Effect of Bergmeister papilla on disc parameters in spectral domain optical coherence tomography.

OBJECTIVES: To investigate the morphological characteristics of Bergmeister papilla (BMP), a persistent hyaloid remnant tissue, and its effects on the measurements and repeatability of spectral-domain optical coherence tomography (OCT). SUBJECTS/METHODS: The subjects of this prospective cross-sectional study including 83 patients with BMP and 76 unaffected individuals, all had open-angle structures. Images, including a 5-line raster and three consecutive optic disc cube scans centred on the optic disc, were acquired using the Cirrus high-definition OCT. BMP's structural characteristics were classified based on the raster scan images, and repeatability of acquiring optic nerve head and retinal nerve fibre layer parameters acquisition was analysed by calculating the test-retest standard deviation (Sw), coefficient of variance (CV), and intraclass correlation coefficient. RESULTS: BMPs (n = 83) were categorised into lifting edge (LE) type (63.9%, n = 53), which partially covers the edge of the optic nerve head, and covering disc (CD) type (36.1%, n = 30), which completely covers the cupping area like a cap. The average cup-to-disc ratio (0.58 ± 0.21), vertical cup-to-disc ratio (0.55 ± 0.21), and cup volume (0.22 ± 0.22) of the CD type were lower than those of the LE type (0.66 ± 0.13, 0.64 ± 0.13, and 0.4 ± 0.27, respectively; all P < 0.05). Tolerability indices for repeatability of cup volume (Sw = 0.40 and CV = 0.36) and inferonasal (4 o'clock) retinal nerve fibre layer (Sw = 0.27 and CV = 0.25) in LE-type BMPs exceeded the cut-off value (0.22) and demonstrated stronger correlation with BMP location than that of the controls. CONCLUSION: Caution should be exercised when interpreting OCT findings in eyes with BMP, as BMP can introduce a pitfall in OCT imaging.

Neural network application for assessing thyroid-associated orbitopathy activity using orbital computed tomography.

This study aimed to propose a neural network (NN)-based method to evaluate thyroid-associated orbitopathy (TAO) patient activity using orbital computed tomography (CT). Orbital CT scans were obtained from 144 active and 288 inactive TAO patients. These CT scans were preprocessed by selecting eleven slices from axial, coronal, and sagittal planes and segmenting the region of interest. We devised an NN employing information extracted from 13 pipelines to assess these slices and clinical patient age and sex data for TAO activity evaluation. The proposed NN's performance in evaluating active and inactive TAO patients achieved a 0.871 area under the receiver operating curve (AUROC), 0.786 sensitivity, and 0.779 specificity values. In contrast, the comparison models CSPDenseNet and ConvNeXt were significantly inferior to the proposed model, with 0.819 (p = 0.029) and 0.774 (p = 0.04) AUROC values, respectively. Ablation studies based on the Sequential Forward Selection algorithm identified vital information for optimal performance and evidenced that NNs performed best with three to five active pipelines. This study establishes a promising TAO activity diagnosing tool with further validation.

Effective encoder-decoder neural network for segmentation of orbital tissue in computed tomography images of Graves' orbitopathy patients.

PURPOSE: To propose a neural network (NN) that can effectively segment orbital tissue in computed tomography (CT) images of Graves' orbitopathy (GO) patients. METHODS: We analyzed orbital CT scans from 701 GO patients diagnosed between 2010 and 2019 and devised an effective NN specializing in semantic orbital tissue segmentation in GO patients' CT images. After four conventional (Attention U-Net, DeepLab V3+, SegNet, and HarDNet-MSEG) and the proposed NN train the various manual orbital tissue segmentations, we calculated the Dice coefficient and Intersection over Union for comparison. RESULTS: CT images of the eyeball, four rectus muscles, the optic nerve, and the lacrimal gland tissues from all 701 patients were analyzed in this study. In the axial image with the largest eyeball area, the proposed NN achieved the best performance, with Dice coefficients of 98.2% for the eyeball, 94.1% for the optic nerve, 93.0% for the medial rectus muscle, and 91.1% for the lateral rectus muscle. The proposed NN also gave the best performance for the coronal image. Our qualitative analysis demonstrated that the proposed NN outputs provided more sophisticated orbital tissue segmentations for GO patients than the conventional NNs. CONCLUSION: We concluded that our proposed NN exhibited an improved CT image segmentation for GO patients over conventional NNs designed for semantic segmentation tasks.

Particulate matter increases Cutibacterium acnes-induced inflammation in human epidermal keratinocytes via the TLR4/NF-κB pathway.

Recent studies have demonstrated that particulate matter (PM) can induce oxidative stress and inflammatory responses that are related to the development or exacerbation of several inflammatory dermatoses. However, the effect of PM on acne vulgaris has yet to be determined. In this study, we induced acne-like inflammation in HEKn cells with several concentrations of Cutibacterium acnes (C. acnes) and Staphylococcus aureus peptidoglycan (PGN) to investigate whether PM exposure exacerbates acne-like inflammation and elucidate the underlying mechanisms. To confirm whether PM increases the messenger ribonucleic acid (mRNA) and protein levels of proinflammatory cytokines (IL-1α, IL-1ß, IL-6, IL-8, and TNF-α) and cyclooxygenase (COX)-2 expression in C. acnes- or PGN-treated HEKn cells, we used quantitative real-time polymerase chain reactions, enzyme-linked immunosorbent assays, and western blot assays. The results demonstrated that C. acnes, PGN, and PM induced the expression of proinflammatory cytokines in a time- and dose-dependent manner at the mRNA and protein levels, respectively. Moreover, PM further increased the expression of proinflammatory cytokines, COX2, TLR4, and the phosphorylation of NF-κB in C. acnes- and PGN-treated HEKn cells. In conclusion, our results suggest that PM may exacerbate acne symptoms by increasing the inflammatory response.

Neural network-based method for diagnosis and severity assessment of Graves' orbitopathy using orbital computed tomography.

Computed tomography (CT) has been widely used to diagnose Graves' orbitopathy, and the utility is gradually increasing. To develop a neural network (NN)-based method for diagnosis and severity assessment of Graves' orbitopathy (GO) using orbital CT, a specific type of NN optimized for diagnosing GO was developed and trained using 288 orbital CT scans obtained from patients with mild and moderate-to-severe GO and normal controls. The developed NN was compared with three conventional NNs [GoogleNet Inception v1 (GoogLeNet), 50-layer Deep Residual Learning (ResNet-50), and 16-layer Very Deep Convolutional Network from Visual Geometry group (VGG-16)]. The diagnostic performance was also compared with that of three oculoplastic specialists. The developed NN had an area under receiver operating curve (AUC) of 0.979 for diagnosing patients with moderate-to-severe GO. Receiver operating curve (ROC) analysis yielded AUCs of 0.827 for GoogLeNet, 0.611 for ResNet-50, 0.540 for VGG-16, and 0.975 for the oculoplastic specialists for diagnosing moderate-to-severe GO. For the diagnosis of mild GO, the developed NN yielded an AUC of 0.895, which is better than the performances of the other NNs and oculoplastic specialists. This study may contribute to NN-based interpretation of orbital CTs for diagnosing various orbital diseases.

Clinical performance of a smartphone-based low vision aid.

Real-time digital image processing to optimally enhance low vision is now realizable with recent advances in personal computers. This study aimed to evaluate the efficacy of a wearable smartphone-based low vision aid (LVA) with customizable vision enhancement in patients with visual impairment. We recruited 35 subjects with visual impairment and who were literate and cognitively capable. The subjects completed a training session and were provided a smartphone-based LVA for a 4-week use. Visual functions including binocular best-corrected distance, intermediate, and near visual acuities; reading performance (reading speed and accuracy); and facial recognition performance were measured at baseline and after 4-weeks use. All subjects also completed the Low Vision Quality of Life (LVQOL) Questionnaire. Thirty-four subjects (mean age, 43.82 ± 15.06 years) completed the study. Significant improvements in binocular best-corrected distance, intermediate, and near visual acuities were observed after smartphone-based LVA use (all p < 0.001). Reading accuracy and facial recognition performance also improved significantly (p = 0.009 and p < 0.001, respectively), but reading speed did not. LVQOL scores significantly improved after 4 weeks of use in subjects aged < 40 years (p = 0.024), but not in subjects aged ≥ 40 years (p = 0.653). Ocular and non-ocular adverse events were infrequent and resolved when the device was removed. The smartphone-based LVA with customizable vision enhancement could provide clinically significant improvements in the visual function of patients with visual impairment and was generally well tolerated. This study suggests that the smartphone-based LVA would be beneficial for visual rehabilitation.

Clinical Factors Associated with the Early Reduction of Corneal Sensitivity in Herpes Zoster Ophthalmicus.

PURPOSE: To identify clinical factors associated with the early reduction of corneal sensitivity (CS) in patients with herpes zoster ophthalmicus (HZO). METHODS: Total 30 subjects were divided into two groups according to the occurrence of an early reduction of CS (group 1, normal CS; group 2, decreased CS). The demographics, ocular manifestations of HZO, and the ocular surface parameters were compared between two groups. Then, the relative risks of variables were analyzed to expect the early decrease of CS by HZO using logistic regression analysis. RESULTS: Among total 30 subjects, the CS decreased in 10 subjects (3.2 ± 1.4 cm, group 2) and the other 20 subjects revealed normal CS (6.0 ± 0.0 cm, group 1). The age was higher in the group 2 (67.0 ± 16.6 years) than in group 1 (48.0 ± 17.6 years, p = 0.013), but sex and the comorbidity of diabetes mellitus was not difference between groups. The presence of corneal punctate epithelial erosions was a single factor among the ocular manifestations of HZO, which discriminated group 1 (5%) and group 2 (60%, p = 0.002). The ocular surface staining scores (i.e., National Eye Institute scores and Sjögren's International Collaborative Clinical Alliance ocular surface score) were higher in group 2 (p = 0.001 and p = 0.021, respectively) than in group 1. The existence of corneal punctate epithelial erosions revealed as a sole risk factor for the early reduction of CS (odds ratio = 33.085; p = 0.016). CONCLUSIONS: It is necessary to pay attention to the possible occurrence of neurotrophic keratopathy especially in older patients with HZO showing an initial presence of corneal punctate epithelial erosions.

Bilateral Increase of Matrix Metalloproteinase-9 Expression in Tears After the Unilateral Decrease of Corneal Sensitivity.

PURPOSE: The purpose of this study is to analyze bilateral changes of matrix metalloproteinase-9 (MMP-9) expression in the tear film in patients with unilateral neurotrophic keratitis. METHODS: We included 24 eyes from 24 subjects with normal corneal sensitivity according to Cochet-Bonnet corneal esthesiometry in the control group and 25 subjects with the unilateral neurotrophic keratitis in the unilateral decrease of corneal sensitivity (UDCS) group. The expression of MMP-9 in tears was assessed using point-of-care immunoassay. The clinical parameters including meibomian gland plugging, quality of the secreted meibum, tear secretion using Schirmer I without anesthesia, and corneal erosions were evaluated among the control, affected, and contralateral unaffected eyes in the UDCS group. RESULTS: Tear MMP-9 grades in affected (2.5 ± 1.0) and contralateral eyes (2.6 ± 0.9) in the UDCS group were higher than those in control eyes (1.5 ± 0.7, P = 0.0003 and P = 0.0006, respectively). The lacrimal secretion decreased in the affected eyes but preserved in the contralateral eyes. There was no difference in corneal erosion scores between control eyes and contralateral eyes in the UDCS group. Tear MMP-9 grades in the contralateral eyes were significantly correlated with the meibum quality grades in the contralateral eyes (r = 0.525 and P = 0.025). CONCLUSIONS: Patients with the unilateral neurotrophic keratitis demonstrated a significant bilateral increase of the MMP-9 expression in the tear film as compared with controls. Despite the tearing reflex and corneal surface barrier being preserved in the unaffected contralateral eyes, it is necessary to pay attention to the possible attenuation of meibomian gland function in the opposite eyes as well.

Comparison of Superior and Inferior Visual Field Asymmetry Between Normal-tension and High-tension Glaucoma.

PRECIS: Increased severity of glaucoma heightened the hemispherical asymmetry in normal-tension and high-tension glaucoma (NTG/HTG), especially NTG. NTG showed localized superior defects in the central and paracentral areas whereas HTG showed mild asymmetry with diffuse defects. PURPOSE: The purpose of this study was to compare the patterns of visual field (VF) defects according to glaucoma severity in NTG and HTG. MATERIALS AND METHODS: A total of 1458 eyes with NTG (936) and HTG (522) were classified by mean deviation values into mild, moderate, and severe. The mean total deviation (mTD) values for each nasal, central, paracentral, arcuate 1, and arcuate 2 region of the Glaucoma Hemifield Test (GHT) were calculated. The differences in mTD between the superior and inferior hemifields of NTG and HTG were compared, and the degree of hemifield asymmetry was plotted. RESULTS: In NTG and HTG, the mTDs of the 5 regions of the superior GHT were significantly worse than those of the corresponding regions of the inferior GHT at all severity levels except for mild HTG. However, NTG showed significantly greater asymmetry than HTG in 2 regions at mild, 3 at moderate, and all 5 at severe. Moderate and severe NTG showed severe asymmetry with localized superior field defects concentrated at the central and paracentral areas with >8 dB asymmetry. However, in all HTG groups showed mild asymmetry with diffuse defects. CONCLUSIONS: The superior hemifield was more severely affected than the inferior hemifield in NTG and HTG. As the severity of glaucoma increased, so did the asymmetry in both groups, with NTG showing more profound asymmetric VF defects in the central and paracentral areas whereas HTG did not. Different VF patterns suggest differing pathologic mechanisms and possible need for different therapeutic strategies in NTG and HTG.

A comparison of accommodation and ocular discomfort change according to display size of smart devices.

BACKGROUND: To evaluate the change of accommodation and ocular discomfort according to the display size, using quantitative measurements of accommodation and ocular discomfort through subjective and objective metrics. METHODS: Forty six subjects without any ophthalmic disease history were asked to watch the documentary movie, using two different sizes of smart devices; smartphones and tablets. Before and after using devices, the near point accommodation (NPA) and the near point convergence (NPC) were measured, and objective accommodation was measured using an auto refractometer/keratometer. The subjective ocular discomfort was assessed through a survey. RESULTS: Both devices showed a decrease in post-use NPA and NPC, and the change after use of the smartphone was significantly severe, 1.8 and 2.5 folds respectively, compared to tablet (p = 0.044, p = 0.033, respectively). Neither smartphone nor tablet showed significant changes in the accommodative response induced by dynamic accommodative stimulus of auto refractometer/keratometer (p = 0.240 and p = 0.199, respectively). Subjects showed a more severe increase in ocular discomfort after using smartphones (p = 0.035) and reported feeling tired even with shorter use times (p = 0.012). CONCLUSIONS: Both devices showed significant decreases in NPA and NPC, and the larger changes were seen when using the small display smartphone. Even within 20minutes of using, subjects start to feel ocular discomfort, and it was more severe and faster after smartphones than tablets. Therefore, the smaller the display size, the greater the adverse impact on eyes, and thus, appropriate display size will need to be selected depending on the time and purpose of use.

Association of DOCK8, IL17RA, and KLK12 Polymorphisms with Atopic Dermatitis in Koreans.

Background: Early-onset and severe atopic dermatitis (AD) in patients increase the probability of the development of allergic rhinitis or asthma. Treatment and prevention strategies in infants and young children with AD are targeted toward treating the symptoms, restoring skin barrier functions, and reducing the absorption of environmental allergens in an attempt to attenuate or block the onset of asthma and food allergy. Objective: Given that the initiating events in AD remain poorly understood, identifying those at risk and implementing strategies to prevent AD is necessary. Methods: Whole-exome sequencing (WES) was performed in a 43 control group and a disease group with 20 AD patients without atopic march (AM) and 20 with AM. Sanger sequencing was carried out to validate found variants in cohorts. Results: DOCK8, IL17RA, and KLK12 single-nucleotide polymorphisms were identified by WES as missense mutations: c.1289C>A, p.P97T (rs529208); c.1685C>A, p.P562G (rs12484684); and c.457+27>C, rs3745540, respectively. A case-control study show that total immunoglobulin E (IgE) level was significantly increased in the AA genotype of DOCK8 compared to the CA genotype in allergic patients. The rs12484684 of IL17RA increased risk of adult-onset AD (odds ratio: 1.63) compared to the control for (A) allele frequency. AD and AM Patients with the IL17RA CA genotype also had elevated IgE levels. rs3745540 of KLK12 was associated with AD in dominant model (odds ratio: 2.86). Conclusion: DOCK8 (rs529208), IL17RA (rs12484684), and KLK12 (rs3745540), were identified using a new WES filtering method. the result suggests that polymorphism of DOCK8 and IL17RA might be related to increase the total IgE level.

Corrigendum: Association of DOCK8, IL17RA, and KLK12 Polymorphisms with Atopic Dermatitis in Koreans.

[This corrects the article on p. 197 in vol. 32.].

Comparison of Vessel Density Reduction in the Deep and Superficial Capillary Plexuses in Branch Retinal Vein Occlusion.

PURPOSE: To quantify the susceptibility of the deep capillary plexus (DCP) in comparison with that of the superficial capillary plexus (SCP) in eyes with branch retinal vein occlusion (BRVO) using swept-source optical coherence tomography angiography (SS-OCTA). METHODS: SS-OCTA (TritonTM; Topcon, Tokyo, Japan) scans (3 × 3 mm) of 41 patients with BRVO were retrospectively analyzed. The mean vessel densities (VDs) of the SCP and the DCP were calculated in eyes with BRVO using the ImageJ program (National Institutes of Health, Bethesda, MD, USA) and compared with those in the normal fellow eye without any morbidity or unaffected sector in the BRVO eye. RESULTS: The reduction rate of mean VD in SCP and DCP between the affected and unaffected sector of eyes with BRVO was 13.88 and 24.60%, respectively. Additionally, the reduction rate of mean VD in the SCP and DCP in the affected sector of BRVO eyes versus the corresponding sector of fellow eyes was 13.31 and 24.49%, respectively. CONCLUSION: The DCP was 1.77-1.84 times more affected than the SCP by ischemic damage in eyes with BRVO.

Comparison of vision-related quality of life and mental health between congenital and acquired low-vision patients.

PURPOSE: To evaluate the impact of the age of onset of low vision on patients' vision-related quality of life (VR-QoL) and mental health. METHODS: Low-vision patients who visited Chung-Ang University hospital from January 2012 to December 2014 were included. Patients were divided into the congenital low-vision (CLV) and acquired low-vision (ALV) groups according to the age of disease onset. People with normal visual function comprised the control group. VR-QoL was estimated with the National Eye Institute Visual Function Questionnaire (NEI VFQ-25), while mental health was assessed through the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI). The mean scores of each questionnaire were compared between the groups in independent t-tests. RESULTS: Overall, 125 low-vision patients (55 CLV and 70 ALV) and 71 control subjects were included. Although the subscale and composite scores of the NEI VFQ-25 were lower in the ALV group than in the CLV group, the differences were not significant. However, the BDI and BAI scores were significantly higher in the ALV group than in the CLV group (12.07 ± 11.97 vs. 7.67 ± 9.04, P = 0.021; 9.11 ± 10.51 vs. 5.69 ± 6.85, P = 0.030, respectively). Also, the number of patients requiring expert consultation for depression was higher in the ALV group than in the CLV group (P = 0.010). CONCLUSION: ALV patients have more vulnerable mental health states than CLV patients. Therefore, assessment of the age of onset of low vision and mental health plays a critical role in successful rehabilitation.

Clinical feasibility of pinhole glasses in presbyopia.

PURPOSE:: To investigate the ocular physiologic changes and subjective symptoms of wearing multiple-pinhole glasses in subjects with presbyopia. METHODS:: This prospective study included 32 eligible subjects with presbyopia. Objective ocular functions and a survey of ocular discomfort were performed at baseline. All participants underwent the same examinations after reading while wearing the pinhole glasses and not wearing these glasses at a 1-week interval in random order. RESULTS:: The pinhole glasses improved uncorrected distance and near visual acuity in presbyopia. These glasses also required 15% less accommodative power over the near stimulus of 25 cm than did eyes without pinholes. Compared to reading without pinhole glasses, reading with pinhole glasses led to the following changes: increase in monocular near point of accommodation from 4.39 ± 0.78 diopter (D) to 5.19 ± 1.12 D, increase in depth of focus from 1.42 ± 0.44 D to 2.00 ± 0.33 D, and increase in amplitude of fusional convergence from 13.38 ± 6.88 prism D to 21.62 ± 10.00 prism D. In contrast, the reading speed decreased, inter-blink interval increased, tear break-up time shortened, and subjective ophthalmic symptoms worsened with pinhole glasses compared to without. CONCLUSION:: In presbyopia, pinhole glasses improve visual acuity and accommodation-related parameters by pseudo-accommodation and the pinhole effect. However, the low legibility, increased inter-blink interval, and shortened break-up time of pinhole glasses cause an uncomfortable feeling and excessive eye fatigue. Pinhole glasses have strengths and limitations that must be considered to provide appropriate guidance in patients with presbyopia. Clinical trial registration was done at www.ClinicalTrials.gov (identifier: NCT02722291).

Association of CDKAL1 Polymorphisms with Early-Onset Atopic Dermatitis in Koreans.

BACKGROUND: Atopic dermatitis (AD) has increased in frequency to rates as high as 20% for children in developed countries. AD is one of the most common childhood diseases and has a complex etiology involving genetic and environmental factors. Thus, a broad understanding of genetic background is needed for early diagnosis of AD. OBJECTIVE: Identification of candidate functional genetic variants associated with early-onset AD in Koreans. METHODS: Whole-exome sequencing (WES) was performed in three families. Sanger sequencing was used to validate detected variants in 112 AD patients and 61 controls. RESULTS: Functional variants were filtered by WES, and then variants related to allergic immune diseases were selected through a literature search. Two candidate non-synonymous single-nucleotide polymorphisms of CDKAL1 (rs77152992) and ERBB2 (rs1058808) were identified, c.1226C>T, p.Pro409Leu, c.3463C>G, and p. Pro1170Ala respectively. A case-control study was performed to determine whether rs77152992 and rs1058808 are candidate risk factors for early-onset AD. rs77152992 was significantly associated with early-onset AD (odds ratio [OR], 0.42; 95% confidence interval [CI], 0.21~0.83; p=0.0133) in allele frequencies. The CC genotype of CDKAL1 had significantly increased risk of AD (OR, 2.16; 95% CI, 1.0~4.6; p=0.0475). rs1058808 had no correlation with AD. Total eosinophil count was significantly increased in AD patients with the CC genotype of CDKAL1 (rs77152992). CONCLUSION: CDKAL1 (rs77152992) and ERBB2 (rs1058808) were deemed functionally interesting based on WES. Our case-control study suggests that the CC genotype of rs77152992 may be associated with increased eosinophil counts. It may enhance the risk of early-onset AD.

Change in eyelid parameters after orbital decompression in thyroid-associated orbitopathy.

PURPOSE: To investigate quantitative changes in eyelid parameters after orbital decompression surgery in thyroid-associated orbitopathy using the PC-based program, Eyelid Analysis Software (EAS). METHODS: This study included 202 eyes of 109 thyroid-associated orbitopathy patients. Digital photographs of the patients in primary gaze were taken just before and after orbital decompression surgery, and exophthalmos degree was measured by Hertel exophthalmometry (Hertel Exophthalmometer SKU:52400; Oculus, Arlington, VA, USA). The custom-made PC-based software EAS (Biomedical Research Institute, Seoul, Korea) was used to analyze eyelid parameters. The 11 parameters included pupil to inferior eyebrow distance (PBD), margin reflex distance 1 (MRD1), margin reflex distance 2 (MRD2), palpebral fissure (PF), total lid length, upper and lower lid length, area, medial area, center area, and lateral area. RESULTS: Univariate linear regression analysis showed a significant positive association between amount of exophthalmos reduction and the following parameters: area (p = 0.007); MRD2 (p = 0.043); upper lid length (p = 0.045); lower lid length (p = 0.006); medial area (p = 0.045); and lateral area (p = 0.005). Multivariate linear regression analysis showed only two parameters, lower lid length (p = 0.022) and lateral area (p = 0.019) were associated with exophthalmos reduction. CONCLUSIONS: A reduction in the inferior lateral part of the eyelid (lateral area + lower lid length) occurred after orbital decompression surgery in patients with thyroid-associated orbitopathy.

TSLP Polymorphisms in Atopic Dermatitis and Atopic March in Koreans.

BACKGROUND: Atopic march (AM) is the progression from atopic dermatitis (AD) to allergic rhinitis and asthma. The development of AD is as high as 20% in children worldwide and continues to increase. AD seems to be caused by both genetic and environmental factors. Recently, polymorphisms of the thymic stromal lymphopoietin (TSLP) gene associated with allergic disorders were reported in ethnic groups from various countries. OBJECTIVE: Identification of TSLP polymorphisms in Koreans with AD or AM. METHODS: Whole-exome sequencing was performed in 20 AD and 20 AM patients. RESULTS: Nine single nucleotide polymorphisms (SNPs) of TSLP were detected (rs191607411, rs3806933, rs2289276, rs2289277, rs2289278, rs139817258, rs11466749, rs11466750, rs10073816). These SNPs have been correlated with susceptibility to allergic diseases in ethnic groups from China, Japan, Turkey, and Costa Rica in previous studies. Remarkably, one of 20 patients in the AD group lacked all SNPs, compared to six of 20 patients in the AM group. Odds ratios showed that Korean patients without the nine TSLP variants had an 8.14 times higher risk of moving from AD to AM. Two haplotype blocks were validated in 60 AD and 59 AM patients using Sanger sequencing. The haplotype blocks (rs3806933 and rs2289276) and (rs11466749 and rs11466750) were in high linkage disequilibrium, respectively (D'=0.97, D'=1). CONCLUSION: The increase of major allele frequency of respective nine TSLP variants may enhance the risk of AM. These data will contribute to improved genetic surveillance system in the early diagnosis technology of allergic disease.

Erratum: Association of CDKAL1 Polymorphisms with Early-Onset Atopic Dermatitis in Koreans.

[This corrects the article on p. 276 in vol. 30, PMID: 29853740.].

Long-term clinical outcome of femtosecond laser-assisted lamellar keratectomy with phototherapeutic keratectomy in anterior corneal stromal dystrophy.

PURPOSE: To evaluate long-term outcome of femtosecond laser-assisted lamellar keratectomy (FLK) with phototherapeutic keratectomy (PTK) in patients with anterior corneal stromal dystrophies. METHODS: A total of 10 eyes from seven patients who underwent FLK were included. The patients had suffered from recurrent corneal erosion or visual disturbance in anterior corneal dystrophies (five Avellino dystrophies and two lattice dystrophies). Planar-shaped lamellar keratectomy was performed using femtosecond laser. The amount of corneal excision was determined by the depth of corneal opacity. Additional PTK with mitomycin C application was performed for smoothening of corneal cut surface. The patients were evaluated with following parameters: uncorrected visual acuity, best-corrected visual acuity (BCVA), mean anterior keratometric value, corneal irregularity, corneal high-order aberrations (HOA) and the recurrence of corneal erosion. RESULTS: Mean duration of follow-up was 64 months (2.5-9.5 years). The BCVA improved more than two lines of Snellen chart at last visit. The changes of keratometric values were within ±1 D in eight out of 10 eyes. Corneal irregularities in central 5 mm cornea and the values of total corneal HOA in central 6 mm cornea decreased by 0.3-3.1 D and 0.01-2.2 µm, respectively. Corneal erosion did not recur in any of those patients during follow-up and corneal dystrophy did not recur in eight out of 10 eyes. CONCLUSION: In anterior corneal stromal dystrophies, FLK with PTK can be an effective surgical option to improve VA through decreasing corneal irregularities and HOA, while minimising corneal curvature changes.