Internal Limiting Membrane Peeling and Inverted Flap Technique in Macular Hole: Postoperative Metamorphopsia and Optical Coherence Tomography.

INTRODUCTION: We compared postoperative metamorphopsia and optical coherence tomography (OCT) findings between eyes that underwent internal limiting membrane (ILM) peeling and the inverted flap (IF) technique for macular hole (MH). METHODS: This retrospective analysis included 64 eyes of 64 patients with idiopathic MH whose MH was closed after initial surgery. Thirty-nine patients were treated with pars plana vitrectomy (PPV) with ILM peeling, and 25 patients were treated with PPV with the IF technique. Best corrected visual acuity (BCVA), severity of metamorphopsia, and OCT images were collected before and 3, 6, and 12 months postoperatively. Based on the OCT images, the status of the external limiting membrane (ELM) and ellipsoid zone and the presence of hyperreflective plugs were assessed. RESULTS: At baseline and 3, 6, and 12 months postoperatively, BCVA and severity of metamorphopsia were not significantly different between groups. The status of the ELM was significantly worse in the IF group than in the ILM peeling group at 3 and 6 months postoperatively. Significantly more hyperreflective plugs were observed in the IF group than in the ILM peeling group at 3 and 6 months postoperatively. Stepwise multiregression analysis revealed that hyperreflective plugs were significantly associated with the severity of metamorphopsia at 12 months postoperatively. DISCUSSION/CONCLUSION: The alterations on the OCT were fewer in the ILM peeling group than in the IF group, while no significant differences were observed in postoperative severity of metamorphopsia between groups. Metamorphopsia was worse in eyes with hyperreflective plugs.

Comparison of stereopsis and foveal microstructure after internal limiting membrane peeling and inverted internal limiting membrane flap techniques in patients with macular hole.

PURPOSE: To compare stereopsis and foveal microstructure after internal limiting membrane peeling and inverted internal limiting membrane flap technique in patients with macular hole. DESIGN: Retrospective observational study. METHODS: Sixty-six patients with macular hole were included, of whom 41 underwent 25-gauge pars-plana vitrectomy with complete internal limiting membrane peeling (Peeling group) and 25 with the inverted flap technique (Inverted group). We evaluated stereopsis using the Titmus Stereo Test and the TNO stereo test, best-corrected visual acuity, macular hole closure rate, and foveal microstructure with optical coherence tomography before and at 3, 6, and 12 months after surgery. MAIN OUTCOME MEASURES: Stereopsis and foveal microstructure. RESULTS: Preoperatively, no difference was observed in the base and minimum diameters of macular hole, Titmus Stereo Test score, TNO stereo test score, and best-corrected visual acuity between the Peeling and Inverted groups. The macular hole closure rate in the Peeling and Inverted groups were 97.6% and 100%, respectively, with no significant difference between groups. At 12 months postoperatively, Titmus Stereo Test score (2.1 ± 0.4 in the peeling and 2.2 ± 0.4 in the inverted groups), TNO stereo test score (2.3 ± 0.4 and 2.2± 0.5), and best-corrected visual acuity (0.20 ± 0.18 and 0.24 ± 0.25) were not significantly different between groups (p = 0.596, 0.332, respectively). The defect of the external limiting membrane was more common in the Inverted group than in the Peeling group at 6 months after surgery (5.4 vs. 28.0%; p < 0.05). No statistically significant inter-group differences were noted in the ellipsoid zone defect ratio throughout the follow-up period. CONCLUSIONS: There was no difference in postoperative stereopsis nor foveal microstructure between the internal limiting membrane peeling group and the inverted group in patients with macular hole.

Vision-Related Parameters Affecting Stereopsis after Retinal Detachment Surgery.

Even after successful surgery, the stereopsis of retinal detachment (RD) patients is inferior to that of normal subjects. However, it is unclear which visual dysfunction in the affected eye is responsible for the postoperative stereopsis impairment. This study included 127 patients after successful surgery for unilateral RD. Stereopsis, best-corrected visual acuity (BCVA), severity of metamorphopsia, letter contrast sensitivity and amount of aniseikonia were examined at 6-month postoperatively. Stereopsis was assessed using the Titmus Stereo Test (TST) and TNO stereotest (TNO). Postoperative stereopsis (log) in patients with RD were 2.09 ± 0.46 in the TST and 2.56 ± 0.62 in the TNO. Multivariate analysis with stepwise regression revealed postoperative TST was associated with BCVA, and TNO was associated with BCVA, letter contrast sensitivity, metamorphopsia and absolute values of aniseikonia. In a subgroup analysis that selected those with more impaired stereopsis, postoperative TST was associated with BCVA (p < 0.001), and TNO was associated with letter contrast sensitivity (p < 0.005) and absolute values of aniseikonia (p < 0.05) by multivariate analysis. Deterioration of stereopsis after RD surgery was affected by a variety of visual dysfunctions. The TST was affected by visual acuity, while the TNO was affected by contrast sensitivity and aniseikonia.

Risk Factors for Legal Blindness in 237 Japanese Patients with Exogenous Endophthalmitis: A Multicenter Cohort Study from J-CREST.

PURPOSE: We investigated potential risk factors for visual prognosis in Japanese patients with exogenous endophthalmitis. METHODS: In this retrospective observational multicenter cohort study, risk factors for legal blindness at 12 weeks after treatment initiation were evaluated based on patient characteristics, initial BCVA, causative events, pathogens, ocular symptoms, duration from symptom onset to initial treatment, and selected treatments. RESULTS: Overall, 23.1% of eyes developed legal blindness. The six risk factors for legal blindness were presence of eye pain, pathogen identification, poor BCVA at the initial visit, longer duration from symptom onset to initial treatment, type of causative event, and type of causative pathogen. Regarding the type of causative pathogen, coagulase-negative staphylococci was associated with a better visual impairment outcome. CONCLUSION: Exogenous endophthalmitis remains a severe ocular infection; however, it can be managed with rapid treatment, as well as other advances in medical knowledge and technology.

Contrast sensitivity and quality of life following intravitreal ranibizumab injection for central retinal vein occlusion.

SYNOPSIS/PRECIS: We investigated the relationship between contrast sensitivity (CS) and vision-related quality of life (VR-QOL) in patients with central retinal vein occlusion following ranibizumab intravitreal injection; CS showed a stronger association with VR-QOL than visual acuity. BACKGROUND/AIMS: To investigate the relationship between CS, VR-QOL and optical coherence tomography (OCT) findings in patients with cystoid macular oedema secondary to central retinal vein occlusion (CRVO-CMO) following intravitreal injection of ranibizumab. METHODS: This was a multicentre, open-label, single-arm, prospective study. The study included 23 patients with CRVO-CMO who were followed up for 12 months after treatment. The best-corrected visual acuity (BCVA), letter contrast sensitivity (LCS) and OCT images were obtained every month. For VR-QOL assessment, the 25-item National Eye Institute Visual Function Questionnaire (VFQ-25) was administered to the patients before treatment and at 3, 6 and 12 months following treatment. RESULTS: The LCS and VFQ-25 composite score improved significantly from baseline to 12 months following treatment. The multiple regression analysis revealed that the LCS of the affected eye and BCVA of the fellow eye were related to the VFQ-25 composite score following treatment. The LCS improvement showed a significant correlation with the improvement in the VFQ-25 composite score, whereas the BCVA improvement was not correlated with the improvement in the VFQ-25 composite score. Stepwise multiple regression analyses revealed that, at the time of macular oedema resolution, the distance between the external limiting membrane and retinal pigment epithelium (ELM-RPE) and average ganglion cell-inner plexiform layer (GCIPL) thickness were associated with LCS. CONCLUSION: CS had a stronger association with VR-QOL than with BCVA in patients with CRVO-CMO. With the resolution of macular oedema, CS was associated with ELM-RPE thickness and average GCIPL thickness.

Vision-related quality of life and subscale items following intravitreal ranibizumab injections for central retinal vein occlusion.

PURPOSE: To evaluate the vision-related quality of life (VR-QOL) before and after intravitreal ranibizumab injections (IVR) for central retinal vein occlusion (CRVO) and to investigate subscale items of VR-QOL in detail. STUDY DESIGN: A multicenter, open-label, prospective and comparative study. METHODS: Twenty-three patients with treatment naïve CRVO and 22 age-matched normal controls were included. VR-QOL was assessed by 25-Item Visual Function Questionnaire (VFQ-25) before and up to 12 months post-treatment. The VFQ-25 composite score and 12 subscales were compared between CRVO patients and normal controls. RESULTS: The VFQ-25 composite scores of CRVO patients showed significant improvement throughout the treatment period compared with baseline. The VFQ-25 composite scores both before and after treatment for CRVO were significantly lower than in normal controls. The subscale items, including general health, general vision, near activities, social functioning, mental health, role difficulties, dependency, and peripheral vision in CRVO, were significantly lower than in the normal controls even after treatment. CONCLUSION: Vision-related QOL was low in patients with CRVO before treatment and improved with IVR. In spite of the improvements, several subscale items remained lower than in normal controls following treatment. Attention should be paid to the patients with CRVO and their decreased visual, social and psychological QOL.

Risk Factors for Legal Blindness in 77 Japanese Patients with Endogenous Endophthalmitis: A Multicenter Cohort Study from J-CREST.

PURPOSE: We investigated potential predictive factors for visual prognosis in Japanese patients with endogenous endophthalmitis. DESIGN: Retrospective observational multicenter cohort study. METHODS: We examined the characteristics of 77 Japanese patients with endogenous endophthalmitis and performed statistical analyses of these real-world data. The primary endpoint was the identification of factors associated with visual prognosis. We examined differences between patients in the better vision and legal blindness groups at 12 weeks after treatment initiation. RESULTS: The five risk factors for visual impairment at 12 weeks after treatment initiation were presence of pressure injuries, severe clinical symptoms (presence of eye pain and ciliary injection), pathogen identification, and poor best-corrected visual acuity at baseline. Staphylococcus aureus and fungus were associated with a better visual impairment outcome. CONCLUSIONS: Endogenous endophthalmitis remains a severe ocular infection; however, it can be managed with rapid treatments, as well as other advances in medical knowledge and technology.

Changes in metamorphopsia following intravitreal aflibercept injection for diabetic macular edema.

The aim of the present study was to investigate changes in metamorphopsia in patients with diabetic macular edema (DME) following intravitreal aflibercept injection (IVA) with the treat and extend (TAE) regimen for a year. We performed a post hoc analysis of a multicenter, open-label, single-arm, prospective study. The study included 20 patients with DME. All eyes received 3 monthly loading injections of 2 mg aflibercept, followed by a TAE regimen. Every visit, the severity of metamorphopsia and the best-corrected visual acuity (BCVA) were evaluated, and optical coherence tomography (OCT) images were obtained. The severity of metamorphopsia was measured using M-CHARTS. The metamorphopsia scores before treatment and at 1, 2, 3, 6 and 12 months following treatment were 0.25 ± 0.23, 0.21 ± 0.15, 0.19 ± 0.23, 0.14 ± 0.16, 0.17 ± 0.20 and 0.10 ± 0.17, respectively, with significant improvement from before treatment to 3 and 12 months following treatment (p < 0.05 and p < 0.005, respectively). At the time of macular edema resolution, the presence of an epiretinal membrane (ERM) was associated with the metamorphopsia score (p < 0.05). In conclusion, the metamorphopsia score in patients with DME improved following IVA with the TAE regimen for one year. The presence of ERM was associated with the metamorphopsia score.

Time course of changes in vision-related quality of life following intravitreal ranibizumab treatment for branch retinal vein occlusion.

To evaluate the vision-related quality of life (VR-QOL) treated by intravitreal ranibizumab (IVR) in patients with branch retinal vein occlusion (BRVO) and to assess subscale items of the VR-QOL. This was prospective, multicenter, open-label, observational study including 38 patients with unilateral BRVO who underwent IVR treatment and 28 age-matched healthy subjects. VR-QOL using the 25-item National Eye Institute Visual Function Questionnaire (VFQ-25) and best-corrected visual acuity (BCVA) were examined before and at 3, 6, and 12 months after treatment. The VFQ-25 composite score and BCVA significantly improved from 3 to 12 months after IVR treatment (P < 0.05), such that there was no significant difference between the BRVO and control groups at 12 months. All subscales of the VFQ-25, except "general health", significantly improved after treatment, while "near vision" and "mental health" were worse than those in healthy subjects (P < 0.05). Patients with superior BRVO had a lower "near vision" score than healthy subjects after treatment (P < 0.05). BCVA in the treated eye and fellow eye had no significant relationship with the VFQ-25 composite score before and after treatment. The VR-QOL of patients with BRVO improved with IVR treatment and was comparable to that of healthy subjects after 12 months. Superior BRVO particularly affected near vision for a low level.

Visual Functions Affecting Vision-Related Quality of Life Following Intravitreal Ranibizumab Therapy for Central Retinal Vein Occlusion.

Visual functions that affect vision-related quality of life (VR-QoL) before and after intravitreal injection of ranibizumab in patients with cystoid macular edema secondary to central retinal vein occlusion (CRVO-CME) are poorly understood. This multicenter, open-label, single-arm prospective study included 23 treatment-naïve patients with CRVO-CME. The best-corrected visual acuity (BCVA), letter contrast sensitivity (LCS), severity of metamorphopsia (M-CHARTS), amount of aniseikonia (New Aniseikonia Test), and stereopsis (Titmus Stereo Test and TNO stereotest) were examined every month from before treatment to 12 months after treatment. For VR-QoL assessment, the 25-item National Eye Institute Visual Function Questionnaire (VFQ-25) was provided to the patients before treatment and at 3, 6, and 12 months after treatment. Stepwise multiple regression analysis revealed that the BCVA of the fellow eye was related to the VFQ-25 composite score before treatment, and that the BCVA of the fellow eye and TNO values were related to the VFQ-25 composite score 12 months after treatment. Changes in LCS were significantly correlated with changes in the VFQ-25 composite score. In patients with CRVO-CME, visual acuity of the fellow eye had the strongest impact on VR-QoL. The contrast sensitivity of the affected eye and stereopsis were also associated with VR-QoL.

Improvement in Dacryoendoscopic Visibility after Image Processing Using Comb-Removal and Image-Sharpening Algorithms.

Recently, a minimally invasive treatment for lacrimal passage diseases was developed using dacryoendoscopy. Good visibility of the lacrimal passage is important for examination and treatment. This study aimed to investigate whether image processing can improve the dacryoendoscopic visibility using comb-removal and image-sharpening algorithms. We processed 20 dacryoendoscopic images (original images) using comb-removal and image-sharpening algorithms. Overall, 40 images (20 original and 20 post-processing) were randomly presented to the evaluators, who scored each image on a 10-point scale. The scores of the original and post-processing images were compared statistically. Additionally, in vitro experiments were performed using a test chart to examine whether image processing could improve the dacryoendoscopic visibility in a turbid fluid. The visual score (estimate ± standard error) of the images significantly improved from 3.52 ± 0.26 (original images) to 5.77 ± 0.28 (post-processing images; p < 0.001, linear mixed-effects model). The in vitro experiments revealed that the contrast and resolution of images in the turbid fluid improved after image processing. Image processing with our comb-removal and image-sharpening algorithms improved dacryoendoscopic visibility. The techniques used in this study are applicable for real-time processing and can be easily introduced in clinical practice.

Relationship between stereopsis and vision-related quality of life in patients with branch retinal vein occlusion.

Background: To investigate the relationship between stereopsis and vision-related quality of life (VR-QOL) in patients with branch retinal vein occlusion (BRVO) before and after treatment with intravitreal ranibizumab (IVR). Methods: This prospective multicentred observational study included 37 patients undergoing IVR treatment for unilateral BRVO and 24 age-matched healthy controls.Stereopsis was evaluated using the TNO stereo test (TNO) and Titmus stereo test (TST) every month, and the 25-item National Eye Institute Visual Function Questionnaire (VFQ-25) was administered at baseline, then at 3, 6 and 12 months after treatment. Results: Time course of the changes in stereopsis and VR-QOL. IVR treatment significantly reduced central fovea thickness and improved both the TNO and the TST from 2 to 12 months (both p<0.05). Stereopsis before and after IVR injection in the eyes with BRVO were significantly worse than those in control subjects (TNO, p<0.001; TST, p<0.001). The VFQ-25 composite score significantly improved from 3 to 12 months after IVR treatment (p<0.05). Univariate analysis showed that the TNO score at baseline was significantly correlated with the VFQ-25 composite score at baseline and after treatment (p<0.05, p<0.05, respectively). TST score was not associated with the VFQ-25 composite score at baseline or after treatment. Conclusions: Treatment with IVR for BRVO improved cystoid macular oedema, which was correlated to improved stereopsis, although not to the control level. The TNO score at baseline was associated with VR-QOL in patients with BRVO.

Visual functions affecting stereopsis in patients with branch retinal vein occlusion.

PURPOSE: To quantify stereopsis and other visual functions in patients with unilateral branch retinal vein occlusion (BRVO) and to investigate vision-related parameters that affect stereopsis. DESIGN: Prospective observational study. SUBJECTS: Forty-five patients undergoing intravitreal ranibizumab (IVR) treatment for unilateral BRVO. METHODS: We examined stereopsis using the Titmus stereo test (TST) and TNO stereotest (TNO), best corrected visual acuity (BCVA), letter contrast sensitivity, severity of metamorphopsia and degree of aniseikonia before and 6 months after IVR. MAIN OUTCOME MEASURES: Visual functions that affect stereopsis. RESULTS: Baseline stereopsis in patients with BRVO was 2.7 ± 0.6 (range, 1.6-3.5) in the TST and 2.8 ± 0.5 (range, 1.8-3.3) in TNO. TST and TNO scores were significantly correlated with BCVA and letter contrast sensitivity at baseline (P < 0.001) but not with other visual functions. IVR treatment significantly improved stereopsis, BCVA, and letter contrast sensitivity. After treatment, TST scores were significantly correlated with BCVA (P < 0.001), letter contrast sensitivity (P < 0.001), and aniseikonia (P < 0.01). TNO scores were significantly correlated with BCVA (P < 0.01) and letter contrast sensitivity (P < 0.01). TST and TNO scores after treatment were significantly correlated with BCVA at baseline (P < 0.01 for both). CONCLUSIONS: Deterioration of stereopsis in patients with BRVO was associated with changes in visual acuity and contrast sensitivity after treatment. Initial visual acuity is a prognostic factor for posttreatment stereopsis.

Relationship between stereopsis and vision-related quality of life following intravitreal ranibizumab injections for central retinal vein occlusion.

The study aimed to evaluate changes in stereopsis and vision-related quality of life (VR-QOL) in patients with central retinal vein occlusion (CRVO) following intravitreal ranibizumab injection (IVR) and investigate the relationship between stereopsis and VR-QOL. This study included 23 treatment-naïve patients with non-ischemic CRVO and 13 age-matched normal controls. Stereopsis, best-corrected visual acuity (BCVA), VR-QOL, and retinal microstructures were examined pre-treatment and 12 months post-treatment. The Titmus Stereo Test (TST) and TNO stereotest (TNO) were used to evaluate stereopsis. VR-QOL was evaluated using the 25-item National Eye Institute Visual Function Questionnaire (VFQ-25). IVR immediately and significantly improved the TST values, TNO values, composite VFQ-25 score, BCVA, and central foveal thickness in patients with CRVO. The 12-month post-treatment TST and TNO values were significantly worse in the CRVO group compared to those in the normal group. At the baseline, the composite VFQ-25 score significantly correlated only with the TST value. Multivariate analysis revealed significant associations between the 12-month post-treatment composite VFQ-25 score and the baseline and 12-month post-treatment TNO values. In conclusion, IVR immediately improved stereopsis in CRVO, albeit below normal levels. Stereopsis (not visual acuity) was associated with pre- and post-treatment VR-QOL in patients with CRVO.

Aniseikonia following intravitreal ranibizumab treatment for branch retinal vein occlusion.

PURPOSE: To quantify aniseikonia following intravitreal ranibizumab (IVR) in patients with branch retinal vein occlusion (BRVO) and assess the relationship between aniseikonia and retinal microstructure. STUDY DESIGN: Prospective observational study. METHODS: This study included 50 patients undergoing IVR treatment for unilateral BRVO. The degree of aniseikonia and best-corrected visual acuity (BCVA) was examined, and retinal microstructure was assessed with optical coherence tomography (OCT) before and 1, 2, 3, 4, 5, and 6 months after treatment. Based on OCT images, we assessed central retinal thickness (CRT), presence of the epiretinal membrane, and serous retinal detachment (SRD), as well as status of the external limiting membrane and ellipsoid zone. RESULTS: At baseline, mean aniseikonia was - 1.0 ± 2.5%, ranging from - 11.0 to + 6.0%. Nine out of 50 patients had micropsia (18%), one had macropsia (2%), and 40 had no aniseikonia (80%). After 6 months of treatment, mean aniseikonia was - 0.7 ± 1.5%, ranging from - 4.5 to + 3.5%. BCVA significantly improved after treatment (P < 0.001), but aniseikonia did not change (P = 0.73). In patients with BRVO who had micropsia (≤ - 2.0%) at baseline, mean aniseikonia significantly improved from - 4.8 ± 3.3% to - 0.9 ± 1.4% (P < 0.05). Aniseikonia after treatment significantly correlated with BCVA (P < 0.05) and the presence of SRD at baseline (P < 0.05). CONCLUSION: Majority of eyes with aniseikonia in BRVO had micropsia. The BCVA as well as the micropsia improved following treatment with IVR for BRVO. BCVA and the presence of SRD were predictors of post-treatment aniseikonia.

Clinical Characteristics and Outcomes in 314 Japanese Patients with Bacterial Endophthalmitis: A Multicenter Cohort Study from J-CREST.

Bacterial endophthalmitis is an intraocular infection that causes rapid vison loss. Pathogens can infect the intraocular space directly (exogenous endophthalmitis (ExE)) or indirectly (endogenous endophthalmitis (EnE)). To identify predictive factors for the visual prognosis of Japanese patients with bacterial endophthalmitis, we retrospectively examined the bacterial endophthalmitis characteristics of 314 Japanese patients and performed statistics using these clinical data. Older patients, with significantly more severe clinical symptoms, were prevalent in the ExE group compared with the EnE group. However, the final best-corrected visual acuity (BCVA) was not significantly different between the ExE and EnE groups. Bacteria isolated from patients were not associated with age, sex, or presence of eye symptoms. Genus Streptococcus, Streptococcus pneumoniae, and Enterococcus were more prevalent in ExE patients than EnE patients and contributed to poor final BCVA. The presence of eye pain, bacterial identification, and poor BCVA at baseline were risk factors for final visual impairment.

Relationship between metamorphopsia and inner retinal microstructure following intravitreal ranibizumab injection for branch retinal vein occlusion.

To evaluate the effects of intravitreal ranibizumab injection (IVR) on metamorphopsia in patients with branch retinal vein occlusion (BRVO), and to assess the relationship between metamorphopsia and inner retinal microstructure and other factors. Thirty-three treatment-naïve eyes of 33 patients with macular edema caused by BRVO with at least 12 months of follow-up were included. The degree of metamorphopsia was quantified using the M-CHARTS. Retinal microstructure was assessed with spectral-domain optical coherence tomography. Disorganization of the retinal inner layers (DRIL) at the first month after resolution of the macular edema (early DRIL) and at 12 months after treatment (after DRIL) was studied. Central retinal thickness (CRT), and status of the external limiting membrane as well as ellipsoid zone were also evaluated. IVR treatment significantly improved best-corrected visual acuity (BCVA) and CRT, but the mean metamorphopsia score did not improve even after 12 months. Post-treatment metamorphopsia scores showed a significant correlation with pre-treatment metamorphopsia scores (P < 0.005), the extent of early DRIL (P < 0.05) and after DRIL (P < 0.05), and the number of injections (P < 0.05). Multivariate analysis revealed that the post-treatment mean metamorphopsia score was significantly correlated with the pre-treatment mean metamorphopsia score (P < 0.05). IVR treatment significantly improved BCVA and CRT, but not metamorphopsia. Post-treatment metamorphopsia scores were significantly associated with pre-treatment metamorphopsia scores, the extent of DRIL, and the number of injections. Prognostic factor of metamorphopsia was the degree of pre-treatment metamorphopsia.

Stereopsis and retinal microstructures following macular hole surgery.

The aim of this prospective study was to evaluate the changes in stereopsis in patients who underwent vitrectomy for macular hole (MH) and assess the relationship between stereopsis and retinal microstructures. Fifty-two patients who underwent successful vitrectomy for unilateral MH and 20 control participants were recruited. We examined stereopsis using the Titmus Stereo Test (TST) and TNO stereotest (TNO), optical coherence tomography, and best-corrected visual acuity measurements, preoperatively, and at 3, 6, and 12 months postoperatively. As a result, preoperative and postoperative 3, 6, and 12-month values of stereopsis assessed by TST (log) were 2.7, 2.2, 2.2, and 2.2, respectively. TNO (log) were 2.8, 2.5, 2.4, and 2.4, respectively. Stereopsis in MH after surgery was significantly worse than that in normal participants (p < 0.001). Preoperative TST significantly correlated with MH size and defect length of external limiting membrane (ELM). Postoperative TST demonstrated significant correlation with the preoperative ELM defect length, and postoperative TNO was associated with the preoperative interdigitation zone defect length. Vitrectomy for MH significantly improved stereopsis, although not to normal levels. The ELM defect lengths, which approximately correspond to TST circles, are prognostic factors for postoperative stereopsis by TST. The interdigitation zone defect length, similar in size to the TNO index, is a prognostic factor for postoperative stereopsis by TNO.

Time course of changes in contrast sensitivity following intravitreal ranibizumab injection for branch retinal vein occlusion.

PURPOSE: To evaluate contrast sensitivity (CS) in patients with branch retinal vein occlusion (BRVO) following intravitreal ranibizumab injection (IVR), and to investigate the relationship between CS and retinal microstructure. DESIGN: A retrospective, observational case series. METHODS: We included 23 eyes with treatment naïve BRVO followed up for 6 months after treatment. Best-corrected visual acuity (BCVA), letter contrast sensitivity (LC), and 10% low contrast visual acuity (LCVA) were measured. All tests were performed before and 1, 2, 3, 4, 5, and 6 months after treatment. Based on optical coherence tomography (OCT) images, we assessed central retinal thickness (CRT), presence of serous retinal detachment (SRD), and status of the external limiting membrane (ELM) and ellipsoid zone (EZ). RESULTS: IVR treatment significantly improved CS (LC: P < 0.0001, LCVA: P = 0.004) as well as BCVA (P = 0.015) and CRT (P < 0.0001). LC and LCVA at 6 months after treatment were significantly correlated with presence of SRD before treatment. At 6 months after treatment, LCVA was significantly correlated with pre-treatment CRT (P = 0.042). In patients with good baseline BCVA, LCVA showed significant improvements (P = 0.022) although their BCVA did not change. In patients with poor improvement in BCVA, LC and LCVA also showed significant improvements (P = 0.008, P = 0.005). CONCLUSION: IVR treatment for BRVO improves both BCVA and CS. Even in patients without any improvement in visual acuity, CS does improve.