Korean journal of ophthalmology : KJO最新文献

Although tinted glasses are part of the fashion and beauty world, these glasses have various therapeutic applications in normal people or people with eye and neurological problems in some cases have been ignored. Tinted spectacles produce their effects by reducing visible light transmission and filtering by removing a certain part of the spectrum and can reduce discomfort and annoyance and improve the quality of life. The therapeutic effects of these glasses are related to controlling photophobia, preventing glare and increasing contrast. These glasses are used in normal people as sunglasses, to improve sports activities, comfortable driving at night and to increase sleep quality. Colored glasses have also been widely used in people with low vision related to congenital and acquired retinal diseases and neurological diseases such as migraine, acquired brain injury, and photosensitive epilepsy. So far, numerous studies have been conducted on the beneficial and therapeutic effects of colored glasses, which sometimes report contradictory effects. In this article, we explore the therapeutic uses of colored glasses in more detail.

Purpose: To evaluate the incidence, clinical features, risk factors, and outcomes of full-thickness macular hole (MH) formation after pars plana vitrectomy (PPV) for the removal of epiretinal membrane (ERM).

Methods: This retrospective study reviewed the medical charts of the 309 eyes of 306 patients with PPV for ERM removal from 2012 to 2024 using clinical data warehouse search. Patients were categorized into two groups: one group with development of MH and the other without MH development after ERM surgery. Baseline demographics and clinical parameters were compared between the two groups. Risk factors for MH formation were analyzed using univariate and multivariate logistic regression. Surgical outcomes of the cases with MH formation were also analyzed.

Results: A total of 141 eyes were included. Five cases (3.5%) developed MH after PPV for ERM removal. In all five cases (100%), ERM was observed at MH detection. In four of the five patients (80%), cystoid macular edema (CME) was present at MH detection. ERM with lamellar hole was significantly associated factors for MH formation (odds ratio [OR], 13.11; p = 0.018). Preoperative central macular thickness (CMT) showed a marginal association (OR, 0.98; p = 0.075). Among the four patients who underwent surgery, macular hole was successfully closed in three cases. There was no significant difference in best-corrected visual acuity before and after MH surgery.

Conclusions: ERM with lamellar hole was a significant factor for MH formation, while thin preoperative CMT showed a marginal association. At the time of MH detection, ERM and CME were observed in most cases, suggesting that tangential traction caused by postoperative ERM or, postoperative CME may represent possible etiologies for MH formation. In patients with ERM with lamellar hole or thin CMT, the possibility of MH formation after ERM surgery should be taken into account and careful monitoring is needed.

Purpose: This study aimed to evaluate the clinical efficacy of low-frequency ear transcutaneous stimulation (TS) for improving ocular symptoms and signs in patients with dry eye disease (DED). The primary outcome was the Ocular Surface Disease Index (OSDI) score difference between TS and sham groups, while secondary outcomes included tear breakup time (TBUT), Schirmer test (strip meniscometry tube, SMTube), and corneal staining (National Eye Institute [NEI] score).

Methods: Patients with a TBUT <5 seconds and tear volume by Schirmer test <5 mm, along with ocular symptoms, were randomized into a TS treatment group (n = 25) and a sham group (n = 24). The TS treatment device was applied bilaterally twice daily for 8 weeks, with each session lasting 30 minutes. The OSDI questionnaire score, corneal and conjunctival stain score (NEI score), TBUT, and tear secretion volume (SMTube) were analyzed at baseline and 4 and 8 weeks after treatment.

Results: The sham group showed no significant changes in any parameters at 4 and 8 weeks. The TS group demonstrated significant improvements in NEI score, TBUT, and SM tube values at both 4 and 8 weeks compared to the sham group (p = 0.002, p = 0.001, and p = 0.017, respectively, at 4 weeks; p = 0.001, p = 0.001, and p = 0.001, respectively, at 8 weeks). No significant difference in OSDI was found between groups at 4 weeks (p = 0.061), but at 8 weeks, the TS group showed a significantly greater improvement (p = 0.018).

Conclusions: The low-frequency ear TS device significantly improved DED symptoms and objective measures compared to the sham group. These findings support the potential of TS as a novel treatment option for DED.

Purpose: This retrospective case series aims to characterize the ocular findings, clinical presentation, management, and outcomes of suprachoroidal hemorrhage (SCH) in pediatric patients undergoing penetrating keratoplasty (PK) or Ahmed glaucoma valve (AGV) implantation.

Methods: From 2012 to 2023, a total of 58 pediatric patients underwent PK, and 89 underwent AGV implantation at our institution. Among these, three perioperative SCH cases were identified. Medical records, anterior segment photographs, and ultrasonographic images of these patients were reviewed.

Results: All three patients had Peters anomaly, congenital glaucoma (CG), and aniridia in both eyes. In case 1 with Peters anomaly, CG, and partial aniridia, SCH developed intraoperatively in an aphakic eye during the third PK. In case 2 with Peters anomaly, CG, and total aniridia, SCH was observed 1 day after PK and lensectomy. In case 3 with Peters anomaly, CG, and partial aniridia, SCH occurred 2 days after AGV implantation in a pseudophakic eye with prior PK and cataract surgery. SCH resolved with conservative management in all cases. However, cases 1 and 2 ultimately lost light perception, while case 3 achieved a best-corrected visual acuity of 0.06.

Conclusions: The risk of intraoperative and delayed SCH should be considered in eyes with Peters anomaly, CG, and aniridia during intraocular surgeries that involve significant intraocular pressure fluctuations.

Purpose: To investigate the anatomical and functional outcomes in cases of re-switching to previous anti?vascular endothelial growth factor (anti-VEGF) agents due to intraocular inflammation (IOI) following a switch to brolucizumab in neovascular age-related macular degeneration.

Methods: This study included patients with neovascular age-related macular degeneration who switched to brolucizumab and discontinued brolucizumab treatment due to IOI, with a follow-up duration of at least 6 months before and after brolucizumab treatment period. Changes in best-corrected visual acuity, central macular thickness, central choroidal thickness, and retinal fluid on optical coherence tomography were evaluated.

Results: A total of 16 eyes from 16 patients were reviewed. Two patients (12.5%) achieved complete fluid resolution before brolucizumab treatment, which increased to 15 (93.8%) during brolucizumab therapy. However, after switching back to other anti-VEGF agents, the proportion of patients with dry macula decreased to 37.5%. There were no statistically significant changes in best-corrected visual acuity, central macular thickness, central choroidal thickness throughout the study period.

Conclusions: In cases where brolucizumab treatment was discontinued due to IOI and switched back to other anti-VEGF agents, the anatomical response was insufficient, indicating the need for alternative treatment options.

Purpose: The purpose of this study was to evaluate economic aspect of diabetic retinopathy (DR) screening strategies in developing countries. It focused on the cost-effectiveness of artificial intelligence (AI) and telemedicine compared to standard care.

Methods: A structured literature search was conducted using PubMed, ScienceDirect, the Cochrane Library, and Google Scholar. Studies were included if they involved patients with type 1 or type 2 diabetes mellitus, conducted in low- or middle-income countries at the time of the study, compared AI or telemedicine-based intervention with standard care, and performed a health economic assessment or provided sufficient data to assess cost-effectiveness.

Results: Seven studies were identified from China, Thailand, Brazil, and India. Of these, four applied cost-utility analysis, two used cost-effectiveness analysis, and one employed both approaches. Three studies evaluated AI-based screening, three focused on telemedicine, and one examined a combined AI-assisted telemedicine model. All studies compared these interventions to standard care, with some using no screening as the comparator. Across all studies, AI and telemedicine-based screening strategies were found to be cost-effective, though the degree of economic benefit varied depending on the model, setting, and assumptions used.

Conclusions: This review supports the cost-effectiveness and feasibility of AI- and telemedicine-based DR screening in developing countries. While most strategies proved economically viable, cost savings and health gains varied. Screening frequency and patient compliance were key factors influencing successful implementation.