İbrahim Edhem Yılmaz, Mustafa Berhuni, Cem Öztürkmen, Hakim Ali Reyhan
{"title":"Focusing on the Future: Patient-Centered Insights into Trifocal Intraocular Lens Adoption.","authors":"İbrahim Edhem Yılmaz, Mustafa Berhuni, Cem Öztürkmen, Hakim Ali Reyhan","doi":"10.31348/2025/12","DOIUrl":"https://doi.org/10.31348/2025/12","url":null,"abstract":"<p><strong>Aims: </strong> To analyze determinants affecting the selection of trifocal intraocular lenses (IOLs) and to evaluate patient satisfaction and adaptation patterns post-implantation in a Turkish cohort.</p><p><strong>Material and methods: </strong> A cross-sectional study was conducted using a 17-item questionnaire administered to 96 patients who underwent phacoemulsification with PanOptix trifocal IOL implantation. Demographics, IOL selection factors, surgeon trust, visual adaptation, and satisfaction metrics were analyzed across various patient subgroups.</p><p><strong>Results: </strong> The cohort (mean age 60.62 ±11.94 years; 58.3% male) demonstrated 96.9% overall satisfaction post-implantation. Significant findings included higher satisfaction rates among patients under 65 years (98.3% vs 94.7%, p = 0.042), among tertiary-educated patients (98% vs 75%, p = 0.03), and 82.3% complete spectacle independence. Visual phenomena were reported at contemporary rates (glare: 18.8%, halos: 22.9%). Ninety-one percent of patients achieved visual adaptation within three months. Preoperative counseling participation (86.7% vs 71.4%, p = 0.035) and consistent follow-up attendance (88.9% vs 73.3%, p = 0.028) emerged as significant predictors of satisfaction.</p><p><strong>Conclusion: </strong> Patient satisfaction with trifocal IOLs correlates significantly with age, educational background, and engagement in the treatment process. While overall satisfaction rates are high, outcomes appear influenced by demographic factors and healthcare engagement patterns. These findings emphasize the importance of comprehensive preoperative assessment, patient education, and tailored follow-up protocols in optimizing trifocal IOL outcomes across diverse population segments.</p>","PeriodicalId":39839,"journal":{"name":"Ceska a Slovenska Oftalmologie","volume":"81 Ahead of Print","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Josef Štorm, Marie Česká Burdová, Jiří Uhlík, Marcela Minaříková, Tereza Vrabcová Lainová, Martin Hložánek, Gabriela Mahelková
{"title":"Modern Biomarkers for Early Diagnosis of Ocular Surface Disease in Type 1 Diabetes. A Pilot Study.","authors":"Josef Štorm, Marie Česká Burdová, Jiří Uhlík, Marcela Minaříková, Tereza Vrabcová Lainová, Martin Hložánek, Gabriela Mahelková","doi":"10.31348/2025/3","DOIUrl":"https://doi.org/10.31348/2025/3","url":null,"abstract":"<p><p>Patients with dry eye syndrome form a significant proportion of those treated in everyday ophthalmology practice. Diabetes mellitus is a major risk factor for the development of dry eye syndrome. Changes in tear film homeostasis, chronic inflammation and subsequent corneal nerve fiber pathology play a key role in its progression. The aim of this study was to describe the status of modern biomarkers of ocular surface damage in patients with type 1 diabetes and asses their utility in early diagnosis of dry eye syndrome.</p><p><strong>Material and methods: </strong> In total the pilot study included 19 patients with type 1 diabetes (T1D) and 15 patients in the control group. All patients underwent a detailed ocular surface examination, sample collection for matrix metalloproteinase-9 (MMP-9) laboratory analysis and epithelial HLA-DR expression evaluation, and in-vivo corneal confocal microscopy.</p><p><strong>Results: </strong> T1D patients showed statistically significantly reduced corneal nerve fiber length (p = 0.0482). The differences between the groups in terms of osmolarity, corneal sensitivity, Oxford score, tear break-up time and MMP-9 level were not statistically significant (p = 0.8272, p = 0.6029, p = 0.3507, p = 0.7561 and p = 0.0826 respectively). HLA-DR expression was examined in 10 T1D patients and 8 patients in the control group. Both groups showed minimal or no expression (p > 0.9999).</p><p><strong>Conclusion: </strong> The previously published literature supports our finding of corneal nerve fiber length reduction in T1D patients compared to controls. However, we did not find any significant changes in standard or modern ocular surface markers (MMP-9 levels, HLA-DR expression) measured in patients with dry eye syndrome.</p>","PeriodicalId":39839,"journal":{"name":"Ceska a Slovenska Oftalmologie","volume":"81 Ahead of Print","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mustafa Berhuni, İbrahim Edhem Yılmaz, Gürbostan Soysal Gizem, Zeynep Özer Özcan, Levent Doğan
{"title":"Efficacy and Safety of Intravitreal Dexamethasone Implant in Treatment-Resistant Diabetic Macular Edema: Six-month Results.","authors":"Mustafa Berhuni, İbrahim Edhem Yılmaz, Gürbostan Soysal Gizem, Zeynep Özer Özcan, Levent Doğan","doi":"10.31348/2025/4","DOIUrl":"10.31348/2025/4","url":null,"abstract":"<p><strong>Aims: </strong>To investigate the efficacy and safety of intravitreal Dexamethasone implant (DEX-I) therapy in the treatment of diabetic macular edema (DME) refractory to intravitreal bevacizumab (IVB).</p><p><strong>Material and methods: </strong>This retrospective and cross-sectional study included 37 eyes of 37 patients who received 3 loading doses of IVB injections for DME with no response and underwent DEX-I implant. Best-corrected visual acuity (BCVA), intraocular pressure (IOP) measurements and central foveal thickness (CFT) measured by spectral domain optical coherence tomography (SD-OCT) were recorded and compared before DEX-I, at the first week, first, second, third and sixth months. Duration of DME, glycated hemoglobin (HbA1c) levels, DME types and lens status (phakic, pseudophakic) were also recorded.</p><p><strong>Results: </strong>The mean age of the patients was 61.14 ±8.69 years (59.5% male, 40.5% female). 35.1% of the patients had cystoid macular edema, 64.9% had diffuse macular edema and 73 % were phakic and 27% were pseudophakic. BCVA, CFT and IOP values before DEX-I injection were 0.78 ±0.16 LogMAR, 493.73 ±107.6 µm and 13.05 ±2.59 mmHg, respectively. At 6 months after DEX-I, BCVA, CFT and IOP values were 0.64 ±0.11 LogMAR, 397.35 ±59.72 µm and 16.3 ±2.51 mmHg, respectively. In all follow-ups, there was a significant improvement in BCVA, a significant decrease in CFT and a significant increase in IOP compared to pre-injection. Ocular hypertension was observed in 0.8 % of patients and progression of cataract progression in 1% of patients after treatment.</p><p><strong>Conclusion: </strong>DEX-I therapy is an effective and safe treatment option for DME refractory to IVB treatment.</p>","PeriodicalId":39839,"journal":{"name":"Ceska a Slovenska Oftalmologie","volume":"81 Ahead of Print","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Juan José Moreno, Virgilio Galvis, Mariana Salazar, Sylvia Juliana Villamizar, Nathaly Leal, Alejandro Tello
{"title":"Presentation of a New Method for Quantitative Determination of Trifocal Intraocular Lens Decentration.","authors":"Juan José Moreno, Virgilio Galvis, Mariana Salazar, Sylvia Juliana Villamizar, Nathaly Leal, Alejandro Tello","doi":"10.31348/2025/10","DOIUrl":"10.31348/2025/10","url":null,"abstract":"<p><strong>Aims: </strong>This pilot study aims to present a novel method for quantitatively assessing the decentration of a trifocal intraocular lens (IOL) (Acrysof IQ PanOptix®) relative to three ocular reference points: the visual axis (first Purkinje reflex), the photopic pupil center, and, for the first time, the corneal geometric center. Additionally, the study evaluates the influence of postoperative chord mu, chord alpha, and the distances of the IOL from these reference points on visual outcomes.</p><p><strong>Materials and methods: </strong>This retrospective, observational study included 18 eyes from 12 patients who underwent cataract surgery with PanOptix® IOL implantation. Postoperative IOL positioning was assessed using OPD-Scan III images, applying a novel approach that combines diffuse frontal and retroillumination views. Distances between the IOL center and three ocular reference points, including the corneal geometric center, were measured, and postoperative patient satisfaction was evaluated using the Catquest-9SF survey. Statistical analyses were performed to assess correlations among reference distances, chord measurements, and visual performance.</p><p><strong>Results: </strong>The study found that in 72.2% of cases, the IOL center was closer to the visual axis than to the corneal geometric center. A greater distance between the IOL and the corneal geometric center was associated with an improved near-vision area under the visual acuity defocus curve. However, no significant correlations were found between chord mu or chord alpha and visual outcomes, patient symptoms, or satisfaction.</p><p><strong>Conclusion: </strong>This new approach to determining IOL centration proved practical, showing that the PanOptix® IOL tends to remain close to the visual axis over time, aligning with the surgeon's initial placement. No clear associations were found between chord mu, chord alpha, or most IOL distances (except the distance to the corneal geometric center) and visual quality or patient satisfaction. Further studies are needed to confirm these findings and to refine selection criteria for multifocal IOLs to enhance patient satisfaction and visual outcomes.</p>","PeriodicalId":39839,"journal":{"name":"Ceska a Slovenska Oftalmologie","volume":"81 Ahead of Print","pages":"1-12"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Analysis of 50 Most Cited Articles About Refractive Surgery From an Altmetric Perspective.","authors":"Mustafa Berhuni, Ozer Zeynep Ozcan","doi":"10.31348/2024/13","DOIUrl":"10.31348/2024/13","url":null,"abstract":"<p><strong>Aims: </strong>The purpose of this study is to evaluate an Altmetric analysis of the 50 most cited refractive surgery articles in Ophthalmology journals and to compare them with traditional metrics.</p><p><strong>Methods: </strong>The term \"refractive surgery\" was searched, using a time filter between 2010-2020 in the Web of Science core collection database. The 50 most cited articles between 2010 and 2020 were recorded. Descriptive statistics were performed. The Spearman correlation test was used to evaluate the correlation between traditional metrics and Altmetrics.</p><p><strong>Results: </strong>The Altmetric scores of the top 50 articles ranged from 0 to 25, and the median Altmetric score was 4. The citation numbers of the 50 articles ranged from 83 to 523, and the median citation number was 119.5. The most cited article topic was \"Toric Intraocular Lens\"; the topics with the highest Altmetric scores were \"Toric Intraocular Lens\" and \"Trifocal Intraocular Lens\". There was no significant correlation between Altmetric scores and number of citations. There was a weak correlation between Altmetric scores and the average citation per year.</p><p><strong>Conclusion: </strong>The Altmetric score is insufficient, compared with traditional metrics, to show the scientific value of articles on refractive surgery. Altmetrics can be used to supplement traditional metrics.</p>","PeriodicalId":39839,"journal":{"name":"Ceska a Slovenska Oftalmologie","volume":"80 Ahead of print","pages":"248-255"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140289097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lenka Musilová, Alena Vodičková, František Pluháček
{"title":"Repeatability of Noninvasive Break-Up Time Measurements using Keratograph Oculus 3.","authors":"Lenka Musilová, Alena Vodičková, František Pluháček","doi":"10.31348/2024/26","DOIUrl":"10.31348/2024/26","url":null,"abstract":"<p><strong>Aim: </strong>The primary aim of this study is to evaluate the repeatability of noninvasive break-up time (NIBUT) measurement by keratograph when it is determined from one, two or three partial measurements, and to recommend a suitable methodology for practice. Another goal is to verify that repeated measurements do not affect the measured value.</p><p><strong>Material and methods: </strong>Thirty-eight healthy volunteers (30 women and 8 men) aged between 19 and 50 years old were included in the study, in which only one eye of each volunteer was measured. The study was designed as a prospective one. Each subject adapted to the local conditions of the laboratory for 15 minutes and subsequently underwent two series of NIBUT measurements (test, retest) on an OCULUS 3 Keratograph. The minimum time interval between the two series was 10 minutes, in which each series contained three partial measurements approximately 3 three measurements in the given series. Repeatability was assessed by a Bland-Altman analysis and expressed as a repeatability coefficient. In every case, only the time of the first break-up of the tear film was monitored.</p><p><strong>Results: </strong>The statistical analysis did not show statistically significant differences both between partial measurements of NIBUT in the individual series (p = 0.92, p = 0.81) and when comparing all six measurements (p = 0.95). The mean values of the partial measurements ranged from 13.6 s to 14.4 s. The repeatability coefficients were found to be 15.0 s, 12.1 s and 10.0 s for methodologies A, B and C, respectively. A supplementary analysis for 12 eyes with low NIBUT (< 10 s) showed statistically significantly better repeatability in this group, with coefficients of 7.0 s (methodology A), 6.0 s (B) and 4.6 s (C).</p><p><strong>Conclusion: </strong>Determination of NIBUT from three consecutive measurements (with a sufficient interval of ideally a few minutes) significantly improves repeatability. Such repeated NIBUT measurements do not have a significant effect on the measured value. The mentioned methodology for measuring NIBUT on a keratograph can be recommended for use in practice.</p>","PeriodicalId":39839,"journal":{"name":"Ceska a Slovenska Oftalmologie","volume":"80 Ahead of print","pages":"266-270"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141459883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M Karhanová, J Čivrný, J Kalitová, J Schovánek, M Malušková, M Hrevuš, Z Schreiberová
{"title":"ULTRASOUND EXAMINATION OF THE ORBIT IN PATIENTS WITH THYROIDASSOCIATED ORBITOPATHY - EXAMINATION GUIDE AND RECOMMENDATIONS FOR EVERYDAY PRACTICE. A REVIEW.","authors":"M Karhanová, J Čivrný, J Kalitová, J Schovánek, M Malušková, M Hrevuš, Z Schreiberová","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The purpose of this study is to present the possibilities and benefits of ultrasonography (US) of the orbit in the diagnosis and treatment of thyroidassociated orbitopathy (TAO). Methods: US examination of the orbit is an essential addition to clinical and laboratory examination in TAO patients. Nevertheless, it is often neglected in clinical practice or indicated with delay. Based on previously published studies and our experience with the diagnosis and treatment of TAO patients, we aim to highlight the clear benefit of US examination of the orbit and oculomotor muscles, not only for correct TAO diagnosis but also in the monitoring of the disease over time. However, knowledge of the drawbacks and limitations of this method is also essential, as we shall point out. It is always necessary to remember that US examination must be evaluated in connection with the clinical findings. A detailed recommendation for US examination of the extraocular muscles and the orbit based on our experiences with diagnosing and treating TAO patients in daily practice is also included. Conclusion: According to our experience, US examination of the orbit is an excellent and irreplaceable tool for timely TAO diagnosis and further disease monitoring. However, considerable examiner experience and detailed knowledge of the clinical and ultrasound manifestations of TAO are essential.</p>","PeriodicalId":39839,"journal":{"name":"Ceska a Slovenska Oftalmologie","volume":"3 Ahead of Print","pages":"3-11"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9076113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zuzana Šulavíková, Zuzana Šustykevičová, Marek Káčerik, Vladimír Krásnik
{"title":"Effect of Intravitreal Aflibercept on Corneal Endothelial Cells.","authors":"Zuzana Šulavíková, Zuzana Šustykevičová, Marek Káčerik, Vladimír Krásnik","doi":"10.31348/2024/18","DOIUrl":"10.31348/2024/18","url":null,"abstract":"<p><strong>Aim: </strong>To determine the effect of repeated intravitreal injections of aflibercept on the corneal endothelium in patients with diabetic macular edema (DME) and macular edema due to retinal vein occlusion (RVO).</p><p><strong>Methods: </strong>In a prospective study conducted between January 2021 and November 2023, a total of 87 treatment-naive eyes with DME and RVO were evaluated. The exclusion criteria were surgery or laser intervention during the follow-up period, contact lens wear, cataract surgery in the last 6 months, dystrophy, or other corneal condition that may cause endothelial damage. In addition to routine examinations on the day of application, we also measured the corneal endothelium using specular microscopy on the 1st, 4th and 8th day of injection. We evaluated 4 parameters: endothelial cell density (CD), hexagonality (HEX), coefficient of variability (CV) and central corneal thickness (CCT). First of all, we evaluated the entire cohort of eyes, and then divided it according to 2 criteria; the diagnosis into DME/RVO and according to the lens status into phakic/pseudophakic eyes.</p><p><strong>Results: </strong>A total of 87 eyes of 68 patients were evaluated. The average age of the patients at the time of diagnosis was 66.8 ±9.3 years. Within the cohort 51 (59%) eyes were phakic and 36 (41%) pseudophakic. A total of 61 (70%) eyes with a diagnosis of DME were treated, and 26 (30%) with RVO. During the follow-up, there were no significant changes in the average values of CD, HEX, CV, CCT due to aflibercept treatment, either in the whole group or in subgroups according to diagnosis or lens condition.</p><p><strong>Conclusions: </strong>The results of this study suggest that intravitreal administration of aflibercept in patients with DME and RVO did not have an impact on corneal endothelial parameters, including CCT, HEX, CD and CV. These parameters were measured using endothelial microscopy during an 8-injection observation period.</p>","PeriodicalId":39839,"journal":{"name":"Ceska a Slovenska Oftalmologie","volume":"80 Ahead of print","pages":"202-207"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140307229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Central Serous Chorioretinopathy. A Review.","authors":"Kateřina Myslík Manethová","doi":"10.31348/2023/27","DOIUrl":"10.31348/2023/27","url":null,"abstract":"<p><p>Central serous chorioretinopathy (CSC) is a disease characterized by serous detachment of the neuroretina, especially in the posterior pole of the eye. It is often accompanied by serous detachment of the retinal pigment epithelium (RPE) and associated with the leakage of fluid into the subretinal space through the defective RPE. CSC most often affects men of working age. The exact pathophysiology of the disease is not completely known. Based on indocyanine green angiography (ICG), which revealed increased permeability of choroidal vessels, and optical coherence tomography (OCT) showing increased choroidal thickness, choroidal vasculopathy is assumed to be the primary cause of CSC. In most cases, CSC has a good prognosis with spontaneous resorption of the subretinal fluid (SRF) and improvement of visual functions. However, in a small percentage of patients the disease progresses to a chronic or recurrent course, and can lead to irreversible functional and anatomical changes of the retina with a final clinical picture of diffuse retinal pigment epitheliopathy (DRPE). The optimal treatment approach for patients with CSC remains controversial. In recent decades, myriad therapeutic approaches have been used in the treatment of chronic forms of CSC (cCSC); these included for example laser photocoagulation, pharmaceutical treatment, standard photodynamic therapy (PDT) or anti-VEGF. In recent years a less destructive method, specifically PDT in reduced dose regimens, either with a reduced dose of verteporfin or the laser beam energy used, has been preferred in the treatment of cCSC. Comparable efficacy and safety has been demonstrated using reduced-dose or reduced-fluence PDT regimens in patients with cCSC, with an improvement in best-corrected visual acuity and reduction of SRF.</p>","PeriodicalId":39839,"journal":{"name":"Ceska a Slovenska Oftalmologie","volume":"80 2","pages":"59-75"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140294867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Atiqah Nur Hasan, Mushawiahti Mustapha, Haslina Abdul Halim Wan Wan
{"title":"Vogt-Koyanagi-Harada Disease: The Clinical Spectrum and Management of Case Series in a Tertiary Eye Centre in Northern Part Of Malaysia.","authors":"Atiqah Nur Hasan, Mushawiahti Mustapha, Haslina Abdul Halim Wan Wan","doi":"10.31348/2024/1","DOIUrl":"10.31348/2024/1","url":null,"abstract":"<p><strong>Aims: </strong>We present the clinical spectrum, the initial clinical presentation with management trends in treating 14 Vogt-Koyanagi-Harada (VKH) disease cases in a tertiary center in the Northern part of Malaysia.</p><p><strong>Case series: </strong>There were 14 cases of Vogt-Koyanagi-Harada (VKH) disease retrospectively reviewed over five years (from 2015 to 2020). The mean age at presentation was 37.7 years (range 21-64 years), with female predominance (85.7%). All cases presented with acute uveitic stage and bilateral eye involvement. Of them, 11 (78.6%) were probable VKH, and three (21.4%) were incomplete VKH. All patients attended with acute panuveitis at first presentation. The main posterior segment involvement was disc edema in 57.1% (16 out of 28 eyes) and exudative retinal detachment (ERD) in 35.7% (10 out of 28 eyes). Most of them presented with blindness (3/60 and worse) and moderate visual impair- ment (6/18-6/60); 35.71% each, followed by mild visual impairment (6/12-6/18), and severe visual impairment (6/60-3/60); 7.1% each. Ten patients (71.4%) required combination second-line immunomodulatory treatment during subsequent visits, and only four patients (28.6%) responded well to corticosteroid therapy. Most of the cases achieved no visual impairment (64.3%), followed by mild visual impairment (21.4%) and moderate visual impairment (14.3%), and none were severe or blind at the end of follow-up.</p><p><strong>Conclusion: </strong>VKH is a potentially blinding illness if there is inadequate control of the disease in the acute stage. Most of our patients achieved good visual outcomes with early immunomodulatory treatment and systemic corticosteroids.</p>","PeriodicalId":39839,"journal":{"name":"Ceska a Slovenska Oftalmologie","volume":"80 Ahead of print","pages":"140-144"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139984135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}