신경매독과 연관되어 발생한 안매독의 임상 양상

조용운,김체론,한용섭,정인영,박종문,Yong Wun Cho,MD,Che Ron Kim,MD,Yong Seop Han,MD,PhD,In Young Chung,MD,PhD,Jong Moon Park,MD,PhD 대한안과학회 2014 대한안과학회지 Vol.55 No.4

Purpose: To report the manifestation of ocular syphilis combined with neurosyphilis in patients who present with uveitis clinically and are diagnosed initially by an ophthalmologist. Methods: This study is a retrospective, clinical investigation of seven male patients with ocular syphilis from a single tertiary center between 2009 and 2012. Results: The average age of the patients at onset was 44.4 years (range, 33-71 years). Posterior segment involvement was found in all patients. Two patients had papillitis. In serologic testing, all patients had positive responses to Venereal Disease Research Laboratory (VDRL), fluorescent treponemal antibody-absorption test (FTA-ABS) and Treponema pallidum hemagglutination (TPHA). In fluorescein angiography (FAG), retinal vascular and disc leakage was the most common finding. Cerebrospinal fluid (CSF) analysis was performed for six patients and demonstrated positive CSF FTA-ABS and CSF TPHA tests in all patients. CSF VDRL was reactive in 2 patients (33.3%). Conclusions: All patients with ocular syphilis were diagnosed with neurosyphilis based on the analysis of CSF with FTA-ABS and TPHA. Ophthalmologists play an important role in the early diagnosis and treatment of syphilis. J Korean Ophthalmol Soc 2014;55(4):602-607

우측 이마에 필러 주입 후 발생한 시력 소실 1예

조용운,정인영,박종문,유지명,김성재,서성욱,한용섭.Yong Wun Cho. MD. In Young Chung. MD. PhD. Jong Moon Park. MD. PhD. Ji Myong Yoo. MD. PhD. Seong Jae Kim. MD. PhD. Seong Wook Seo. MD. PhD. Yong Seop Han. MD. PhD. 대한안과학회 2014 대한안과학회지 Vol.55 No.8

Purpose: We report a case of visual loss after the injection of poly-L-lactic acid filler into the right forehead area for cosmetic purposes. Case summary: A 46-year-old female patient visited our clinic due to sudden visual disturbance and dysesthesia on the right forehead and cheek. Her best corrected visual acuity was no light perception in the right eye and 20/20 in the left eye. Visual acuity in her right eye was not corrected. An afferent papillary defect in the right eye and paralysis of oculomotor muscles were observed. Fundus exam revealed a pale optic nerve and turbid retina on the posterior pole. The retinal vessels were narrowed. A papule 1 cm to the lateral margin of the right eyebrow due to the needle injection was found and no other visible skin abnormalities were observed. She had a cosmetic poly-L-lactic acid filler injection into the right forehead area immediately before the visual disturbance occurred. Fluorescent angiography showed occlusion of the right retinal artery and blood flow defects on the retina and choroid were present. The patient was followed up for 6 months and visual acuity and dysesthesia in her right forehead and cheek did not improve. Conclusions: Several cases of visual loss have occurred after injection of filler on the glabella and forehead for cosmetic purposes. However, most of the complications were observed after the use of hyaluronic fillers and not due to poly-L-lactic acid filler. This is the first case report of visual loss caused by poly-L-lactic acid filler in South Korea in a normal patient. Hence, consideration of complications when using this type of fillers is important. J Korean Ophthalmol Soc 2014;55(8):1253-1256

Antiphospholipid Syndrome of Bilateral Nonarteritic Anterior Ischemic Optic Neuropathy Patient Deteriorating Over Time

조용운(Yong Wun Cho),김병선(Byoung Seon Kim),유웅선(Woong-Sun Yoo),서성욱(Seong-Wook Seo),정인영(In Young Chung) 대한안과학회 2021 Korean Journal of Ophthalmology Vol.35 No.2

동물용 접종 주사바늘에 수상 후 발생한 안내염 및 망막박리

권리하(Leeha Kwon),조용운(Yong-Wun Cho),서성욱(Seong-Wook Seo),김성재(Seong-Jae Kim),정인영(In Young Chung),유웅선(Woong-Sun Yoo) 대한안과학회 2021 대한안과학회지 Vol.62 No.9

목적: 동물용 접종 주사바늘에 의해 수상 후 발생한 안내염 및 망막박리 1예를 보고하고자 한다. 증례요약: 39세 남자가 돼지 백신 주입 중 동물용 접종 주사바늘에 좌안 수상 후 시력저하로 내원하였다. 내원 당시 좌안의 최대교정시력은 안전수지였으며, 세극등현미경검사상 각막열상 및 수정체 전낭파열과 외상성 백내장이 관찰되었다. 초음파검사상 유리체 및 망막의 특이 소견은 보이지 않았다. 이에 일차각막봉합술과 수정체유화술을 시행하였고, 후낭파열과 유리체탈출이 있어 앞유리체절제술을 시행한 후 인공수정체삽입술, 유리체강내 항생제주입술을 시행하였다. 술 후 1일째 전방축농 등의 안내염 징후로 유리체절제술, 전방세척술, 유리체강내 항생제주입술 및 실리콘기름주입술을 시행하였으며, 수술 중 망막열공 및 국소망막박리가 관찰되었다. 술 후 7개월째 실리콘기름제거술을 시행하였고 좌안 최대교정시력 0.6으로 측정되며 재발 없이 경과 관찰 중이다. 결론: 동물용 접종 바늘에 안구의 손상은 국내 최초 보고로 이러한 손상 시 안저가 관찰되지 않는다면 안내염과 망막박리의 가능성이 있어 초기 유리체절제술이 필요할 것으로 생각된다. Purpose: To report a case of endophthalmitis and retinal detachment after injury caused by an animal inoculation needle. Case summary: A 39-year-old man received an injury to his left eye with an animal inoculation needle while vaccinating a pig came to the hospital due to decreased visual acuity. At initial presentation, the best-corrected visual acuity in the left eye was “counting fingers,” and slit lamp examination revealed corneal lacerations, anterior capsule rupture, and traumatic cataract. Ultrasonography showed no specific findings in the vitreous and retina. Primary corneal suture, phacoemulsification, anterior vitrectomy due to rupture of the posterior capsule and vitreous prolapse, intraocular lens implantation, and intravitreal antibiotic injection were performed. On day 1 postoperatively, vitrectomy, anterior chamber irrigation, intravitreal antibiotic injection, and silicone oil injection were performed as signs of endophthalmitis, such as hypopyon and retinal tear, and focal retinal detachment were observed during surgery. Silicone oil removal was performed 7 months after the operation and the best-corrected visual acuity was 0.6. There has been no recurrence during follow-up. Conclusions: This is the first report in Korea of ocular injury caused by an animal inoculation needle. If the fundus is not observed in such injuries, there is a possibility of endophthalmitis and retinal detachment and early vitrectomy should be considered.

점상내측맥락막병증에서 베바시주맙 치료 후 재발된 맥락막 신생혈관의 치료 1예

김현웅(Hyun Woong Kim),조용운(Yong Wun Cho),정인영(In Young Chung) 대한안과학회 2016 대한안과학회지 Vol.57 No.3

목적: 단안에 발생한 점상내측맥락막병증에 동반된 황반하 맥락막 신생혈관막 치료로 유리체강 내 베바시주맙 주사 치료 시행 후 호전되었다가 재발된 드문 증례를 치료하고 이를 문헌고찰과 함께 보고하고자 한다. 증례요약: 근시를 동반한 25세 여자 환자가 우안에 발생한 점상내측맥락막병증에 동반된 황반하 맥락막 신생혈관막으로 진단 받고 한 달 간격으로 세 번 유리체강 내 베바시주맙 주사 치료 후 호전되었다. 마지막 주사 2개월 후 처음보다 훨씬 심해진 맥락막 염증과 신생혈관막이 재발되어 고용량의 전신 스테로이드와 유리체강 내 베바시주맙 주사를 병합 치료하여 해부학적인 호전과 시력호전을 경험하였다. 결론: 점상내측맥락막병증에 동반된 황반하 맥락막 신생혈관막 치료로 유리체강 내 베바시주맙 주사 치료 후 재발된 염증성 병변에 전신적인 스테로이드와 유리체강 내 주사를 병합하여 치료하고 18개월 이상 재발 없이 안정적인 시력이 유지되었다. Purpose: To report a rare case of relapsed inflammatory choroidal neovascularization (CNV) in a young female patient after intravitreal bevacizumab (IVB) treatment for subfoveal CNV secondary to punctate inner choroidopathy (PIC). Case summary: A 25-year-old myopic female presented with PIC complicated by subfoveal CNV in the right eye. Her lesion initially responded to three monthly 1.25 mg IVB injections, but the lesion recurred two months after the final injection, and the size of the lesion was larger than that observed before treatment. Further treatment with systemic steroids and IVB resulted in successful anatomic and visual improvement. Conclusions: This report presents a rare case of relapsed inflammatory CNV in a young female patient after IVB treatment for subfoveal CNV secondary to PIC. Systemic steroid and IVB were performed after relapse, which successfully improved and maintained vision for longer than 18 months.

2형 당뇨병 환자에서 황반부 미세혈관과 신경섬유층 및 신경절세포-속얼기층 두께의 변화

서진석(Jin-Seok Seo),조용운(Yong-Wun Cho),서성욱(Seong-Wook Seo),김성재(Seong-Jae Kim),정인영(In Young Chung),유웅선(Woong-Sun Yoo) 대한안과학회 2021 대한안과학회지 Vol.62 No.6

목적: 당뇨망막병증이 발견되지 않은 2형 당뇨병 환자에서 파장가변광원 optical coherence tomography (OCT, swept source OCT [SS-OCT])와 optical coherence tomography angiography (OCTA, swept source OCTA [SS-OCTA])를 이용하여 황반의 신경섬유층(nerve fiber layer, NFL) 및 신경절세포-속얼기층(ganglion cell-inner plexiform layer, GCIPL)의 두께와 황반부의 표층망막혈관밀도 및 심층망막혈관밀도, 맥락막모세혈관밀도 변화를 확인하고자 한다. 대상과 방법: 2형 당뇨병으로 진단받은 환자 중 당뇨망막병증이 발견되지 않은 64안을 대상으로 하였으며, 당뇨병이 없는 54안을 대조군으로 하여 비교하였다. 모든 환자에서 SS-OCT와 SS-OCTA를 이용하여 검사를 시행하였다. 결과: 황반의 표층 및 심층 망막혈관의 혈관밀도는 환자군과 대조군 사이에서 차이를 보이지 않았다. 하지만 NFL-GCIPL 두께는 환자군에서 대조군에 비해 통계적으로 의미 있는 감소를 나타냈으며 당뇨병의 이환 기간이 길수록 두께가 얇아져 있음을 확인하였다. 결론: 본 연구의 결과에서 2형 당뇨병 환자에서 당뇨망막병증 발생의 초기 변화에서 신경변성이 일어남을 추측할 수 있다. Purpose: To investigate thickness of the nerve fiber layer-ganglion cell inner plexiform layer (NFL-GCIPL) complex and vessel density of the superficial and deep retinal vessels and choriocapillaris using swept source optical coherence tomography (SS-OCT) and angiography (OCTA) in type 2 diabetic patients without diabetic retinopathy (DR). Methods: Sixty-four eyes of type 2 diabetic patients without DR were included. A control group of 54 eyes without diabetes was also recruited. All patients underwent multimodal imaging evaluation using SS-OCT and OCTA. Results: Vessel density of the superficial and deep retinal vessels was not different between the study and control groups. A significant decrease in NFL-GCIPL complex thickness was observed in the study group compared to the control group. NFL-GCIPL thickness of the macula decreased with increased duration of diabetes. Conclusions: These results suggest that neurodegeneration might be an early change in the development of DR.

삼출성 황반변성에서 이중 망막색소상피파열 및 출혈성 망막박리 후 발생한 급성폐쇄각발작

최유진(Yu-Jin Choi),최영제(Young Je Choi),조용운(Yong Wun Cho),김병선(Byoung Seon Kim),유웅선(Woong-Sun Yoo),정인영(In Young Chung) 대한안과학회 2021 대한안과학회지 Vol.62 No.4

목적: 거대망막색소상피박리가 동반된 삼출성 황반변성에서 유리체강내 주사 후 이중 망막색소상피파열이 발생하였고 출혈성 망막박리와 급성폐쇄각발작을 치료하였기에 이를 보고하고자 한다. 증례요약: 66세 여자가 1달 전부터 시작된 좌안의 시력저하를 주소로 내원하였다. 빛간섭단층촬영과 인도시아닌그린혈관조영술에서 거대망막색소상피박리를 동반한 삼출성 황반변성으로 진단하고 유리체강내 애플리버셉트주입술을 1차 시행하였다. 주사 2주 후 망막색소상피파열이 발생, 이후 2차 주사 4주 후 망막색소상피파열의 범위가 황반부를 포함하여 확대되었다. 3차 주입술 3개월 후 대량의 황반하출혈이 발생하여 4차 주사 시행, 3일 후 안압 60 mmHg 상승과 전방각 폐쇄, 수정체 후면에 접촉되는 출혈성 장액망막박리가 발생하였다. 공막절개술을 이용한 망막하출혈과 망막하액의 배액을 시행하였고, 이후 안압하강과 망막박리의 감소 소견이 보여 경과 관찰 중이다. 결론: 삼출성 황반변성에서 유리체강내 주사 후 이중 망막색소상피파열로 진행되는 경우는 매우 드물다. 이중 망막색소상피파열에서 출혈성 망막박리로 발생한 급성폐쇄각발작으로 안압상승을 경험하고 이를 치료하였기에 보고하고자 한다. Purpose: To report a case of acute angle-closure attack resulting from hemorrhagic retinal detachment after a double retinal pigment epithelium (RPE) tear in exudative age-related macular degeneration (AMD) with large pigment epithelial detachment (PED). Case summary: A 66-year-old female visited with a complaint of poor vision in left eye, which began 1 month prior. She was diagnosed with exudative AMD with a large PED using optical coherence tomography and indocyanine green angiography. Intravitreal aflibercept injection was performed. The RPE tear occurred at 2 weeks after the intravitreal anti-vascular endothelial growth factor injection for AMD, after which the range of the RPE tear expanded and included the macular area at 4 weeks after the second injection. At 3 months after the third injection, massive submacular hemorrhage occurred; aflibercept injection was repeated. At 3 days after the fourth injection, the patient’s intraocular pressure (IOP) was 60 mmHg, and massive hemorrhagic serous retinal detachment and anterior movement of the lens with total angle closure were observed. Therefore, we performed a sclerotomy; a large amount of dark blood and subretinal fluid was drained. The IOP decreased, and the retinal detachment improved somewhat. The patient was kept under observation for careful monitoring of her condition. Conclusions: It is very rare to experience a double RPE rupture after intravitreal anti-vascular endothelial growth factor injection in AMD. We report on our experience and treatment of acute angle-closure attack. The IOP increased due to hemorrhagic retinal detachment after a double RPE tear over the treatment course.

망막분지정맥폐쇄에 동반된 황반부종에서 베바시주맙치료 결과

최유진(Yu-Jin Choi),최영제(Young Je Choi),조용운(Yong Wun Cho),유웅선(Woong-Sun Yoo),정인영(In Young Chung) 대한안과학회 2021 대한안과학회지 Vol.62 No.9

목적: 망막분지정맥폐쇄에 동반된 황반부종에서 유리체내 베바시주맙주입술 방법에 따른 치료 결과를 알아보고자 한다. 대상과 방법: 망막분지정맥폐쇄에서 첫 치료로 유리체내 베바시주맙을 주입한 62명 62안에 관하여 후향적으로 분석하였다. 초기 한 달 간격으로 3회 로딩 치료에 성공한 21안과 그렇지 않은 그룹 41안을 대상으로 주사 전과 주사 후 시기별 최대교정시력 및 빛간섭단층촬영의 소견 변화와 예후 관련인자를 분석하였다. 결과: 최대교정시력은 초기 3회 주입군에서 3회 로딩으로 치료하지 않은 군보다 3개월, 6개월, 12개월째 더 큰 호전을 보였다(p=0.025, p=0.019, p=0.008). 중심황반두께는 6개월째 초기 3회 주입군에서 3회 로딩으로 치료하지 않은 군보다 더 큰 호전을 보였다(p=0.034). 다변량 회귀분석 결과 증상 발현 기간, 3회 로딩, 최대교정시력, 망막내층손상, 맥락막두께가 시력호전 정도와 관련된 예측인자였으며(p=0.044, p=0.047, p=0.004, p=0.045, p=0.034), 연령, 3회 로딩, 최대교정시력, 망막내층손상이 최종 시력과 관련된 예측인자로 나타났다(p=0.045, p=0.046, p=0.002, p=0.034). 증상 발현 기간, 중심황반두께, 맥락막두께가 중심황반두께 호전에 관련된 예측인자로 나타났다(p=0.042, p=0.009, p=0.015). 결론: 망막분지정맥폐쇄의 황반부종에서 유리체내 베바시주맙 초기 3회 주입은 3회 로딩으로 치료하지 않은 방법에 비하여 단기적인 기능적 및 해부학적 호전과 장기적인 기능적 호전에 치료 우위적 효과를 보였다. Purpose: To evaluate the results of treatment according to the method of intravitreal injection of bevacizumab for macular edema due to branch retinal vein occlusion (BRVO). Methods: The clinical records of macular edema patients were analyzed retrospectively for a total of 62 eyes of 62 patients who were injected with bevacizumab into the vitreous as the first treatment for BRVO. Best-corrected visual acuity (BCVA), the findings of spectral-domain optical coherence tomography before and after injection, and prognosis-related factors were evaluated for 21 eyes that received the initial three monthly loading treatments and the 41 eyes that did not. Results: Significant improvement in BCVA was observed in the group having received the initial three injections compared with the group who did not receive the injections at 3, 6, and 12 months (p = 0.025, p = 0.019, and p = 0.008, respectively). The central macular thickness (CMT) showed greater improvement in the initial three injections group than the group without at 6 months (p = 0.034). Multivariate regression showed that the duration from the onset, the three loadings, BCVA, disorganization of the retinal inner layer (DRIL), and choroidal thickness were predictors related to visual gain (p = 0.044, p = 0.047, p = 0.004, p = 0.045, and p = 0.034, respectively). Age, three loadings, BCVA, and DRIL were predictors related to final visual acuity (p = 0.045, p = 0.046, p = 0.002, and p = 0.034, respectively). Duration from the onset, CMT, and choroidal thickness were predictors related to CMT improvement (p = 0.042, p = 0.009, and p = 0.015, respectively). Conclusions: In macular edema of BRVO, the initial three monthly intravitreal injections of bevacizumab provided superior treatment outcomes regarding short-term functional and anatomical improvements and long-term functional improvement, compared with methods that did not treat with the initial three monthly injections.

결막편평세포유두종 절제 병력이 있는 젊은 환자에서 발생한 누낭 편평세포암종

이동우(Dong Woo Lee),박미화(Mi Hwa Park),조용운(Yong Wun Cho),김성재(Seong Jae Kim),서성욱(Seong Wook Seo) 대한안과학회 2021 대한안과학회지 Vol.62 No.5

목적: 젊은 환자에서 흔하게 나타나지 않는 누낭 편평세포암종을 경험하여 이를 보고하고자 한다. 증례요약: 15년 전 하비측 결막편평세포유두종을 절제한 적 있는 30세 여자 환자가 1주 전부터 발생한 우측 하부눈물길 부위의 통증과 종괴를 주소로 내원하였다. 누낭염 의심하에 10일간 항생제 치료하였으며, 영상학적 검사상 비루관폐쇄 진단받은 후 1.7 × 1.7 cm 크기의 누관 낭종, 누낭류 의심 소견으로 내시경하 누낭비강연결술과 절제생검을 시행하였다. 조직병리학적 검사 결과상 초기 침습적 편평세포암종으로 진단되어 이후 추가적인 절제생검을 시행하였다. 암종으로 진단된 종괴는 완전절제를 시행하였으며, 절제된 주위로 악성 세포가 없음을 확인하였다. 결론: 누낭 편평세포암종은 드물게 나타나며 젊은 환자에게서는 더 흔하지 않은 것으로 알려져 있다. 본 증례를 통해 연령과 상관없이 누낭의 악성 종양 발생 가능성을 배제해서는 안 될 것으로 생각되며, 누낭 편평세포암종은 고위험 사람유두종바이러스와 연관성이 있기에 결막편평세포유두종의 병력이 있는 경우 고려해야 되는 질환으로 생각된다. Purpose: To report a squamous cell carcinoma in the lacrimal sac of a young patient. Case summary: A 30-year-old female patient who had a history of conjunctival squamous papilloma resected at 15 years of age complained of pain and a mass around the right lacrimal sac that had occurred 1 week prior. Antibiotic treatment for 10 days under suspicion of dacryocystitis did not relieve her symptoms. After being diagnosed with lacrimal sac obstruction after dacryocystography, a 1.7 × 1.7 cm round mass was found on orbit non-contrast computed tomography. Endonasal dacryocystorhinostomy and excisional biopsy were performed. Histopathological examination revealed the initial invasive squamous cell carcinoma. An additional resected tissue biopsy was performed later. The mass diagnosed as carcinoma was completely resected and it was confirmed that there were no malignant cells around the resected area. Conclusions: Squamous cell carcinoma of the lacrimal sac is rare and is known to be less common in young patients. It is believed that this case should not exclude the possibility of malignant tumors of the lacrimal sac regardless of age. Given that squamous cell carcinoma of the lacrimal sac is associated with a high-risk of human papillomavirus, this disease should be considered if there is a history of papilloma.

처음 진단된 습성 나이관련황반변성에서 라니비주맙 치료 및 연장 방법의 1년 결과 : 후향적 연구

최영제(Young-Je Choi),유웅선(Woong-Sun Yoo),조용운(Yong-Wun Cho),최유진(Yu-Jin Choi),정인영(In Young Chung) 대한안과학회 2021 대한안과학회지 Vol.62 No.7

목적: 습성 나이관련황반변성에서 라니비주맙 치료 및 연장 방법의 1년 결과와 같은 기간 내 약제를 변경하여 치료한 경우 임상결과를 알아보고자 하였다. 대상과 방법: 습성 나이관련황반변성으로 처음 진단되고 라니비주맙 치료 및 연장 방법으로 1년 이상 치료한 32안과 같은 기간 내에 약제를 변경하여 치료한 24안을 대상으로 주사 횟수, 중심망막두께 변화, 최대교정시력 변화를 후향적으로 분석하였다. 결과: 라니비주맙 치료 및 연장 방법으로 치료한 32안은 초기 최대교정시력은 평균 59.46 ± 15.13글자에서 12개월에 68.00 ± 12.48글자로 향상되었다. 초기 중심망막두께는 평균 409 ± 141 μm였고, 12개월에 273 ± 89 μm로 감소하였다. 1년간 평균 주사 회수는 7.2 ± 0.85회였다. 12개월간 주사와 관련된 합병증은 망막색소상피 찢겨짐이 1건 관찰되었으며, 전신적인 합병증은 관찰되지 않았다. 약제를 변경한 24안 중 애플리버셉트 3회 주사를 시행한 12안에서 초기 시력이 호전되거나 보존할 수 있었던 비율은 83% (10안)였으며, 중심망막두께는 초기 371.58 ± 109.96에서 290.33 ± 58.66으로 호전을 보였다. 결론: 1년간의 관찰에서 습성 나이관련황반변성에서 라니비주맙 치료 및 연장 방법은 효과적이고, 애플리버셉트로 변경한 경우 단기간의 결과 시력을 유지하는 경우가 많고, 해부학적 호전을 보일 수 있음을 알 수 있었다. Purpose: This study investigated the 1-year outcomes of a treat-and-extend regimen of ranibizumab for exudative age-related macular degeneration and examined the clinical results when drug treatment was changed within the same period. Methods: This retrospective analysis included 32 eyes first diagnosed with wet age-related macular degeneration and treated for more than 1 year with a treat-and-extend regimen of ranibizumab, as well as 24 eyes treated by changing from ranibizumab to aflibercept within the same period. The injection number, maximum injection interval, change in central retinal thickness, and best-corrected visual acuity were assessed in all eyes. Results: In 32 eyes that received a treat-and-extend regimen of ranibizumab, the mean best-corrected visual acuity improved from 59.46 ± 15.13 to 68.00 ± 12.48 at 12 months (p < 0.0001). The mean central retinal thickness decreased from 409 ± 141 μm to 273 ± 89 μm at 12 months (p < 0.0001). The average number of injections per year was 7.2 ± 0.85. One complication related to the 12 months of injections was a tear in the retinal pigment epithelium; no systemic complications were observed. Of 24 eyes that underwent a change in medication, the rate of maintenance or improvement in initial visual acuity was 83% (10 eyes). The central retinal thickness was initially 371.58 ± 109.96 μm, but improved to 290.33 ± 58.66 μm in 12 eyes that received three injections of aflibercept. Conclusions: At 1 year, good outcomes were obtained using treat-and-extend ranibizumab for exudative age-related macular degeneration. When the treatment was changed to aflibercept within the same period, vision was often maintained and short-term anatomical improvement was evident.