Complete Visual Recovery From Severe Outer Retinitis After Tonsillitis.

BACKGROUND: To report a case of severe acute bilateral outer retinitis after tonsillitis and rapid morphologic and functional recovery after steroid treatment. METHODS: Observational case report. RESULTS: A 26-year-old woman with acute bilateral blurred vision that developed after tonsillitis underwent spectral-domain optical coherence tomography (SD-OCT) that showed photoreceptor outer segment damage. Full-field electroretinography (ERG) and multifocal ERG were nonrecordable. The patient had a remarkable anatomic and functional recovery in response to steroid treatment; however, partial damage remained around the macula on SD-OCT, and an adaptive optics imaging system showed damaged cone photoreceptors. CONCLUSIONS: Prednisolone is an effective treatment for a disease that is believed to be due to suspicious involvement of the autoimmune system. Even severe outer retinitis can recover completely with rapid diagnosis and treatment.

Novel mutation identified in Leber congenital amaurosis - a case report.

BACKGROUND: Leber congenital amaurosis (LCA) is the earliest onset and the most severe form of all inherited retinal degenerative disorders, characterized by blindness, or severe visual impairment from birth, and typically exhibits clinical and genetic heterogeneity. Recently, 14 causative genes of LCA were reported. We performed whole-exome sequencing (WES) for Japanese siblings, and identified a novel homozygous nonsense mutation in the RPGR-interacting protein 1 (RPGRIP1) gene. We also report their follow-up data over 27 years. CASE PRESENTATION: Patient 1 is a 37-year-old male. In 1992, his eye position indicated orthophoria, however, horizontal nystagmus was evident, and he complained of photophobia. His best corrected decimal visual acuity (BCVA) was 0.2 (S + 6.5/C-3.5/170°) OD and 0.1 (S + 6.0/C-2.5/10°) OS. Fundus examination revealed bisymmetrical inferior focal retinal pigment epithelium (RPE) mottling. Bright-flash electroretinogram (ERG) revealed a subnormal pattern, while 30 Hz flicker ERG was non-recordable in both eyes. At his final visit in 2019, his BCVA was 0.09 (S + 3.5/C-3.5/180°) OD and 0.09 (S + 3.0/C-4.0/10°) OS. Patient 2, a 34-year-old female, is the sibling of patient 1. In 1992, her BCVA was 0.05 (S + 6.0) OD and 0.06 (S + 5.0) OS. She was in a chin-up position during visual acuity testing. Horizontal nystagmus was evident, and she also complained of photophobia. Bright-flash ERG was severely attenuated, and 30 Hz flicker ERG was non-recordable in both eyes. At her final visit in 2019, her BCVA was 0.02 (uncorrectable) OD and 0.03 (uncorrectable) OS. There were no other patients with LCA in their family and their parents were non-consanguineous. WES revealed a homozygous, consecutive, two-nucleotide variation in the RPGRIP1 gene (NM_020366: exon15:c.G2294A and c.C2295A, p.C765X), resulting in a premature stop codon. We interpreted this variation as a novel pathogenic mutation of RPGRIP1 that contributes to LCA6 development. CONCLUSIONS: Herein, we report a novel nonsense mutation of RPGRIP1 in two patients with LCA6 and present their long-term follow-up data. These clinical data linked to genotypes provide important information for the development of new treatments, such as gene therapy, as well as for genetic counseling.

Using redox-sensitive mitochondrial cytochrome Raman bands for label-free detection of mitochondrial dysfunction.

Mitochondrial activity is a widely used criterion to judge the metabolic condition of a living specimen. Numerous methods have been developed for related analyses, including the detection of O2 consumption, trans-membrane potential, and ATP production. In this study, we demonstrate that the redox state of cytochromes can serve as a sensitive mitochondrial activity indicator in glutamate-stressed neuronal cells. Mitochondrial dysfunction was detected by Raman imaging as early as 30 min after glutamate-stress induction. By comparing this result with other commonly used mitochondrial function assays, we found Raman imaging has a similar sensitivity to ATP production and trans-membrane potential assays. Other viability tests, such as MTT assay and ROS production tests, showed a slower response than our method. A thorough understanding of cytochrome dynamics with our new method will help establish Raman spectroscopy as a competitive clinical diagnosis tool for neurodegenerative diseases involving mitochondrial dysfunction.

The influence of visual field position induced by a retinal prosthesis simulator on mobility.

PURPOSE: Our aim is to develop a new generation of suprachoroidal-transretinal stimulation (STS) retinal prosthesis using a dual-stimulating electrode array to enlarge the visual field. In the present study, we aimed to examine how position and size of the visual field-created by a retinal prosthesis simulator-influenced mobility. METHODS: Twelve healthy subjects wore retinal prosthesis simulators. Images captured by a web camera attached to a head-mounted display (HMD) were processed by a computer and displayed on the HMD. Three types of artificial visual fields-designed to imitate phosphenes-obtained by a single (5 × 5 electrodes; visual angle, 15°) or dual (5 × 5 electrodes ×2; visual angle, 30°) electrode array were created. Visual field (VF)1 is an inferior visual field, which corresponds to a dual-electrode array implanted in the superior hemisphere. VF2 is a superior visual field, which corresponds to a single-electrode array implanted in the inferior hemisphere. VF3 is a superior visual field, which corresponds to a dual-electrode array implanted in the inferior hemisphere. In each type of artificial visual field, a natural circular visual field (visual angle, 5°) which imitated the vision of patients with advanced retinitis pigmentosa existed at the center. Subjects were instructed to walk along a black carpet (6 m long × 2.2 m wide) without stepping on attached white circular obstacles. Each obstacle was 20 cm in diameter, and obstacles were installed at 40-cm intervals. We measured the number of footsteps on the obstacles, the time taken to complete the obstacle course, and the extent of head movement to scan the area (head-scanning). We then compared the results recorded from these 3 types of artificial visual field. RESULTS: The number of footsteps on obstacles was lowest in VF3 (One-way ANOVA; P = 0.028, Fisher's LSD; VF 1 versus 3 P = 0.039, 2 versus 3 P = 0.012). No significant difference was observed for the time to complete the obstacle course or the extent of head movement between the 3 visual fields. CONCLUSION: The superior and wide visual field (VF3) obtained by the retinal prosthesis simulator resulted in better mobility performance than the other visual fields.

Electrophysiological evaluation of a chronically implanted electrode for suprachoroidal transretinal stimulation in rabbit eyes.

In this study, we aimed to determine the electrophysiological efficacy, safety, and electrical stability of a chronically implanted electrode for suprachoroidal transretinal stimulation (STS) in rabbit eyes. A platinum microelectrode was implanted into the scleral pocket of rabbit eyes (n = 5) and followed-up for 6 months. To evaluate the electrophysiological efficacy, electrically evoked potentials (EEPs) were measured every month after implantation. To evaluate safety, fundus examinations, fluorescein angiograms, electroretinograms (ERGs), and visually evoked potentials (VEPs) were measured before and every month after the implantation. At the end of the experiment, histological examination of retinal tissue beneath the site of the electrode was performed. To evaluate electrical stability, the resistance of the circuit was measured every month after implantation. EEPs could be elicited from the STS electrodes at all testing times. The mean threshold current to evoke EEPs was 186.4 ± 47.0 µA at 6 months after implantation. There was no significant change in the threshold over the follow-up period. The resistance of the circuit was significantly increased at 1 months after implantation, with no further increase at 6 months. There was no statistically significant change in the relative amplitudes and implicit times of a- and b-waves of ERGs and VEPs. No intraocular infection, inflammation, or vitreoretinal proliferation was observed in any eye. Histological examination revealed no retinal damage beneath the electrode. We conclude that chronically implanted electrodes for STS appear to be effective, safe, and electrically stable.

Comparison of visual fatigue caused by head-mounted display for virtual reality and two-dimensional display using objective and subjective evaluation.

This study aimed to evaluate objective and subjective visual fatigue experienced before and after performing a visual task while using a head-mounted display for virtual reality (VR-HMD) and two-dimensional (2D) display. Binocular fusion maintenance (BFM) was measured using a binocular open-view Shack-Hartmann wavefront aberrometer equipped with liquid crystal shutters. Twelve healthy subjects performed the BFM test and completed a questionnaire regarding subjective symptoms before and after performing a visual task that induces low visually induced motion sickness (VIMS). BFM (p = .87) and total subjective eye symptom scores (p = .38) were not significantly different between both groups, although these values were significantly lower after the visual task than before the task within both groups (p < .05). These findings suggest that visual fatigue after using a VR-HMD is not significantly different from that after using a 2D display in the presence of low-VIMS VR content. Practitioner summary: Objective and subjective evaluation of visual fatigue were not significantly different with the use of a head-mounted display for virtual reality (VR-HMD) and two-dimensional display. These results should be valuable not only to engineers developing VR content but also to researchers involved in the evaluation of visual fatigue using VR-HMD. Abbreviations: VR: virtual reality; VR-HMD: head-mounted display for virtual reality; BFM: binocular fusion maintenance; BWFA: binocular open-view Shack-Hartmann wavefront aberrometer.

Light localization with low-contrast targets in a patient implanted with a suprachoroidal-transretinal stimulation retinal prosthesis.

PURPOSE: To evaluate the improvement in targeted reaching movements toward targets of various contrasts in a patient implanted with a suprachoroidal-transretinal stimulation (STS) retinal prosthesis. METHODS: An STS retinal prosthesis was implanted in the right eye of a 42-year-old man with advanced Stargardt disease (visual acuity: right eye, light perception; left eye, hand motion). In localization tests during the 1-year follow-up period, the patient attempted to touch the center of a white square target (visual angle, 10°; contrast, 96, 85, or 74%) displayed at a random position on a monitor. The distance between the touched point and the center of the target (the absolute deviation) was averaged over 20 trials with the STS system on or off. RESULTS: With the left eye occluded, the absolute deviation was not consistently lower with the system on than off for high-contrast (96%) targets, but was consistently lower with the system on for low-contrast (74%) targets. With both eyes open, the absolute deviation was consistently lower with the system on than off for 85%-contrast targets. With the system on and 96%-contrast targets, we detected a shorter response time while covering the right eye, which was being implanted with the STS, compared to covering the left eye (2.41 ± 2.52 vs 8.45 ± 3.78 s, p < 0.01). CONCLUSIONS: Performance of a reaching movement improved in a patient with an STS retinal prosthesis implanted in an eye with residual natural vision. Patients with a retinal prosthesis may be able to improve their visual performance by using both artificial vision and their residual natural vision. CLINICAL TRIAL REGISTRATION: Beginning date of the trial: Feb. 20, 2014 Date of registration: Jan. 4, 2014 Trial registration number: UMIN000012754 Registration site: UMIN Clinical Trials Registry (UMIN-CTR) http://www.umin.ac.jp/ctr/index.htm.

Correction to: Light localization with low-contrast targets in a patient implanted with a suprachoroidal-transretinal stimulation retinal prosthesis.

The original publication of this paper contain an error because of an incorrect captured corresponding author.

Characteristics of higher-order aberrations and anterior segment tomography in patients with pathologic myopia.

PURPOSE: To investigate prospectively the characteristics in the higher-order aberrations and anterior segment tomography in patients with pathologic myopia. METHODS: One hundred and twelve consecutive highly myopic patients (mean age 43.4 ± 9.3 years, spherical equivalent of refractive error ≥8 D and an axial length ≥26.5 mm) were studied. Thirty-seven emmetropic individuals (mean age 37.0 ± 14.5 years, spherical equivalent of refractive error ≤ ±1 D) were analyzed as controls. The ocular and cornea higher-order aberrations were measured using a Hartmann-Shack wavefront sensor (KR-1W; Topcon Corporation, Tokyo, Japan). The crystalline lens rise, the angle-to-angle, and the white-to-white values were measured using anterior segment OCT (SS-1000; Tomey Corporation, Nagoya, Japan). The mean curvature of the anterior corneal surface, the thickness at the thinnest central corneal point, the location of the central corneal point, the corneal volume, the anterior chamber volume, and the anterior chamber depth were measured using the Pentacam HR (Oculus, Inc., Wetzlar, Germany). RESULTS: The ocular total higher-order aberration for 4-mm pupil, the ocular spherical aberrations, and internal spherical aberration for 6-mm pupil were significantly higher in highly myopic eyes than in the emmetropic controls. The crystalline lens rise was significantly smaller in highly myopic eyes than in the emmetropic controls. The anterior chamber depth and the anterior chamber volume were significantly larger in highly myopic eyes than in the emmetropic controls. CONCLUSION: Highly myopic eyes had higher-order aberrations than emmetropic eyes because of the increasing internal aberrations.

Voltage-controlled accommodating IOL system using an ion polymer metal composite actuator.

Surgeons treat cataracts by replacing the clouded lens with an intraocular lens (IOL), but patients are required to wear reading glasses for tasks requiring near vision. We suggest a new voltage-controlled accommodating IOL made of an ionic polymer metal composite (IPMC) actuator to change focus. An in vitro experiment was conducted where an actuator was placed inside the eye and moved with applied voltage. The lens attached to the actuator was deformed by its movement to change the patient's focus. The results showed that this system can accommodate a change of approximately 0.8 diopters under an applied voltage of ± 1.3 V.

False reaching movements in localization test and effect of auditory feedback in simulated ultra-low vision subjects and patients with retinitis pigmentosa.

PURPOSE: To determine the accuracy of reaching movements with localization tests in subjects with simulated ultra-low vision, and to examine the effectiveness of auditory feedback training in improving the accuracy of the reaching movements. METHODS: Twenty-one subjects with simulated ultra-low vision and three patients with advanced retinitis pigmentosa (RP) were studied with the localization tester. The localization tester had white square targets with a visual angle of 10° that were projected randomly on a computer monitor screen. The subjects or RP patients were instructed to touch the center of the target. Each subject was tested 20 trials. The distance from the center of the target to the point where subjects touched, the deviation, was calculated automatically by the computer. We also examined the effect of auditory feedback on improving the accuracy of reaching movements. RESULTS: The average angle of deviation in the subjects was not significantly correlated with visual acuity. The points touched by subjects with simulated low vision were located downward and horizontally toward the hand they used. They were condensed around the barycenter of the touched points (paired t tests; *p = 0.037). The touched points of the patients also deviated downward and condensed around the barycenter. The deviations decreased significantly with auditory feedback when trained over 100 trials. CONCLUSIONS: The subjects with simulated ultra-low vision and the advanced RP patients had false orientations against the position of localized target systematically. An auditory feedback system may help to correct the false orientations for reaching movements in patients with very low vision.

Surgical feasibility and biocompatibility of wide-field dual-array suprachoroidal-transretinal stimulation prosthesis in middle-sized animals.

PURPOSE: To investigate the safety and efficacy of a newly-developed wide-field dual-array suprachoroidal-transretinal stimulation (STS) prosthesis in middle-sized animals. METHODS: The prosthesis consisted of two arrays with 50 to 74 electrodes. To test the feasibility of implanting the prosthesis and its efficacy, the prosthesis was implanted for 14 days into two rabbits. Optical coherence tomography (OCT) and ophthalmoscopy were performed 7 and 14 days after the implantation. Then the rabbits were euthanized, eyes were enucleated, and the posterior segment of the eye was examined histologically. In a second experiment, the arrays were implanted into two cats, and their ability to elicit neural responses was determined by electrically evoked potentials (EEPs) at the chiasm and by optical imaging of the retina. RESULTS: All arrays were successfully implanted, and no major complications occurred during the surgery or during the 2-week postoperative period. Neither OCT nor ophthalmoscopy showed any major complications or instability of the arrays. Histological evaluations showed only mild cellular infiltration and overall good retinal preservation. Stimulation of the retina by the arrays evoked EEPs recorded from the chiasm. Retinal imaging showed that the electrical pulses from the arrays altered the retinal images indicating an activation of retinal neurons. The thresholds were as low as 100 µA for a chiasm response and 300 µA for the retinal imaging. CONCLUSION: Implantation of a newly-developed dual-array STS prosthesis for 2 weeks in rabbits was feasible surgically, and safe. The results of retinal imaging showed that the dual-array system was able to activate retinal neurons. We conclude that the dual-array design can be implanted without complication and is able to activate retinal neurons and optic nerve axons.

Transient Deficit of Accommodation After Laser Barrage for Retinal Tear.

PURPOSE: To report a case of transient loss of accommodation after laser photocoagulation for peripheral retinal tear. Loss of accommodation is one of the lesser known and less common complications of peripheral retinal laser photocoagulation. In fact, only a few works concerning this issue have been published so far. Deficit of accommodation has been described only after extensive laser treatment of the peripheral retina. To the best of our knowledge, this is the first case that reports this complication after treatment limited to a small retinal area. We discuss the possible pathogenetic mechanism of this phenomenon. CASE REPORT: A 25-year-old healthy myopic woman came to the eye clinic for flashes and floaters in her right eye. Fundus evaluation revealed a small horseshoe retinal tear at the 6 o'clock position. She was treated with prophylactic retinal laser barrage in the right eye. Twelve days later, she returned to our Retinal Clinic because of difficulty with near vision. The problem started soon after the laser procedure. On examination, her distance visual acuity was 20/20 wearing her glasses. The patient could read J1+ at 33 cm with the left eye and required a +3.00D addition over her corrective lens to read J1+ with the right eye. The accommodative disturbance resolved itself spontaneously and gradually within 3 months of laser treatment. CONCLUSIONS: We believe that transient loss of accommodation, although rare, should be included during pretreatment discussion with young patients regarding the possible side effects of laser photocoagulation, even if this is limited to a small area of the peripheral retina.

[National clinical investigation of anti-aquaporin-4 seropositive optic neuritis].

PURPOSE: We carried out a national clinical investigation of anti-aquaporin-4 seropositive optic neuritis which is resistant to steroid pulse therapy. METHODS: A questionnaire of clinical training institutions authorized by the Japanese Ophthalmological Society regarding anti-aquaporin-4 seropositive optic neuritis. RESULTS: We received responses from 44 facilities (40%). There were 188 anti-aquaporin-4 seropositive cases (24 men, 162 women), with a mean age of 52.4 +/- 15.5 (14-88 years old, median 54). Visual acuity at the time of the first medical examination was 3.4 to -0.18 logMAR (median 1.30) and at the last 3.4 to -0.18 logMAR (median 0.70). The average number of times of recurrence and steroid pulse therapy were 1.5 +/- 2.3 (median 1) and 3.3 +/- 4.1 (median 2) respectively. There was no significant difference in visual acuity between patients who received additional therapy such as plasma exchange therapy and immunoadsorption therapy and patients who were not treated additionally. CONCLUSIONS: Clinical characteristics of anti-aquaporin-4 seropositive optic neuritis were revealed. A well-designed prospective study is needed to obtain evidence of availability of plasma exchange therapy and other related issues.

Morphology, Fundus Autofluorescence, and Retinal Sensitivity of Photocoagulated Lesions in Proliferative Diabetic Retinopathy.

Purpose: To evaluate the relationships among morphology, fundus autofluorescence (FAF), and retinal sensitivity of photocoagulated lesions more than 1 year after panretinal photocoagulation in patients with proliferative diabetic retinopathy and good vision. Methods: This retrospective cohort study included patients with proliferative diabetic retinopathy who had undergone panretinal photocoagulation more than 1 year ago. The photocoagulated lesions were classified according to FAF levels: group A, no FAF; group B, diffuse FAF; group C, white-dotted centers with diffuse FAF; group D, white-dotted centers without FAF; and group E, controls. The main outcome measures were FAF, retinal sensitivity, and morphology of the photocoagulated lesions. Results: The median sensitivity values and number of photocoagulated lesions in groups A (n = 37), B (n = 39), C (n = 4), D (n = 15), and E (n = 39) were 0 dB, 18.0 dB, 13.9 dB, 0.3 dB, and 21.5 dB, respectively. EZ lines were absent in 93.5%, 18.1%, 50%, 93.3%, and 0% of lesions in groups A, B, C, D, and E, respectively. The inner retinal layer was damaged in 45.2%, 3.0%, 50%, 73.3%, and 0% lesions in groups A, B, C, D, and E, respectively. Statistically significant between-group differences were observed in the retinal sensitivities of the photocoagulated lesions, presence of EZ lines, and damage to the inner retinal layer (p < 0.05). Conclusions: The photoreceptors in most photocoagulated lesions with diffuse FAF retain their morphology and function. Translational Relevance: Using fundus autofluorescence, the damage to photoreceptors after panretinal photocoagulation in patients with diabetes can be estimated in a noninvasive manner. This process can help in determining the need for additional panretinal photocoagulation.

Two Japanese Families with Pigmented Paravenous Retinochoroidal Atrophy and HK1 Mutation: A Case Report.

Hexokinase 1 (HK1) gene is the cause of autosomal dominant retinitis pigmentosa (RP) 79. To date, only E874K mutation has been reported as the causative mutation in patients with nonsyndromic RP. As a Caucasian RP case with a pathological variant of HK1 exhibiting pigmented paravenous retinochoroidal atrophy (PPRCA) phenotype was recently reported, we reviewed RP79 cases in our Japanese RP cohort. Consequently, 2 Japanese patients, who were diagnosed with RP79 by genetic tests in our RP cohort, were included in this study. Patient 1 was a 60-year-old woman. Fundus examination revealed symmetrical donut-shaped retinal degeneration, with pigment deposition avoiding the macula. Moreover, degeneration extended in a peripheral direction along the vessels like a starfish, and degeneration was observed around the veins and arteries. Patient 2 was a 75-year-old man. Fundus examination revealed symmetric macula-avoiding donut-shaped retinal degeneration, with paravenous protruding degeneration along the blood vessels like in case 1. Both Japanese cases, which belonged to two separate families, had the same HK1 pathogenic mutation, with a phenotype of PPRCA. Furthermore, atrophy along retinal arteries was noted. Reviewing previous nonsyndromic RP79 cases revealed symptoms that are believed to be those of PPRCA. Ultra-widefield fundus imaging, especially ultra-widefield fundus autofluorescence, has been useful in detecting PPRCA. If these devices become widely available, more cases may be discovered in the future because PPRCA can be used as a clue to suspect RP79, and Sanger sequencing may be used to identify pathogenic mutations in HK1 at a lower cost and more easily than using whole-exome sequencing.

[Viewing 3D stereoscopic images in children and adults with and without strabismus: multicenter study in Japan].

PURPOSE: To investigate the ability of patients with strabismus and/or amblyopia to see 3D images. METHODS: A questionnaire survey conducted for children aged 6 to 19 years and adults aged 20 to 39 years on their experience of viewing 3D images (movies, motion attractions, television, games), asking whether they could see stereoscopically, with or without adverse effects. A retrospective investigation of ophthalmological examinations was followed. RESULTS: Of 507 cases, 342 had had the experience of veiwing 3D images. In 212 (62%) cases of strabismus and/or amblyopia, stereopsis was lacking in 17 to 18% of the subjects for movies, in 6 to 7% for attractions, in 32% in children and 50% in adults for television and 23% in children and 17% in adults for games. Adults complained of a higher rate of adverse effects, 65% for movies and 75% for games, as compared with 34% for movies and 26% for games in children(p < 0.01). The lack of stereopsis for games and movies was higher in the subgroup of Fly (-) and convergence insufficiency (p < 0.05). CONCLUSIONS: Since many patients with strabismus and/or amblyopia found some difficulty in stereoscopic viewing, precise examinations for stereopsis and convergence are needed to assess individual aptitude for 3D viewing.

The influence of stimulating electrode conditions on electrically evoked potentials and resistance in suprachoroidal transretinal stimulation.

PURPOSE: To determine the influence of stimulating electrode conditions on the amplitudes and latencies of electrically evoked potentials (EEPs) and the resistance at the electrode-tissue interface in the suprachoroidal transretinal stimulation (STS) system. STUDY DESIGN: Experimental study. METHODS: A scleral pocket (3 × 5 mm) was created just over the visual streak in anesthetized pigmented rabbits (weight, 1.9-2.7 kg), and STS stimulating electrodes were implanted into the pocket. Measurements were obtained with stimulating electrodes of different lengths (0.3 or 0.5 mm) and different surface characteristics (smooth or porous). EEPs elicited with a fixed current under each set of electrode conditions were recorded; three measurement sessions were performed for each rabbit. The resistance at each electrode-tissue interface was measured. RESULTS: The latencies and amplitudes of the EEPs did not differ significantly with changes in the height and surface characteristics of the stimulating electrodes, but the resistances at the electrode-tissue interface differed significantly (P = 0.001; the resistance values for the 0.3-mm-long electrode with a porous surface was 5.24 ± 0.67 kΩ and with the 0.3- and 0.5-mm-long electrodes with smooth surfaces were 7.63 ± 0.12 kΩ and 6.77 ± 0.20 kΩ). CONCLUSION: Being shorter did not affect the EEPs of the stimulating electrodes with a porous surface while decreasing the resistance at the electrode-tissue interface.

Assessment of myopic rebound effect after discontinuation of treatment with 0.01% atropine eye drops in Japanese school-age children.

PURPOSE: Having previously demonstrated the efficacy of 0.01% atropine eye drops for inhibiting progression of childhood myopia, we conducted additional analyses to assess post-treatment changes in myopia progression. STUDY DESIGN: Analysis of follow-up data from a previously reported randomized controlled trial METHODS: A mixed-effects model was used to compare intergroup changes in spherical equivalent (SE) and axial length (AL) at 1 month and 12 months after discontinuation of 2-year treatment with atropine or placebo in 167 school-age children. RESULTS: Follow-up measurements were available for 149 participants at 1 month after discontinuation of treatment and for 51 participants at 12 months after discontinuation. At 1 month post-treatment, differences between the atropine and placebo groups in least squares (LS) mean changes in SE and AL, respectively, from 24 months were -0.06 diopters (D) (95% CI: -0.21, 0.08; P = .39) and 0.02 mm (95% CI: -0.05, 0.08; P = .60). At 12 months post-treatment, intergroup differences (atropine vs placebo) in LS mean changes in SE and AL, respectively, were -0.13 D (95% CI: -0.35, 0.10; P = .26) and -0.02 mm (95% CI: -0.12, 0.09; P = .75). LS mean changes in SE and AL from treatment discontinuation did not differ between the groups at 1 or 12 months post-treatment. CONCLUSION: Axial elongation was significantly less in the atropine group than in the placebo group. The suppression effect obtained at 2 years was maintained after 12 months. The absence of intergroup differences in myopia progression since treatment cessation suggests that myopic rebound did not occur.

Adaptive optics dioptric scanning ophthalmoscope with a wider field of view similar to those of normal ophthalmoscopes.

We introduce a newly developed adaptive optics dioptric scanning ophthalmoscope (AO-DSO) in which all powered optical parts were refractive lenses instead of concave or convex mirrors. By designing dioptric optics, we were able to achieve a compact instrument with a 10 deg field of view (FOV10) and 1.5 deg field of view (FOV1.5) high-resolution imaging. Although the resolution of FOV10 was sacrificed because of the variation of aberrations of the eye over the 10 deg field, our system works with AO in the case of FOV1.5 and can be used as a scanning laser ophthalmoscope with good optical slicing in the case of FOV10. To test the ability of the AO-DSO, we performed imaging on a normal subject and on a patient with occult macular dystrophy.