Metabolite Changes during the Transition from Hyperthyroidism to Euthyroidism in Patients with Graves’ Disease

Background@#An excess of thyroid hormones in Graves’ disease (GD) has profound effects on systemic energy metabolism that are currently partially understood. In this study, we aimed to provide a comprehensive understanding of the metabolite changes that occur when patients with GD transition from hyperthyroidism to euthyroidism with methimazole treatment. @*Methods@#Eighteen patients (mean age, 38.6±14.7 years; 66.7% female) with newly diagnosed or relapsed GD attending the endocrinology outpatient clinics in a single institution were recruited between January 2019 and July 2020. All subjects were treated with methimazole to achieve euthyroidism. We explored metabolomics by performing liquid chromatography-mass spectrometry analysis of plasma samples of these patients and then performed multivariate statistical analysis of the metabolomics data. @*Results@#Two hundred metabolites were measured before and after 12 weeks of methimazole treatment in patients with GD. The levels of 61 metabolites, including palmitic acid (C16:0) and oleic acid (C18:1), were elevated in methimazole-naïve patients with GD, and these levels were decreased by methimazole treatment. The levels of another 15 metabolites, including glycine and creatinine, were increased after recovery of euthyroidism upon methimazole treatment in patients with GD. Pathway analysis of metabolomics data showed that hyperthyroidism was closely related to aminoacyl-transfer ribonucleic acid biosynthesis and branched-chain amino acid biosynthesis pathways. @*Conclusion@#In this study, significant variations of plasma metabolomic patterns that occur during the transition from hyperthyroidism to euthyroidism were detected in patients with GD via untargeted metabolomics analysis.

Contrast Sensitivity and Inner Retinal Layer Thickness Analysis of Type 2 Diabetic Patients Without Retinopathy

Purpose@#To compare the contrast sensitivities of type 2 diabetic patients without retinopathy and healthy subjects, and to assess the risk factors associated with a change in contrast sensitivity in diabetes. @*Methods@#A total of 75 (diabetic patients without retinopathy) and 41 (healthy subjects) eyes were reviewed from the medical records. The threshold of contrast sensitivity was measured at 6.3°, 4.0°, 2.5°, 1.6°, 1.0°, and 0.64° under scotopic and photopic states. Optical coherence tomography (OCT) imaging was used to measure the retinal nerve fiber layer (RNFL) thickness and ganglion cell-inner plexiform layer (GC-IPL) thickness in diabetic patients. @*Results@#Diabetic patients showed a lower threshold of contrast sensitivity at all degree measures than did the controls under both scotopic and photopic states. In subgroup analyses, diabetic patients with abnormal contrast sensitivity showed a longer duration of diabetes, decreased total retinal thickness, and decreased average GC-IPL, superior RNFL, superior GC-IPL, and temporal GC-IPL thicknesses. Multivariate logistic regression analyses showed that the duration of diabetes and total retinal thickness were significant predictive factors of decreased contrast sensitivity (odds ratio = 1.117 and 0.942, respectively). @*Conclusions@#As the duration of diabetes increased, the contrast sensitivity decreased in type 2 diabetic patients. Neuroretinal degeneration changes both the inner retinal thickness and total retinal thickness and affects contrast sensitivity. Therefore, for longer-term diabetic patients, it is necessary to consider the changes in contrast sensitivity and retinal thickness on OCT evaluation, even if the patient presents with normal fundus findings.

Contrast Sensitivity and Inner Retinal Layer Thickness Analysis of Type 2 Diabetic Patients Without Retinopathy

Purpose@#To compare the contrast sensitivities of type 2 diabetic patients without retinopathy and healthy subjects, and to assess the risk factors associated with a change in contrast sensitivity in diabetes. @*Methods@#A total of 75 (diabetic patients without retinopathy) and 41 (healthy subjects) eyes were reviewed from the medical records. The threshold of contrast sensitivity was measured at 6.3°, 4.0°, 2.5°, 1.6°, 1.0°, and 0.64° under scotopic and photopic states. Optical coherence tomography (OCT) imaging was used to measure the retinal nerve fiber layer (RNFL) thickness and ganglion cell-inner plexiform layer (GC-IPL) thickness in diabetic patients. @*Results@#Diabetic patients showed a lower threshold of contrast sensitivity at all degree measures than did the controls under both scotopic and photopic states. In subgroup analyses, diabetic patients with abnormal contrast sensitivity showed a longer duration of diabetes, decreased total retinal thickness, and decreased average GC-IPL, superior RNFL, superior GC-IPL, and temporal GC-IPL thicknesses. Multivariate logistic regression analyses showed that the duration of diabetes and total retinal thickness were significant predictive factors of decreased contrast sensitivity (odds ratio = 1.117 and 0.942, respectively). @*Conclusions@#As the duration of diabetes increased, the contrast sensitivity decreased in type 2 diabetic patients. Neuroretinal degeneration changes both the inner retinal thickness and total retinal thickness and affects contrast sensitivity. Therefore, for longer-term diabetic patients, it is necessary to consider the changes in contrast sensitivity and retinal thickness on OCT evaluation, even if the patient presents with normal fundus findings.

Measurement of Ophthalmic-arterial Blood-flow Velocity Using Transcranial Doppler Ultrasonography in Patients with Central Serous Chorioretinopathy

PURPOSE: To measure and compare the ocular blood-flow velocity of ophthalmic artery in patients with central serous chorioretinopathy (CSC); affected eyes, asymptomatic fellow eyes, and CSC resolved eyes using transcranial Doppler ultrasonography. METHODS: A total of 31 patients (age 20-52 years) with CSC were evaluated using power motion mode Doppler 150 digital transcranial Doppler ultrasonography. The peak systolic velocity (PSV), peak diastolic velocity (PDV), and resistance index (RI) were measured in the ophthalmic artery of both affected and asymptomatic fellow eyes. After 2 months, 23 patients with resolved serous retinal detachment underwent repeated measurement of the above hemodynamic indices. RESULTS: The PSV and PDV of the ophthalmic artery were 30.05 ± 5.34 cm/sec and 14.07 ± 2.90 cm/sec in affected eyes and 33.03 ± 2.00 cm/sec and 17.17 ± 2.76 cm/sec in asymptomatic fellow eyes, respectively. Both indices were significantly lower in affected eyes (p = 0.004, p < 0.001, respectively). The RI was 0.52 ± 0.08 in affected eyes and 0.43 ± 0.04 in fellow eyes, a significant difference (p < 0.001). After 2 months, in 23 eyes with resolved CSC, the PSV and PDV were 32.94 ± 6.24 cm/sec and 15.54 ± 2.88 cm/sec, respectively. Both indices were significantly higher than at baseline (p = 0.031, p = 0.045, respectively). However, RI was 0.48 ± 0.04 and was not significantly different (p = 0.073). CONCLUSIONS: The CSC-affected eyes showed lower ocular blood-flow velocity and higher RI than the asymptomatic fellow eyes. The ocular blood-flow velocity was increased as CSC was resolved. These findings provide insights into the ophthalmic arterial vascular factors related to the pathogenesis of CSC.

Short-Term Clinical Results and Safety of Ultra Q Laser Treatment for Vitreous Floaters

PURPOSE: To evaluate the short-term clinical results and safety of Ultra Q neodymium-doped yttrium aluminium garnet (Nd:YAG) laser treatment for vitreous floaters. METHODS: The present study included 31 eyes of 31 patients with symptomatic floaters lasting more than 3 months. The vitreous floaters were photodisrupted using Ultra Q Nd:YAG laser. Preoperative and postoperative best corrected visual activity (BCVA) and intraocular pressure, change of the floater, patient satisfaction and postoperative complications were analyzed prospectively. RESULTS: There was no significant difference between preoperative and postoperative BCVA and intraocular pressure (p > 0.05). Vitreous floaters were not found in 9 eyes (29.03%), decreased floaters were observed in 19 eyes (61.29%) and definite change of floaters was not observed in 3 eyes (9.68%). Patient satisfaction after the laser treatment was very satisfied in 11 eyes (35.48%) and satisfied in 20 eyes (64.58%). Satisfaction in Weiss ring type of the floater was the highest, very satisfied in 6 of the 8 eyes (75%) and vitreous floaters were not observed in 7 of the 8 eyes (87.50%). Postoperative complications were not observed during a follow-up period of at least 3 months. CONCLUSIONS: Ultra Q Nd:YAG laser was an effective and safe treatment for the vitreous floaters in this short-term study.

Comparison of Biometric Measurements and Refractive Results between Applanation Ultrasonography and Three Different Interferometries

PURPOSE: To compare ocular biometry and refractive results measured using conventional applanation ultrasonography and 3 different optical interferometries, Lenstar LS900(R), AL-Scan(R) and OA-2000(R). METHODS: The biometries of 31 cataractous eyes were measured using ultrasonography, Lenstar LS900(R), AL-Scan(R) or OA-2000(R). The axial length, anterior chamber depth and keratometry were measured. The SRK/T formula was used to calculate intraocular lens power. Two months after cataract surgery, the refractive outcome was determined and results from the 4 different biometry methods were compared. RESULTS: Axial lengths were 23.39 +/- 0.95 mm, 23.42 +/- 0.98 mm, 23.43 +/- 0.98 mm and 23.44 +/- 0.98 mm measured using ultrasonography, Lenstar LS900(R), AL-Scan(R) and OA-2000(R), respectively with no statistically significant differences observed (p = 0.996). The anterior chamber depth and keratometry were 3.14 +/- 0.41 mm, 3.10 +/- 0.38 mm and 3.13 +/- 0.39 mm (p = 0.936) and 44.41 +/- 1.52 D, 44.54 +/- 1.57 D and 44.44 +/- 1.52 D (p = 0.937) for Lenstar LS900(R), AL-Scan(R) and OA-2000(R) respectively. There were no statistically significant differences between the 3 optical devices. The mean absolute error of the 4 different devices were not statistically significant (p = 0.722). CONCLUSIONS: The ocular biometric measurements and prediction of postoperative refraction using ultrasonography, Lenstar LS900(R), AL-Scan(R) or OA-2000(R) showed no significant differences.