Prescription patterns of herbal medicine for menopausal disorders in major Korean medicine hospitals: a multicenter retrospective study.

BACKGROUND: This study aimed to obtain the symptom, prescription and therapeutic patterns for the treatment of patients with menopausal syndrome in major Korean medicine (KM) hospitals. METHODS: We used a retrospective chart review of climacteric disorder and postmenopausal syndrome patients by examining medical records (ICD-10, menopausal and female climacteric states: N95.1, Menopausal and perimenopausal disorder, unspecified: N95.9) from eight university KM hospitals in South Korea. RESULTS: The main symptoms of 1,682 patients with menopausal disorders visiting eight college-affiliated oriental medicine hospitals were hot flush, hyperhidrosis, fatigue, insomnia, and chest tightness. Guipi decoction, Si-wu guipi decoction, Qing-xin lianzi-yin, Jiawei xiao-yao-san and Guipi wen-dan decoction were the most commonly prescribed treatments for menopausal disorders. Patients were most often treated with a combination of herbal medicine and acupuncture. CONCLUSION: Our study shows that the current prescribed herbal medicines were used for treating menopausal disorders in Korean medicine hospitals. However, the objectivity of the efficacy assessment should be studied further.

Comparison of MultiColor fundus imaging and colour fundus photography in the evaluation of epiretinal membrane.

PURPOSE: To compare MultiColor fundus imaging (MC) and colour fundus photography (CFP) for the evaluation of epiretinal membrane (ERM). METHODS: In this retrospective study, 192 eyes (181 patients) that underwent vitrectomy for ERM were imaged using Spectralis optical coherence tomography (for MC) and AFC-210 digital camera (for CFP) 1 week before vitrectomy. Two investigators independently determined the rate of delineability and ERM area for each modality. RESULTS: The intergrader agreement rates for delineability were very high for both image modalities. The rate of delineability of ERM (%) was higher for MC than for CFP, for both investigators [70.8% versus 52.6% and 73.4% versus 53.6% (both p -)]. Epiretinal membrane (ERM) area measurement showed high agreement between investigators for MC (p = 0.466) but differed significantly between the investigators for CFP (p -). The ERM area determined on MC was significantly wider than that on CFP for both investigators (p - for investigator 1 and p - for investigator 2). CONCLUSION: The ERM area is more clearly detectable and widely demarcated in MC than in CFP images. MultiColor imaging (MC) may be more sensitive and accurate for early detection of ERM and ERM area measurement.

Choroidal Thickness Indicates Subclinical Ocular and Systemic Inflammation in Eyes with Behçet Disease without Active Inflammation.

PURPOSE: To investigate whether subfoveal choroidal thickness, measured using enhanced depth imaging optical coherence tomography (EDI-OCT), is an indicator of subclinical ocular or systemic inflammation in eyes with Behçet disease (BD) without active ocular inflammation. METHODS: A retrospective analysis was used to examine clinical features of non-uveitic patients with BD (NUBD group), patients with a previous history of Behçet uveitis in an inactive state (IUBD group), and healthy controls were evaluated from October 2014 to September 2015. Subfoveal choroidal thickness was measured using EDI-OCT. RESULTS: The NUBD group included 46 eyes in 24 patients; the IUBD group included 16 eyes in 11 patients; and the control group included 35 eyes in 23 individuals. The mean subfoveal choroidal thicknesses differed significantly among these groups. Choroidal thickness was significantly greater in the NUBD (310.5 ± 81.0 µm) than in the IUBD (263.1 ± 56.6 µm, p = 0.013) and control (256.9 ± 67.9 µm, p = 0.002) groups. The disease activity score was significantly higher in the NUBD than in the IUBD group (p < 0.001), while the use of cyclosporine was significantly associated with choroidal thickness in eyes with NUBD (p = 0.039). CONCLUSIONS: Subfoveal choroidal thickness, as measured by EDI-OCT, may be a clinical indicator of subclinical ocular inflammation and systemic inflammation in BD patients without active ocular inflammation.

Quarter-Shifted Microincisional Sutureless Vitrectomy in Patients with a Glaucoma Drainage Implant or Filtering Bleb.

When vitrectomy is performed in eyes that have undergone glaucoma surgery, the site of sclerotomy often overlaps with the previous glaucoma operation site. It can lead to serious complications such as postoperative hypotony, leakage, and/or infection. Our technique involves modification of surgeon's position and two sclerotomy sites 45° away from the original position, with an infusion cannula inserted infranasally to avoid damage to the glaucoma drainage implant or filtering bleb. The modified approach was applied to seven eyes with various indications. Vitrectomy was successfully completed, and there were no sclerotomy site complications, leakage, or hypotony in any case. Good intraocular pressure control was maintained throughout the postoperative course in all cases.

Agreement of New Automated Matched Alternation Flicker using Undilated Fundus Photography for the Detection of Glaucomatous Structural Change.

PURPOSE: To determine the agreement among glaucoma experts and general ophthalmologists regarding detection of glaucomatous structural changes using a new automated matched alternation flicker (AMAF) method with fundus photographs (FPs) of undilated eyes. METHODS: Sixty-six pairs of FPs of normal tension glaucoma patients were collected. FPs were taken at intervals of more than 12 months. Alternating flicker images were created using a new AMAF application. In a blinded manner, two glaucoma experts and two general ophthalmologists compared the presence of glaucomatous structural changes using either the AMAF method or the side-by-side comparison method. The interobserver and intraobserver agreements were compared using the Bland and Altman plot analysis. RESULTS: The glaucoma experts detected more glaucoma progression using the AMAF method (average, 50.7%) compared with the side-by-side method (average, 32.5%). General ophthalmologists detected more glaucomatous progression with the AMAF method (average, 40.9%) than with the side-by-side method (average, 25.0%). The AMAF method showed fair to substantial interreader agreement (k = 0.511-0.724) and fair to perfect intrareader agreement (k = 0.631-0.943). Interreader and intrareader agreements using the AMAF method were better for the glaucoma experts compared with the general ophthalmologists. CONCLUSIONS: The AMAF method showed more changes in FPs than the classical side-by-side comparison method. Regarding inter- and intrareader agreements, agreement for the glaucoma experts was best using the AMAF method, but for the general ophthalmologists agreement was best using the side-by-side comparison method.