Background:To evaluate the presence and extent of metamorphopsia using M-CHARTS™ (Inami Co., Tokyo, Japan) in patients with central serous chorioretinopathy (CSC).Design:Retrospective consecutive medical record review in a university hospital.Materials and Methods:We examined 33 eyes of 33 consecutive CSC patients using M-CHARTS, which yields scores reflecting the severity of metamorphopsia. The condition was considered present when an M-CHARTS score was 0.3 or over. In all patients, optical coherence tomography (OCT) was performed, best-corrected visual acuity (BCVA) was assessed, and M-CHARTS scores were calculated at the first and the 1- and 3-month follow-up visits. The correlation between M-CHARTS scores and BCVA values was determined. We also sought to define relationships between the level of metamorphopsia and specific OCT findings.Results:Of 33 CSC patients, 15 showed symptoms of metamorphopsia, and all 15 had M-CHARTS scores of over 0.3. However, no correlation was evident between BCVA values and the extent of metamorphopsia as determined using M-CHARTS. In metamorphopsia patients, the incidence of focal retinal pigment epithelial detachment was notably greater than in the non-metamorphopsia group (P = 0.03).Conclusion:M-CHARTS is valuable for monitoring subjective symptom improvement during the clinical course of CSC. M-CHARTS serves as a useful adjunct to OCT.

Sunitinib was given in an intermittent schedule 4/2 (6-week cycle, 4 weeks on treatment, 2 weeks off treatment). The dose was reduced to 37.5 mg per day at the next treatment cycle. The patient developed the same clinical picture after re-initiating treatment. During the 2 weeks off period, a spontaneous regression of the serous detachment occurred again. Even after the reduction of sunitinib to 25 mg per day, the same 'yoyo-effect' was observed.The patient was receiving anti-hypertensive treatment at that time that included a selective beta-blocker (bisoprolol), an angiotensin-converting enzyme inhibitor (ramipril) and an angiotensin II receptor antagonist (candesartan). None of them was discontinued at any time the patient received sunitinib. The patient did not take any corticosteroids. Blood pressure was well controlled (130/80 mm Hg).Blood count, electrolytes, liver, and kidney function parameters were within normal range.The underlying mechanisms of subretinal exudation are thought to include changes of the choroidal vascular permeability and choroidal vascular perfusion. 3,4 Any medication, which can cause such changes, may be liable to induce serous retinal detachments. This is, to the best of our knowledge, the first report of a reversible neurosensory retinal detachment and retinal oedema due to sunitinib. Neovascular age-related macular degeneration and macular oedema due to vascular occlusion are the main indication for treatment with anti-VEGF in ophthalmology. Serous retinal detachment has not been reported as a side effect when using these substances. Moreover, neurosensory retinal detachment can even be treated with anti-VEGF. 5 This might suggest that not the anti-VEGF-receptor effect of sunitinib was responsible for the neurosensory retinal detachment but other properties of its spectrum of action.

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Purpose:To compare the surgical outcome between V-pattern intermittent exotropia without inferior oblique overaction and comitant intermittent exotropia. Methods: The authors of the present study investigated 15 patients (V-pattern group) who had standard horizontal surgery with half-tendon width vertical transposition and 36 patients (Comitant group) with unilateral rectus muscle recession/ resection. Preoperative visual acuity, presence of amblyopia, abnormal head posture, stereoacuity, amount of exotropia, and duration of postoperative diplopia were recorded. Surgical success was defined as final alignment of orthophoria or less than 10 PD orthophoria. Results: The frequency of good stereoacuity with 80 sec of stereoacuity or more was higher in the V-pattern group (73.3%) than in the Comitant group (33.3%) (Fisher's exact test, p = 0.01). One case of V-pattern showed consecutive esotropia for 1 year postoperatively. Exotropia recurred in 2 patients in the V-pattern group (13.3%), and in 4 patients in the Comitant group (11.1%) 1 year postoperatively. Surgical success rates were statistically significant higher in the V-pattern group (86.7%) as compared to the Comitant group (58.3%) on final follow-up (Fisher's exact test, p = 0.04). Conclusions: V-pattern exotropia patients without inferior oblique overaction who had standard horizontal surgery with half-tendon width vertical transposition showed a lower recurrence rate of exotropia than patients with comitant intermittent exotropia. J Korean Ophthalmol Soc 2013;54(2):324-330