SLT treatment was shown to significantly lower IOP and decrease IOP fluctuations during the nocturnal periods in NTG patients. These effects might be important to prevent the progression of NTG.

Diabetic retinopathy (DR) is a leading cause of blindness. DR is recognized as a microvascular disease and inner retinal neurodegeneration. In the course of retinal neurodegeneration, N-methyl-D-aspartate receptor (NMDAR)-mediated excitotoxicity is involved. Full activation of NMDAR requires binding of agonist glutamate and coagonist glycine or D-serine. D-Serine is produced from L-serine by serine racemase (SRR) and contributes to retinal neurodegeneration in rodent models of DR. However, the involvement of SRR in both neurodegeneration and microvascular damage in DR remains unclear. Here, we established diabetic model of SRR knockout (SRR-KO) and control wild-type (WT) mice by streptozotocin injection. Six months after the onset of diabetes, the number of survived retinal ganglion cells was higher in SRR-KO mice than that of WT mice. The reduction of thickness of inner retinal layer (IRL) was attenuated in SRR-KO mice than that of WT mice. Moreover, the number of damaged acellular capillaries was lower in SRR-KO mice than that of WT mice. Our results suggest the suppression of SRR activity may have protective effects in DR.

Purpose. To examine the graft-host interface during Descemet's stripping automated endothelial keratoplasty (DSAEK) surgery with optical coherence tomography (OCT). Design. Prospective, interventional case series. Patients and Methods. Eight patients who underwent a DSAEK were included. A handheld OCT was used intraoperatively to examine the presence of interface fluid between the host cornea and the graft. Results. In 3 patients, no interface fluid was detected between the host cornea and the graft after the graft was attached by air injection. In 4 patients, interface fluid was detected after the graft was attached by air injection. The remaining interface fluid was drained through corneal stab incisions. One patient required a second surgery because the first surgery failed due to persistence of the interface fluid. All patients showed a complete attachment of the graft at one month after the DSAEK surgery. Conclusion. A handheld OCT is useful to detect the interface fluid between the host cornea and the graft during a DSAEK.

Purpose:To report a series of three cases of neurofibromatosis type 1 examined by near-infrared fundus autofluorescence (NIR-AF) with a scanning laser ophthalmoscope and spectral-domain optical coherence tomography (OCT) to show the characteristics of choroidal abnormalities.Methods:Retrospective case series. Six eyes of three patients were examined by conventional fundus examinations, near-infrared monochromatic light reflectance (NIR-R) and NIR-AF, OCT, fluorescein angiography, and indocyanine green angiography.Results:All eyes showed multiple bright patchy regions in the choroid of the posterior pole with NIR-R. NIR-AF revealed high fluorescent regions of similar sizes at fundus locations identical to those shown by NIR-R. In one case, hypofluorescent regions were shown by indocyanine green angiography in the bright fluorescent region shown by NIR-AF. The other two cases showed no abnormality under conventional fundus examination or fluorescein angiography. OCT images crossing the bright patchy region showed irregular hyper-reflectivity in the choroid in two cases and hyporeflectivity in one case.Conclusions:NIR-AF demonstrated that dense melanin was included in the choroidal nodules of neurofibromatosis type 1. The choroidal nodules showed hyper- or hyporeflectivity in the choroid on OCT, which did not affect the retinal structure.

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Purpose To examine the prognostic factors related to postoperative visual acuity in patients with rhinogenic optic neuropathy. Study Design Retrospective observational study. Materials and Methods We retrospectively studied the medical records for 15 eyes of 15 patients who underwent surgery for the treatment of rhinogenic optic neuropathy between 31 January 2010 and 30 April 2018 at Toyama University Hospital. The patient age, sex, preoperative and postoperative visual acuity, duration from visual deficit to surgery, use of steroids, type of rhinogenic optic neuropathy, and the part of sinus lesion were analyzed. We also examined postoperative visual acuity for patients whose preoperative visual acuity was less than light perception. Results The type of optic neuropathy was sinusitis in 7 cases, mucocele in 5 cases, and pyocele in 3 cases. Visual acuity was improved in 9 cases and deteriorated or unchanged in 6 cases. Patients in the improvement group were significantly younger than those in the nonimprovement group (p=0.01). In univariate regression analysis, preoperative visual acuity and type of optic neuropathy significantly related to postoperative visual acuity. Finally, 4 of the 15 cases (27%) had preoperative visual acuity less than light perception, but there was an improvement in postoperative visual acuity in 2 of 4 cases (50%). Conclusions Preoperative visual acuity is the predictive factor for postoperative visual acuity in patients with rhinogenic optic neuropathy, but even if the preoperative visual acuity is less than light perception, it can be improved by surgical treatment.

PurposeTo investigate changes in cone photoreceptors with adaptive optics (AO) fundus imaging and spectral domain optical coherence tomography (SD-OCT) in a case of occult macular dystrophy (OMD).Patient and methodsBoth eyes of a 42-year-old woman diagnosed with OMD were examined. We used an AO fundus camera to obtain images of cone photoreceptors in the macula of the OMD subject and five healthy control subjects. Correlations between the AO images and the SD-OCT images were examined. Cone photoreceptors in eight areas in the macula of OMD and healthy control subjects were analyzed and compared.ResultsSD-OCT showed a loss of the cone outer-segment tips line outside of the fovea in both eyes of the subject with OMD. The left eye with decreased visual acuity showed a discontinuous photoreceptor inner-segment and outer-segment line and cone outer-segment tips line at the fovea in SD-OCT and loss of cone mosaics as a dark spot in the AO image. In panoramic AO images and cone-density maps, less cone density was observed in a ring-like region outside the fovea than in the peripheral retina. In most of the areas examined, the cone densities were lower in the OMD eyes than in the healthy control eyes.ConclusionsCone densities in the macula of the OMD patient were greatly decreased. AO images were found to be useful to evaluate morphologic changes in cone photoreceptors in patients with OMD.