To examine the safety and efficacy of azithromycin eye drops in Japanese individuals with meibomian gland dysfunction (MGD)-associated posterior blepharitis, individuals with MGD-associated posterior blepharitis who visited the Itoh Clinic, Saitama, Japan, were randomly assigned to receive azithromycin (1%) eyedrops (AZM group, 16 eyes of 16 patients) or preservative-free artificial tears (control group, 20 eyes of 20 patients) for two weeks. All subjects also applied a warming eyelid compress twice per day. Subjective symptoms (Standardized Patient Evaluation of Eye Dryness [SPEED] score), lipid layer thickness (LLT) and interferometric pattern of the tear film, plugging and vascularity of the lid margin, noninvasive break-up time of the tear film (NIBUT) and fluorescein-based break-up time of the tear film (TBUT), corneal-conjunctival fluorescein staining score, tear meniscus height, meibum grade, meiboscore, tear osmolarity, and Schirmer test value were determined before and after treatment. Side effects of treatment were also recorded.

In the AZM group, SPEED score, LLT, interferometric pattern, plugging and vascularity of the lid margin, NIBUT, TBUT, meibum grade and tear osmolarity were significantly improved after treatment, compared with baseline. The SPEED score, interferometric pattern, plugging, vascularity, meibum grade and tear osmolarity were also significantly improved after treatment in the AZM group compared with the control group. Common side effects in the AZM group were transient eye irritation and blurred vision.

Researchers wrote that azithromycin eye drops improved eyelid inflammation, the quality and quantity of the lipid layer of the tear film, and tear film stability. As such, they added, the eye drops appeared to be a safe and effective treatment for MGD-associated posterior blepharitis.

To compare lamina cribrosa (LC) morphology between eyes with nonarteritic anterior ischemic optic neuropathy (NAION) and eyes with normal-tension glaucoma (NTG) in the Korean population, this retrospective study evaluated 48 eyes with NAION, 48 eyes with NTG; and 48 healthy control eyes matched by age, intraocular pressure, axial length and optic disc area. Eyes with NAION and NTG were also matched by retinal nerve fiber layer (RNFL) thickness in the affected sector. Optic nerve heads were scanned using enhanced depth imaging spectral-domain optical coherence tomography. LC depth (LCD) and the LC curvature index (LCCI) were measured at seven locations spaced equidistantly across the vertical optic disc diameter. LCD and the LCCI were compared in the three groups.

RNFL thicknesses of the matched affected sectors did not differ between the NAION and NTG groups. LCD and the LCCI were significantly larger in the NTG group than in the NAION and healthy control groups at all seven planes, but were comparable in the NAION and healthy control groups. The LCCI was larger in the affected than in the unaffected sector of NTG eyes but did not differ in NAION eyes. LCD did not differ between affected and unaffected sectors in either NAION or NTG eyes.

Investigators wrote that LC morphology differed in eyes with NAION and NTG, despite a similar degree of RNFL damage. They added that evaluation of LC morphology may help to understand the distinctive pathophysiology of NAION and to differentiate NAION from NTG eyes.

Severe cases of thyroid eye disease with high intraocular pressure and visual field defects are a real diagnostic challenge requiring the exclusion of dysthyroid optic neuropathy and differential diagnosis with glaucoma. This case report involved a patient with active thyroid eye disease (TED), decreased visual acuity and elevated intraocular pressure. A 52-year-old woman with TED in both eyes, class 2c3c4a6a (NOSPECS), with 6 points (by CAS) activity, who received corticosteroid therapy to a maximum cumulative dose of 5750 mg, with non-insulin-dependent diabetes mellitus and topical antihypertensive treatment with tapticom, brizadop, and luxfen received a full ophthalmological exam, tonometry, exophthalmometry, computer perimetry, optical coherence tomography (OCT) and computed tomography (CT) scan of orbits.

The following results were obtained: BCVA of right eye=0.6, BCVA of left eye=0.3; TOD=26 mmHg and ТОS=21 mmHg; exophthalmometry: 30 mm for the right eye and 31 mm for the left one; diplopia in all directions; edema and hyperemia of the eyelids and conjunctiva; eyelids retraction, sluggish pupil reactions, normal color vision, transparent ocular media, indistinct borders of the optic nerve disc, without glaucomatous excavation; tortuosity and dilation of the venules; retina—without diabetic changes; maculas—with normal reflex; CP datа for a localized inferotemporal visual field defect; CT data for thickening of all extraocular muscles; soft tissue orbital edema; and optic nerves compression.

Researchers wrote that the results confirmed the presence of dysthyroid optic neuropathy, based on the decreased visual acuity, ophthalmo-scopic evaluation of the optic nerve head, lack of glaucomatous OCT changes, atypical perimetric changes and CT data. They added that optic neuropathy is the most severe complication in patients with TED, which develops due to the compression of the optic nerve and/or its blood supply from the enlarged extraocular muscles and soft tissues in the orbital apex and due to the mechanical tension of the optic nerve in cases when moderate or severe proptosis is present.