As the population grows older each year, age-related macular degeneration (AMD) is becoming the leading eye disease resulting in blindness. Although some drugs are available for the treatment of wet AMD, no drug is currently available for dry AMD. Actual research is taking place to invent novel drug for the treatment of dry AMD and the hurdles of the R&D are reviewed. Literature search and review were conducted to identify various ideas to treat dry AMD and to overcome the difficulties of developing clinical end points for developing the new drugs. Some promising drug candidates had been identified and clinical end points of drug efficacy determination had been collected. With the proof of new concepts and clinical end points available, the hope is high to expect some new novel drugs be put in the market sometime in the future.

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Leber hereditary optic neuropathy (LHON) is the most common primary mitochondrial DNA (mtDNA) disorder in the general population. It is an important cause of severe, usually irreversible, visual loss among young adults with a peak age of onset in the second and third decades of life. Management is currently mostly supportive but recent developments in LHON research are pointing the way towards more effective treatments for this blinding mitochondrial disorder.

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Purpose: To analyze retinal nerve fiber layer (RNFL) thickness in eyes with optic tract syndrome (OTS) by using optical coherence tomography (OCT) and to evaluate the capability of OCT to detect the characteristic pattern of RNFL loss. Methods: Eight patients (4 males and 4 females) with optic tract syndrome were enrolled in this retrospective collection of medical records. Characteristics including age, sex, etiology of optic tract lesion, visual acuity, visual field defect type were recorded. The diagnosis of optic tract syndrome were made by clinical history and typical optic disc findings, visual field defect and neuro-imaging findings including brain MRI and/or CT. The average of RNFL thickness of optic disc, four quadrants, specific four o’clock meridians and related parameters were analyzed and compared between both eyes. Results: The nasal segment average of RNFL thickness was significantly lower in contralateral eyes than that of ipsilateral eyes (37.5 ± 6.7 μm and 67.9 ± 10.3 μm respectively; p < 0.001). The average RNFL thickness and mean thickness of other three quadrants were not significantly different between both eyes. The ratio of superior maximum to nasal segment (Smax/Navg), superior maximum to temporal segment (Smax/Tavg) and inferior maximum to temporal segment (Imax/Tavg) of were significantly different between both eyes (p < 0.001 in all comparisons). The RNFL thickness at nasal, temporal sectors of the contralateral and those at superior, inferior sectors of the ipsilateral eyes were significantly thinner than those of fellow eyes. Conclusion: The RNFL thickness measured by OCT demonstrated a characteristic pattern of optic atrophies in OTS. The difference of nasal average, Smax/Navg, Smax/Tavg, Imax/Tavg values and specific radians between both eyes can provide useful information in the diagnosis of optic tract syndrome.

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Myocilin and optineurin are two genes linked to glaucoma, a major blinding disease characterized by progressive loss of retinal ganglion cells and their axons. This review describes the characteristics of myocilin and optineurin protein products and summarizes the consequences of ectopically expressed wild-type and mutant myocilin and optineurin in trabecular meshwork and/or neuronal cells. Myocilin and optineurin exhibit differential characteristics and have divergent functional consequences. They contribute to the development of glaucoma probably via distinct mechanisms.

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Purpose: This study investigated clinical outcomes of the combined method of scraping, coagulation, and subconjunctival bevacizumab for the treatment of corneal neovascularization (NV) in penetrating keratoplasty (PKP). Methods: This study included patients undergoing PKP who were diagnosed with bullous keratopathy with dense subepithelial scarring that was not suitable for Descemet’s stripping automated endothelial keratoplasty. Corneal NV was treated by scraping the corneal epithelium and lightly coagulating the superficial corneal stromal NV combined with subconjunctival bevacizumab injection at the end of surgery. Patients without corneal NV were used as the control group. Results: There were six patients with vascularized corneas in the study group and three patients without vascularized corneas in the control group. The original corneal NV in the study group disappeared in all patients after surgery. Three of the six (50%) study patients experienced recurrent corneal NV. One of the three (33%) control patients developed corneal NV. These patients had no corneal NV recurrences over the next 6 months after repeat treatment. In both groups, no graft failure or chronic epithelial defects occurred. Conclusion: The combination of scraping the corneal epithelium, coagulating the superficial corneal stromal NV and the feeding vessels in the sclera after peritomy, and subconjunctival bevacizumab injection is an effective method to treat corneal NV in corneal transplantation for bullous keratopathy.

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A 22-year-old female patient received penetrating keratoplasty (PK) of her right eye for ocular rosacea complicated with corneal perforation. Intraocular pressure (IOP) fluctuated and could not be well controlled by full antiglaucomatous agents after surgery. Therefore transscleral diode laser cyclo-photocoagulation (TSCPC) was performed for the intractable glaucoma one year after PK. Unfortunately, acute cataract formation was noted 50 days after the laser treatment. Pigmented keratic precipitates (KPs) developed and IOP rose subsequently. Cataract extraction with intraocular lens implantation combined with trabeculectomy was performed 3 months later. Polymerase chain reaction (PCR) tests of the aqueous humor to detect cytomegalovirus (CMV) and herpes simplex virus (HSV) were negative. However, HSV type I DNA was detected in the lenticular material and excised trabecular tissue. Trabe-culitis caused by herpetic infection could be the reason of fluctuated and intractable IOP elevation. The virus hidden in the intraocular tissue could be reactivated by TSCPC and result in cataract formation. Therefore, performing TSCPC in a phakic eye with atypical IOP presentation should be undertaken with caution.

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Subconjunctival hemorrhage (SCH) is a common eye disorder that is characterized by the sudden onset of a flat area of bleeding under the conjunctiva. Although SCH is a well-known and relatively common disease, the cause in a number of cases remains unknown. Here, we report an unusual ocular presentation of bulbar SCH in a patient who had received an influenza vaccine. Patients who present with SCH other than trauma episode should be evaluated with metabolic diseases or coagulopathy. Although there are rare cases of SCH related to vaccination, we should closely follow a patient if there is a risk of the SCH becoming bleeding disorder. To our knowledge, the features of SCH related to vaccination have not been reported.

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