Nan-Kai Wang

Acute syphilitic posterior placoid chorioretinopathy mimicking central serous chorioretinopathy: A case report

A 51-year-old man had experienced declining visual acuity for 4 months. His best-corrected visual acuity was 20/40 in both eyes. Ophthalmoscopic examination showed a yellowish placoid lesion over the macular area, and spectral-domain optical coherence tomography (SD-OCT) revealed subretinal fluid accumulation in the left eye, which resembled that seen with central serous chorioretinopathy (CSCR). Three days later, fluorescein angiography (FA) revealed fluorescein leakage, and indocyanine green angiography (ICGA) showed hypofluorescence over the lesion. Persistent ellipsoid zone loss as spontaneously resolved subretinal fluid was noted at the same time with SD-OCT. Laboratory examination disclosed positive rapid plasma reagin and Treponema pallidum particle agglutination tests (titer >1:1280), which confirmed the diagnosis of ocular syphilis. Acute syphilitic posterior placoid chorioretinopathy (ASPPC) could mimic CSCR with spontaneously resolved subretinal fluid observed in SD-OCT images. The acute loss of the ellipsoid zone, mismatched results from SD-OCT and FA, and picture of retinitis can also provide hints for differentiating the two diseases.

Nomogram for prediction of non-proliferative diabetic retinopathy in juvenile-onset type 1 diabetes: a cohort study in an Asian population

The need for screening for retinopathy in patients with type 1 diabetes mellitus (T1DM) has been emphasised, but diagnostic delays were reported when screening was done at fixed intervals. To establish an individualised risk-prediction model to assist screening non-proliferative diabetic retinopathy (NPDR) in T1DM, we performed a retrospective cohort study enrolling participants in the Chang Gung Juvenile Diabetes Eye Study. There were 413 patients with 12 381 records analysed from 2005 to 2015. A time-dependent Cox proportional hazard analysis was used to evaluate the risks of NPDR development and a nomogram with risk-stratification indicators was established based on the results. During 97 months of follow-up, 43 of 413 patients (10.4%) developed NPDR. Male sex (HR: 0.4, 95% CI: 0.19–0.85), age 5–14 years at onset of T1DM (6.38, 2.41–16.87), duration of diabetes (1.57, 1.41–1.75), and hemoglobin A1c level (1.56, 1.35–1.80) were independently associated with NPDR. Using the nomogram offers a quick method in the clinical setting to interpret the risk of NPDR development. Based on its weighting, each of the independent factors is allocated a score, and the total points indicate the probabilities of NPDR occurring within 6 months, 1 year, and 3 years.

Retinopathy of Prematurity Trends in Taiwan: A 10-Year Nationwide Population Study

PurposenTo investigate the 10-year epidemiology and risk factors of retinopathy of prematurity (ROP) in Taiwan using the National Health Insurance Research Database.nnnMethodsnAll premature infants (n = 34,192) from 2002 to 2011 were screened, and those with length of stay (LOS) longer than 28 days who survived after the initial discharge were enrolled (n = 11,180). The annual incidence of ROP and the risk factors associated with it were analyzed.nnnResultsnA total of 4096 ROP infants, 36.6% of premature babies with LOS longer than 28 days, were identified. The numbers of newborns, premature infants, and cases with ROP decreased over time, but the proportion of extremely low birth weight infants increased over time (P < 0.01 for test of trend in number). Also, the proportion of ROP infants receiving treatment increased over time (P < 0.01 for test of trend in number). However, the incidence of ROP was steady throughout the study period. Multivariable analysis revealed that low birth weight, male sex (odds ratio [OR] = 1.12, P = 0.007), and multiparity (OR = 1.17, P = 0.002) were positively associated with ROP, whereas necrotizing enterocolitis (OR = 0.72, P = 0.002) had a negative association with ROP.nnnConclusionsnThe average incidence of ROP from 2002 to 2011 in Taiwan showed no significant change over the 10-year period. Proportion of treatment-requiring ROP increased. Low birth weight, multiparity, and male sex were independent risk factors of ROP.

The intraocular staining potential of anthocyanins and their retinal biocompatibility: a preclinical study

Abstract Purpose: To perform preclinical studies to determine the efficacy and safety of anthocyanins as stains for the internal limiting membrane (ILM) of the eye. Materials and methods: Cyanidin (Cya), delphinidin (Del), luteolinidin (Lut), peonidin (Peo) and pelargonidin (Pel) were evaluated. These natural dyes were used to stain the lens capsule and ILM of pig eyes. The effects of these dyes on retinal cell viability was determined using a water-soluble tetrazolium salt assay, and oxidative stress was measured in vitro. Histopathology, in situ TUNEL labelling, transmission electronic microscopy (TEM), and electroretinography (ERG) were performed on rats following the intravitreal and subretinal injection of the neuroprotective dyes. Results: All anthocyanins stained the lens capsule and ILM of the pigs at a concentration of 1u2009mg/ml. Del, Lut and Peo were non-toxic and produced survival rates in the ARPE19 and RGC5 cells that were similar to those in control cells. We treated eyes with H2O2 and three dyes (Del, Lut, and Peo) to explore the possible neuroprotective effects and observed significantly higher survival rates in the ARPE19 cells treated with Del, Lut or Peo and the RGC5 cells treated with Lut or Peo than those in the control cells. Three dyes were intravitreally and subretinally injected into rats in vivo, and the histology showed mildly disorganized retinal cell layers. TUNEL staining and TEM examinations did not reveal additional toxic effects. Rat ERGs were not altered after intravitreal injections. Conclusions: This preclinical study, Del, Lut, and Peo show potential as staining agents and warrant further investigation as vital dyes.

Refractory macular hole repaired by autologous retinal graft and blood clot

BackgroundTo evaluate the surgical technique using autologous retinal graft (ARG) and autologous blood clot (ABC) for the management of refractory macular holes (MHs).MethodsThis study was a retrospective, consecutive, interventional case series. Six eyes of 6 patients who underwent vitrectomy combined with ARG and ABC for the treatment of refractory MH were reviewed. Visual and anatomic outcomes were evaluated.ResultsThe mean age was 59.0u2009±u20099.9xa0years. All cases had multiple vitreoretinal procedures including vitrectomy and gas fluid exchange before patient presentation. The average numbers of vitrectomies were 2.3u2009±u20090.5, and those of gas fluid exchange were 3u2009±u20091.7. Closure of the macular hole was achieved in four (66.7%) cases at last follow-up. The mean follow-up time was 25.2u2009±u200915.6xa0months. The averaged BCVA before and after 12xa0months of the surgery improved from 20/591 to 20/244.ConclusionsThis surgical technique using ARG and ABC provide an option for the treatment of refractory MHs.