Yung-Jen Chen

Visual acuity as measured with Landolt C chart and Early Treatment of Diabetic Retinopathy Study (ETDRS) chart

BackgroundWe compared the Landolt C chart checked under normal clinical conditions and the Early Treatment of Diabetic Retinopathy Study (ETDRS) chart, using standard clinical research protocols for subjects with normal vision, cataract and maculopathy.MethodsThis prospective, comparative study was approved by the hospital Institutional Review Board. Patients with cataract and maculopathy were included, with the normal fellow eyes analyzed as normal vision group. Differences between the two charts were analyzed using Student’s t-test.ResultsNormal and cataract eyes showed no statistically significant differences between methods. In the maculopathy group, ETDRS acuity (0.714u2009±u20090.393) was better than Landolt C acuity (0.845u2009±u20090.579), but the differences were not statistically significant (pu2009=u20090.152). Furthermore, if after dividing visual acuity into subgroups, >20/200 andu2009≤20/200 by Landolt C acuity, the latter subgroup had significant differences between the two tests (pu2009<u20090.001). ETDRS acuity (1.014u2009±u20090.319) was better than Landolt C acuity (1.419u2009±u20090.385). The average acuity difference was 4 lines.ConclusionsFor maculopathy patients with VAu2009≤u200920/200, the ETDRS chart had a better score than the Landolt C chart.

Serum uric acid concentration is associated with worsening in severity of diabetic retinopathy among type 2 diabetic patients in Taiwan--a 3-year prospective study.

AIMSnTo explore the role of serum uric acid (SUA) concentration in diabetic retinopathy (DR) for patients with type 2 diabetes mellitus (T2DM).nnnMETHODSnA 3-year prospective study in 749 patients with T2DM and without proliferative diabetic retinopathy (PDR) was conducted at a medical center. Baseline SUA concentration and parameters of glycemic control, blood pressure, kidney disease, and lipid profiles were analyzed to determine their contribution to DR.nnnRESULTSnFundus examination showed that 184 patients (24.6%) had non-proliferative retinopathy and 565 (75.4%) without DR at baseline. After 3 years, increase in the severity of DR was recognized in 103 patients (13.8%), including 81 patients with newly developed DR. Patients with increase in severity of DR positively associated with duration of DM (11.9 vs. 9.4 years, p = 0.001), HbA1c (7.6 vs. 7.2%, p = 0.001), albuminuria (45.5 vs. 31.0%, p = 0.006), and SUA (6.47 vs. 5.87 mg/dl, p<0.001) than did those without change in DR stage. Cox regression showed that patients with SUA in the 3rd (5.9-6.9 mg/dl) and 4th (≥ 7.0mg/dl) quartiles had hazard ratios for DR worsening of 2.57 and 3.66 (95% C.I. 1.30-5.08 and 1.92-7.00) when compared with patients with SUA in the 1st quartile (<4.9 mg/dl).nnnCONCLUSIONSnSUA concentration is associated with the increase in severity of DR over a 3-year period in patients with T2DM. Further study is required to define the exact role of SUA in DR.

Subthreshold transpupillary thermotherapy in Chinese patients with myopic choroidal neovascularization: one- and two-year follow up

Background:u2002 To perform a safety and efficacy study of subthreshold transpupillary thermotherapy (TTT) in Chinese patients with choroidal neovascularization (CNV) secondary to pathologic myopia.

The flicker electroretinogram interocular amplitude ratio is a strong prognostic indicator of neovascularization in patients with central retinal vein occlusion

BackgroundTo evaluate the prognostic value of interocular amplitude ratio of flicker electroretinogram (ERG) in determining the development of neovascularization in patients with central retinal vein occlusion (CRVO).MethodsWe retrospectively reviewed the data obtained from flicker ERG in 51 CRVO patients. Of these, 22 eyes which had enough follow-up to differentiate ischemic CRVO from nonischemic CRVO were included for data analysis. The flicker ERG was recorded at a 30xa0Hz frequency after dark adaptation, and ten sweeps were averaged.ResultsEleven eyes were ischemic and 11 eyes were nonischemic. Three amplitude parameters had the potential to explain the type of CRVO. They were amplitude of lesion eye (pu2009=u20090.0001), interocular difference of amplitude (pu2009<u20090.0001), and interocular ratio of amplitude (pu2009<u20090.0001). Both an interocular amplitude difference of u2009−23xa0μV and interocular amplitude ratio of 60% were very good cutoff points to differentiate ischemic from nonischemic CRVO. Receiver operating characteristic curve analysis revealed that each of the two cutoff values had a sensitivity and specificity of 100%.ConclusionsInterocular comparison of amplitude is a good solution for avoiding the variability of ERG. An interocular amplitude ratio of flicker ERG of 60% is a succinct, useful parameter in clinical practices for differentiating ischemic from nonischemic CRVO.

Factors associated with corneal epithelial defects after pars plana vitrectomy

PurposeTo investigate the risk factors associated with corneal epithelial defects (CED) and delayed healing (exceeding 1xa0week) following pars plana vitrectomy (PPV).MethodsThis retrospective study enrolled patients who underwent PPV at a single center in Taiwan between 2011 and 2012. Medical records were reviewed, including demographic, underlying disease, surgical indication, operation parameters, and existence of CED. These data were statistically analyzed. All patients were evaluated during follow-ups at day 1 and week 1 after PPV. Patients with persistent CED 1xa0week after PPV were diagnosed with delayed healing.ResultsA total of 255 patients were included in the study, consisting of 139 men and 116 women, with a mean age of 56.9xa0years. PPV was performed under the indications of rhegmatogenous retinal detachment (RRD), diabetic retinopathy, or vitreoretinal interface disease. Out of 255 eyes, 59 developed CED 1xa0day after surgery (23.1%), and CED was associated with younger age, diabetes mellitus (DM), RRD, longer duration of surgery, and silicon oil use during surgery. Among them, seven patients (11.9%) demonstrated delayed healing, which was associated with a higher rate of DM (pxa0=xa00.085), compared to patients who healed within 1xa0week.ConclusionPatients with RRD, longer duration of surgery, and DM may be at risk of developing CED after PPV. In addition, patients with DM demonstrated a higher incidence of delayed corneal healing.

Retinal Detachment Associated With Basketball-Related Eye Trauma.

PURPOSEnBasketball is a popular sport involving significant body contact, which may frequently result in ocular trauma. The aim of this study was to evaluate the characteristics and visual outcomes of retinal detachment associated with basketball-related injury.nnnDESIGNnRetrospective, interventional case series.nnnMETHODSnWe reviewed the course of patients who sustained traumatic retinal detachment from basketball-related ocular trauma between 2003 and 2015.nnnRESULTSnThirteen patients were evaluated for basketball-related traumatic retinal detachment. Twelve (92%) were male and 1 (8%) female, with an average age of 18.2 years. The majority (9 of 13, 70%) of patients had moderate-to-high myopia, and none were using protective eyewear when they sustained the eye trauma. Rhegmatogenous retinal detachment was observed in all eyes. The preoperative mean visual acuity was 20/625 (range, hand motions to 20/20). Initial surgery using scleral buckling alone was performed in most (8 of 13, 62%) of the patients. Retinal reattachment was achieved in 10 (76%) eyes after the first operation and in 12 (92%) at the end of the intervention. The mean follow-up was 3.9 years (range, 4xa0months to 12 years). The visual acuity during last follow-up was 20/231 (range, light perception to 20/20). In the multivariable analysis, initial visual acuity was an independent factor affecting the final visual outcome (Pxa0= .006).nnnCONCLUSIONnRetinal detachment associated with basketball-related injury may cause severe visual loss. In the current study, all retinal detachments were of rhegmatogenous type and commonly occurred in young individuals with myopia. Initial visual acuity was associated with the prognosis. Risk awareness for early detection and intervention are important in these traumas.

Fixation behavior in macular dystrophy assessed by microperimetry

PurposeTo investigate the fixation behavior in macular dystrophy using microperimetry.MethodsThis retrospective study included patients with macular dystrophy and unilateral macular pucker. Macular dystrophic eyes were compared based on fixation within or outside of the atrophic region. The normal fellow eyes in patients with unilateral macular pucker formed the control group. Clinical and demographic characteristics of age, sex, best-corrected visual acuity, spherical equivalent, and fixation behavior (which included foveal mean sensitivity (MS), fixation MS, MS improvement, stability, centrality, and eccentric distance of fixation) were analyzed. A total of 58 patients were recruited, comprising 29 eyes of 29 patients in the macular dystrophy group and 29 eyes of 29 patients in the control group.ResultsCompared to the control group, patients with macular dystrophy had significantly poorer visual acuity, foveal MS, fixation MS, stability, and centrality, and more eccentric preferred retinal locations (PRLs). In macular dystrophy, the PRLs were most common on the superior side (48.3%). Compared to fixation in the atrophic region, PRLs out of the atrophic lesion gained more MS (7.41 vs. 0.89xa0dB, pu2009=u20090.001), although with less stable fixation (10.0 vs. 47.4%, pu2009=u20090.044). By multivariate linear regression, eccentric distance was found to be significantly associated with MS improvement (pu2009=u20090.023).ConclusionsThe commonest location of PRLs in macular dystrophy is anatomically superior to the lesion. The dystrophic eye can gain better sensitivity by using PRLs outside the atrophic area.