{"title":"Effects of cyclosporine on steroid-refractory dry eyes.","authors":"Wan-Lin Wu, Shu-Wen Chang","doi":"10.4103/tjo.TJO-D-22-00165","DOIUrl":"10.4103/tjo.TJO-D-22-00165","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose is to compare the effects of cyclosporine (CsA) on the steroid-refractory mixed-type dry eye (MTDE) and aqueous deficient dry eye (ADDE).</p><p><strong>Materials and methods: </strong>We retrospectively enrolled 71 patients with levels 3 and 4 dry eye that were refractory to artificial tears and topical steroids. The effects were analyzed using the ocular surface disease index (OSDI) and standard patient evaluation of eye dryness (SPEED) questionnaires, Schirmer test II, blink patterns, lipid layer thickness (LLT), meibomian gland expressibility (MGE) and extent of meibomian gland (MG) dropout (meiboscale).</p><p><strong>Results: </strong>MTDE patients (LLT ≤60 nm, <i>n</i> = 38) were younger than those in ADDE (LLT >60 nm, <i>n</i> = 33). Before CsA treatment, they had higher Schirmer scores, less MGE, and a thinner LLT. There was no statistically significant difference in OSDI/SPEED scores between groups. CsA improved the OSDI in the ADDE group but not in the MTDE group. CsA treatment decreased the severity of superficial punctate keratitis (SPK) in both groups, but it significantly decreased partial blinks, total blinks, and partial blink rates in the ADDE group only. CsA did not increase the Schirmer score, LLT, MGE, or meiboscale grade in both groups. CsA could significantly improve subjective symptoms, SPK, and blink patterns in dry eyes refractory to topical steroids, which were more pronounced in ADDE than in MTDE.</p><p><strong>Conclusion: </strong>In MTDE cases, concurrent MG treatment modalities, such as intense pulse light and/or thermal pulsation, could be considered to maximize the effects of CsA treatment.</p>","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10712756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49206608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Infrared images help to identify retinal emboli in hemodynamic retinal artery occlusion.","authors":"Yu Chen, Hsiao-Fan Tung, Jiunn-Feng Hwang","doi":"10.4103/tjo.TJO-D-22-00166","DOIUrl":"10.4103/tjo.TJO-D-22-00166","url":null,"abstract":"<p><p>To report a case of stroke with internal carotid artery (ICA) occlusion and retinal artery occlusion (RAO) with multiple emboli identified by infrared images. The patient presented with acute blurred vision and slurred speech since woke up in the morning. Carotid Doppler ultrasonography showed severe left ICA stenosis with the decreased flow. Computed tomography angiography demonstrated left ICA critical stenosis with compensatory flows from the right ICA. There was coexistent RAO with multiple emboli, silver-wiring, and segmentation of the retinal artery. More hyperreflective emboli were uncovered by infrared images of spectral-domain optical coherence tomography. Embolism may accompany with the compensatory flow for ICA occlusion. RAO patients should have thorough carotid evaluations, especially those with multiple retinal emboli.</p>","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11034682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70847383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Retinal nerve fiber layer thickness and peripapillary vasculature of post-COVID-19 patients with and without olfactory/gustatory dysfunction symptoms.","authors":"Oğuzhan Kılıçarslan, Aslıhan Yılmaz Çebi, Didar Uçar","doi":"10.4103/tjo.TJO-D-22-00065","DOIUrl":"10.4103/tjo.TJO-D-22-00065","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to compare retinal nerve fiber layer (RNFL) thickness and peripapillary vessel density values between COVID-19 patients with or without olfactory/gustatory dysfunction symptoms and healthy controls.</p><p><strong>Materials and methods: </strong>We evaluated RNFL and radial peripapillary capillary vessel density (RPC-VD) values of 41 patients who had COVID-19 history and age- and gender-matched control group including 31 healthy individuals with optical coherence tomography angiography. First, post-COVID-19 group's and control group's RNFL and RPC-VD values were compared, then post-COVID-19 patients were divided into subgroups according to the presence (subgroup-A) and absence (subgroup-B) of olfactory/gustatory dysfunction symptoms, and same parameters were analyzed for subgroups.</p><p><strong>Results: </strong>Forty-one eyes of 41 post-COVID-19 patients and 31 eyes of 31 age- and gender-matched healthy controls were included in this cross-sectional study. In RNFL analysis, inferior sector thickness was found significantly lower in post-COVID-19 patients by comparison with control group (<i>P</i> = 0.041). In subgroup analyses, COVID-19 patients who first presented with olfactory/gustatory dysfunction symptoms had higher peripapillary and whole image optic disc capillary density (<i>P</i> = 0.011 and <i>P</i> = 0.002) compared to those who had not had these symptoms.</p><p><strong>Conclusion: </strong>Lower RPC-VD and RNFL thickness were detected in COVID-19 patients compared to healthy controls. Higher Disc-VD values were found in COVID-19 patients with chemosensorial dysfunction (CSD) symptoms compared to those who had not had these symptoms probably due to milder disease course in COVID-19 with CSD. Sectorial RNFL attenuation in COVID-19 might have occurred secondary to peripapillary capillary circulation defect.</p>","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11034685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70846591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Advancing beyond our recent advances in ocular surface disease and corneal surgery.","authors":"Bennie H Jeng","doi":"10.4103/2211-5056.371625","DOIUrl":"10.4103/2211-5056.371625","url":null,"abstract":"","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/71/0e/TJO-13-1.PMC10220435.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9539777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Retinal pigment epithelium tear in an idiopathic acute onset bullous central serous chorioretinopathy.","authors":"You-Ci Ou, Cheng-Kuo Cheng, Chang-Sue Yang","doi":"10.4103/tjo.TJO-D-22-00150","DOIUrl":"10.4103/tjo.TJO-D-22-00150","url":null,"abstract":"<p><p>Although retinal pigment epithelium (RPE) tears are common in patients with chronic conditions such as exudative age-related macular degeneration or may occur in response to anti-vascular endothelial growth factor or laser treatment, a spontaneous RPE tear can occur in patients with acute and new-onset bullous central serous chorioretinopathy (CSCR). We present a rare case of a healthy young Asian man with unilateral massive subretinal fluid (SRF). An idiopathic acute-onset bullous CSCR with an RPE tear was diagnosed through ancillary examinations. This patient exhibited good visual recovery as indicated by foveal sparing, spontaneous resolution of SRF, and the lack of a need for unnecessary surgery.</p>","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10712755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47816198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Laura Liu, Yih-Shiou Hwang, Wei-Chi Wu, Chi-Chun Lai, Jorn-Hon Liu
{"title":"Trocar blade-assisted skewer technique for phacoemulsification of a dislocated lens.","authors":"Laura Liu, Yih-Shiou Hwang, Wei-Chi Wu, Chi-Chun Lai, Jorn-Hon Liu","doi":"10.4103/tjo.TJO-D-22-00138","DOIUrl":"10.4103/tjo.TJO-D-22-00138","url":null,"abstract":"<p><p>A posteriorly dislocated lens is often managed with a fragmatome through a pars plana approach because it is difficult to manage anteriorly. The lens often sinks to the surface of the retina or floats around in the vitreous cavity during pars plana lensectomy. Mechanical trauma can occur while removing the dislocated lens fragments. However, sometimes the lens can be confined to the anterior vitreous cavity even though the zonules are completely disrupted. It would be ideal if there was a simple way to stabilize and support the lens so that the lens could remain in the posterior chamber while phacoemulsification is performed through a corneal incision as usual. We describe a technique using a trocar blade to stabilize the lens while performing phacoemulsification through a corneal incision. We found it to be a useful and safe instrument to support the subluxated lens during phacoemulsification.</p>","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11034686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70847292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lillian Chien, Cammille C Go, Gabriela M Lahaie Luna, César A Briceño
{"title":"Changes in retinal nerve fiber layer, ganglion cell complex, and ganglion cell layer thickness in thyroid eye disease: A systematic review.","authors":"Lillian Chien, Cammille C Go, Gabriela M Lahaie Luna, César A Briceño","doi":"10.4103/tjo.TJO-D-22-00110","DOIUrl":"10.4103/tjo.TJO-D-22-00110","url":null,"abstract":"<p><p>Thyroid eye disease (TED) is characterized by progressive orbital inflammation. In severe cases, it can lead to dysthyroid optic neuropathy (DON), involving death of retinal ganglion cells and permanent vision loss. Imaging with optical coherence tomography (OCT) has enabled noninvasive examination of the structural impact of the disease, including of the retinal nerve fiber layer (RNFL), the ganglion cell layer (GCL), and the inner plexiform layer (IPL). In this study, we systematically review 20 studies (897 patients, 1430 eyes) to evaluate changes in retinal thickness in patients with TED, stratified by severity. Most studies found a decrease in thickness in peripapillary RNFL (pRNFL), non-pRNFL, combined RNFL/GCL/IPL, or combined GCL/IPL when comparing patients with DON to healthy controls or to patients without DON. However, results were equivocal regarding differences between non-DON TED patients and controls. In addition, several studies reported a postoperative decrease in pRNFL thickness after orbital decompression surgery. Future studies examining OCT changes of retinal thickness along with disease progression are needed to assess the potential of OCT in diagnosis and management of patients with TED.</p>","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11254005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70847247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Brain fog and vessel clogs.","authors":"Aditya Maitray, Anju Kuriakose, Anand Rajendran, Karthik Srinivasan, Maanasi Mahalingam","doi":"10.4103/tjo.TJO-D-22-00107","DOIUrl":"10.4103/tjo.TJO-D-22-00107","url":null,"abstract":"<p><p>We present a unique case of a 36-year-old female presenting with features suggestive of bilateral combined vascular occlusion, hearing loss, and encephalopathy. Multimodal imaging was done for both eyes fundus evaluation including wide-field color fundus photography, optical coherence tomography, and fundus fluorescein angiography. After extensive ocular and systemic investigations, she was diagnosed to have Susac syndrome (SS). She was referred to a neurologist and otologist for systemic evaluation and underwent laser photocoagulation in both eyes, followed by pars plana vitrectomy in her left eye. Combined bilateral retinal vascular occlusion in association with SS is very rare.</p>","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11254002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70847074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nir Erdinest, Naomi London, Itay Lavy, David Berkow, David Landau, Nadav Levinger, Yair Morad
{"title":"Peripheral defocus as it relates to myopia progression: A mini-review.","authors":"Nir Erdinest, Naomi London, Itay Lavy, David Berkow, David Landau, Nadav Levinger, Yair Morad","doi":"10.4103/tjo.TJO-D-22-00100","DOIUrl":"10.4103/tjo.TJO-D-22-00100","url":null,"abstract":"<p><p>Myopia is the most common refractive error in the world and has reached a pandemic level. The potential complications of progressive myopia have inspired researchers to attempt to understand the sources of myopia and axial elongation and to develop modalities to arrest progression. Considerable attention has been given over the past few years to the myopia risk factor known as hyperopic peripheral blur, which is the focus of this review. It will discuss the primary theories believed to be the cause of myopia and the parameters considered to contribute to and influence the effect of peripheral blur, such as the surface retinal area of blur or the depth of blur. The multitude of optical devices designed to provide peripheral myopic defocus will be mentioned, including bifocal and progressive addition ophthalmic lenses, peripheral defocus single-vision ophthalmic lenses, orthokeratology lenses, and bifocal or multifocal center distance soft lenses, as well as their effectivity as discussed in the literature to date.</p>","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10712741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45375895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Changing etiology of sympathetic ophthalmia: A 10-year study from a tertiary referral center in Taiwan.","authors":"Shih-Chou Chen, Shwu-Jiuan Sheu, Tsung-Tien Wu","doi":"10.4103/tjo.TJO-D-22-00094","DOIUrl":"10.4103/tjo.TJO-D-22-00094","url":null,"abstract":"<p><strong>Purpose: </strong>In this study, we describe our experience of sympathetic ophthalmia (SO) at a tertiary referral center in Taiwan.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed records of patients diagnosed with SO from January 2011 to December 2020.</p><p><strong>Results: </strong>We collected data of 15 patients diagnosed with SO (eight males, seven females). Six patients developed SO after ocular penetrating trauma, and nine developed SO after ocular surgery, including seven with vitrectomy, one with penetrating keratoplasty, and one with cataract surgery. Penetrating ocular trauma was the primary cause of SO in the first 5 years (four of six cases), but the proportion was much lower in the last 5 years (two of nine cases). The interval between trigger events and SO ranged from 0.2 to 120 months. Nine patients received oral steroids alone, five patients received methylprednisolone pulse therapy followed by oral steroids, and immunosuppressants were added in four cases. Visual acuity of sympathetic eyes and exciting eyes improved after treatment. The initial visual acuity of sympathetic eyes in trauma related and ocular surgery related revealed no significant difference, but the final visual acuity of sympathetic eyes was better in ocular surgery-related cases than in the trauma-related cases (mean ± standard deviation, 1.01 ± 1.33 versus 0.49 ± 0.68 logarithm of the minimum angle of resolution, <i>P</i> = 0.021).</p><p><strong>Conclusions: </strong>With the increased number of eye surgeries performed in recent years, eye surgery has emerged as the dominant etiology of SO in our 10-year study. Early detection and proper treatment help to maintain vision in most of the SO patients.</p>","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10712751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70846687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}