Shih-Hao Wang

Genetic Characteristics in Children with Cochlear Implants and the Corresponding Auditory Performance

To explore the genetic characteristics of children with cochlear implants (CIs) and to correlate the auditory performance after implantation to the genetic diagnosis of children with CIs.

Mutation screening of the EYA1, SIX1, and SIX5 genes in an east asian cohort with branchio‐oto‐renal syndrome

To explore the genetic characteristics of branchio‐oto‐renal (BOR) syndrome in an East Asian population.

The changes of red blood cell viscoelasticity and sports anemia in male 24-hr ultra-marathoners

Background: In endurance sports, stress, dehydration and release of chemical factors have been associated with red blood cell (RBC) alterations of structure and function, which may contribute to sports anemia, a well‐observed phenomenon during long‐distance running. Until now, the investigation of the changes of viscoelastic properties of RBC membrane, a decisive factor of RBC deformability to avoid hemolysis, is lacking, especially in an Oriental population. Methods: nineteen runners were prospectively recruited into our study. Hematological parameters were analyzed before and immediately after the 2015 Taipei 24H Ultra‐Marathon Festival, Taiwan. Video particle tracking microrheology was used to determine viscoelastic properties of each RBC sample by calculating the dynamic elastic modulus G′(f) and the viscous modulus G″(f) at frequency f = 20 Hz. Results: Haptoglobin, RBC count, hemoglobin, hematocrit, mean cell hemoglobin, plasma free hemoglobin and unsaturated iron‐binding capacity values of the recruited runners showed a statistically significant drop in the post‐race values. Blood concentration of reticulocyte and ferritin were significantly higher at post‐race compared with pre‐race. 15 out of the 19 runners had a concurrent change in the elastic and the viscous moduli of their RBCs. Changes in the elastic and the viscous moduli were correlated with changes in the RBC count, hemoglobin and hematocrit. Conclusion: Viscoelasticity properties, the elastic modulus G′(f) and the viscous modulus G″(f) of RBCs are associated with endurance exercise‐induced anemia.

Airbag-Associated Severe Blunt Eye Injury Causes Choroidal Rupture and Retinal Hemorrhage: A Case Report

A case of choroidal rupture caused by airbag-associated blunt eye trauma and complicated with massive subretinal hemorrhage and vitreous hemorrhage that was successfully treated with intravitreal injection of expansile gas and bevacizumab is presented. A 53-year-old man suffered from loss of vision in his right eye due to blunt eye trauma by a safety airbag after a traffic accident. On initial examination, the patient had no light perception in his right eye. Dilated ophthalmoscopy revealed massive subretinal hemorrhage with macular invasion and faint vitreous hemorrhage. We performed intravitreal injection of pure sulfur hexafluoride twice for displacement, after which visual acuity improved to 0.03. For persistent subretinal hemorrhage and suspicion of choroidal neovascularization (CNV), intravitreal bevacizumab (1.25 mg/0.05 mL) injection was administered. After 3 weeks, the visual acuity of his right eye recovered to 0.4. For early-stage choroidal rupture-induced subretinal hemorrhage and complications of suspected CNV, intravitreal injection of expandable gas and intraocular injection of antiangiogenesis drugs seem to be an effective treatment.

Tracheal transection caused by clothesline injury

A 30-year-old motorcyclist was referred to our emergency department after he struck his neck on a rope at night. Apart from mild dyspnea and hoarseness, his vital signs were stable. There was a 7-cm shallow laceration across the lower neck with erythematous welt (Fig. 1A). Subcutaneous emphysema from the lower neck to the upper chest wall with palpable crepitus was also found. Fiberoptic laryngoscope revealed bilateral vocal folds palsy with intact endolaryngeal structures. Plain radiographs of chest and neck revealed subcutaneous emphysema mainly at the left lower neck without pneumomediastinum or pneumothorax. Language: en

Major ocular trauma in Taiwan: 2002–2004 versus 2012–2014

We investigated the temporal changes in major eye injuries in Taiwan by reviewing the medical records of all patients with ocular trauma hospitalized at the National Cheng Kung University Hospital during 2002–2004 and 2012–2014. A total of 169 eyes (161 patients) during 2002–2004 and 121 eyes (120 patients) during 2012–2014 were enrolled (meanu2009±u2009SD age: 41.9u2009±u200920.8 years in 2002–2004, and 51.8u2009±u200919.3 years in 2012–2014). Males accounted for ~75% of patients. The most frequent injury-causing object was metallic material (~24%), and blunt traumas were most frequently attributable to traffic accidents and falls. The most common locations of injuries for males and females were the workplace and home, respectively. Open-globe injuries occurred in ~70% of eyes, requiring primary repair, cataract extraction, and/or intraocular lens implantation. The frequencies of fall injury, lacrimal system laceration, lens injury, corneal/scleral foreign bodies, and use of intracameral antibiotics increased from 2002–2004 to 2012–2014, while those of closed-globe injury, vitreous haemorrhage, optic nerve injury, and medical treatment decreased. The final visual acuity remained poor (≤20/200) in >1/3 of injured eyes. Despite therapeutic advancements, major eye injuries still pose a high risk for poor visual outcome.

Real-world use of ranibizumab for neovascular age-related macular degeneration in Taiwan

This study investigated the “real-world” use of ranibizumab for neovascular age-related macular degeneration (nAMD) in Taiwan and assessed the visual outcome. We reviewed the medical records at National Cheng Kung University Hospital, Taiwan, during 2012–2014 for 264 consecutive eyes of 229 patients with nAMD, who applied for ranibizumab covered by national health insurance. A total of 194 eyes (73.5%) in 179 patients (65.5% men; meanu2009±u2009standard deviation age 69.4u2009±u200910.7 years) were pre-approved for treatment. Applications for treatment increased year by year, but approval rates decreased during this time. The major causes of rejection for funding were diseases mimicking nAMD, including macular pucker/epiretinal membrane, macular scarring, dry-type AMD, and possible polypoidal choroidal vasculopathy. After completion of three injections in 147 eyes, visual acuity significantly improved, gaining ≥1 line in 51.8% of eyes and stabilising in 38.3% of 141 eyes in which visual acuity was measured. The 114 eyes approved with only one application had a better visual outcome than the 27 eyes approved after the second or third applications. In conclusion, ranibizumab is effective for nAMD; however, approval after the second or third application for national health insurance cover is a less favourable predictor of visual outcome.

Author Correction: Major ocular trauma in Taiwan: 2002–2004 versus 2012–2014

A correction to this article has been published and is linked from the HTML and PDF versions of this paper. The error has not been fixed in the paper.

Airbag-assoziierte schwere stumpfe Augenverletzung verursacht Aderhautruptur und Netzhautblutung: Ein Fallbericht

Wir stellen hier den Fall einer Aderhautruptur vor, die durch ein Airbag-assoziiertes stumpfes Augentrauma verursacht und durch massive subretinale und Glaskörperblutungen kompliziert wurde; die Behandlung mittels intravitrealer Injektion von Expansionsgas und Bevacizumab verlief erfolgreich. Ein 53-jähriger Mann klagte über Sehverlust im rechten Auge, nachdem er bei einem Autounfall ein stumpfes Augentrauma durch einen Sicherheitsairbag erlitt. Bei der initialen Untersuchung hatte der Patient keine Lichtwahrnehmung im rechten Auge. In der dilatierten Ophthalmoskopie zeigten sich massive subretinale Blutungen mit Makulainvasion und schwacher Glaskörperblutung. Wir nahmen 2 intravitreale Injektionen von reinem Schwefelhexafluorid mit dem Ziel der Verdrängung vor, danach verbesserte sich die Sehschärfe auf 0,03. Wegen persistierender subretinaler Blutung und Verdacht auf choroidale Neovaskularisation (CNV) wurde Bevacizumab (1,25 mg/0,05 ml) intravitreal injiziert. Nach 3 Wochen hatte sich die Sehschärfe im rechten Auge des Patienten wieder auf 0,4 verbessert. Bei früher Aderhautruptur-induzierter subretinaler Blutung und Verdacht auf CNV als Komplikation scheint die intravitreale Injektion von Expansionsgas in Verbindung mit der intraokularen Injektion von Angiogenesehemmern ein wirksames therapeutisches Vorgehen zu sein. Übersetzung aus Case Rep Ophthalmol 2017;8:13-20 (DOI:10.1159/000452652)

Motorized injector-assisted intrascleral intraocular lens fixation

For eyes with deficient capsular support, intraocular lens (IOL) implantation has long been a technical challenge. Recently, intrascleral fixation of the haptics of a three‐piece posterior chamber IOL has become a popular option. In this procedure, externalization of the leading haptic during IOL injection is a stressful step. We present a modified technique to improve the ease and safety of this step. Our modified technique involves IOL injection with a motorized injector with several important modifications described here. With these modifications, a surgeon can easily maintain the correct orientation of the IOL in a well‐controlled manner during IOL injection. The records of 13 patients who underwent this technique were retrospectively evaluated. Corrected‐distance visual acuity improved significantly after surgery (p < 0.05). No postoperative retinal detachment, endophthalmitis, IOL decentration, or vitreous hemorrhage was noted during the follow‐up period. In conclusion, the motorized injector‐assisted intrascleral IOL fixation technique is a safe and effective alternative to the conventional procedure. This technique makes the process of leading haptic externalization easier and more controllable.