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Purpose To evaluate vortex vein engorgement and choroidal vascular hyperpermeability in patients with polypoidal choroidal vasculopathy (PCV) using ultra-widefield indocyanine green angiography (ICGA). Methods This retrospective case control study included 51 patients with unilateral PCV, 7 patients with bilateral PCV, and 43 age-matched controls. The number of quadrants of vortex vein engorgement was evaluated in the middle phase of ICGA, which was classified as extended engorgement if the dilated choroidal vessels expanded to the macula. The area of choroidal vascular hyperpermeability was quantified stereographically from the late-phase ICGA and correlated with clinical and optical coherence tomography findings. Results Affected eyes had a larger choroidal hyperpermeability area and a thicker subfoveal choroid than eyes in the control group or fellow eyes ( P < 0.001, P < 0.001). More quadrants with extended vortex vein engorgement were observed in affected eyes than in fellow eyes ( P < 0.001). Significant differences were observed in the area of choroidal hyperpermeability, Haller layer thickness and greatest linear dimension according to the extended vortex vein engorgement in eyes with PCV ( P < 0.001, P = 0.001, and P = 0.001, respectively). The area of choroidal hyperpermeability was significantly correlated with subfoveal choroidal thickness ( P < 0.001, Pearson's correlation coefficient = 0.471). Conclusions Ultra-widefield ICGA results revealed that patients with PCV had vortex vein engorgement and an increased choroidal hyperpermeability area. The results from this study provide substantial information to clarify the pathogenesis and predict the prognosis in the patients with PCV.

Purpose To evaluate the clinical characteristics of patients with intermittent exotropia who exhibited a dramatic decrease in ocular deviation 1 day before surgery. Methods This study retrospectively enrolled patients with intermittent exotropia who underwent surgery between December 2013 and December 2019. Those who exhibited a decrease in ocular alignment ≥10 prism diopters (PD) at the last examination (1 day before surgery) compared with the largest previous angle of deviation were included. A monocular occlusion test was performed to re-confirm the largest angle of ocular deviation. Results Among 547 patients with intermittent exotropia, 10 (six females; mean age, 8.6 years) exhibited a dramatic decrease in ocular deviation before impending surgery. The mean largest angle of deviation was 31.0 PD (range, 20 to 50 PD) at distance and 34.5 PD (range, 20 to 55 PD) at near. The mean control scores using the LACTOSE (Look and Cover then Ten Seconds of Observation Scale for Exotropia) scoring system were 2.5 at distance, 1.8 at near, and 4.3 when combined. Mean ocular deviation prior to the impending surgery decreased to 7.4 PD (range, 0 to 10 PD) at distance and 6.2 PD (range, -10 to 10 PD) at near. The largest angle of ocular deviation was re-confirmed using the monocular occlusion test in all patients. All patients underwent surgery as planned, and none exhibited postoperative overcorrection. Conclusions A relatively small number of patients with intermittent exotropia exhibited a dramatic decrease in ocular alignment 1 day before surgery but demonstrated a relatively better level of control. The monocular occlusion test was helpful in re-confirming the largest angle of ocular deviation.

Purpose: To compare clinical characteristics between the poor visual outcome (PVO) and good visual outcome (GVO) groups in culture-proven bacterial keratitis.Methods: A total of 230 cases (44 and 186 eyes in the PVO and GVO groups, respectively) of culture-proven bacterial keratitis, treated between January 2007 and December 2020, were reviewed retrospectively. The PVO group included cases with the final best-corrected visual acuity (BCVA) of less than 0.1 and no improvement compared to the initial BCVA. The remaining cases were included in the GVO group. The microbiological profiles, epidemiology, predisposing factors, and clinical characteristics were compared between the PVO and GVO groups, and the risk factors for PVO were analyzed.Results: <i>Staphylococcus</i> spp. and <i>Pseudomonas</i> spp. were common isolates in both the PVO and GVO groups, with no significant differences in the distribution of isolates. There were no significant differences between the groups in terms of sex, seasonal distribution, corneal trauma, and prior topical steroid use, but contact lens wear was significantly less in the PVO group. Significant risk factors for PVO were age ≥60 years (<i>Z</i> = 4.22, two-proportion <i>Z</i>-test), central corneal lesions (<i>Z</i> = 3.80), epithelial defect size ≥5 mm² (<i>Z</i> = 3.74), prior ocular surgery (<i>Z</i> = 3.63), hypopyon (<i>Z</i> = 3.42), previous ocular surface disease (<i>Z</i> = 3.32), and diabetes (<i>Z</i> = 3.12).Conclusions: In patients with bacterial keratitis, PVO was associated with older age, severe initial corneal findings, previous ocular disease history, and diabetes, but not with the causative pathogen itself.