A Study of Retinal and Choroidal Vessel Changes in Chronic Alcoholics

Purpose@#To compare the retinal and choroidal vessels of chronic alcoholics with non-alcoholics. @*Methods@#This study included alcohol-associated liver disease (ALD) patients admitted between December 2020 and October 2021, along with age-matched controls. Retinal and choroidal vessel densities, measured using image binarization at the superficial capillary plexus (SCP), deep capillary plexus (DCP), choriocapillaris, and choroidal layers, were compared between ALD patients and controls. Correlations between clinical parameters and vessel densities in ALD patients were also analyzed. @*Results@#Vessel densities at SCP, DCP, choriocapillaris, and choroidal layers were not significantly different between controls and ALD patients (p = 0.496, 0.988, 0.909, and 0.317, respectively). Platelet time and international normalized ratio (INR) were positively correlated with SCP density in ALD patients (r = 0.393 and 0.393; p = 0.015 and 0.015, respectively). @*Conclusions@#ALD does not significantly affect vessel densities in the retina and choroid. The positive correlations of platelet time and INR with SCP may be related to vessel dilatation, but they require further investigation.

Clinical Factors Affecting Subfoveal Choroidal Thickness and Choroidal Vascularity Index after Phacoemulsification for Cataracts

Purpose@#To investigate clinical factors affecting subfoveal choroidal thickness (SFCT) and choroidal vascularity index (CVI) after cataract surgery. @*Methods@#A retrospective medical record review was performed of 62 patients (95 eyes) who underwent cataract surgery. The SFCT and CVI were calculated based on cross-section measurements obtained from enhanced depth imaging-optical coherence tomography preoperatively and postoperatively at 1 week, 1 month, and 2 months. The changes in SFCT and CVI were analyzed with respect to anesthesia, diabetes mellitus (DM), hypertension (HTN), and phaco power/time. @*Results@#Regardless of anesthesia, DM, or HTN, SFCT had increased at 1 week postoperatively and continued to decrease up to 2 months postoperatively. In the case of topical anesthesia and patients without DM or HTN, the CVI was significantly higher at 1 month postoperatively, but was followed by a steady reduction up to the 2-month follow-up. In the case of retrobulbar anesthesia and patients with DM or HTN, the CVI increased up to 2 months postoperatively. @*Conclusions@#In this study, clinical factors had a significant impact on the change in CVI after surgery, but not on the SFCT. This suggests that the presence of DM affects the change in the choroidal vessels after cataract surgery.

Clinical Factors Affecting Subfoveal Choroidal Thickness and Choroidal Vascularity Index after Phacoemulsification for Cataracts

Purpose@#To investigate clinical factors affecting subfoveal choroidal thickness (SFCT) and choroidal vascularity index (CVI) after cataract surgery. @*Methods@#A retrospective medical record review was performed of 62 patients (95 eyes) who underwent cataract surgery. The SFCT and CVI were calculated based on cross-section measurements obtained from enhanced depth imaging-optical coherence tomography preoperatively and postoperatively at 1 week, 1 month, and 2 months. The changes in SFCT and CVI were analyzed with respect to anesthesia, diabetes mellitus (DM), hypertension (HTN), and phaco power/time. @*Results@#Regardless of anesthesia, DM, or HTN, SFCT had increased at 1 week postoperatively and continued to decrease up to 2 months postoperatively. In the case of topical anesthesia and patients without DM or HTN, the CVI was significantly higher at 1 month postoperatively, but was followed by a steady reduction up to the 2-month follow-up. In the case of retrobulbar anesthesia and patients with DM or HTN, the CVI increased up to 2 months postoperatively. @*Conclusions@#In this study, clinical factors had a significant impact on the change in CVI after surgery, but not on the SFCT. This suggests that the presence of DM affects the change in the choroidal vessels after cataract surgery.

Antineutrophil Cytoplasmic Antibody-associated Optic Neuritis

Purpose@#We report a case of antineutrophil cytoplasmic antibody (ANCA)-associated optic neuritis with glomerulonephritis.Case summary: A 66-year-old male with a history of acute kidney injury presented with decreased visual acuity in both eyes. His best-corrected visual acuity (BCVA) was 0.15 in the right eye and 0.6 in the left eye. Both eyes showed optic disc swelling and Ishihara’s tests were 1/17. He was treated with intravenous methylprednisolone for 3 days to treat presumed bilateral optic neuritis. In follow-up, anti-myeloperoxidase antibody (anti-MPO antibody, p-ANCA) was positive at 32.0 IU/mL and ANCA-associated chronic sclerosing glomerulonephritis was found in the left kidney biopsy. He is currently being followed-up on oral steroids in the outpatient clinic. Kidney function improved immediately after high-dose steroid therapy. After 3 months of treatment, optic disc swelling resolved. On the other hand, there was minimal improvement in visual acuity. @*Conclusions@#In ANCA-associated optic neuritis with glomerulonephritis, both optic disc swelling and kidney function improved with steroid therapy. On the other hand, there was only a small improvement in visual acuity.

Serial Follow-up of Commotio Retinae Using Ultra-wide Field Imaging

PURPOSE: To quantify the size of commotio retinae and investigate its spontaneous resolution over time using ultra-wide field (UWF) color fundus photography.METHODS: We analyzed serial UWF color fundus photographs of 33 eyes of 33 ocular trauma patients with commotio retinae. Total visible retinal areas and the areas of commotio retinae were measured at baseline, 3 days, 1 week, and 4 weeks from the initial traumatic event.RESULTS: The median time of observation was 10.8 ± 12.1 (4-44) weeks. Spontaneous resolution of commotio retinae was observed in all patients, and no patients experienced any complications during the follow-up period. The mean percentage of commotio retinae at 3 days significantly decreased compared to the baseline (8.51 ± 9.66% versus 12.23 ± 10.39%; p < 0.001), and more decreased at 1 week (1.04 ± 2.75%; p < 0.001), but no significant differences were observed between 1 week and 4 weeks (0.00 ± 0.00%; p = 0.219). The spontaneous resolution percentages during the first 3 days, between 3 days and 1 week, and during the next 4 weeks were 12.97 ± 13.44%/day, 19.62 ± 9.22%/day, and 0.87 ± 1.87%/day, respectively (p = 0.192 and p < 0.001, respectively). The resolution rate was higher during the first 1 week.CONCLUSIONS: We quantified the size of commotio retinae using UWF color fundus photography. Most patients with commotio retinae resolved spontaneously during the first 1 week following trauma, and all cases completely resolved at 1 month without any complications.

Antineutrophil Cytoplasmic Antibody-associated Optic Neuritis

Purpose@#We report a case of antineutrophil cytoplasmic antibody (ANCA)-associated optic neuritis with glomerulonephritis.Case summary: A 66-year-old male with a history of acute kidney injury presented with decreased visual acuity in both eyes. His best-corrected visual acuity (BCVA) was 0.15 in the right eye and 0.6 in the left eye. Both eyes showed optic disc swelling and Ishihara’s tests were 1/17. He was treated with intravenous methylprednisolone for 3 days to treat presumed bilateral optic neuritis. In follow-up, anti-myeloperoxidase antibody (anti-MPO antibody, p-ANCA) was positive at 32.0 IU/mL and ANCA-associated chronic sclerosing glomerulonephritis was found in the left kidney biopsy. He is currently being followed-up on oral steroids in the outpatient clinic. Kidney function improved immediately after high-dose steroid therapy. After 3 months of treatment, optic disc swelling resolved. On the other hand, there was minimal improvement in visual acuity. @*Conclusions@#In ANCA-associated optic neuritis with glomerulonephritis, both optic disc swelling and kidney function improved with steroid therapy. On the other hand, there was only a small improvement in visual acuity.

Effect of Acetazolamide on Choroidal Morphology in Central Serous Chorioretinopathy

PURPOSE: We sought to elucidate the influence of acetazolamide on choroidal structure changes during the treatment of central serous chorioretinopathy (CSC).METHODS: This was a retrospective study of 45 eyes from 45 patients with acute CSC who were divided into an acetazolamide group (group 1, n = 20) and an observation group (group 2, n = 25). The main outcome measures were the changes in best-corrected visual acuity, subretinal fluid (SRF) height, subfoveal choroidal thickness (SFCT), and choroidal vascularity index (CVI) at one week, one month, two months, and three months, respectively.RESULTS: Although statistical significance was not reached, best-corrected visual acuity improved in both groups at month 3 (from 0.06 ± 0.07 to 0.01 ± 0.03 in group 1 and 0.17 ± 0.24 to 0.09 ± 0.18 in group 2; p = 0.083 and 0.183, respectively). Separately, SRF height and CVI showed a significant decrease at three months in both groups (all p < 0.05), while a significant SRF height decrease was also noted in group 1 at one month (p = 0.038). In group 1, a significant decrease in the SFCT and CVI started at one week and one month (p = 0.021 and 0.008), respectively. However, in group 2, a significant decrease in the SFCT and CVI started at one month and two months (p = 0.005 and 0.015), respectively.CONCLUSIONS: Acetazolamide has no effect on final functional or anatomical status at three months in eyes with CSC but does shorten the time for SRF absorption and accompanying choroidal structural changes.

Two Cases of Endogenous Endophthalmitis That Progressed to Globe Rupture

No abstract available.

Factors Associated with Insomnia among the Elderly in a Korean Rural Community

OBJECTIVE: Sleep disturbance is common in the elderly, which is result from multi-factorial causes encompassing socio-demographic, behavioral, and clinical factors. We aimed to identify factors associated with insomnia among the elderly in a rural community in South Korea, a country with a rapidly growing aged population. METHODS: This cross-sectional study used the data from the second wave of the Korean Social life, Health and Ageing Project, which is a cohort study of individuals living in a typical rural community in South Korea. Socio-demographic, behavioral, and clinical characteristics were obtained through face-to-face interviews. Various factors suspected to be associated with insomnia were compared between elderly participants with and without insomnia, and multiple logistic regression analyses were conducted to identify independent risk factors for insomnia. RESULTS: We found that 32.4% of 509 participants (72.8±7.7 years old) had insomnia. Female sex [odds ratio (OR)=2.19], low education level (OR=2.44), current smoking (OR=2.26), number of chronic diseases (OR=2.21 for 2–3 chronic diseases; OR=2.06 for 4 or more chronic diseases), and depression (OR=2.53) were independently associated with insomnia. CONCLUSION: We found that sex, education, chronic disease, and depression independently increase the risk of insomnia of the elderly in a Korean rural community. To overcome the elderly's insomnia, interventions should target modifiable factors such as depression. To promote active aging, longitudinal studies of factors associated with insomnia among the elderly should be performed in different regions and communities.

Is Whole Exome Sequencing Clinically Practical in the Management of Pediatric Crohn's Disease?

BACKGROUND/AIMS: The aim of this study was to identify the profile of rare variants associated with Crohn's disease (CD) using whole exome sequencing (WES) analysis of Korean children with CD and to evaluate whether genetic profiles could provide information during medical decision making. METHODS: DNA samples from 18 control individuals and 22 patients with infantile, very-early and early onset CD of severe phenotype were used for WES. Genes were filtered using panels of inflammatory bowel disease (IBD)-associated genes and genes of primary immunodeficiency (PID) and monogenic IBD. RESULTS: Eighty-one IBD-associated variants and 35 variants in PID genes were revealed by WES. The most frequently occurring variants were carried by nine (41%) and four (18.2%) CD probands and were ATG16L2 (rs11235604) and IL17REL (rs142430606), respectively. Twenty-four IBD-associated variants and 10 PID variants were predicted to be deleterious and were identified in the heterozygous state. However, their functions were unknown with the exception of a novel p.Q111X variant in XIAP (X chromosome) of a male proband. CONCLUSIONS: The presence of many rare variants of unknown significance limits the clinical applicability of WES for individual CD patients. However, WES in children may be beneficial for distinguishing CD secondary to PID.