Photodynamic Therapy in the Treatment of Choroidal Neovascularization Complicating Central Serous Chorioretinopathy

We report the favorable anatomic and functional outcome of photodynamic therapy with verteporfin in a case of chronic central serous chorioretinopathy complicated with choroidal neovascularization (CNV). This 37-year-old Chinese male with bilateral chronic central serous chorioretinopathy presented with central scotoma, reduced vision and metamorphopsia in his right eye. Fluorescein angiography (FA) disclosed macular hemorrhage, exudate and subfoveal classic CNV. Photodynamic therapy (PDT) with verteporfin was applied to the CNV according to standard protocol with 2.2-mm spot size. Best-corrected visual acuity (BCVA) improved from 6/20 to 6/10 1 month after PDT. BCVA recovered to 6/7.5 without leakage on FA 3 months after PDT. Neither recurrent CNV lesion nor new hemorrhage was noted over 12 months of follow-up. Short-term results suggest that PDT with verteporfin for CNV secondary to central serous chorioretinopathy is a safe and effective treatment modality

Effects of eye rubbing and breath holding on corneal biomechanical properties and intraocular pressure.

PurposeTo determine whether corneal biomechanical properties and intraocular pressure (IOP) are affected by eye rubbing and breath holding.MethodsCorneal hysteresis, corneal resistance factor, corneal compensated IOP (IOPcc), and Goldmann equivalent IOP (IOPg) were measured on both eyes of 40 subjects. Measurements were taken at baseline before eye rubbing (ER(0)) and before breath holding (BH(0)), immediately after 2 episodes of eye rubbing (ER(1) and ER(2)), and during 2 episodes of breath holding (BH(1) and BH(2)).ResultsCorneal hysteresis, corneal resistance factor, and IOPg were significantly lower after ER(1) compared with ER(0) and were significantly lower after ER(2) compared with ER(1). In contrast, IOPcc did not decrease significantly. There were no significant differences among BH(0), BH(1), and BH(2) in any of the 4 outcomes.ConclusionsEye rubbing should be avoided before measurements of corneal biomechanical properties and IOPg. In contrast, breath holding during measurements is not likely to cause a significant change in IOPg and IOPcc or corneal biomechanical properties

Distribution and associated factors of optic disc diameter and cup-to-disc ratio in an elderly Chinese population

AbstractBackgroundGlaucoma is the second leading cause of blindness worldwide and East Asian people account for almost half of those affected. Vertical elongation of the optic cup is a characteristic feature of glaucoma. However, there is a significant overlap in the vertical cup-to-disc ratio (VCDR) between normal eyes and eyes affected by glaucoma. The purpose of this study was to determine the distribution of VCDR and vertical disc diameter (VDD) and their predictive factors in a population of elderly Chinese residents in Taiwan.MethodsFour hundred and sixty elderly Chinese residents aged 72 years and older in the Shihpai district, Taipei, Taiwan participated in this study. Slit lamp biomicroscopic measurement of the VCDR and VDD after pupil dilation with a 78 diopter lens was performed by one glaucoma specialist. Multiple linear regression analyses were used to fit the best model for independent variables.ResultsThe VCDR was recorded for 438 right eyes and 430 left eyes. After excluding participants with glaucoma, the mean ± SD VCDR was 0.44 ± 0.17 for both eyes, and the 97.5th percentile was 0.8. A greater VCDR was associated with a longer axial length [VCDR = −0.47 + 0.04(axial length)] under multiple regression analysis. The VDD was obtained for 420 right eyes and 406 left eyes. The mean ± SD VDD for all participants was 1.77 ± 0.22 mm for the right eye and 1.79 ± 0.22 mm for the left eye. A higher body mass index (BMI) and a longer axial length were significantly associated with a larger VDD under multiple regression analysis. [VDD = −0.05 + 0.07 (axial length) + 0.06 (obesity); if BMI <24, then obesity = 0; if BMI ≥24, then obesity = 1]. A larger VDD was associated with a larger VCDR (p < 0.001) and the VCDR could be predicted by the equation VCDR = −0.07 + 0.3VDD.ConclusionA greater VCDR was related to a longer axial length. A greater VDD was related to a higher BMI and a longer axial length

Factors Affecting Consumer Preferences for Fish in Taiwan

Stepwise logistic regression was used to explore consumption survey data to identify factors affecting consumer preference for fish in Taiwan. Most of the consumers responding prefer to eat fish, although the per capita consumption of fish was stagnant. Some demographic factors and consumer preference for food attributes were identified to affect preferences for fish. The older, white collar worker, those who believed in the religion of Daoism, those who paid more attention to food nutrition, to food taste, and/or to food quality had higher odds of preference for fish, while the unmarried, the female, those who believed in the religion of Yi-Guan-Daoism, those who lived in eastern, middle, or southern Taiwan had lower odds of preference for eating fish. The results implied that fish had an overall good perception in Taiwan. However, the fact that younger consumers and/or female consumers had lower odds in preference for fish implies a risk for future development. Further exploration of characteristics of food preference of these groups may be needed to illuminate information of marketing and product development for the fishery industry to further development.Keywords: consumer preferences, fish, food attributes, demographic factors, Taiwan, logistic regression

Impact of the Herbal Medicine Sophora flavescens on the Oral Pharmacokinetics of Indinavir in Rats: The Involvement of CYP3A and P-Glycoprotein

Sophora flavescens is a Chinese medicinal herb used for the treatment of gastrointestinal hemorrhage, skin diseases, pyretic stranguria and viral hepatitis. In this study the herb-drug interactions between S. flavescens and indinavir, a protease inhibitor for HIV treatment, were evaluated in rats. Concomitant oral administration of Sophora extract (0.158 g/kg or 0.63 g/kg, p.o.) and indinavir (40 mg/kg, p.o.) in rats twice a day for 7 days resulted in a dose-dependent decrease of plasma indinavir concentrations, with 55%–83% decrease in AUC0-∞ and 38%–78% reduction in Cmax. The CL (Clearance)/F (fraction of dose available in the systemic circulation) increased up to 7.4-fold in Sophora-treated rats. Oxymatrine treatment (45 mg/kg, p.o.) also decreased indinavir concentrations, while the ethyl acetate fraction of Sophora extract had no effect. Urinary indinavir (24-h) was reduced, while the fraction of indinavir in faeces was increased after Sophora treatment. Compared to the controls, multiple dosing of Sophora extract elevated both mRNA and protein levels of P-gp in the small intestine and liver. In addition, Sophora treatment increased intestinal and hepatic mRNA expression of CYP3A1, but had less effect on CYP3A2 expression. Although protein levels of CYP3A1 and CYP3A2 were not altered by Sophora treatment, hepatic CYP3A activity increased in the Sophora-treated rats. All available data demonstrated that Sophora flavescens reduced plasma indinavir concentration after multiple concomitant doses, possibly through hepatic CYP3A activity and induction of intestinal and hepatic P-gp. The animal study would be useful for predicting potential interactions between natural products and oral pharmaceutics and understanding the mechanisms prior to human studies. Results in the current study suggest that patients using indinavir might be cautioned in the use of S. flavescens extract or Sophora-derived products

Optical Coherence Tomography in Spontaneous Resolution of Vitreomacular Traction Syndrome

Vitreomacular traction syndrome (VTS) is a vitreoretinal interface abnormality. The disorder is caused by incomplete posterior vitreous detachment with persistent traction on the macula that produces symptoms and decreased vision. Most symptomatic eyes with VTS undergo a further decrease in visual acuity. Spontaneous complete vitreomacular separation occurs infrequently in eyes with VTS. Surgical intervention may be considered if severe metamorphopsia and decreased visual quality occur. Herein, we report 2 typical cases of idiopathic VTS with spontaneous resolution of vitreo-retinal traction demonstrated by optical coherence tomography. Optical coherence tomography is a sensitive and useful tool for the confirmation of diagnosis and for the serial anatomical evaluation of patients with VTS

Combination photodynamic therapy and intravitreal bevacizumab used to treat circumscribed choroidal hemangioma

Circumscribed choroidal hemagioma (CCH) is an ocular tumor that can result in decreased vision or blindness. Numerous treatment methods have been reported without satisfying results. In recent years, photodynamic therapy (PDT) with verteporfin has been used to treat choroidal hemagioma and resolve the associated exudative retinal detachment, and the results have been inspiring. Here, we report the case of a 36-year-old man with longstanding CCH who suffered from blurred vision for 3 years. He underwent PDT with intravenous infusions of verteporfin, which was a treatment method based on a modified version of the standard macular degeneration PDT protocol, in addition to subsequent intravitreal administrations of bevacizumab as adjuvant therapy for macular edema. Twelve months after treatment, the CCH tumor remained noticeably shrunken, with the complete absorption of the subretinal fluid and the absence of macular edema. In terms of treating subretinal fluid retention, this combination treatment is a safe, effective, and long-lasting therapy for treating established CCH tumors. However, even though the patient’s visual field defects improved, the patient’s visual acuity remained stable at 6/60 without further improvement. Long-term CCH with prolonged macular edema might have affected the visual prognosis. Patients with CCH still require long-term follow-up examinations after receiving PDT treatments

Intravitreal Injection of Bevacizumab for the Treatment of Choroidal Neovascularization in a Patient with Angioid Streaks

We report the favorable outcome of intravitreal injection of bevacizumab (Avastin) to treat choroidal neovascularization (CNV) secondary to angioid streaks in an 82-year-old Chinese man. Within 2 weeks of bevacizumab injection, visual acuity improved from 20/40 to 20/25 and optical coherence tomography revealed complete resolution of CNV and retinal edema. The juxtafoveal hemorrhage nearly disappeared, and the size of CNV markedly regressed from 1,200 mm to unre- markable on fluorescein angiography. These improvements were maintained after 2 additional doses of intravitreal bevacizumab administered at 4-week intervals. No ocular or systemic side effects were observed. Neither recurrent CNV lesion nor new hemorrhage was noted during 18 months of follow-up. The short-term results suggest that intravitreal injection of bevacizumab for the treatment of CNV in patients with angioid streak is well tolerated and highly effective. It may be a promising pharmacologic treatment option since limited therapies are available for this disease with a rather aggressive course

Management of double-penetrating ocular injury with retained intraorbital metallic foreign body

The prognosis of double penetrating ocular trauma is usually guarded. We report the good anatomical and functional outcome in a patient with double-penetrating ocular trauma associated with intraorbital foreign body. A 58-year-old man presented at the emergency room complaining of blurred vision of the left eye with stinging pain after he hammered an iron plate. Best-corrected visual acuity was hand movement/30 cm. Subconjunctival hemorrhage with one 1.4-mm laceration wound was noted over the nasal conjunctiva. Fundus examination showed vitreous hemorrhage with one whitish patch over the nasal retina. Orbital computed tomography scan revealed one metallic foreign body at the posterior nasal upper orbit. Double-penetrating globe injury with intraorbital foreign body was impressed, and immediate vitrectomy surgery with endolaser photocoagulation was carried out. One exit wound nasal to the disc was noted during operation. The intraorbital metallic foreign body was left alone. Vision recovered to 6/8.6 without ocular complication after a 20-month follow-up. Prompt, careful preoperative evaluation and meticulous vitrectomy intervention are essential in the successful management of such patients. Posteriorly located intraorbital metallic foreign body should be managed conservatively. Long-term regular electroretinography evaluation is needed for possible retinal toxicity from intraorbital foreign body