Taiwan Journal of Ophthalmology最新文献

{"title":"Can interferon-inducible gene expression guide treatment? A prospective study in QuantiFERON-positive uveitis with undetermined cause.","authors":"Rina La Distia Nora, Mei Riasanti, Ratna Sitompul, Lukman Edwar, Made Susiyanti, Yulia Aziza, Ikhwanuliman Putera, Maria Valentina Wibawa, Ulifna Alfiya Sifyana, Muhammad Zakiy Waliyuddin, Rachel Ethelind, Beti Ernawati Dewi, Heri Wibowo","doi":"10.4103/tjo.TJO-D-25-00029","DOIUrl":"10.4103/tjo.TJO-D-25-00029","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to evaluate the utility of baseline interferon (IFN)-inducible gene expression as a prognostic biomarker for Anti-tubercular therapy (ATT) response in patients with undetermined cause of uveitis who tested positive for QuantiFERON-TB Gold (QFT-positive uveitis).</p><p><strong>Methods: </strong>This prospective cohort study included 17 QFT-positive uveitis patients at a tertiary uveitis center in Indonesia. Baseline and week 2 peripheral blood transcripts were evaluated through real time-quantitative polymerase chain reaction to assess the expression of 10 IFN-inducible genes (IRF7, IFIT2, STAT1, IL1B, MyD88, TLR8, FCGR1B, GBP1, UBE2L6, and SERPING1). Patients were stratified into clusters based on gene expression patterns. The primary outcome was complete resolution of uveitis at 6 months.</p><p><strong>Results: </strong>Hierarchical clustering revealed two distinct groups. Patients with higher baseline expression of IFN genes (Cluster 2) were more likely to achieve complete uveitis resolution after ATT compared to those with lower expression levels (Cluster 1) (80% vs. 43%). Using a previously established IFN gene signature score (IGSS) cutoff (≥5.61), 82% of high-scoring patients showed complete resolution, compared to only 33% in the low-scoring group (<i>P</i> = 0.046). However, week 2 gene expression changes did not correlate with treatment response, indicating limited utility in monitoring disease activity or predicting long-term outcomes.</p><p><strong>Conclusion: </strong>Baseline, but not week 2, peripheral blood IFN-inducible gene expression may serve as a prognostic biomarker for stratifying QFT-positive uveitis patients through prediction of their response to treatment. Patients with higher baseline IGSS are more likely to require ATT to achieve uveitis resolution at 6-month follow-up.</p>","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":"15 2","pages":"259-269"},"PeriodicalIF":1.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12204651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530205","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":"Clinical features, pathogens, and mortality of endogenous endophthalmitis: A 10-year retrospective review in Northern Taiwan.","authors":"Yu-Hsun Chuang, Po-Jung Lai, Tzyy-Chang Ho, Chung-May Yang, Chang-Hao Yang, Chang-Ping Lin, Yi-Ting Hsieh, Tso-Ting Lai, Ta-Ching Chen, Po-Ting Yeh","doi":"10.4103/tjo.TJO-D-25-00030","DOIUrl":"10.4103/tjo.TJO-D-25-00030","url":null,"abstract":"<p><strong>Purpose: </strong>To comprehensively review the epidemiology, clinical features, causative pathogens, primary infection sites, and mortality of endogenous endophthalmitis (EE).</p><p><strong>Materials and methods: </strong>A retrospective review was conducted on patients diagnosed with EE at National Taiwan University Hospital between 2014 and 2024. Clinical data, including patient demographics, underlying systemic diseases, identified pathogens, infection sources, and outcomes, were analyzed.</p><p><strong>Results: </strong>Ninety-nine eyes from 91 patients with EE were enrolled. The majority of cases were bacterial (61.5%), followed by fungal infections (27.5%). A small number of cases had no documented pathogens. Bilateral involvement was more frequent in fungal cases. Among patients with endogenous bacterial endophthalmitis (EBE), <i>Klebsiella pneumoniae</i> was the most common causative pathogen, typically originating from liver abscesses. Diabetes mellitus (DM) was the most frequently associated systemic disease. In endogenous fungal endophthalmitis (EFE), <i>Candida albicans</i> was the predominant pathogen. Patients with EFE had a higher prevalence of bilateral involvement and increased mortality. Overall, the visual prognosis for EE patients was poor, regardless of the causative pathogen. Generalized estimating equations analysis identified female sex (<i>P</i> = 0.014), EFE (<i>P</i> < 0.001), bilateral involvement (<i>P</i> < 0.001), and DM (<i>P</i> = 0.014) as risk factors for mortality in EE.</p><p><strong>Conclusion: </strong>EE remains a vision-threatening condition. <i>K</i>. <i>pneumoniae</i>, frequently associated with liver abscesses, is the leading cause of EBE. <i>C</i>. <i>albicans</i> is the most common pathogen in EFE. However, patients with bilateral EFE have a higher mortality rate. Overall, final visual outcomes were generally poor, with many patients experiencing severe vision impairment despite treatment.</p>","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":"15 2","pages":"245-251"},"PeriodicalIF":1.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12204661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530173","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":"Excessive corneal endothelial single-cell loss following endothelial injuries.","authors":"Yuan-Kai Fu, Matthew Lin, Kuo-Hsuan Hung, Lung-Kun Yeh, Hsin-Yuan Tan","doi":"10.4103/tjo.TJO-D-24-00118","DOIUrl":"10.4103/tjo.TJO-D-24-00118","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to investigate corneal endothelial changes following common clinical endothelial injury scenarios in order to uncover mechanisms underlying unexplained chronic corneal endothelial wound healing.</p><p><strong>Materials and methods: </strong>This cross-sectional study included patients with endothelial injuries from three common scenarios: postcataract surgery, corneal dystrophies, and penetrating injuries. Noncontact specular microscopy was used to capture images from five distinct corneal regions. Endothelial cell density (ECD), coefficient of variation (CV), and percentage of hexagonal cells (HEX) were assessed. All endothelial photographs were also reviewed. Statistical analysis was performed to compare injured and noninjured eyes.</p><p><strong>Results: </strong>Seventy-seven patients were enrolled, with a mean age of 64 years (48 females, 29 males). The mean central ECD was 2138.91 ± 869.34 cells/mm² in postcataract surgery eyes, 1999.48 ± 763.91 cells/mm² in endothelial dystrophy eyes, and 1854.86 ± 551.85 cells/mm² in trauma cases. While most parameters showed no significant differences, postcataract surgery eyes exhibited a significant increase in CV value in the upper and temporal regions (<i>P</i> < 0.05). Unexpectedly, stochastic single-cell loss was observed in 42.86% of patients, continuing up to two years postinjury. This loss was significantly higher compared to uninjured eyes (<i>P</i> = 0.00005), suggesting that excessive single-cell loss occurs well beyond the expected wound healing period.</p><p><strong>Conclusion: </strong>We identified accelerated stochastic single-cell loss in the corneal endothelium following primary injuries, persisting well beyond the expected wound healing period, a phenomenon that has not been previously highlighted. This finding offers a potential explanation for the chronic endothelial cell loss following a primary injury.</p>","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":"15 3","pages":"480-486"},"PeriodicalIF":1.2,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12456922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138925","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":"Current understanding of ocular fluid analysis in uveitis.","authors":"Mariko Shirane, Nobuyo Yawata, Koh-Hei Sonoda","doi":"10.4103/tjo.TJO-D-25-00001","DOIUrl":"10.4103/tjo.TJO-D-25-00001","url":null,"abstract":"<p><p>Uveitis sometimes causes severe inflammation and significant loss of visual function. However, the cause is unknown in approximately 50% of cases, and the pathogenesis of the disease is also unknown in many cases. Intraocular fluid is rich in biological substances such as DNA/RNA, cytokines, antibodies, proteins, and metabolites and analysis of intraocular fluid is important for identifying biomarkers and understanding the pathogenesis of uveitis. For example, comprehensive polymerase chain reaction test of intraocular fluid has enabled rapid diagnosis of infectious uveitis. In addition, a combination of histopathological examination of intraocular fluid, cytokine measurement, flow cytometry, and genetic assessments has increased the efficiency of diagnosis of intraocular malignant lymphoma. In recent years, omics analysis such as metabolomics, proteomics, and transcriptomics has been actively conducted in the medical field, and there are scattered reports of intraocular fluid analysis in uveitis. Moreover, research and practical application of artificial intelligence (AI) is also progressing rapidly in the medical field. In the field of ophthalmology, many studies introducing AI have been reported, and a small number of machine learning studies using intraocular fluid have also been reported. In this review, we searched PubMed for previous reports on intraocular fluid analysis in uveitis and aim to introduce the analysis of intraocular fluid in uveitis, including the results of our comprehensive genetic analysis of cytomegalovirus in the eye.</p>","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":"15 2","pages":"196-202"},"PeriodicalIF":1.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12204668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530176","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":"Author's response to letter of editor for Evaluating the role of serum cystatin C as a circulating biomarker of diabetic retinopathy from a rural Indian population.","authors":"Keerthana Raghu, R Janani Surya, Chitaranjan Mishra, Karan Singh, Nabatika Mohanty, Jitendra Kumar Sahoo, Shiva Prasad Sahoo, Ashok Kumar Singh, Rajiv Raman","doi":"10.4103/tjo.TJO-D-25-00020","DOIUrl":"10.4103/tjo.TJO-D-25-00020","url":null,"abstract":"","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":"16 3","pages":"510-511"},"PeriodicalIF":1.4,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13668170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197014","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":"Polymerase chain reaction in viral anterior uveitis with secondary glaucoma: Analysis of 28 eyes from a tertiary eye care center in South India.","authors":"Bhavini Johri, Dhanurekha Lakshmipathy, Jyotirmay Biswas","doi":"10.4103/tjo.TJO-D-24-00089","DOIUrl":"10.4103/tjo.TJO-D-24-00089","url":null,"abstract":"<p><strong>Purpose: </strong>To study the role of polymerase chain reaction (PCR) in viral anterior uveitis with secondary glaucoma.</p><p><strong>Materials and methods: </strong>This was a retrospective cohort study in which aqueous humor from 28 eyes of 23 patients with viral uveitis and secondary glaucoma from 2008 to 2024 was sent for real-time/nested PCR. The clinical features of the patients were analyzed (<i>P</i> < 0.05 statistically significant).</p><p><strong>Results: </strong>The median age at uveitis onset was 45 years. Secondary open-angle glaucoma was found in 23 out of 28 eyes, 82.1%. The median intraocular pressure (IOP) reduced significantly from baseline, 18.5 to 14 mmHg at the final visit (<i>P</i> = 0.01). Maximum IOP was 60 mmHg. PCR was positive in 57.1% of eyes, mostly for varicella-zoster virus (32.1%), followed by Cytomegalovirus (CMV) (17.8%) and herpes simplex virus (10.7%). Valacyclovir was used to treat 50% of eyes. CMV was treated with valganciclovir (10.7% eyes). Antiglaucoma and anti-inflammatory medications were reduced significantly from initiation (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>PCR enables timely and accurate detection of virus causing anterior uveitis and helps salvage vision in secondary glaucoma with appropriate antiviral therapy.</p>","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":"15 2","pages":"283-289"},"PeriodicalIF":1.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12204670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530257","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":"Evaluating the role of serum cystatin C as a circulating biomarker of diabetic retinopathy from a rural Indian population.","authors":"Mahmood Dhahir Al-Mendalawi","doi":"10.4103/tjo.TJO-D-25-00019","DOIUrl":"10.4103/tjo.TJO-D-25-00019","url":null,"abstract":"","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":"16 3","pages":"509"},"PeriodicalIF":1.4,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13668186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196993","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":"Diagnostic microbiology for intraocular infections: A comprehensive approach.","authors":"Sanchita Mitra","doi":"10.4103/tjo.TJO-D-25-00026","DOIUrl":"10.4103/tjo.TJO-D-25-00026","url":null,"abstract":"<p><p>Ocular infections, particularly intraocular infections, face challenges due to low sample volumes and their paucibacillary nature (low pathogen load) compared to other anatomical sites. This often leads to culture-negative cases, complicating the identification of the causative pathogen. Intraocular sample collection is mainly invasive and difficult to repeat. Ocular microbiology diagnostics require specialized expertise developed over years of experience, along with effective communication between clinicians and microbiologists, to ensure accurate pathogen diagnosis. This review offers an overview of ocular microbiology practices employing both conventional and molecular techniques for pathogen identification, including unusual pathogens primarily affecting the eye, antimicrobial susceptibility testing, result interpretation, emerging diagnostic techniques, challenges in intraocular sample processing, troubleshooting strategies, serological approaches, and basic operating room sterility assessments in eye care institutions. The review aims to assist both ophthalmologists and microbiologists in their daily practice of ocular microbiology diagnostics.</p>","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":"15 2","pages":"182-195"},"PeriodicalIF":1.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12204658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530178","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":"Human immunodeficiency virus ocular involvement and retinopathy: Clinical spectrum and management strategies.","authors":"Hou-Ting Kuo, Hsin Tseng, Alan Y Hsu, Bing-Qi Wu, Ning-Yi Hsia, Chun-Ju Lin, John Gonzales","doi":"10.4103/tjo.TJO-D-24-00160","DOIUrl":"10.4103/tjo.TJO-D-24-00160","url":null,"abstract":"<p><p>This study highlights the significant ocular complications associated with human immunodeficiency virus (HIV), particularly its impact on the retina. Historically, HIV infection frequently resulted in severe retinal infections, such as <i>Cytomegalovirus</i> retinitis. However, with the widespread adoption of highly active antiretroviral therapy, the prevalence of these infections has significantly declined. Despite this progress, unresolved challenges in treatment approaches remain. In addition, HIV is known to cause nonopportunistic ocular conditions, such as optic neuropathy, immune recovery uveitis, and HIV-associated retinopathy, which require further clinical attention. In addition, we conducted an in-depth discussion on the phenomenon of early senescence in HIV patients. With the widespread adoption of optical coherence tomography angiography, this technology has enabled us to detect subtle changes associated with early senescence at an earlier stage. In this review, we conducted an extensive literature search to consolidate current evidence on the ophthalmic manifestations of HIV, particularly among patients in Taiwan. By synthesizing this information, we aim to highlight areas for improvement in clinical practice and offer insights into optimizing care for HIV patients with ocular complications.</p>","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":"15 2","pages":"218-224"},"PeriodicalIF":1.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12204653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530252","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":"Four cases of endogenous <i>Klebsiella</i> endophthalmitis in Los Angeles County: A case series.","authors":"Christopher Chung, Alexander M Tseng, Yicheng K Bao, Betty A Situ, Maria Sibug Saber, Brian Toy, Juan Carlos Martinez-Camarillo","doi":"10.4103/tjo.TJO-D-24-00155","DOIUrl":"10.4103/tjo.TJO-D-24-00155","url":null,"abstract":"<p><p><i>Klebsiella pneumoniae (K</i>. <i>pneumoniae)</i> represents a frequent cause of endogenous endophthalmitis in East Asia but remains an uncommon cause of endogenous endophthalmitis in the United States. Recent reports have characterized the emergence of hypervirulent <i>K</i>. <i>pneumoniae</i> strains, which are now thought to be the predominant cause of endogenous <i>K</i>. <i>pneumoniae</i> endophthalmitis. We document four cases of endogenous <i>Klebsiella</i> endophthalmitis in Los Angeles County from 2022 to 2024, including two cases confirmed secondary to a hypervirulent strain. The first two cases occurred in diabetic females with associated renal abscesses. While both patients were initially treated with systemic and intravitreal antibiotics, they ultimately required evisceration or enucleation. The third case occurred in a 54-year-old diabetic male, who presented with panophthalmitis of the left eye, subsequently found to have multiple hepatic abscesses. Our final case occurred in a 47-year-old diabetic male with bilateral endogenous endophthalmitis and disseminated cerebral, pulmonary, and hepatic abscesses consistent with <i>K</i>. <i>pneumoniae</i> invasive syndrome. Both the latter two patients were treated with intravitreal and systemic antibiotics, followed by vitrectomy. These cases underscore the importance of recognizing endogenous <i>Klebsiella</i> endophthalmitis as a potential complication in diabetic patients and its association with both hepatic and renal abscesses, as prompt systemic workup may facilitate timely diagnosis and intervention.</p>","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":"15 2","pages":"313-318"},"PeriodicalIF":1.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12204652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530251","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}