The Nationwide Incidence of Retinal Vein Occlusion Following Dialysis due to End-stage Renal Disease in Korea, 2004 through 2013

Background@#We investigated the incidence and risk of retinal vein occlusion (RVO) in endstage renal disease (ESRD) patients on dialysis in Korea. @*Methods@#In this nationwide cohort study, we used Korean National Health Insurance Service data between 2004 and 2013 for analysis. ESRD patients who started dialysis from 2004 to 2013 and an equal number of controls were selected through propensity score matching. RVO incidence in both cohorts were calculated for 2004–2013 using washout data from 2003. The multivariable Cox proportional hazards model was used to assess the risk of RVO in dialysis cohort. The Kaplan-Meier method was used to generate the cumulative RVO incidence curve.Whether the dialysis modality affects the development of RVO was also evaluated. @*Results@#In this study, 74,551 ESRD patients on dialysis and the same number of controls were included. The incidence of RVO was significantly higher in the dialysis cohort than in the control cohort (dialysis = 7.3/1,000 person-years [PY]; control = 1.9/1,000 PY; P < 0.001). The cumulative-incidence of RVO was also significantly higher in the dialysis cohort than in the control cohort (P < 0.001; log-rank test). However, there was no significant difference in the incidence of RVO between the two dialysis methods (P = 0.550; log-rank test). @*Conclusion@#This study provided epidemiological evidence that receiving dialysis for ESRD could increase the risk of developing RVO. We also found a rapid increase in the incidence of RVO with a longer dialysis period. These results strengthen the relationship between retinal vascular disease and renal function.

The Nationwide Incidence of Retinal Vein Occlusion Following Dialysis due to End-stage Renal Disease in Korea, 2004 through 2013

Background@#We investigated the incidence and risk of retinal vein occlusion (RVO) in endstage renal disease (ESRD) patients on dialysis in Korea. @*Methods@#In this nationwide cohort study, we used Korean National Health Insurance Service data between 2004 and 2013 for analysis. ESRD patients who started dialysis from 2004 to 2013 and an equal number of controls were selected through propensity score matching. RVO incidence in both cohorts were calculated for 2004–2013 using washout data from 2003. The multivariable Cox proportional hazards model was used to assess the risk of RVO in dialysis cohort. The Kaplan-Meier method was used to generate the cumulative RVO incidence curve.Whether the dialysis modality affects the development of RVO was also evaluated. @*Results@#In this study, 74,551 ESRD patients on dialysis and the same number of controls were included. The incidence of RVO was significantly higher in the dialysis cohort than in the control cohort (dialysis = 7.3/1,000 person-years [PY]; control = 1.9/1,000 PY; P < 0.001). The cumulative-incidence of RVO was also significantly higher in the dialysis cohort than in the control cohort (P < 0.001; log-rank test). However, there was no significant difference in the incidence of RVO between the two dialysis methods (P = 0.550; log-rank test). @*Conclusion@#This study provided epidemiological evidence that receiving dialysis for ESRD could increase the risk of developing RVO. We also found a rapid increase in the incidence of RVO with a longer dialysis period. These results strengthen the relationship between retinal vascular disease and renal function.

Reading Speed after Anti-vascular Endothelial Growth Factor Therapy in Patients with Wet Age-related Macular Degeneration

Purpose@#To demonstrate the changes in reading speed after anti-vascular endothelial growth factor (VEGF) treatment in wet age-related macular degeneration (wAMD) patients. @*Methods@#This retrospective study enrolled wAMD patients who were treated with intravitreal anti-VEGF injection from May 2019 to September 2019. The reading speed was measured before anti-VEGF treatment and at the next injection visit using an iPad application for the assessment of reading speed. Best-corrected visual acuity (BCVA) and central retinal thickness (CRT) were also analyzed. In addition, we investigated whether the improvement in optical coherence tomography (OCT)-related biomarkers affected the change in reading speed after anti-VEGF injection. As a subgroup analysis, patients were further divided into a loading dose group and a maintenance group. @*Results@#Seventy-four patients were enrolled in this study. In the loading dose group (n = 38), there were significant improvements in BCVA (p = 0.01) and CRT (p = 0.001); additionally, the reading speed improved significantly in two of the four areas (words per minute (WPM) reading [p = 0.035] and WPM speaking [p = 0.013]) after anti-VEGF injection. In the maintenance group (n = 36), BCVA, CRT, and reading speed showed some improvement; however, the results were not statistically significant. In the maintenance group, reading speed improved significantly as the size of the pigment epithelial detachment decreased after anti-VEGF injection. @*Conclusions@#Reading speed may be useful as an index for measuring visual function related to the quality of life of wAMD patients. Precise evaluation and continuous monitoring of OCT biomarkers are necessary for the treatment of wAMD especially in the maintenance group because they can be predictors of reading speed improvement.

Comparison of Clinical Features among Children of Multicultural Families, Ethnic Koreans and Native Koreans

PURPOSE: To explore whether genetic and environmental factors influenced ophthalmic disease among children of multicultural families, ethnic Koreans, and native Koreans. METHODS: In this retrospective study, 120 patients who visited the pediatric ophthalmology clinic of a university hospital were included. They were equally divided into three groups: a multicultural group, an ethnic Korean group, and a native Korean group. Parental nationalities, age, gender, chief complaint, visual acuity, refractive error, diagnosis at the initial visit and the extent of compliance with treatment were analyzed. RESULTS: Of the multicultural group, 14 (35%) of 40 patients were Chinese immigrants, and constituted the most common subgroup. None of the age at initial visit, gender, the prevalence of refractive error, or amblyopia status differed significantly among the three groups. In the multicultural and native Korean groups, the proportions of abnormal eye positioning as the chief complaint were higher than that of the ethnic Korean group (p = 0.005). The most common diagnosis in the two former groups was strabismus. Myopia was the most common diagnosis in the ethnic Korean group. The prevalence of strabismus in the multicultural group (55%) was significantly higher than that in the native Korean group (30%) and the ethnic Korean group (20%) (p = 0.003). The prevalence of strabismus in the multicultural group was significantly higher than in the other groups (p = 0.003). However, we found no significant difference in strabismus subtype among the three groups. In the general family group, the extent of loss to follow-up was significantly higher than in the other groups (p = 0.002). CONCLUSIONS: The chief complaint, the prevalence of ophthalmic disease, and the compliance rate differed significantly among the three groups. Both genetic and environmental factors may have played a role.

Ocular and Systemic Manifestation of Amaurosis Fugax: Six-Year Observational Study

PURPOSE: To investigate the prevalence of ocular and systemic disease causing amaurosis fugax and to discuss the ocular and systemic manifestation of each disease. METHODS: Consecutive patients who had amaurosis fugax were retrospectively studied from 2007 to 2013. Carotid evaluation using Doppler was performed in all patients. Ocular and medical histories were taken and bilateral ophthalmic evaluation performed. RESULTS: This study included 35 patients. The mean age of patients was 63 years and 27 patients were male; 29 unilateral and 6 bilateral eyes were involved. Associated systemic disease included hypertension (54.3%) and diabetes mellitus (34.2%). The most frequent cause of amaurosis fugax was retinal artery occlusion (28.6%) followed by ocular ischemic syndrome (22.9%), other vascular diseases (11.4%), and retinal vein occlusion (5.7%). The remaining 31.4% patients with amaurosis fugax had no vascular disease. Clinically significant stenosis of the internal carotid artery was observed in 16 patients (45.7%) and 6 of these patients (37.5%) had retinal artery occlusion disease. CONCLUSIONS: Prevalence and clinical manifestation of amaurosis fugax is very complex. Patients with transient visual disturbance are at risk for retinal artery occlusion, ocular ischemic syndrome and other diseases which cause visual loss. Therefore, careful history taking and urgent systemic and ophthalmic evaluations should be performed.

Surgical Results of Patients with +3.00 Diopters or More Hyperopia and Exotropia

PURPOSE: To evaluate the surgical result of patients who had intermittent or constant +3.00 diopter (D) or more exotropia and hyperopia. METHODS: Twenty-seven patients who had an operation for +3.00 D or more hyperopia and exotropia were included. The duration of follow-up was 6 months or more after surgery. Age at the initial visit, visual acuity, refractive errors, presence of amblyopia, reduced rate of hyperopic correction, changes in exodeviated angle after reduction of hyperopic correction, surgical results and postoperative data were analyzed. RESULTS: The mean age at the initial visit was 5.4 years and at surgery was 7.3 years. The mean degree of hyperopia in the worse eye was 3.86 +/- 1.35 D and the better eye 1.31 +/- 1.19 D. Fourteen of the 27 patients had amblyopia. The degree of reduced hyperopia correction was 1.35 +/- 1.06 D during the preoperative period. The initial angles of deviation were 26.8 +/- 7.7 prism diopters (PD) at distance and 28.2 +/- 8.9 PD at near. At postoperative 12 months, 19 of 27 patients (70.4%) achieved deviated angle within 10 PD. The cause of surgical failure was recurrence of exotropia. All the surgically failed patients had reduced hyperopic correction of the better eye before surgery. Reduction rate of hyperopic correction in the surgically failed group was significantly higher than in the surgically successful group (p = 0.004). CONCLUSIONS: There was a high incidence of amblyopia in the patients with +3.00 D or more exotropia and hyperopia before surgery. The cause of surgical failure was the recurrence of exotropia, and the degree of reduced hyperopic correction in the surgically failed group was larger than in the surgically successful group.