A lack of ongoing diabetes is an important factor in preserving eyes from late or suboptimally treated endogenous endophthalmitis secondary to Klebsiella pneumoniae liver abscess

AbstractPurposeThe purpose of this study is to identify the possible factors for preserving the eyes after late or suboptimally treated endogenous endophthalmitis secondary to Klebsiella pneumoniae (KP) liver abscess.MethodsA retrospective chart review was conducted for patients admitted with KP liver abscess from January 1991 to June 2012.ResultsSix hundred and ninety-three patients with KP liver abscess were recorded, in which endophthalmitis was identified in 53 cases (65 eyes, 8.29%). Diabetes was significantly associated with the development of endophthalmitis (p = 0.014). Eleven eyes received their last ocular treatment ≥10 days and final vision ≥ counting fingers, and were defined as benign type KP endophthalmitis. The absence of diabetes was the only consistent candidate factor for benign type KP endophthalmitis.ConclusionA lack of ongoing diabetes is an important factor in preserving eyes with late or suboptimally treated endogenous endophthalmitis second to KP liver abscess

Inhibitory Effect of Anoectochilus formosanus Extract on Hyperglycemia-Related PD-L1 Expression and Cancer Proliferation

Traditional herb medicine, golden thread (Anoectochilus formosanus Hayata) has been used to treat various diseases. Hyperglycemia induces generation of reactive oxygen species (ROS) and enhancement of oxidative stress which are risk factors for cancer progression and metastasis. In this study, we evaluated hypoglycemic effect of A. formosanus extracts (AFEs) in an inducible hyperglycemia animal model and its capacity of free-radical scavenging to establish hyperglycemia-related carcinogenesis. AFE reduced blood glucose in hyperglycemic mice while there was no change in control group. The incremental area under blood glucose response curve was decreased significantly in hyperglycemic mice treated with AFE in a dose-dependent manner. AFE and metformin at the same administrated dose of 50 mg/kg showed similar effect on intraperitoneal glucose tolerance test in hyperglycemic mice. Free-radical scavenger capacity of AFE was concentration dependent and 200 μg/ml of AFE was able to reduce more than 41% of the free radical. Treatment of cancer cells with AFE inhibited constitutive PD-L1 expression and its protein accumulation. It also induced expression of pro-apoptotic genes but inhibited proliferative and metastatic genes. In addition, it induced anti-proliferation in cancer cells. The results suggested that AFE not only reduced blood glucose concentration as metformin but also showed its potential use in cancer immune chemoprevention/therapy via hypoglycemic effect, ROS scavenging and PD-L1 suppression

Nonarteritic Ischemic Optic Neuropathy

To describe the systemic and visual characteristics and prognosis in patients with nonarteritic ischemic optic neuropathy (NAION) undergoing different treatments. Methods: Retrospective chart review was performed in Kaohsiung Veterans General Hospital patients from 1995-2005 with a clinical diagnosis of NAION, including nonarteritic anterior ischemic optic neuropathy and posterior ischemic optic neuropathy (PION). There were 14 PION patients out of a total of 103 cases. The average age at disease attack was 61 years old, and the ratio of males to females was 1.24:1. Comorbid systemic diseases and visual function were recorded at both initial presentation and the later follow-up period. The final results were recorded and compared by the different treatments they received in 4 groups. Results: In all, NAION usually affected people > 50 years old, without any difference between sexes. Presenting visual acuity, age, and different treatment modes had no direct influence on the final visual outcome. The most significant associated factor was hypertension. Conclusion: NAION is a serious illness; the visual deficit persists even with aggressive treatment

Surgical treatment of acquired esotropia in patients with high myopia

Acquired esotropia with high myopia may be associated with superotemporal eyeball prolapse from the muscle cone and the subsequent shift of extraocular muscles limits the success of the traditional recession–resection surgery. In this study, we report two patients diagnosed with myopic strabismus fixus with esodeviation >90 prism diopter. Marked axial elongation of globes was present in both the patients. They received medial rectus muscle recession and hemi-Jensen procedure in both eyes. Postoperatively, they showed significant improvement in abduction, elevation, and ocular alignment. We found that the combination of medial rectus muscle recession and hemi-Jensen procedure was effective in treating patients with acquired large esotropia with high myopia

Manifested strabismus in a case of Apert syndrome

A full-term female baby was diagnosed as having Apert syndrome with craniosynostosis, hypertelorism, syndactyly, polydactyly, and cleft plate. At her first ophthalmic visit at 8 months old, she was noted to have bilateral exophthalmos with epiblepharon on her lower lids, exotropia, and right inferior oblique muscle overaction (IOOA) and manifested right dissociated vertical deviation (DVD). There was no keratopathy or optic neuropathy. Bilateral lateral rectus muscles and right inferior oblique muscle recession were performed with correction of bilateral epiblepharon at 1 year of age. Orthotropia was achieved postoperatively. However, recurrent exotropia with left inferior oblique muscle overaction and manifested left DVD developed 2 years later. We performed left medial rectus muscle resection and left inferior oblique muscle recession, and the patient maintained orthotropia. Her best-corrected visual acuity was 6/8.6 in the right eye and 6/7.5 in the left eye at the latest follow-up. Amblyopia, OD, was still noted. We report this case of Apert syndrome with exophthalmos, exotropia, and IOOA. The exophthalmos progressed as the patient grew, thus the strabismus pattern changed during follow-up. Frequent follow-up and titrated management may be needed for such case to ensure good binocular vision