These findings indicate that the effects of PDT and IVB have a different time course, and that IVB provides a significantly better BCVA than PDT for mCNV over the long-term.

The presence on glial cells of receptors for neurotransmitters suggests the capability of neuron-to-glial signalling. Here, we asked whether the retinal transmitter, glutamate, may serve as a mitogenic signal for human retinal glial cells. Using cultured glial from the adult postmortem retina, we found that glutamate stimulated the proliferation of these glial cells. Pharmacological experiments indicated that this proliferative effect involved activation of N-methyl-D-aspartate (NMDA) receptor channels. Activation of NMDA receptors on retinal glial cells may mediate a proliferative response of these cells to pathophysiologic conditions causing a sustained elevation of glutamate.

Topical immune depression may induce ACV-resistant HSV-1 infection in the cornea, with a prolonged course in association with ocular complications. The prolonged infectious course of the viral isolates in the animal study partially supported the clinical demonstrations in the patient. The existence of latent infection by one ACV-resistant HSV-1 in its animals may indicate the possibility of its recurrence. Trifluridine may be an alternative choice for treating corneal epithelial lesions caused by ACV-resistant HSV-1.

SUMMARY We report seven cases of subretinal neovascularisation with inferior posterior staphyloma. The upper border of the shallow staphyloma, detected by B-mode echography, invaded the macular area, and there was a neovascular net at the edge of the staphyloma. Three of the cases showed chorioretinal atrophy at the upper edge of the staphyloma in the same location as the neovascular net. Our cases were identical to those of subretinal neovascularisation in high myopic eyes in which the rupture of Bruch's membrane was related to the deformity of the scleral shell. As our cases included not-high-myopic eyes, the results suggest that the identical mechanism might be involved in the occurrence of neovascular maculopathy in the pathological high myopic eye and in the not-high-myopic eye with posterior staphyloma. Localised inferior posterior staphyloma may be an important cause of 'idiopathic' subretinal neovascularisation.Subretinal neovascularisation is triggered by the rupture of Bruch's membrane in the posterior fundus. ' High myopia has been described as a cause of subretinal neovascularisation,2 as have aging, trauma, uveitis, angioid streaks, and macular dystrophies. In the high myopic eye the uvea and retina at the posterior fundus expand so that the axial length of the eye is elongated. This condition leads to the rupture of Bruch's membrane and the growth of subretinal neovascularisation.1 However, when a localised posterior staphyloma exists, the posterior fundus may expand somewhat without significant elongation of the axial length. For example, the tilted disc syndrome is not necessarily associated with high myopia but has the typical high myopic fundus in the lower half of the eye related to the inferior staphyloma.45 In such a case myopic pathological complications may occur inside the posterior staphyloma even if the eye is not high myopic.We report here a series of consecutive cases with subretinal neovascularisation that are not severely high myopic but have inferior posterior staphylomas in order to study the relationship between the inferior staphyloma and subretinal neovascularisation.Correspondcncc to Shunji Tsuboi, MD,