Associations between Nutritional Risk and Mental Health in an Elderly Korean Population

Objective@#：Older adults are at greater risk for malnutrition than younger adults, and malnutrition can be associated with a variety of mental problems. This study was undertaken to investigate differences in mental health indicators according to nutritional risk administered to elderly people living in the community. @*Methods@#：Nutritional risk score was assessed using the ‘Determine Your Nutrition Health’ checklist, developed by the Nutritional Screening Initiative. The study enrolled 400 elderly people living in the community. Study subjects were divided into 3 groups based on their nutritional risk score: good nutrition (score ≤2; n=275), moderate nutritional risk (score 3-5; n=63), and high nutritional risk (score ≥6; n=62). The General Health Questionnaire-12 (GHQ-12), suicide risk screening tool, memory decline awareness, sleep disorder questionnaire, and health-related quality of life (EuroQoL-5 dimension, EQ-5D) were used to assess mental health problems. Statistical analyses were performed using chi-square test, analysis of variance, and Pearson correlation analysis. @*Results@#：In the high nutrition risk group, GHQ-12 score was highest. In the good nutrition group, subjective memory impairment score and sleep difficulty were lowest, and EQ-5D index was highest. The risk of suicide tended to increase with increasing nutritional risk. Nutritional risk score was significantly correlated with GHQ-12, subjective memory impairment, sleep latency time, total sleep duration, sleep difficulty, and EQ-5D index. @*Conclusion@#：This study confirms that nutritional risk in the elderly is related to various psychological symptoms and low quality of life. High nutritional risk in the elderly warrants clinical attention to mental health and quality of life.

Central Serous Chorioretinopathy with Peripapillary Retinoschisis

PURPOSE: To report a case of central serous chorioretinopathy with peripapillary retinoschisis. CASE SUMMARY: A 64-year-old male presented with abnormal color vision of the left eye, which occurred 6 months prior to his visit. At the initial visit, a funduscopic examination revealed retinal elevation with suspected serous retinal detachment around the optic disc in the left eye. Spectral domain optical coherence tomography showed subretinal fluid on the nasal side of the optic disc and retinoschisis on the temporal side of the optic disc in the left eye. Fluorescein angiography revealed multiple leakages in the left eye. Indocyanine green angiography revealed choroidal vascular hyperpermeability in both eyes. Based on these results, the patient was diagnosed with chronic central serous chorioretinopathy and was treated with argon laser photocoagulation at the leakage points. After 8 weeks of laser therapy, optical coherence tomography indicated that there was no retinoschisis or subretinal fluid in the macula, nasal, or temporal sides of the optic disc. CONCLUSIONS: Peripapillary retinoschisis due to central serous chorioretinopathy improves with argon laser photocoagulation at leakage sites.

Intraindividual Comparison of Visual Outcomes between Blue Light-filtering and Ultraviolet Light-filtering Intraocular Lens

PURPOSE: To compare the clinical results of short-term visual acuity and quality of vision after implantation of a yellow-tinted blue light-filtering intraocular lens (IOL) (Acrysof IQ® SN60WF) and an clear ultraviolet (UV) light filtering IOL (enVista™ MX60) in the same patient. METHODS: 44 patients with bilateral cataract received an SN60WF in one eye and an MX60 in the other eye. All eyes were evaluated for refraction power and uncorrected visual acuity (UCVA) at preoperative and 1, 3 months postoperatively. At postoperative 3 months, corrected visual acuity, quality of vision (OQAS II®), contrast sensitivity (CGT 2000®) and visual field (Humphrey Field Analyzer®), and subjective patients' response to the degree of brightness were evaluated. Furthermore, glistening degree, intraocular stability, and posterior capsular opacification were examined. RESULTS: There were no significant differences in average refractive power or UCVA at 1 and 3 months (p > 0.05) between the two groups. At 3 months after cataract surgery, the quality of vision according to OQAS II®, the contrast sensitivity according to CGT 2000® with the glare either on or off, and visual field; showed no difference between the two groups (p > 0.05). Both IOLs had no glistening and posterior capsular opacity. The patients' response to the degree of brightness shows that MX60 (48.3%) has a higher degree of satisfaction. CONCLUSIONS: Yellow-tinted blue light-filtering IOL and clear UV light-filtering IOL had no difference in short-term visual acuity and quality of vision. Subjective brightness perception, however, was better with clear UV light-filtering IOL.

The Effectiveness of Topical Chemotherapy for the Primary Treatment of Ocular Surface Squamous Neoplasia

PURPOSE: In the present study, the effectiveness of topical chemotherapy for the primary treatment of ocular surface squamous neoplasia (OSSN) was evaluated. METHODS: We enrolled 10 patients (10 eyes) diagnosed with OSSN who received both clinical examination and anterior segment optical coherence tomography (AS-OCT) imaging. The patients were administered topical 0.02% mitomycin-C (MMC) 4 times/day in the affected eye. The patients with MMC-resistant OSSN received topical 1% 5-fluorouracil (5-FU) 4 times/day. AS-OCT imaging was performed before and after the treatment. Clinical examination and AS-OCT were used to monitor the efficacy of topical chemotherapy, recurrence and side effects. RESULTS: The mean age of the 10 patients (8 males, 2 females) was 76.7 years. The proportion of complete remission resulting from topical treatment with MMC was 80.0% (8 eyes) and 20.0% (2 eyes) when 5-FU was changed to MMC. The average duration of complete remission was 4.3 weeks and the average duration of no recurrence was 17.5 months. The epithelial thickness of the lesions, measured using AS-OCT, significantly decreased from 315.0 µm (pretreatment) to 105.3 µm (after complete remission). Additionally, the epithelial lesion appeared normal after treatment. The most common side effect was conjunctival hyperemia (60.0%, 6 eyes), followed by ocular allergy (30.0%, 3 eyes), superficial punctate keratitis (30.0%, 3 eyes) and corneal erosion (20%, 2 eyes). No serious complications were reported. CONCLUSIONS: Topical chemotherapy is as effective and well tolerated as a primary treatment for OSSN. Additionally, AS-OCT is a useful noninvasive adjunctive tool in the diagnosis and management of OSSN.

Comparison of Choroidal Thickness Change between Ranibizumab and Aflibercept in Age-related Macular Degeneration: Six Month Results

PURPOSE: To compare the changes in subfoveal choroidal thickness between intravitreal aflibercept and ranibizumab injection in wet age-related macular degeneration (AMD). METHODS: Fifty patients with wet AMD patients who were treated with aflibercpet or ranibizumab were evaluated retrospectively. All patients were treated with pro re nata after 3 consecutive monthly injections and were followed up for at least 6 months. We measured subfoveal choroidal thickness (SFCT) using enhanced depth imaging spectral-domain optical coherence tomography before the first injection and 1, 2, 3, and 6 months after initial injection. RESULTS: The SFCT measures before initial injection and 1, 2, 3, and 6 months after initial injection were 244.94 ± 103.77 µm, 219.04 ± 95.89 µm, 208.74 ± 91.03 µm, 203.64 ± 91.35 µm, and 226.98 ± 96.79 µm in the aflibercept group (25 eyes) and 222.68 ± 102.04 µm, 210.23 ± 95.91 µm, 203.66 ± 99.39 µm, 197.27 ± 100.25 µm, and 210.32 ± 111.86 µm in the ranibizumab group (28 eyes). Mean change in SFCT was greater in the aflibercept group at 1 month, 2 months, and 3 months after initial injection (p 0.05). CONCLUSIONS: The decrease in SFCT was greater after aflibercept injection than ranibizumab injection in 3 consecutive months. However, at 6 months after initial injection, the difference in the change in SFCT was not significant.

Utility of the Swept Source Optical Coherence Tomography for Measurements of Central Corneal Thickness

PURPOSE: To evaluate the efficacy of swept source optical coherence tomography (SS-OCT) by comparing the measurement of central corneal thickness (CCT) to the measurement obtained using Orbscan II, anterior segment optical coherence tomography (AS-OCT) and ultrasound pachymetry. METHODS: One examiner measured the CCT in 65 eyes of 65 healthy subjects using Orbscan II, AS-OCT, SS-OCT and ultrasound pachymetry. The mean values and correlations were analyzed. RESULTS: The average CCT measurements obtained using Orbscan II, AS-OCT, SS-OCT and ultrasound pachymetry were 534.83 ± 38.46, 517.80 ± 32.48, 528.22 ± 33.71 and 528.02 ± 34.90 µm, respectively. A significant linear correlation was observed among Orbscan II, AS-OCT, SS-OCT and ultrasound pachymetry (r > 0.894, p < 0.001). There was no significant difference between the SS-OCT and ultrasound pachymetry (p = 0.782). CONCLUSIONS: The results of the 4 methods were significantly correlated and the SS-OCT reached a high level of agreement when CCT was determined using ultrasound pachymetry. The CCT measurements using SS-OCT is a better alternative for ultrasound pachymetry than Orbscan II and AS-OCT.

Electroconvulsive Therapy for Patients with Treatment-Resistant Schizophrenia Patients : A Retrospective Study / 신경정신의학

OBJECTIVES: This study analyzes the effect of electroconvulsive therapy (ECT) by predicting the factors contributing to the effectiveness of ECT and evaluating the persistency of ECT effect in patients with treatment-resistant schizophrenia. METHODS: Using retrospective review of the charts of 24 schizophrenic inpatients who were admitted to Busan Paik Hospital between March 1, 2005 and December 31, 2009. We compared the pre-ECT Clinical Global Impression (CGI) scores and post-ECT CGI scores among these patients. We evaluated the differences in the ECT responses by sex, age, duration of illness and dose of antipsychotic agents, and investigated the rate of continuation of out-patient treatment and readmission, and the change of the CGI score for 12 months after the ECT. RESULTS: ECT resulted in an overall clinical improvement as measured on the CGI scale. 15 (62.50%) patients were good responders, while 9 (37.50%) were poor responders. There was no significant difference between sex, age, duration of the illness, and dose of antipsychotics taken by the patient before the ECT. 21 (87.50%) patients continuously visited the outpatient department for 12 month, and 14 (66.67%) of them maintained the ECT effect with medical treatment only and without readmission. CONCLUSION: This study showed that the ECT could be a useful treatment option for schizophrenic patients who are resistant to antipsychotics.