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for the Korean Retina Society IMPORTANCE Iatrogenic occlusion of the ophthalmic artery and its branches is a rare but devastating complication of cosmetic facial filler injections.OBJECTIVE To investigate clinical and angiographic features of iatrogenic occlusion of the ophthalmic artery and its branches caused by cosmetic facial filler injections. DESIGN, SETTING, AND PARTICIPANTS Data from 44 patients with occlusion of the ophthalmic artery and its branches after cosmetic facial filler injections were obtained retrospectively from a national survey completed by members of the Korean Retina Society from 27 retinal centers. Clinical features were compared between patients grouped by angiographic findings and injected filler material. MAIN OUTCOMES AND MEASURESVisual prognosis and its relationship to angiographic findings and injected filler material.RESULTS Ophthalmic artery occlusion was classified into 6 types according to angiographic findings. Twenty-eight patients had diffuse retinal and choroidal artery occlusions (ophthalmic artery occlusion, generalized posterior ciliary artery occlusion, and central retinal artery occlusion). Sixteen patients had localized occlusions (localized posterior ciliary artery occlusion, branch retinal artery occlusion, and posterior ischemic optic neuropathy). Patients with diffuse occlusions showed worse initial and final visual acuity and less visual gain compared with those having localized occlusions. Patients receiving autologous fat injections (n = 22) had diffuse ophthalmic artery occlusions, worse visual prognosis, and a higher incidence of combined brain infarction compared with patients having hyaluronic acid injections (n = 13).CONCLUSIONS AND RELEVANCE Clinical features of iatrogenic occlusion of the ophthalmic artery and its branches following cosmetic facial filler injections were diverse according to the location and extent of obstruction and the injected filler material. Autologous fat injections were associated with a worse visual prognosis and a higher incidence of combined cerebral infarction. Extreme caution and care should be taken during these injections, and physicians should be aware of a diverse spectrum of complications following cosmetic facial filler injections.

Age-related macular degeneration (AMD) is a major cause of blindness, but presents differently in Europeans and Asians. Here, we perform a genome-wide and exome-wide association study on 2,119 patients with exudative AMD and 5,691 controls, with independent replication in 4,226 patients and 10,289 controls, all of East Asian descent, as part of The Genetics of AMD in Asians (GAMA) Consortium. We find a strong association between CETP Asp442Gly (rs2303790), an East Asian-specific mutation, and increased risk of AMD (odds ratio (OR)=1.70, P=5.60 × 10−22). The AMD risk allele (442Gly), known to protect from coronary heart disease, increases HDL cholesterol levels by 0.17 mmol l−1 (P=5.82 × 10−21) in East Asians (n=7,102). We also identify three novel AMD loci: C6orf223 Ala231Ala (OR=0.78, P=6.19 × 10−18), SLC44A4 Asp47Val (OR=1.27, P=1.08 × 10−11) and FGD6 Gln257Arg (OR=0.87, P=2.85 × 10−8). Our findings suggest that some of the genetic loci conferring AMD susceptibility in East Asians are shared with Europeans, yet AMD in East Asians may also have a distinct genetic signature.

Depression was associated with DED symptoms in subjects with normal or mildly reduced tear production.

To evaluate the prevalence of and risk factors for dry eye disease (DED) in an elderly Korean population.Methods: This population-based study in Yongin, Korea, included 657 individuals 65 years or older randomly selected from an official household registration database. Dry eye symptoms were assessed using a 6-item questionnaire, and DED was defined as having 1 or more dry eye symptoms often or all the time. Dry eye tests, including the Schirmer test, tear film break-up time measured using fluorescein, cornea fluorescein staining, and examination for meibomian gland dysfunction, were performed. Results:The crude prevalence of DED was 30.3%, and the age-, sex-, and region (urban vs rural)-adjusted preva-lence was 33.2%. Women (P=.01) and urban dwellers (P =.001) were more likely to have DED. Of those with DED, 85.1% had tear film break-up time of 10 seconds or less, 54.1% had meibomian gland dysfunction, 39.2% had a fluorescein score of 1 or greater, and 32.8% had a Schirmer test score of 5 mm or less. A low Schirmer score was correlated with increased prevalence of DED, although sensitivity was low.Conclusions: Dry eye disease is common in elderly Koreans; female sex and living in an urban region were strongly correlated with its frequency. We also noted a positive correlation between low Schirmer test scores and symptom-based DED.

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