Publications by authors named "Ki Ho Park"

516 Publications

Dual respiratory virus detection in adult patients with acute respiratory illness.

BMC Infect Dis 2021 Sep 23;21(1):997. Epub 2021 Sep 23.

Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Republic of Korea.

Background: Nonrandom multiple respiratory virus (RV) detection provides evidence for viral interference among respiratory viruses. However, little is known as to whether it occurs randomly.

Methods: The prevalence of dual RV detection (DRVD) in patients with acute respiratory illnesses (ARIs) at 4 academic medical centers was investigated; data about the prevalence of 8 RVs were collected from the Korean national RV surveillance dataset. Linear regression analysis was performed to assess the correlation between observed and estimated prevalence of each type of DRVD.

Results: In total, 108 patients with ARIs showing DRVD were included in this study between 2011 and 2017. In several types of regression analysis, a strong correlation was observed between the observed and estimated prevalence of each type of DRVD. Excluding three DRVD types (influenza/picornavirus, influenza/human metapneumovirus, and adenovirus/respiratory syncytial virus), the slope of the regression line was higher than that of the line of random occurrence (1.231 > 1.000) and the 95% confidence interval of the regression line was located above the line of random occurrence.

Conclusions: Contrary to the results of previous epidemiologic studies, most types of DRVD occur more frequently than expected from the prevalence rates of individual RV, except for three underrepresented pairs above.
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http://dx.doi.org/10.1186/s12879-021-06699-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8460188PMC
September 2021

A phase I study to evaluate the safety, tolerability, pharmacodynamic and pharmacokinetic profiles of ocular GLH8NDE in healthy male adults.

Clin Transl Sci 2021 Sep 15. Epub 2021 Sep 15.

Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine, Seoul, Korea.

GLH8NDE, a derivative of eupatilin, is currently under development to treat dry eye disease. We conducted a randomized, double-masked, placebo-controlled, single- and multiple-day study to evaluate safety, tolerability, pharmacodynamics, and pharmacokinetics of ocular GLH8NDE in healthy male adults. Subjects randomly received topical ocular dosing of GLH8NDE or its matching placebo for a day, then for 7 consecutive days with a 62-h washout at one of the following daily doses: 9, 18, 36 (Koreans), and 36 mg (Whites). The study drug was administered in divided doses over 10 h with 2- or 5-h intervals. Thirty-nine (97.5%) out of 40 subjects completed the study. A total of 17 subjects experienced 31 treatment-emergent adverse events, all of which were mild in severity and recovered without sequelae. Neither pathological changes in eye compartments nor clinically significant systemic effects were observed. GLH8NDE was rapidly absorbed reaching the peak concentration within 0.25-0.75 h postdose. The systemic exposure as measured by area under the concentration-time curve from time of administration up to the time of the last quantifiable concentration (AUC ) after single-day administration of the same dose was 109% higher in Koreans than in Whites. In conclusion, GLH8NDE was safe and well-tolerated in healthy Korean and White male adults at 9-36 mg/day after single- and multiple-day administrations.
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http://dx.doi.org/10.1111/cts.13150DOI Listing
September 2021

Ramal inclination in the frontal plane after bimaxillary orthognathic surgery in skeletal class III facial asymmetry : Spontaneous changes and stability.

J Orofac Orthop 2021 Sep 1. Epub 2021 Sep 1.

Department of Orthodontics, School of Dentistry, Kyung Hee University, Hoegi-dong 1, Dongdaemun-gu, 02447, Seoul, Korea (Republic of).

Purpose: This study aimed to observe spontaneous changes of ramal inclination in the frontal plane (FRI) and its stability in skeletal class III asymmetry patients corrected with bimaxillary surgery. The correlation between FRI change and surgical skeletal change was also investigated.

Methods: Forty-nine patients with skeletal class III facial asymmetry who underwent orthognathic surgery with at least 1° change in FRI after surgery were analyzed. FRI and other factors were measured on frontal and lateral cephalograms before surgery (T1), after surgery (T2), and at follow-up after at least 6 months (T3). Correlation analysis was performed to determine pre- and postoperative factors associated with FRI change and stability.

Results: FRI increased significantly on the deviated side and decreased on the nondeviated side after surgery. The FRI changes remained stable during follow-up. No correlation between FRI changes and skeletal changes during surgery were found except between the change of FRI during follow-up (T3-T2) and mandibular setback amount (T2-T1), with a weak coefficient of 0.32.

Conclusion: The FRI changes after bimaxillary orthognathic surgery in skeletal class III asymmetry reduced the FRI difference between the deviated and nondeviated side and remained stable for at least 6 months after surgery. No clinically significant correlation was found between measured skeletal changes during surgery and FRI changes.
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http://dx.doi.org/10.1007/s00056-021-00344-9DOI Listing
September 2021

Clostridium difficile infection after orthopedic surgery: Incidence, associated factors, and impact on outcome.

Am J Infect Control 2021 Aug 23. Epub 2021 Aug 23.

Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Republic of Korea.

Background: To identify the incidence, associated factors, and impact of hospital-acquired Clostridium difficile infection (CDI) among patients who have undergone orthopedic surgery.

Methods: We retrospectively reviewed the charts of all adults patients who underwent orthopedic surgery from January 2016 through December 2017 at a tertiary hospital.

Results: Of 7,363 patients who underwent orthopedic surgical procedures, 52 (0.7%) developed hospital-acquired CDI. The independent factors associated with CDI were age ≥65 years (adjusted odds ratio [aOR], 3.4; P < .001), preoperative hospital stay ≥3 days (aOR, 3.7; P < .001), operating time ≥3 hours (aOR, 2.5; P < .005), and antibiotic use for infection treatment (aOR, 4.3; P < .001). After adjusting for the timing of CDI using a multistate model, the mean excess LOS attributable to CDI was 2.8 days (95% confidence interval [CI], 0.4-5.3). The impact of CDI on excess LOS was more evident among patients aged ≥65 years (4.4 days; 95% CI, 1.8-7.0) and those with any comorbidity (5.6 days; 95% CI, 3.0-8.1).

Conclusions: The overall incidence of CDI after orthopedic surgery was 0.7%. The occurrence of CDI after orthopedic surgery contributes to increased LOS. The greatest impact of CDI on LOS occurs among elderly patients and patients with comorbidities.
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http://dx.doi.org/10.1016/j.ajic.2021.08.021DOI Listing
August 2021

Sovesudil (locally acting rho kinase inhibitor) for the treatment of normal-tension glaucoma: the randomized phase II study.

Acta Ophthalmol 2021 Jul 28. Epub 2021 Jul 28.

Department of Medicine, Seoul National University College of Medicine, Seoul, Korea.

Purpose: To evaluate ocular hypotensive efficacy and the safety of sovesudil (formally known as PHP-201), a novel Rho-associated protein kinase (ROCK) inhibitor, in patients with normal-tension glaucoma (NTG).

Design: Multicentre, prospective, double-masked, randomized, placebo-controlled, parallel clinical study.

Methods: Patients with NTG (unmedicated baseline IOP ≤ 21 mmHg) were randomized in 3 groups and treated with sovesudil in concentrations of 0.25% and 0.5%, or with a placebo three times daily (TID) for 4 weeks. The primary end-point was the mean diurnal IOP change from the baseline at week 4. Safety was recorded over a 4-week treatment period and the following 2-week observation period.

Results: A total of 119 patients were included in the primary efficacy analysis. The mean diurnal IOP change from the baseline at week 4 was -1.56 mmHg for the high-dose group, -1.10 mmHg for the low-dose group and -0.65 mmHg for the placebo group. The difference between the high-dose and the placebo groups was -0.91 mmHg (95% confidence intervals: -1.73, -0.09). 0.5% sovesudil TID met the criteria for superiority to the placebo. The most frequent ocular adverse event among sovesudil-treated patients was conjunctival hyperaemia (24.4% for the high-dose and 17.5% for the low-dose group) and predominately classified as mild.

Conclusions: Sovesudil 0.25% and 0.5% TID showed statistically significant IOP-lowering effects and 0.5% concentration's IOP-lowering effects met the superiority criteria in comparison with the placebo at week 4. Sovesudil was well tolerated with mild adverse events including relatively low incidence of conjunctival hyperaemia in patients with NTG.
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http://dx.doi.org/10.1111/aos.14949DOI Listing
July 2021

MG53 suppresses NF-κB activation to mitigate age-related heart failure.

JCI Insight 2021 Sep 8;6(17). Epub 2021 Sep 8.

Department of Surgery, Division of Cardiac Surgery, Davis Heart and Lung Research Institute, The Ohio State University, Columbus, Ohio, USA.

Aging is associated with chronic oxidative stress and inflammation that affect tissue repair and regeneration capacity. MG53 is a TRIM family protein that facilitates repair of cell membrane injury in a redox-dependent manner. Here, we demonstrate that the expression of MG53 was reduced in failing human hearts and aged mouse hearts, concomitant with elevated NF-κB activation. We evaluated the safety and efficacy of longitudinal, systemic administration of recombinant human MG53 (rhMG53) protein in aged mice. Echocardiography and pressure-volume loop measurements revealed beneficial effects of rhMG53 treatment in improving heart function of aged mice. Biochemical and histological studies demonstrated that the cardioprotective effects of rhMG53 are linked to suppression of NF-κB-mediated inflammation, reducing apoptotic cell death and oxidative stress in the aged heart. Repetitive administration of rhMG53 in aged mice did not have adverse effects on major vital organ functions. These findings support the therapeutic value of rhMG53 in treating age-related decline in cardiac function.
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http://dx.doi.org/10.1172/jci.insight.148375DOI Listing
September 2021

Association of Intereye Visual-Sensitivity Asymmetry With Progression of Primary Open-Angle Glaucoma.

Invest Ophthalmol Vis Sci 2021 07;62(9)

Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.

Purpose: To investigate the relationship between intereye visual field defect (VFD) asymmetry and subsequent VF progression in primary open-angle glaucoma (POAG).

Methods: Moderate-stage patients with POAG (226 eyes of 113 patients) with a single hemifield defect were followed for 8.7 years. Participants were categorized into three groups by initial VF pattern: (1) unilateral VFD, (2) bilateral VFD within same hemifield (superior-superior, inferior-inferior), (3) bilateral VFD within opposite hemifield (superior-inferior). The mean deviation (MD) difference between the intereye was defined as the intereye MD asymmetry index (iMAI). Intereye visual-sensitivity difference within the same hemifield was calculated as the intereye hemifield visual-sensitivity asymmetry index. Functional progression was detected by Glaucoma Progression Analysis. The overall rate of MD change and the association between new indices were evaluated by linear regression. A Kaplan-Meier survival analysis was performed and the factors associated with glaucoma progression were evaluated by Cox proportional hazard modeling.

Results: Unilateral VFD eyes and bilateral VFD eyes within opposite VF hemifield showed significant progression and faster rate of MD change compared with bilateral VFD eyes within same VF hemifield (71.1% vs. 45.9% vs. 21.1% [P = 0.001]; -1.27 dB/y vs. -0.64 dB/y vs. -0.32 dB/y [P = 0.001]). Unilateral VFD eyes showed the fastest time to VF progression compared with other groups (P = 0.002). A faster rate of MD change was associated with greater intereye MD asymmetry index (P = 0.001) and greater intereye hemifield visual-sensitivity asymmetric index (P = 0.031), which were significant risk factors for glaucoma progression (all P < 0.001).

Conclusions: Among POAG eyes with comparable hemifield VFDs, eyes without a corresponding hemifield defect in the fellow eye showed faster rates of progression compared with those with a corresponding hemifield defect.
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http://dx.doi.org/10.1167/iovs.62.9.4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8267216PMC
July 2021

Methodology and Rationale for Ophthalmic Examinations in the Seventh and Eighth Korea National Health and Nutrition Examination Surveys (2017-2021).

Korean J Ophthalmol 2021 08 21;35(4):295-303. Epub 2021 Jun 21.

Department of Ophthalmology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.

This report provides a detailed description of the methodology for ophthalmic examinations according to the Korea National Health and Nutrition Examination Survey (KNHANES) VII and VIII (from 2017 to 2021). The KNHANES is a nationwide survey which has been performed since 1998 in representatives of whole Korean population. During the KNHANES VII and VIII, in addition to the ophthalmic questionnaire, intraocular pressure measurement, visual field test, auto refractometry, axial length and optical coherence tomography measurements were included. This new survey will provide not only provide normative and pathologic ophthalmic data including intraocular pressure, refractive error, axial length, visual field and precise measurement of anterior segment, macula and optic nerve with optical coherence tomography, but also a more accurate diagnosis for major adult blindness diseases, including age-related macular degeneration, diabetic retinopathy, glaucoma, and other ocular diseases, for the national Korean population.
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http://dx.doi.org/10.3341/kjo.2021.0016DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8357612PMC
August 2021

Association of Optic Disc Tilt and Torsion with Open-Angle Glaucoma-Progression Risk: Meta-Analysis and Meta-Regression Analysis.

Am J Ophthalmol 2021 Jun 6. Epub 2021 Jun 6.

Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea; Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea.

Purpose: To evaluate the association of optic disc deformation with open-angle glaucoma (OAG)-progression risk.

Design: Meta-analysis and meta-regression analysis.

Methods: Reports on the association of optic disc tilt and/or torsion with OAG progression published to June 2020 were identified in the PubMed, EMBASE and Cochrane databases. Tilt ratio was measured as the longest-to-shortest diameter ratio of the optic disc. The angle (in degrees) between the vertical meridian and the disc's long axis was defined as the torsional angle. We utilized random-effects models to combine the pooled effects. Random-effects meta-regression was used to quantify the study characteristics' potential moderating influences. The protocol was registered in the International Database (PROSPERO CRD42020201151).

Results: Eleven longitudinal studies (1,100 participants) were included. For 10 of them evaluated for tilt ratio and glaucoma progression, the pooled hazard ratio (HR) was 0.988 (95% CI, 0.921-1.059, I=59%) per 0.1 unit increase. In the meta-regression-based subgroup analysis, risk tended to decrease as the patients' mean age increased (P=.08). For 7 of the studies (605 patients) reporting data on torsion and glaucoma progression, the pooled HR was 0.936 (0.860-1.018, I=32%) per 10-degree increase. The meta-regression analyses showed that the glaucoma-progression assessment methods had had a modulating influence (P=.01). In studies assessing just functional glaucomatous progression, the pooled HR was 0.890 (0.831-0.952; I=0%).

Conclusions: Evidence for the effects of optic nerve deformation on glaucoma progression is still lacking. Future research employing stratified analysis according to age and tailored diagnostic criteria will allow for more rigorous analyses for this topic.
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http://dx.doi.org/10.1016/j.ajo.2021.06.003DOI Listing
June 2021

Visual outcomes and associated factors of primary congenital glaucoma in children.

Graefes Arch Clin Exp Ophthalmol 2021 Jun 2. Epub 2021 Jun 2.

Department of Ophthalmology, Seoul National University Hospital, Seoul, Republic of Korea.

Purpose: We evaluated the long-term visual outcomes in children with primary congenital glaucoma and determined the factors associated with the final visual outcomes.

Methods: Medical records of children with primary congenital glaucoma between 2005 and 2016, seen at Seoul National University Children's Hospital in South Korea, were reviewed. The minimum follow-up period after surgery for primary congenital glaucoma was 3 years. Visual acuity (VA) was categorized into good (≧20/70) and poor (< 20/70). Factors including age, VA, refractive errors, intraocular pressure (IOP), laterality, and cup-to-disc (C/D) ratio were compared between the groups.

Results: A total of 71 eyes of 44 patients were included. The patients' age at the time of surgery was 14.7 ± 12.2 months. The mean IOP was 28.3 ± 7.0 mmHg. During 6.7 ± 2.7 years of mean follow-up after surgery, 39 eyes (54.9%) needed occlusion treatment. After occlusion, patients with lower IOP values, lesser additional surgeries, reversal of optic disc cupping, and better initially measured VA achieved a better visual outcome. At the final assessment, the mean age was 7.8 ± 2.6 years, and the mean VA gain was 15.0 ± 19.4 letters. There were 44 eyes (62.0%) with VA ≧20/70.

Conclusions: In children with primary congenital glaucoma, IOP control and the optic disc configuration over time are important factors associated with visual outcome. Regular follow-up and correction of refractive errors-along with occlusion for those with difference in VA between the two eyes-might be helpful for achieving better visual outcomes.
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http://dx.doi.org/10.1007/s00417-021-05232-xDOI Listing
June 2021

Genetic Risk and Phenotype Correlation of Primary Open-Angle Glaucoma Based on Rho-Kinase Gene Polymorphisms.

J Clin Med 2021 May 1;10(9). Epub 2021 May 1.

Department of Ophthalmology, Seoul National University Hospital, Seoul 03080, Korea.

Rho-associated coiled-coil kinase (ROCK) signaling can affect glaucoma risk by regulating trabecular meshwork outflow. We investigated the effect of gene polymorphism on the risks of primary open-angle glaucoma (POAG) and POAG-related phenotypes including intraocular pressure (IOP) in a Korean population. A total of 24 single-nucleotide polymorphisms (SNPs) from and were selected and genotyped for 363 POAG patients and 213 healthy controls. Among the 363 POAG patients, 282 were normal-tension glaucoma (NTG, baseline IOP ≤ 21 mmHg) and 81 were high-tension glaucoma (HTG, baseline IOP > 21 mmHg). The SNPs rs288979, rs1006881, rs35996865, rs10083915, and rs11873284 in (tagged to each other, = 1) were nominally associated with risk of HTG (OR = 0.52, = 0.045). However, there were no SNPs that were significantly associated with the risk of NTG. In the genotype-phenotype correlation analysis, the SNPs rs2230773 and rs3771106 in were significantly correlated with central corneal thickness (CCT)-adjusted IOP ( = 0.024) and axial length (AXL; = 0.024), respectively. The present data implicated the role of in POAG development, and as such, can serve as a good reference for upcoming Rho/ROCK-pathway-related studies on POAG.
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http://dx.doi.org/10.3390/jcm10091953DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8124732PMC
May 2021

Effects of Beta-zone Peripapillary Atrophy and Focal Lamina Cribrosa Defects on Peripapillary Vessel Parameters in Young Myopic Eyes.

J Glaucoma 2021 Aug;30(8):703-710

Department of Ophthalmology, Seoul National University Hospital, Seoul.

Precis: The development of beta-zone peripapillary atrophy (β-PPA) and focal lamina cribrosa defect (FLD) was significantly associated with decreased peripapillary optical coherence tomography angiography (OCTA) vessel parameters in young myopic eyes.

Purpose: The purpose of this study was to investigate whether β-PPA and FLD affect peripapillary vessel density (VD) or perfusion density (PD) from OCTA in young myopic eyes.

Materials And Methods: In a cross-sectional study, 330 eyes of 165 healthy volunteers with myopia were involved. Eyes underwent OCTA to measure peripapillary PD and VD. Eyes were grouped according to the presence of β-PPA or FLD: eyes without β-PPA or FLD (group A), eyes with β-PPA but without FLD (group B), and eyes with both β-PPA and FLD (group C). PD and VD were compared among 3 groups, and linear mixed-effect regression model was used to investigate the determinants of PD.

Results: β-PPA was found in 219 eyes (66.4%), and FLD was detected in 27 eyes (8.2%). The average VD and PD were greatest in group A (19.13±2.04 mm-1 and 0.375±0.038), followed by group B (18.34±2.26 mm-1 and 0.363±0.042) and group C (16.71±2.81 mm-1 and 0.330±0.052) (P<0.001). The linear mixed-effect model demonstrated that presence of FLD (P=0.001) or β-PPA (P<0.001), FLD count (P=0.004), and maximal β-PPA width (P<0.001) were significantly associated with average PD after controlling for multiple confounding factors.

Conclusions: Development of β-PPA and FLD, which is closely related with axial elongation in myopic eyes, was significantly associated with reduced OCTA vessel parameters in young myopic eyes. OCTA may help to detect vascular changes and assess glaucoma risk in these eyes.
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http://dx.doi.org/10.1097/IJG.0000000000001890DOI Listing
August 2021

Novel glaucoma model in rats using photo-crosslinked azidobenzoic acid-modified chitosan.

Mater Sci Eng C Mater Biol Appl 2021 Jun 17;125:112112. Epub 2021 Apr 17.

Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Ophthalmology, Seoul National University Hospital, Seoul, Republic of Korea. Electronic address:

An experimental model of pressure-induced optic nerve damage promises to greatly expand understanding of the cellular events leading to retinal ganglion cell (RGC) death and of how they are influenced by intraocular pressure (IOP) and other risk factors associated with glaucoma. In this work, we propose a novel strategy employing photo-crosslinkable azidobenzoic acid-modified chitosan (Az-CH) for long-term, persistent elevation of IOP. For this purpose, a solution of Az-CH was injected into the anterior chamber of experimental rat eyes, which were subsequently irradiated with ultraviolet (UV) light to form an Az-CH gel that hindered aqueous outflow and effected prolonged IOP elevation thereby. The control eyes were treated as follows: (1) intracameral injection of Az-CH without UV irradiation, (2) intracameral injection of saline solution without UV irradiation or (3) no injection with UV irradiation. A significant IOP increase was observed in the experimental eyes, which was continuously higher for the whole testing period of 12 weeks after one-time treatment with Az-CH injection and UV irradiation. Also, a more significant loss of RGCs, one of the major features of glaucoma, was observed in experimental eyes than in the control eyes. Therefore, the strategy presented herein can be a novel experimental model to study the mechanism of RGC damage by elevated IOP over the course of a prolonged period.
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http://dx.doi.org/10.1016/j.msec.2021.112112DOI Listing
June 2021

Ten-year-and-beyond longitudinal change of ß-zone parapapillary atrophy in glaucoma: association with retinal nerve fibre layer defect.

Br J Ophthalmol 2021 Apr 30. Epub 2021 Apr 30.

Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea

Background: To investigate the longitudinal change of localised retinal nerve fibre layer (RNFL) defects associated with change of ß-zone parapapillary atrophy (PPA) in primary open-angle glaucoma (POAG) eyes.

Methods: POAG patients with a localised RNFL defect and ß-zone PPA who had undergone disc/RNFL photography at 1-year intervals for 10 years or longer were enrolled. The topographic parameters of ß-zone PPA (area, maximal radial extent and angular extent around disc) were measured. Progression of RNFL defect was defined as widening of defect and/or appearance of new defect. The factors associated with progression of RNFL defect were assessed by OR using multivariable logistic regression.

Results: A total of 209 patients (209 eyes) with POAG were included (mean: 54 years old). Over the course of 11.5±2.3-year follow-up period, progression of RNFL defect was detected in 114 eyes (54.5%). Enlargement of PPA parameters (area and angular extent) was significantly more common in patients with RNFL defect progression than in eyes without progression (all p<0.001, respectively). Widening of radial extent did not show a significant difference in both groups (p=0.61). Increment of angular extent was in the direction of RNFL defect progression in 82.1% of eyes. Progression of RNFL defect was significantly associated with disc haemorrhage (OR: 6.653, p<0.001), enlargement of PPA area (OR: 4.114, p=0.004) and angular extent (OR: 6.572, p<0.001).

Conclusions: Progression of RNFL defect is associated with increment of angular extent of PPA in POAG eyes.
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http://dx.doi.org/10.1136/bjophthalmol-2020-318464DOI Listing
April 2021

Automated Real-Time Evaluation of Condylar Movement in Relation to Three-Dimensional Craniofacial and Temporomandibular Morphometry in Patients with Facial Asymmetry.

Sensors (Basel) 2021 Apr 7;21(8). Epub 2021 Apr 7.

Department of Orthodontics, Kyung Hee University School of Dentistry, Seoul 02447, Korea.

The aim of this study was to investigate the correlation between craniofacial morphology, temporomandibular joint (TMJ) characteristics, and condylar functional movement in patients with facial asymmetry using an up-to-date automated real-time jaw-tracking system. A total of 30 patients with mandibular asymmetry and prognathism were included. Three-dimensional (3D) craniofacial and TMJ morphometric variables were analyzed in images captured using cone-beam computed tomography. Three-dimensional condylar movements were recorded during the opening, protrusion, and laterotrusion of the jaw and divided into those for deviated and non-deviated sides. Overall functional and morphometric variables were compared between the sides by a paired -test. Pearson's correlation analysis and factor analysis were also performed. As a result, significant differences were found between the sides in morphometric and functional variables. The condylar path length was significantly longer and steeper on the deviated side during protrusion and lateral excursion. TMJ morphometric asymmetry, more so than the craniofacial morphologic asymmetry, seemed to be reflected in the functional asymmetry, representing different correlations between the sides, as supported by factor analysis. This study provides evidence explaining why the asymmetric condylar path remained unchanged even after orthognathic surgery for the correction of craniofacial asymmetry.
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http://dx.doi.org/10.3390/s21082591DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8068048PMC
April 2021

Longitudinal Observation of Border Tissue Configuration During Axial Elongation in Childhood.

Invest Ophthalmol Vis Sci 2021 04;62(4):10

Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.

Purpose: To investigate the change of border tissue configuration during axial elongation in childhood.

Methods: Fifty-four subjects (108 eyes; age range, 29.3-132.5 months) who had undergone a series of swept-source optical coherence tomography scans at intervals of 6 months or longer were classified into stable axial length (AXL) eyes (n = 55; AXL change of ≤0.36 mm) and elongating AXL eyes (n = 53; AXL change of >0.36 mm). The angle between the Bruch's membrane opening (BMO) reference plane and the border tissue of Elschnig was defined as the border tissue angle (BTA). The border tissue angle, BMO distance (BMOD) and minimum rim width (MRW) were measured in the temporal and nasal regions.

Results: During 15.6 ± 7.2 months of follow-up, the AXL significantly increased from 22.8 ± 1.3 mm to 23.3 ± 1.4 mm (P < 0.001). Changes of border tissue angle and AXL showed a significant correlation only in the temporal region of elongating AXL eyes (r = -0.409; P = 0.002), but not in stable AXL eyes. Both BMOD and nasal MRW significantly increased from 1482.5 ± 153.0 to 1506.1 ± 154.6 µm and from 310.6 ± 83.2 to 324.6 ± 95.6 µm, respectively (all Ps < 0.001). The changes of BMOD and nasal MRW showed a significant positive correlation with changes of AXL in elongating AXL eyes but not in stable AXL eyes.

Conclusions: During the axial elongation in childhood, temporal border tissue configuration change, BMO enlargement, and nasal peripapillary tissue elevation showed a significant correlation with changes in the AXL.
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http://dx.doi.org/10.1167/iovs.62.4.10DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8039469PMC
April 2021

Nationwide Glaucoma incidence in end stage renal disease patients and kidney transplant recipients.

Sci Rep 2021 Apr 1;11(1):7418. Epub 2021 Apr 1.

Department of Ophthalmology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea.

Glaucoma shares common risk factors with chronic kidney disease (CKD) but previous cross-sectional studies have demonstrated discrepancies in the risk of glaucoma in CKD patients. This study enrolled kidney transplantation recipients (KTRs) (n = 10,955), end stage renal disease (ESRD) patients (n = 10,955) and healthy controls (n = 10,955) from National Health Insurance Service database of the Republic of Korea. A Cox proportional hazard regression model was used to calculate the hazard ratios (HR) for primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG) incidences. The incidence of POAG was higher in ESRD patients (3.36/1,000 person-years, P < 0.0001) and KTRs (3.22 /1,000 person-years, P < 0.0001), than in healthy controls (1.20/1,000 person-years). However, POAG risk showed no significant increase in either ESRD patients (P = 0.07) or KTRs (P = 0.08) when adjusted for the confounding factors. The incidence of PACG was significantly higher in ESRD patients (0.41/1,000 person-years) than in healthy controls (0.14/1,000 person-years, P = 0.008). The PACG incidence was significantly lower in KTRs than in ESRD patients (HR = 0.35, P = 0.015). In conclusion, this nationwide cohort study demonstrated that kidney transplantation can reduce the risk of PACG but not POAG in ESRD patients.
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http://dx.doi.org/10.1038/s41598-021-86846-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8017003PMC
April 2021

Health screening program revealed risk factors associated with development and progression of papillomacular bundle defect.

EPMA J 2021 Mar 4;12(1):41-55. Epub 2021 Mar 4.

Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.

Background/aims: The papillomacular bundle (PMB) area is an important anatomical site associated with central vision. As preventive medicine and health screening examinations are now becoming commonplace, the incidental detection of papillomacular bundle defect (PMBD) on fundus photography has been increasing. However, clinical significance of incidental PMBD has not been well documented to date. Thus, through long-term and longitudinal observation, we aimed to investigate the risk factors for the development and progression of PMBD and its predictive role associated with systemic diseases and glaucoma.

Methods: This longitudinal study included subjects who had undergone standardized health screening. We retrospectively reviewed patients for whom PMBD had been detected in fundus photography and followed up for more than 5 years. For a comparative analysis, non-PMBD groups of age- and gender-matched healthy controls were selected.

Results: A total of about 67,000 fundus photographs were analyzed for 8.0 years, and 587 PMBD eyes were found. Among them, 234 eyes of 234 patients who had had fundus photographs taken for more than 5 years were finally included. A total of 216 eyes (92.3%) did not progress during the 8.1 ± 2.7 years, whereas 18 eyes (7.7%) showed progression at 7.6 ± 2.9 years after initial detection. A multivariate logistic regression analysis using 224 non-PMBD healthy controls revealed low body mass index (BMI < 20 kg/m), systemic hypertension, and sclerotic changes of retinal artery as the significant risk factors for the development of PMBD. Regarding PMBD progression, low BMI, concomitant retinal nerve fiber layer defect (RNFLD) at non-PMB sites, optic disc hemorrhage, and higher vertical cup/disc ratio were individual significant risk factors.

Conclusion: PMBD is associated with ischemic effects. Although the majority of PMBD do not progress, some of cases are associated with glaucomatous damage in a long-term way. PMBD might be a personalized indicator representing ischemia-associated diseases and a predictive factor for diagnosis and preventive management of glaucoma.
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http://dx.doi.org/10.1007/s13167-021-00235-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7954962PMC
March 2021

Predictors of Acute Kidney Injury and 28-Day Mortality in Carbapenem-Resistant Complex Bacteremia.

Microb Drug Resist 2021 Aug 3;27(8):1029-1036. Epub 2021 Mar 3.

Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Republic of Korea.

Colistin is an, antibiotic used to treat carbapenem-resistant complex (CRABC) infection. However, colistin is well known for its nephrotoxicity. To accurately assess the effects of colistin on acute kidney injury (AKI) and 28-day mortality, we investigated the risk factors associated with AKI and mortality in patients with CRABC bacteremia who received or never received colistin. Patients with CRABC bacteremia aged ≥18 years were retrospectively identified for 3 years at five tertiary teaching hospitals. AKI was defined by using the Kidney Disease Improving Global Outcomes criteria. AKI developed in 103 (34.9%) of the 295 patients enrolled patients. AKI developed more frequently in patients who received colistin than in patients who did not (46.7% vs. 29.5%,  = 0.004). Multivariate analysis showed that intravenous colistin usage was an independent risk factor for AKI in these patients. Nonfatal disease, catheter-related bloodstream infection, and administration of colistin were protective factors for 28-day mortality. However, the sequential organ failure assessment score and AKI were associated with poor outcomes. In conclusion, colistin may be a double-edged sword; although it causes AKI, it also reduces 28-day mortality in patients with CRABC bacteremia. Therefore, colistin administration as an appropriate antibiotic may improve CRABC bacteremia prognosis, despite its nephrotoxicity.
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http://dx.doi.org/10.1089/mdr.2020.0312DOI Listing
August 2021

Efficacy and safety of fixed-combination brimonidine tartrate/timolol maleate in primary open-angle glaucoma, including normal-tension glaucoma.

Jpn J Ophthalmol 2021 Mar 16;65(2):295-305. Epub 2021 Feb 16.

Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.

Purpose: To assess the 12-month efficacy and safety of fixed-combination brimonidine tartrate 0.2%/timolol maleate 0.5% (FCBT) with or without bimatoprost 0.01% (BIM) in primary open-angle glaucoma (POAG), including normal-tension glaucoma (NTG).

Study Design: Prospective, multicenter, open-label study.

Methods: FCBT was self-administered twice daily after applicable washout (study eye). Intraocular pressure (IOP) was measured at baseline and months 1, 3, 6, 9, and 12. BIM could be added for IOP ≥ 21 mmHg, IOP reduction from baseline < 20%, or the investigator deemed it necessary. Primary endpoint: mean (11-a.m.) month-12 IOP change from baseline. Secondary endpoints included mean IOP changes from baseline at other visits, median time to achieving and patients (%) achieving target IOP reduction with FCBT, and visual field (VF) progression rate over 12 months. Safety was assessed at each visit.

Results: Of 118 eyes with POAG (NTG, n = 93), 87 used FCBT; 31 required FCBT + BIM. Mean IOP changes from baseline (16.8 and 15.3 mmHg) to month 12 were - 4.1 mmHg (FCBT, n = 62) and - 3.5 mmHg (FCBT + BIM, n = 15), respectively (both P < 0.0001). Patients who achieved target IOP reduction with FCBT did so in 1 month (median). VF progression rates were 0.17%/year (FCBT, P = 0.8367) and - 0.08%/year (FCBT + BIM, P = 0.9410). Ocular treatment-emergent adverse events occurred in 42.5% (FCBT) and 71.0% (FCBT + BIM) of patients; most were mild and included ocular hyperemia (9.2% and 41.9%, respectively).

Conclusions: Despite low mean baseline IOP, ≥ 20% IOP reduction from baseline persisted over 12 months with FCBT and FCBT + BIM, without clinically significant VF progression. Tolerability was consistent with reported drug safety profiles.
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http://dx.doi.org/10.1007/s10384-020-00796-3DOI Listing
March 2021

Machine-Learning-Based Approach to Differential Diagnosis in Tuberculous and Viral Meningitis.

Infect Chemother 2021 Mar 11;53(1):53-62. Epub 2020 Dec 11.

Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.

Background: Tuberculous meningitis (TBM) is the most severe form of tuberculosis, but differentiating between the diagnosis of TBM and viral meningitis (VM) is difficult. Thus, we have developed machine-learning modules for differentiating TBM from VM.

Material And Methods: For the training data, confirmed or probable TBM and confirmed VM cases were retrospectively collected from five teaching hospitals in Korea between January 2000 - July 2018. Various machine-learning algorithms were used for training. The machine-learning algorithms were tested by the leave-one-out cross-validation. Four residents and two infectious disease specialists were tested using the summarized medical information.

Results: The training study comprised data from 60 patients with confirmed or probable TBM and 143 patients with confirmed VM. Older age, longer symptom duration before the visit, lower serum sodium, lower cerebrospinal fluid (CSF) glucose, higher CSF protein, and CSF adenosine deaminase were found in the TBM patients. Among the various machine-learning algorithms, the area under the curve (AUC) of the receiver operating characteristics of artificial neural network (ANN) with ImperativeImputer for matrix completion (0.85; 95% confidence interval 0.79 - 0.89) was found to be the highest. The AUC of the ANN model was statistically higher than those of all the residents (range 0.67 - 0.72, <0.001) and an infectious disease specialist (AUC 0.76; = 0.03).

Conclusion: The machine-learning techniques may play a role in differentiating between TBM and VM. Specifically, the ANN model seems to have better diagnostic performance than the non-expert clinician.
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http://dx.doi.org/10.3947/ic.2020.0104DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8032912PMC
March 2021

Etiology, Characteristics, and Outcomes of Community-Onset Pyomyositis in Korea: A Multicenter Study.

Infect Chemother 2021 Mar 7;53(1):46-52. Epub 2021 Jan 7.

The Korean Skin and Soft Tissue Study Group, Korea.

Background: Pyomyositis (PM) is a serious soft tissue infection and despite its clinical importance, previous studies have not been able to fully determine the clinical characteristics and microbial epidemiology of PM in Korea, which we therefore aimed to investigate.

Materials And Methods: We retrospectively identified 140 adult patients diagnosed with PM from 13 general hospitals between January 2012 and December 2015. We analyzed the clinical and microbial characteristics of community-onset PM and compared them with community-acquired (CA) and healthcare-associated (HCA) PM.

Results: One hundred eleven organisms were isolated from 96 (68.6%) patients with PM. (38 patients) was the most common pathogen, followed by streptococci (24 patients), and enteric Gram-negative organisms (27 patients). Methicillin-resistant (MRSA) was identified in four (2.9%) patients and in-hospital mortality reached 8.6% (12/140). Enterococci isolates were identified in the HCA PM subgroup only The proportion of MRSA isolates was not comparable between CA and HCA PM subgroups. In the 83 patients with PM infected by monomicrobial pathogens, isolates of Gram-negative organisms were more commonly found in HCA PM subgroup than in CA PM subgroup (47.6% [10/21] of patients with HCA PM 20.7% [12/58] of patients with CA PM; = 0.01).

Conclusion: Gram-positive cocci such as and streptococci were dominant etiologies in community-onset PM, whereas MRSA appears to an uncommon causative organism of PM in Korea. Enteric Gram-negative organisms should also be considered as major etiologies, especially in HCA PM patient population in Korea.
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http://dx.doi.org/10.3947/ic.2020.0102DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8032918PMC
March 2021

Evaluation of interradicular space, soft tissue, and hard tissue of the posterior palatal alveolar process for orthodontic mini-implant, using cone-beam computed tomography.

Am J Orthod Dentofacial Orthop 2021 Apr 29;159(4):460-469. Epub 2021 Jan 29.

Department of Orthodontics, Graduate School, Kyung Hee University, Seoul, South Korea.

Introduction: To investigate the anatomy of the posterior palatal alveolar process, which is often used for placement of the orthodontic mini-implant (OMI), and to suggest simple guidelines for safe placement of OMI.

Methods: Cone-beam computed tomography (CBCT) scans of 60 patients (30 men, 30 women; age range, 18-39 years; average age, 25.8 years) was used to measure the palatal interradicular distance, the palatal bone thickness, and the palatal soft-tissue thickness. Measurements were performed on the area from the maxillary canine to the maxillary second molar based on the vertical distance apical from the cementoenamel junction. The CBCT data were analyzed by Bonferroni correction for multiple testing and the multivariable mixed linear model.

Results: The palatal interradicular distance was the widest between the second premolar and the first molar and the narrowest between the first and second premolars. The palatal bone thickness at interdental sites was the thickest between the first and second premolars and the thinnest between the first and second molars. The interdental palatal soft-tissue thickness from the canine to the second premolar was thicker than any other area. There were minor measurement differences between genders and positive correlations between vertical distance from the cementoenamel junction plane and all of the parameters.

Conclusion: In this study, we evaluated the anatomy of the posterior palatal area using CBCT scans of adult patients. The data will provide guidelines to the clinicians before OMI placement in the posterior palatal alveolar process.
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http://dx.doi.org/10.1016/j.ajodo.2020.01.019DOI Listing
April 2021

Surface Roughness on the Slots and Wings of Various Ceramic Self-Ligating Brackets and their Potential Concern on Biofilm Formation.

J Clin Pediatr Dent 2020 Dec;44(6):451-458

Objective: The surface roughness of various orthodontic materials could affect biofilm formation and friction. The purpose of this study was to examine the surface roughness and chemical composition of the slots and wings of several ceramic self-ligating brackets.

Study Design: Four types of ceramic self-ligating brackets were separated into experimental groups (DC, EC, IC, and QK) while a metal self-ligating bracket (EM) was used as the control group. Atomic force microscopy and energy-dispersive x-ray spectroscope were used to examine the surface roughness and chemical composition of each bracket slot and wing.

Results: The control group was made of ferrum and chrome while all the experimental groups were comprised of aluminum and oxide. There was a statistically significant difference in the roughness average (Sa) among the various self-ligating brackets (p< 0.001 in slots and p<0.01 in the wing). The slots in the EC group had the lowest Sa, followed by the DC, IC, control, and QK groups. The wings in the IC group had the lowest Sa, followed by the EC, DC, control, and QK groups.

Conclusions: There is a significant difference in the surface roughness of the slots and wings among several types of ceramic self-ligating brackets.
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http://dx.doi.org/10.17796/1053-4625-44.6.10DOI Listing
December 2020

Causative Pathogens and Antibiotic Resistance in Infectious Arthritis.

Authors:
Ki Ho Park

Infect Chemother 2020 Dec;52(4):641-643

Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Korea.

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http://dx.doi.org/10.3947/ic.2020.52.4.641DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7779996PMC
December 2020

Comparison of the Efficacy and Safety of Trabeculectomy with Mitomycin C According to Concentration: A Prospective Randomized Clinical Trial.

J Clin Med 2020 Dec 26;10(1). Epub 2020 Dec 26.

Department of Ophthalmology, Seoul National University College of Medicine, Seoul 08826, Korea.

(1) Background: Mitomycin C (MMC) is commonly used during trabeculectomy. However, there is no consensus on which concentration should be used. We aimed to compare the efficacy and safety of 0.2 mg/mL and 0.4 mg/mL of MMC in eyes undergoing trabeculectomy. (2) Methods: Thirty-six eyes (36 glaucoma patients) were randomized to undergo a trabeculectomy with 0.2 mg/mL or 0.4 mg/mL of MMC. The success rate was evaluated according to three criteria: (A) intraocular pressure (IOP) ≤18 mmHg and IOP reduction ≥20%; (B) IOP ≤15 mmHg and IOP reduction ≥25%; (C) IOP ≤12 mmHg and IOP reduction ≥30%. Cox's proportional hazard model was used to identify the predictive factors for failure. Immunohistochemical procedures for matrix metalloproteinase (MMP) were performed on Tenon's tissue. Bleb morphology was evaluated. Safety was assessed based on the incidence of complications. (3) Results: Of the 36 eyes, 19 underwent trabeculectomy with 0.2 mg/mL of MMC and 17 with 0.4 mg/mL. The success rates were 75%, 67%, and 47% at 6 months for criteria A, B, and C, respectively. There were no significant differences between the two groups. High MMP-9 staining and low preoperative IOP were associated with failure (hazard ratio (HR), 5.556; = 0.033, and HR, 0.936; = 0.033). Complications included hypotony in two eyes (6%), hyphema in one eye (3%), and choroidal detachment in one eye (3%). (4) Conclusions: Trabeculectomy with 0.2 mg/mL and 0.4 mg/mL of MMC showed similar IOP-control effects to those recorded in previous studies, along with a low rate of complications. There was no significant difference in efficacy or safety between the 0.2 mg/mL and 0.4 mg/mL MMC groups.
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http://dx.doi.org/10.3390/jcm10010059DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7796253PMC
December 2020

Clinical Use of PanoMap for Glaucoma: Frequently Damaged Areas in Early Glaucoma.

J Glaucoma 2021 01;30(1):10-16

Department of Ophthalmology, Hanyang University College of Medicine.

Prcis: Recognizing the shortcomings of poor consistency of the fovea-disc relationship at different time points and comparing PanoMaps may well facilitate the understanding of the spatial relationship between parapapillary and macular areas in glaucoma.

Purpose: The aims of this study are to analyze the spatial distribution of the frequently damaged areas in early glaucoma, compare the patterns between nonprogressors and progressors using the combined wide-field parapapillary and macular deviation maps (PanoMap), and to evaluate the consistency of the fovea-disc relationship in PanoMap. The fovea-disc distance (FDD) and fovea-disc axis (FDA) were compared at baseline and at the last follow-up.

Materials And Methods: In total, 118 patients with early glaucoma and a minimum follow-up period of 3 years were included in this retrospective observational study. The pattern of structural changes was evaluated by averaging the PanoMaps of the enrolled patients at baseline and last follow-up. Longitudinal comparison of the FDD and FDA was performed at baseline and the last follow-up. Patients were divided into nonprogressor (n=44) and progressor (n=74), and the patterns of glaucoma progression in PanoMaps were compared between them.

Results: At baseline, the glaucomatous damage was found more frequently in the macular compared with the parapapillary area. The spatial distribution of frequently damaged areas was similar between the nonprogressor and progressor. At the last follow-up, compared with the baseline structural change on the PanoMap, the progressive structural changes extended toward the fovea at both the parapapillary and macular areas in the progressor. The FDD and FDA were significantly different between the baseline and the last follow-up.

Conclusions: The PanoMaps showed a clear spatial distribution of early glaucomatous changes, indicating that the damaged area was frequently observed in the macular area. As the consistency of the fovea-disc relationship in PanoMaps was not excellent, this aspect should be considered when interpreting the PanoMap.
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http://dx.doi.org/10.1097/IJG.0000000000001690DOI Listing
January 2021

Normal-tension Glaucoma Management: A Survey of Glaucoma Sub-specialists in Korea.

Korean J Ophthalmol 2020 12 3;34(6):425-431. Epub 2020 Dec 3.

Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.

Purpose: To investigate the current management patterns of glaucoma subspecialists with regard to normal-tension glaucoma (NTG) in Korea and to determine the effect of the two largest NTG trials on their clinical practice.

Methods: A questionnaire survey was sent to glaucoma subspecialist members of the Korean Glaucoma Society. The questionnaire concerned regular practice with respect to NTG and the extent to which it has been influenced by the Collaborative Normal-tension Glaucoma Study and the Low-pressure Glaucoma Treatment Study (LoGTS).

Results: A total of 134 glaucoma subspecialists completed the survey, with a response rate of 56%. The survey reported that 88% and 78% of glaucoma subspecialists were familiar with the Collaborative Normal-tension Glaucoma Study and the LoGTS, respectively. With respect to mild or moderate NTG, most of the respondents (87%-91%) tended to treat their patients immediately without waiting for structural or functional progression. Among the respondents, 47 indicated that the LoGTS results-according to which, 20% of the respondents tended to use brimonidine more often-affected their management. The first-choice topical drugs for NTG were prostaglandin analogues (76%), brimonidine (9%), beta-blockers (8%), and topical carbonic anhydrase inhibitor (6%).

Conclusions: Regarding mild-to-moderate NTG, Korean glaucoma subspecialists tended to initiate treatment without waiting for further progression. The impact of the LoGTS on NTG management was not dominant in clinical practice in Korea. Prostaglandin analogs are the most frequently selected first-choice drugs for the management of NTG in Korea.
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http://dx.doi.org/10.3341/kjo.2020.0061DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7738222PMC
December 2020

Estimating visual field loss from monoscopic optic disc photography using deep learning model.

Sci Rep 2020 12 3;10(1):21052. Epub 2020 Dec 3.

Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.

Visual field assessment is recognized as the important criterion of glaucomatous damage judgement; however, it can show large test-retest variability. We developed a deep learning (DL) algorithm that quantitatively predicts mean deviation (MD) of standard automated perimetry (SAP) from monoscopic optic disc photographs (ODPs). A total of 1200 image pairs (ODPs and SAP results) for 563 eyes of 327 participants were enrolled. A DL model was built by combining a pre-trained DL network and subsequently trained fully connected layers. The correlation coefficient and mean absolute error (MAE) between the predicted and measured MDs were calculated. The area under the receiver operating characteristic curve (AUC) was calculated to evaluate the detection ability for glaucomatous visual field (VF) loss. The data were split into training/validation (1000 images) and testing (200 images) sets to evaluate the performance of the algorithm. The predicted MD showed a strong correlation and good agreement with the actual MD (correlation coefficient = 0.755; R = 57.0%; MAE = 1.94 dB). The model also accurately predicted the presence of glaucomatous VF loss (AUC 0.953). The DL algorithm showed great feasibility for prediction of MD and detection of glaucomatous functional loss from ODPs.
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http://dx.doi.org/10.1038/s41598-020-78144-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7712913PMC
December 2020
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