ efficacy in portal vein thrombosis.

Direct oral anticoagulants appear to be effective and safe in the treatment of portal vein thrombosis and in preventing recurrent thromboembolic events. Future studies with larger sample sizes are warranted to confirm direct oral anticoagulants’ efficacy in portal vein thrombosis.

The mechanisms underlying de-novo hepatocellular carcinoma (HCC) after direct-acting antivirals (DAAs) is still under investigation. This work aims to study P53 and hepatocyte growth factor (HGF) as possible diagnostics of de-novo hepatocellular carcinoma (HCC) following DAAs in comparison to alpha-fetoprotein (AFP).

This case-control study included 166 patients with liver cirrhosis divided into group-1 patients without HCC (n = 50), group-2 patients with de-novo HCC following DAAs, and achieved sustained virological response (n = 50), and group-3 patients with HCC without DAAs (n = 66). P53 antibody and HGF were determined using a quantitative sandwich enzyme immunoassay technique (Cusabio Co, Houston, USA).

Patients with HCC showed significantly higher HGF. Patients with de-novo HCC following DAAs had significantly higher P53 than HCC without DAAs (P < 0.0001). The multiple logistic regression analysis showed that the P53 levels were significantly associated with susceptibility to de-novo HCC (P value = 0.