Po-Liang Chen

Hyperbaric oxygen therapy ameliorates the blood-retinal barrier breakdown in diabetic retinopathy.

Background:  To study the effect of hyperbaric oxygen (HBO) therapy on diabetic retinopathy in a streptozotocin‐induced diabetic rat model.

Impact of Cylinder Axis on the Treatment for Astigmatic Amblyopia

PURPOSE To compare the effects of oblique astigmatism on refractive amblyopia in children aged 3-7 years with those having orthogonal astigmatism. DESIGN A retrospective review of medical records. METHODS The medical records of patients attending Tri-Service General Hospital in Taiwan from January 2003 to December 2010 were reviewed and summarized. Seventy-two children with oblique astigmatism-related refractive amblyopia (Group 1) and 82 children with orthogonal astigmatism (Group 2) were chosen. Characteristics such as baseline visual acuity (VA), the time course of VA improvement, refractive error, and family history were assessed. RESULTS Group 1 showed a worse baseline mean VA (±SD) of 0.61 (0.13) vs 0.52 (0.16) logMAR (P = .01), a slower rate of amblyopia improvement, and higher prevalence of parental oblique astigmatism (29% vs 5.5%; P < .01) than did Group 2. The cylinder power of astigmatism (in D) causing amblyopia in Group 1 of 2.48 (0.82) was lower than that in Group 2: 2.93 (0.71) (P = .006). However, Group 1 achieved a noninferior resolution of amblyopia (mean final VA 0.18 vs 0.16 logMAR) after longer treatment of 6.45 (2.44) vs 5.86 (2.92) months (P = .039). CONCLUSIONS A smaller degree of initial oblique astigmatism caused amblyopia than did orthogonal astigmatism. Although the children with oblique astigmatism achieved equal resolution rates after treatment, this took longer. Therefore, we should pay more attention to children with mild oblique astigmatism, as they are more likely to develop oblique astigmatism-related amblyopia. Moreover, early diagnosis and prompt treatment might help visual improvement.

Influence of Protein and Immunoglobulin a Deposition on Female Patient Comfort and Satisfaction: Comparison of Conventional and 2-Week Disposable Soft Contact Lenses

Purpose: We would like to compare (a) the deposition of total protein and immunoglobulin A (IgA), (b) the changing of clinical symptoms and comfort on conventional soft contact lenses (CSCL) and 2-week disposable soft contact lenses (TWSCL). Methods: One hundred and six women (mean age 25.3±8.7 years) with myopia, spherical equivalents less than -10 D and astigmatism less than -1.5 D, who wore CSCL at least 8 months, were recruited for the study. After undergoing baseline examination (including slit-lamp assessment and evaluation of refractive status and corrected visual acuity), the women were refitted with TWSCL. All female patients underwent follow-up examination 2 weeks later. Proteins deposited on the original CSCL as well as on the newly refitted disposable lenses collected during follow-up were analyzed. Results: More protein (57.03 vs 14.51 μg/lens) and IgA (380.90 vs 260.49 ng/lens) was deposited on the CSCL than on the TWSCL (reductions of approximately 75% and 32%, respectively), but the IgA-protein ratio was 1.5-fold higher on the disposable lenses than on the CSCL (P＜0.05, paired-sample test). Contact lens-associated symptoms (eg, discharge, pain, and discomfort) improved for wearers of the disposable lenses. Conclusions: In general, protein and IgA deposition were less on the 2-week disposable soft contact lens than on the 8-month conventional soft contact lens. Concomitant improvement in clinical symptoms was noted when patients changed from CSCL to TWSCL. TWSCL might improve patient comfort and satisfaction.

Juxtapapillary Choroidal Melanoma-A Case Report

Purpose: To report a case of medium size of juxtapapillary choroidal melanoma. Method: Retrospective review of literatures. Result: Fundus examination of a 36-year-old female revealed a dome-shaped and pigmented subretinal lesion straddling the superonasal retina with disc insertion in the right eye. Ultrasonography showed an acoustically hollow lesion with initial high amplitude echoes and low-amplitude internal reflections. Based on clinical and ultrasonographic findings, the diagnosis was choroidal melanoma. The eye was enucleated. Histopathologic examination revealed a picture of malignant melanoma of choroid characterized by prominent nuclei and nucleoli (Spindle B cells). Conclusion: Treatment of melanomas should be directed toward minimizing the potential for recurrence and metastasis. However, few literatures have reported the treatment of jaxtapapillary choroidal melanoma. With the uncertain outcome of conservative treatment, the patient was treated with enucleation.

Anterior Capsular Phimosis after Successful Surgery for a Patient with Traumatic Cataract: Case Report

A patient received successful cataract surgery with a silicone intraocular lens (IOL) implantation for treating traumatic cataract and partial zonular damage, but severe anterior capsule phimosis developed six months later. To restore vision, the encapsulated IOL was removed and a second implantation was performed using sulcus fixation. Gross examination of the encapsulated IOL disclosed severe anterior capsule contraction and multiple linear fibrous bands radiating from the central opening of the capsulorrhexis. Histology showed some reserved lens epithelial cells beneath the basement membrane and multilayered spindle-shaped fibroblast-like cells within the myxoid and hyaline matrix. Thus, even performing a perfect capsulorrhexis and maintaining an intact IOL capsule bag could not avoid anterior capsule opacification.

A Comparison between Early Trabeculectomy with Mitomycin and Medical Treatment in Young Patients with Glaucoma

Background: The aim of this study is to compare the clinical outcome of early mitomycin-augmanted trabeculectomy to medications in glaucoma of the youth. Methods: Twenty-two young patients (average 23.1±4.8 years old) with glaucoma of both eyes, totally 44 eyes, were enrolled and followed up for three years in this study. Each patient underwent trabeculectomy in one eye, with the use of intra-operative mitomycin-C (0.4mg/ml×1 minute), and traditional medications in the other eye. Results: After surgery, 18 operated eyes with intraocular pressure less than 20 mmHg were considered as success (success rate at 81.8%). In the follow-up of these 18 patients, the decrease of the mean intraocular pressure by trabeculectomy was more than that by medications. The mean sensitivity loss in visual field examination was less in the operated than the medicated eyes. However, there were no significant differences in the cup-disc ratio between operated and medicated eyes. Conclusion: Our results suggested that early mitomycin-augmented trabeculectomy was more effective than traditional medication in delaying progression of visual field in young patients with glaucoma. Thus, early trabeculectomy could be an alternative, even the better choice, to medication in treating glaucoma of youths.