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1.
Ocul Immunol Inflamm ; : 1-6, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38691837

RESUMO

PURPOSE: To review the presentation and visual prognostic factors of patients with endogenous endophthalmitis before and after the introduction of microincision vitrectomy surgery (MIVS), at a tertiary referral hospital in Taiwan, over a 21-year period. METHODS: We retrospectively analyzed medical records of patients diagnosed with endogenous endophthalmitis before and after the introduction of MIVS between January 2002 and December 2022. RESULTS: Data were collected from 147 patients. Diabetes mellitus was the most common comorbidity (59.9%). Liver abscess (32.7%) was the leading source of infection, followed by urinary tract infection (15.0%), and infective endocarditis (5.4%). Klebsiella pneumoniae (50.4%) was the most common pathogen, followed by Staphylococcus aureus (13.5%), and Candida albicans (8.3%). Poor initial visual acuity worse than counting fingers (CF) (p < 0.001) and diabetes mellitus (p = 0.008) were significantly associated with poor visual outcomes. In the treatment of 98 patients with poor initial visual acuity worse than CF, the proportion of vitrectomy surgeries performed increased from 13/56 (23.2%) to 24/42 (57.1%) (p = 0.001) after the introduction of MIVS. Final visual acuity of CF or better increased from 7/56 (12.5%) to 12/42 (28.6%) after the introduction of MIVS (p = 0.046). Vitrectomy was a better prognostic factor for final visual outcome in patients with poor initial visual acuity of worse than CF (p = 0.011) than other factors. CONCLUSION: In endogenous endophthalmitis patients presenting with poor initial visual acuity, vitrectomy was a better visual prognostic factor. MIVS has allowed more patients to undergo vitrectomy and improved visual outcomes.

2.
Ophthalmol Ther ; 13(4): 935-954, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38308746

RESUMO

INTRODUCTION: The EVEREST II study previously reported that intravitreally administered ranibizumab (IVR) combined with photodynamic therapy (PDT) achieved superior visual gain and polypoidal lesion closure compared to IVR alone in patients with polypoidal choroidal vasculopathy (PCV). This follow-up study reports the long-term outcomes 6 years after initiation of the EVEREST II study. METHODS: This is a non-interventional cohort study of 90 patients with PCV from 16 international trial sites who originally completed the EVEREST II study. The long-term outcomes were assessed during a recall visit at about 6 years from commencement of EVEREST II. RESULTS: The monotherapy and combination groups contained 41 and 49 participants, respectively. The change in best-corrected visual acuity (BCVA) from baseline to year 6 was not different between the monotherapy and combination groups; - 7.4 ± 23.0 versus - 6.1 ± 22.4 letters, respectively. The combination group had greater central subfield thickness (CST) reduction compared to the monotherapy group at year 6 (- 179.9 vs - 74.2 µm, p = 0.011). Fewer eyes had subretinal fluid (SRF)/intraretinal fluid (IRF) in the combination versus monotherapy group at year 6 (35.4% vs 57.5%, p = 0.032). Factors associated with BCVA at year 6 include BCVA (year 2), CST (year 2), presence of SRF/IRF at year 2, and number of anti-VEGF treatments (years 2-6). Factors associated with presence of SRF/IRF at year 6 include combination arm (OR 0.45, p = 0.033), BCVA (year 2) (OR 1.53, p = 0.046), and presence of SRF/IRF (year 2) (OR 2.59, p = 0.042). CONCLUSION: At 6 years following the EVEREST II study, one-third of participants still maintained good vision. As most participants continued to require treatment after exiting the initial trial, ongoing monitoring and re-treatment regardless of polypoidal lesion status are necessary in PCV. TRIAL REGISTRATION: ClinicalTrials.gov identifier, NCT01846273.

3.
Taiwan J Ophthalmol ; 13(3): 353-359, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38089513

RESUMO

PURPOSE: In this study, we describe our experience of sympathetic ophthalmia (SO) at a tertiary referral center in Taiwan. MATERIALS AND METHODS: We retrospectively analyzed records of patients diagnosed with SO from January 2011 to December 2020. RESULTS: We collected data of 15 patients diagnosed with SO (eight males, seven females). Six patients developed SO after ocular penetrating trauma, and nine developed SO after ocular surgery, including seven with vitrectomy, one with penetrating keratoplasty, and one with cataract surgery. Penetrating ocular trauma was the primary cause of SO in the first 5 years (four of six cases), but the proportion was much lower in the last 5 years (two of nine cases). The interval between trigger events and SO ranged from 0.2 to 120 months. Nine patients received oral steroids alone, five patients received methylprednisolone pulse therapy followed by oral steroids, and immunosuppressants were added in four cases. Visual acuity of sympathetic eyes and exciting eyes improved after treatment. The initial visual acuity of sympathetic eyes in trauma related and ocular surgery related revealed no significant difference, but the final visual acuity of sympathetic eyes was better in ocular surgery-related cases than in the trauma-related cases (mean ± standard deviation, 1.01 ± 1.33 versus 0.49 ± 0.68 logarithm of the minimum angle of resolution, P = 0.021). CONCLUSIONS: With the increased number of eye surgeries performed in recent years, eye surgery has emerged as the dominant etiology of SO in our 10-year study. Early detection and proper treatment help to maintain vision in most of the SO patients.

4.
J Ophthalmol ; 2023: 9647418, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38025927

RESUMO

In this study, we reported the patterns, epidemiology, and clinical features of anterior uveitis (AU) in Taiwan, an area of Eastern Asia. This prospective, cross-sectional case series study was performed to identify patients with AU at two tertiary medical centers (Kaohsiung Chang Gung Memorial Hospital and Kaohsiung Veterans General Hospital) located at the southern Taiwan between December 1, 2018, and March 31, 2020. The clinical diagnoses, ocular presentations, and laboratory data, including the results of the aqueous polymerase chain reaction tests, were investigated in these patients. A total of 112 patients, with a mean age of 48.9 years, were included. Most patients (87.5%) presented with unilateral eye disease, with 30 cases of ocular hypertension at the first presentation (27%). The most common clinical diagnoses were idiopathic AU (37.5%), human leukocyte antigen (HLA)-B27-associated acute AU (25.0%), and herpetic AU (18.8%). Among patients with herpetic AU, cytomegalovirus (CMV) was the most common pathogen (17/21, 81%). Compared to HLA-B27-associated acute AU, CMV-related AU was mostly observed in patients that were older in age, exhibited higher intraocular pressure, more keratic precipitates, greater iris atrophy, and more pseudophakia, but was least reported in those with posterior synechiae. This prospective study identified the pattern and clinical features of AU in southern Taiwan.

5.
J Formos Med Assoc ; 122(8): 668-674, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37003913

RESUMO

Cytomegalovirus (CMV) uveitis, a type of herpetic uveitis, is a major cause of infectious uveitis. Anterior and posterior CMV uveitis have diverse clinical presentations and treatment modalities. Based on expert consensus in Taiwan, this article provides suggestions regarding clinical manifestations, diagnosis, and treatment strategies for CMV uveitis based on clinical practice experience in Taiwan. CMV uveitis may have a distinct clinical presentation. Polymerase chain reaction (PCR) is an essential diagnostic tool to confirm a diagnosis. Antiviral therapy is the mainstay of treatment. Different agents, routes, and other supplemental treatments have been summarized and discussed in this article. Early diagnosis and appropriate treatment of CMV uveitis are crucial to avoid irreversible complications and vision loss. This consensus provides practical guidelines for ophthalmologists in Taiwan.


Assuntos
Infecções por Citomegalovirus , Infecções Oculares Virais , Uveíte Anterior , Uveíte , Humanos , Citomegalovirus/genética , Infecções por Citomegalovirus/diagnóstico , Infecções por Citomegalovirus/tratamento farmacológico , Taiwan , Consenso , Uveíte Anterior/diagnóstico , Uveíte Anterior/tratamento farmacológico , Infecções Oculares Virais/diagnóstico , Infecções Oculares Virais/tratamento farmacológico , DNA Viral , Uveíte/diagnóstico , Uveíte/tratamento farmacológico , Uveíte/etiologia
7.
Graefes Arch Clin Exp Ophthalmol ; 257(9): 1847-1855, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31177300

RESUMO

PURPOSE: To evaluate changes in the microcirculation of various retinal layers and choroid following successful repair of macula-off rhegmatogenous retinal detachment (RRD) using optical coherence tomography angiography (OCTA). METHODS: Twenty-eight patients (28 eyes) who underwent successful repair of macula-off RRD were prospectively investigated. Differences in OCTA characteristics between retinal detachment (RD) and fellow eyes were compared. Quantitative measurements of the retinal capillary and choriocapillary associated with the preoperative and intraoperative factors were analyzed. RESULTS: The mean vessel and parafoveal vessel densities were significantly lower in the superficial retinal capillary plexus (SCP) and deep retinal capillary plexus (DCP) in the RD eyes than the fellow eyes. Presence of preoperative intraretinal separation in the RD eyes was significantly associated with both an enlarged foveal avascular zone (P = 0.022) and a lower DCP vessel density (P = 0.031) postoperatively. Eyes with a scleral buckle alone had a greater postoperative subfoveal choroidal thickness (P = 0.037). Eyes undergoing vitrectomy alone had a higher postoperative vessel density in the choriocapillaris (P = 0.035). Eyes undergoing a vitrectomy and scleral buckle had a lower SCP (P = 0.031) and DCP (P = 0.035) vessel density postoperatively. CONCLUSIONS: Macula-off RRD may cause not only retinal structural damage but also decreased retinal perfusion even after successful anatomical repair. Our findings suggested that RD eyes had a significantly lower vessel density than fellow eyes after surgery. The combined procedure might result in a lower vessel density, as compared with a scleral buckle or vitrectomy alone.


Assuntos
Angiofluoresceinografia/métodos , Macula Lutea/patologia , Descolamento Retiniano/diagnóstico , Vasos Retinianos/patologia , Recurvamento da Esclera/métodos , Tomografia de Coerência Óptica/métodos , Acuidade Visual , Vitrectomia/métodos , Adulto , Idoso , Capilares/patologia , Feminino , Seguimentos , Fundo de Olho , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Descolamento Retiniano/cirurgia , Adulto Jovem
8.
J Chin Med Assoc ; 80(8): 503-507, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28601626

RESUMO

BACKGROUND: To report our 3-year experience of 23-gauge transconjunctival sutureless vitrectomy (TSV) for acute postoperative endophthalmitis at a tertiary referral center in southern Taiwan. METHODS: This retrospective chart review study included 19 patients with acute postoperative endophthalmitis who underwent 23-gauge TSV from January 2011 to January 2015 at Kaohsiung Veterans General Hospital, Taiwan. Bacterial and fungal cultures from aqueous samples, vitreous samples, or both were performed. RESULTS: Nineteen patients (12 male; 7 female) were included. The mean age was 72.4 ± 8.29 years. Acute postoperative endophthalmitis was noted in 18 patients after cataract surgery and in 1 patient after 23-gauge vitrectomy for a rhegmatogenous retinal detachment. Upon presentation, visual acuity was less than hand movement for 80% of the patients. Chief complaints included blurred vision (19 patients, 100%), followed by pain (10 patients, 52.6%) and red eye (4 patients, 21%). All patients were administered an intravitreal injection (IVI) of antibiotics and 23-gauge TSV, and the average number of IVIs was 2.68 ± 1.73 (1-9 IVIs). The interval between their initial eye symptoms and vitrectomy was 4.11 ± 4.73 days (0-2 days), and the interval between diagnosis with endophthalmitis and a vitrectomy was 1.11 ± 1.52 days (0-6 days). The final visual acuity was no light perception for 1 patient (5.3%), between 6/60 and 6/12 for 8 patients (42.1%), and 6/12 or better for 9 patients (47.4%). No retinal detachment or hypotony was noted postoperatively in any case. CONCLUSION: 23-gauge vitrectomy is safe and effective for the management of acute postoperative endophthalmitis. Early diagnosis and treatment with 23-gauge vitrectomy may provide a good visual outcome.


Assuntos
Endoftalmite/cirurgia , Complicações Pós-Operatórias/cirurgia , Técnicas de Sutura , Vitrectomia/métodos , Doença Aguda , Idoso , Idoso de 80 Anos ou mais , Túnica Conjuntiva/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Acuidade Visual
9.
F1000Res ; 6: 280, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28357059

RESUMO

Uveitis is a sight-threatening disease entity with intraocular inflammation that arises from various causes. It mainly affects working-age individuals and may lead to irreversible visual loss if not treated properly in a timely manner. This article reviews recent advances in the management and understanding of uveitis since 2014, including treatment with new immunosuppressive therapies that use biological agents, local therapy with steroid implants, and imaging studies for the evaluation of uveitis.

10.
Int J STD AIDS ; 28(12): 1224-1228, 2017 10.
Artigo em Inglês | MEDLINE | ID: mdl-28201950

RESUMO

Human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) is a multisystem disease that can involve the human eyes. Using ophthalmic examination records from January 2006 to November 2015, we retrospectively reviewed all patients who were diagnosed with HIV/AIDS in our hospital. The study was performed at a tertiary referral center in southern Taiwan. Data included age, gender, ophthalmic examinations, systemic conditions, CD4 cell counts, course, and treatment. Eleven patients were identified as having AIDS with uveitis as their presenting manifestation. All were men, with a mean age of 39.5 ± 11.4 years (range 24-56). The mean CD4+ T-cell counts were 91.7 ± 50.3 cells/µl (range 27-169). Ocular diagnoses included cytomegalovirus (CMV) retinitis in five patients, ocular syphilis in four patients, and ocular toxoplasmosis in two patients. Uveitis resolved in all patients after medical treatment. However, a retinal detachment developed in two eyes in CMV retinitis and one eye in ocular syphilis. Ocular manifestations are among the most common clinical features in patients with HIV/AIDS who have varying clinical presentations that affect almost all ocular structures. This study demonstrated that ocular findings could be an initial manifestation of an underlying disease. Awareness of ocular lesions in HIV/AIDS is important for early recognition and management.


Assuntos
Infecções Oportunistas Relacionadas com a AIDS/etiologia , Retinite por Citomegalovirus/diagnóstico , Infecções por HIV/diagnóstico , Sífilis/diagnóstico , Toxoplasmose Ocular/diagnóstico , Uveíte/etiologia , Infecções Oportunistas Relacionadas com a AIDS/tratamento farmacológico , Síndrome da Imunodeficiência Adquirida , Adulto , Terapia Antirretroviral de Alta Atividade , Antivirais/uso terapêutico , Contagem de Linfócito CD4 , Retinite por Citomegalovirus/complicações , Retinite por Citomegalovirus/terapia , Feminino , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Sífilis/complicações , Sífilis/terapia , Toxoplasmose Ocular/complicações , Toxoplasmose Ocular/terapia
11.
Ocul Immunol Inflamm ; 25(sup1): S31-S38, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-27463023

RESUMO

PURPOSE: To analyze the patterns and etiologies of uveitis at a tertiary referral center in Taiwan. METHODS: This retrospective chart review of uveitis patients from January 2001 to December 2014 updates a previous study a decade ago (2003). RESULTS: We identified 450 patients, among whom anterior uveitis was most common, followed by panuveitis, posterior uveitis, and intermediate uveitis. A specific diagnosis was identified in 331 patients. In 73 infectious uveitis cases, herpetic anterior uveitis was the leading cause, followed by endogenous bacterial endophthalmitis and acute retinal necrosis. In 258 non-infectious uveitis cases, HLA-B27-associated uveitis was most commonly seen, followed by Vogt-Koyanagi-Harada disease and Posner-Schlossman syndrome. Compared with our previous study, we found more viral infection and sarcoidosis but fewer cases of Behçet disease, tuberculosis, and toxoplasmosis. CONCLUSIONS: Our results provide useful information about the patterns and etiologies of uveitis in a selected population in Taiwan.


Assuntos
Uveíte/epidemiologia , Uveíte/etiologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Distribuição por Sexo , Taiwan/epidemiologia , Centros de Atenção Terciária/estatística & dados numéricos , Uveíte/diagnóstico , Adulto Jovem
12.
Ocul Immunol Inflamm ; 25(6): 870-877, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27438458

RESUMO

PURPOSE: To compare the characteristics, visual outcome, and prognostic factors of patients with endogenous endophthalmitis and to determine the association of endophthalmitis with Klebsiella pneumoniae infection. METHODS: We retrospectively analyzed records of patients diagnosed with endogenous endophthalmitis from January 2002 to August 2013. RESULTS: A total of 86 patients were diagnosed with endogenous endophthalmitis; 48 patients were infected with K. pneumoniae, 28 patients were infected with other pathogens, and 10 were culture-negative. Diabetes mellitus was more prevalent among patients infected with K. pneumoniae. Liver abscess and urinary tract infection were the leading sources of infection in patients with and without a K. pneumoniae infection, respectively. In patients with endogenous endophthalmitis, poor initial vision (p<0.001) and K. pneumoniae infection (p = 0.048) were significantly associated with a poor visual outcome. CONCLUSIONS: Poor initial vision and K. pneumoniae infection were significantly associated with poorer visual outcome for patients with endogenous endophthalmitis.


Assuntos
Endoftalmite/microbiologia , Infecções Oculares Bacterianas/microbiologia , Infecções por Klebsiella/microbiologia , Klebsiella pneumoniae/isolamento & purificação , Transtornos da Visão/microbiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Humor Aquoso/microbiologia , Endoftalmite/diagnóstico , Endoftalmite/tratamento farmacológico , Infecções Oculares Bacterianas/diagnóstico , Infecções Oculares Bacterianas/tratamento farmacológico , Feminino , Humanos , Infecções por Klebsiella/diagnóstico , Infecções por Klebsiella/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Taiwan , Acuidade Visual , Corpo Vítreo/microbiologia
13.
Kaohsiung J Med Sci ; 31(7): 358-62, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-26162816

RESUMO

To investigate the incidence and prognostic factors of ethambutol-related optic neuropathy (EON) in one medical center of southern Taiwan, a retrospective chart review study with 4803 newly diagnosed tuberculosis cases from January 2002 to July 2011 at one medical center hospital in southern Taiwan were reviewed. Of these patients, 1004 had ophthalmic records. Sixty-two cases (1.29%) experienced visual impairment and were diagnosed as EON with mean visual acuity of 0.86 ± 0.69 by logMAR. Sixteen of the 62 patients had a follow-up time > 6 months. Of these, eight patients (50%) showed visual improvement (an increase in visual acuity of ≥ 2 Snellen lines) after ethambutol was discontinued. Another eight patients (50%) showed no visual improvement. We analyzed multiple factors between the patients with and without visual improvement by logistic regression, including body weight, daily dose of ethambutol, duration of ethambutol use, cumulative dose of ethambutol, renal function, underlying disease of diabetes mellitus, hypertension, and initial visual acuity showed no statistically significant difference. In conclusion, the incidence of EON was 1.29%. Half of the patients showed visual improvement after discontinuation of ethambutol, and no obvious prognostic factors were found to facilitate the vision recovery. Ethambutol should be discontinued as soon as EON is suspected.


Assuntos
Etambutol/efeitos adversos , Doenças do Nervo Óptico/induzido quimicamente , Doenças do Nervo Óptico/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Doenças do Nervo Óptico/diagnóstico , Doenças do Nervo Óptico/fisiopatologia , Prognóstico , Taiwan/epidemiologia , Visão Ocular
14.
Invest Ophthalmol Vis Sci ; 54(9): 6426-38, 2013 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-24008411

RESUMO

PURPOSE: Resveratrol (RSV) alleviates oxidative damage in human adult retinal pigment epithelial (ARPE) cells. Mitochondrial bioenergetics is associated with oxidative stress. The purpose of this study was to examine the role of mitochondrial bioenergetics in the cytoprotective effect of RSV. Its role in protection against the adverse effects of cigarette smoke (CS) in experimental choroidal neovascularization (CNV) was also examined. METHODS: Cultured ARPE-19 cells were treated with acrolein alone or acrolein with added RSV. Temporal changes in cell viability, expression of the antioxidant protein, and mitochondrial bioenergetics were evaluated. In an animal study, CNV lesions were created in Brown Norway rats by laser-induced photocoagulation. Effects of CS alone or with additional RSV treatment on CNV lesions were quantified by fundus fluorescein angiography. RESULTS: In ARPE-19 cells, RSV rescued acrolein-induced cell death, alongside reversal of acrolein-induced superoxide dismutase expression. Resveratrol increased the mitochondrial bioenergetics, including basal respiratory rate, adenosine triphosphate synthesis via oxidative phosphorylation, and maximal mitochondrial capacity. In animal experiments, CS induced a significant increase in CNV following laser injury, and this increase in CNV was appreciably prevented following peripheral infusion of RSV. CONCLUSIONS: Our results indicate that RSV, a major polyphenol found in red wine, exerts protection against acrolein-induced cytotoxicity in human ARPE-19 cells via increases in the mitochondrial bioenergetics. In addition, the antioxidant effect of RSV may contribute to protection against laser-induced CNV in animals exposed to CS. Therefore, RSV might be beneficial for treatment of acrolein-induced or CS-evoked RPE degeneration.


Assuntos
Citoproteção/efeitos dos fármacos , Metabolismo Energético/efeitos dos fármacos , Degeneração Macular/prevenção & controle , Mitocôndrias/metabolismo , Estresse Oxidativo/efeitos dos fármacos , Epitélio Pigmentado da Retina/metabolismo , Estilbenos/farmacologia , Adulto , Inibidores da Angiogênese , Animais , Sobrevivência Celular , Dano ao DNA/efeitos dos fármacos , Modelos Animais de Doenças , Inibidores Enzimáticos/farmacologia , Feminino , Humanos , Degeneração Macular/metabolismo , Degeneração Macular/patologia , Mitocôndrias/efeitos dos fármacos , Mitocôndrias/patologia , Ratos , Ratos Endogâmicos BN , Resveratrol , Epitélio Pigmentado da Retina/efeitos dos fármacos , Epitélio Pigmentado da Retina/patologia
15.
Graefes Arch Clin Exp Ophthalmol ; 251(9): 2087-92, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23504104

RESUMO

BACKGROUND: To identify the prevalence and related risk factors for diabetic retinopathy (DR) in non-insulin dependent diabetes in Taiwan. METHODS: A retrospective review of type II diabetic patients in the Diabetes Shared Care System database of our Hospital enrolled from 2002 to 2009. A retinopathy severity score was assigned according to fundus examination by indirect ophthalmoscopy or binocular biomicroscopy. RESULTS: Data was collected on 901 subjects, 497 males and 404 females. Of these, 230 (25.53 %) had DR at enrolment. Compared with patients without DR, those with DR were more likely to be female (p = 0.03) or have higher HbA1c (p < 0.001), longer duration of diabetes (p < 0.001), hypertension (p < 0.001), higher systolic blood pressure (p < 0.001), higher diastolic blood pressure (p = 0.05), as well as impaired renal function (p = 0.001). In subgroup analysis stratified by diabetes duration, HbA1c was the most consistent independent risk factor associated to the prevalence of DR. Higher systolic blood pressure and female sex were significantly independent risk factors only in patients with a duration of diabetes < 4 years. On the contrary, old onset age showed a protective effect against DR only in those with a disease duration > 8 years. CONCLUSIONS: High HbA1c level was the most important factor associated with prevalence of DR in Taiwanese type II DM patients with a fixed duration.


Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Retinopatia Diabética/sangue , Retinopatia Diabética/epidemiologia , Hemoglobinas Glicadas/metabolismo , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Povo Asiático , Glicemia/metabolismo , Pressão Sanguínea , Colesterol/sangue , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/diagnóstico , Retinopatia Diabética/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Oftalmoscopia , Prevalência , Estudos Retrospectivos , Fatores de Risco , Taiwan/epidemiologia , Triglicerídeos/sangue , Adulto Jovem
16.
J Ophthalmic Inflamm Infect ; 3(1): 41, 2013 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-23514340

RESUMO

BACKGROUND: Vogt-Koyanagi-Harada (VKH) disease and sympathetic ophthalmia (SO) are both autoimmune disorders targeting melanin-bearing cells, even though their etiologies are different. Both shared many ocular and systemic manifestations, including integumentary findings. Most of the literature focused on the ocular manifestations and related treatment. Alopecia was seldom mentioned. FINDINGS: We report one case of VKH disease and one case of SO. Both developed severe alopecia and early sunset glow fundus, which are probably due to incomplete treatment. Fortunately, the alopecia improved soon after systemic steroid treatment. CONCLUSIONS: Early and complete treatments are important in the management of VKH or SO and prevent integumentary manifestation. Alopecia can be reversible after steroid treatment in time.

17.
J Chin Med Assoc ; 74(3): 140-3, 2011 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-21421211

RESUMO

We report a case of extensive paranasal sinus and orbit rhabdomyosarcoma (RMS) with intra-cranial invasion treated successfully with chemotherapy and radiotherapy. A 13-years-old male patient complained of painless and progressive proptosis of his left eye for two weeks. Ocular examination showed elevated intraocular pressure, limited extraocular movement, proptosis, and conjunctival ciliary injection in the left eye. Brain CT and MRI demonstrated a large enhancing soft tissue mass lesion with bone destruction involving left ethmoid sinus, nasal cavity, maxillary sinus, and orbital cavity with crossing of the midline to the right ethmoid sinus, nasal cavity, and intra-cranial invasion across the frontal base. The pathology of tumor biopsy revealed rhabdomyosarcoma, alveolar type. Systemic survey showed no evidence of distant metastasis. Then, the patient received combined radiochemotherapy with Taiwan Pediatric Oncology Group Rhabdomyosarcoma 2007 High-risk Treatment Protocol. No light perception in his left eye with optic disc atrophy was noted at the beginning of radiotherapy. After 44 weeks of combined radiochemotherapy, the tumor regressed, and no recurrence has been noted until now. In young patients with sudden-onset proptosis, RMS should be considered, and early diagnosis is crucial due to more effective prognosis with current radiochemotherapy protocol.


Assuntos
Neoplasias Encefálicas/terapia , Neoplasias Orbitárias/terapia , Neoplasias dos Seios Paranasais/terapia , Rabdomiossarcoma Alveolar/terapia , Adolescente , Neoplasias Encefálicas/patologia , Terapia Combinada , Humanos , Masculino , Invasividade Neoplásica , Neoplasias Orbitárias/patologia , Neoplasias dos Seios Paranasais/patologia , Rabdomiossarcoma Alveolar/patologia
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