Objectives: Non-infectious optic neuritis (ON) in Caucasians is typically associated with multiple sclerosis (MS), and steroid treatment is optional.In Chinese patients, however, ON is often atypical and more likely to be associated with neuromyelitis optica spectrum disorder (NMOSD), for which early initiation of pulse intravenous steroid treatment is recommended.We aimed to identify factors associated with visual acuity (VA) improvement after intravenous and oral steroid treatment.Methods: We reviewed the medical records of 64 Chinese patients (64 eyes) who presented to Hong Kong Eye Hospital between 2000 and 2019 with their first episode of acute ON and received intravenous methylprednisolone and oral prednisolone.Results: Among all cases, 45.3% were idiopathic and isolated, 25.0% were NMOSD-related, and 17.2% were MS-related.Patients with MS-related ON were younger than patients with idiopathic or NMOSD-related ON (p<0.01).Greater improvement in VA was associated with worse nadir VA, greater VA improvement on day 14 of steroid treatment, and NMOSD-related ON, whereas
A 62-year-old Chinese woman, with a history of immunoglobulin A nephropathy, presented with an ulcerative conjunctival lesion and anterior orbital inflammation.No infective foci were found, and her symptoms were not alleviated by antibiotic treatment or drainage of the lesion.She was diagnosed with idiopathic orbital inflammatory disease, also known as orbital pseudotumor, which completely resolved with oral corticosteroid treatment.To the best of our knowledge, this is the first documented case of idiopathic orbital inflammatory disease that initially presented with an ulcerative conjunctival lesion.We illustrate our stepwise diagnostic approach and management of the disease.
how NIU was managed during the COVID-19 pandemic, specifically addressing the use of immunosuppressants and biologics.
Neovascular age-related macular degeneration (nAMD) is a major cause of vision loss in older adults.Neovascularization is caused by angiogenic mechanisms of the angiopoietin and vascular endothelial growth factor (VEGF) pathways.Standard treatments for nAMD target the VEGF pathway, but the efficacy of single-target anti-VEGF agents is limited by angiopoietin.Some patients may respond inadequately.Faricimab is a bispecific antibody targeting VEGF-A and angiopoietin-2.Its efficacy and safety have been illustrated in the TENAYA, LUCERNE, and TRUCKEE studies.Compared with aflibercept 2 mg, faricimab 6 mg demonstrated rapid best-corrected visual acuity gains and central subfield thickness reductions.A larger proportion of patients did not develop subretinal fluid during the loading phase.Faricimab is well tolerated with a risk-benefit profile comparable to the standard anti-VEGF treatment.Guidelines from the National Institute for Health and Care Excellence and the European Society of Retina Specialists recommend early diagnostic imaging and examinations for timely treatment of nAMD.Faricimab is an efficacious, well-tolerated, and long-acting treatment option for nAMD, with the potential for long-term cost savings.PERSPECTIVE HKJOphthalmol Vol.27 No.2VEGF-A and Ang-2, is a treatment option for nAMD. 6,11e discuss the mechanism of action, clinical evidence, and treatment recommendations of faricimab for nAMD.
Objective: This study evaluated the real-world performance in an Asian population with diabetes mellitus (DM) of the EyeArt system, which is the only United States Food and Drug Administration-approved system available in Hong Kong.Methods: Fundus photographs taken from December 2020 to June 2021 during a diabetic retinopathy (DR) screening program in patients with DM who attended Pamela Youde Nethersole Eastern Hospital in Hong Kong were retrieved.Two vitreoretinal-trained ophthalmologists independently graded the fundus photographs for DR and concomitant pathologies.Discrepancies were resolved through discussion with a senior vitreoretinal ophthalmologist for a final decision.Fundus photographs (in jpg format) were then uploaded to the EyeArt AI system.The EyeArt system's sensitivity and specificity on detecting (1) referable DR (moderate or severe non-proliferative DR, proliferative DR, or diabetic macular edema [DME]) and (2) any DR or DME were calculated based on the ophthalmologists' diagnoses (the gold standard).Results: 23 men and 79 women (93 Chinese, 3 Pakistanis,
Retinopathy of prematurity (ROP) is one of the most common causes of childhood blindness worldwide.Its prevalence is rising as more premature infants are surviving owing to advances in neonatal care.The current treatments for ROP are invasive and may increase the risk of future eye complications.Nutraceuticals (dietary oils, carotenoids, and vitamin supplements) are generally safe for use in children without detrimental adverse effects.Research has demonstrated nutraceuticals' anti-angiogenesis properties and their potential to protect against ROP.Dietary oils suppress inflammation and neovascularization in ROP models when administered intravenously.Carotenoids, such as lutein, promote retinal revascularization in mice.Vitamin A, C, and E supplements are unable to prevent ROP pathogenesis, despite well-documented antioxidative effects.The discrepancy between laboratory and clinical trial results may be due to differences in the dosage that can affect the eye, the outcome measurements used, and the presence of confounders in clinical trials.Future studies should investigate the short-and longterm effects of nutraceuticals on infants' vision.
Purpose: To retrospectively review visual outcomes of patients with myopia who were implanted with the IC-8 intraocular lens in the nondominant eye and a monofocal intraocular lens in the dominant eye at a private ophthalmology clinic in Australia.Methods: We retrospectively reviewed medical records of consecutive patients aged ≥18 years who had myopia (≥-0.25 diopter) in both eyes and astigmatism (≤-2.50 diopters) in the nondominant eye and underwent bilateral cataract surgery and implantation of the IC-8 intraocular lens in the nondominant eye and a monofocal intraocular lens in the dominant eye between January 2018 and February 2020 at a private ophthalmology clinic in Australia.At 6 months, uncorrected monocular and binocular distance, intermediate, and near visual acuity was assessed.Dysphotopsia symptoms was evaluated with the Quality of Vision questionnaire.Results: Medical records of 15 men and 10 women aged 28 to 79 (mean, 60.8±11.5)years of Chinese (n=16), Caucasians (n=8), and South Asian (n=1) ethnicity were reviewed.The mean spherical equivalent improved from -2.92 to -1.20 diopters in nondominant eyes and from -2.42 to -0.13 diopters in dominant eyes.Binocularly, 92%, 64%, and 100% of patients achieved uncorrected distance, intermediate, and near visual acuity of logMAR 0 or better, logMAR 0 or better, and logMAR 0.20 (N5) or better, respectively.The mean Quality of Vision questionnaire score was 32.1 for frequency, 25.4 for severity, and 23.9 for bothersomeness of dysphotopsia
Among commercially available AI products for ophthalmology, 4,5 analysis of fundus photographs 6 and optical coherence tomography images 7 remains the core technologies.Two AI systems for diabetic retinopathy
The use of the three-dimensional (3D) digital heads-up microscope is increasingly popular in ophthalmology.Its advantages include improved depth of field, excellent visualization, lower illumination requirements, better ergonomics, and more effective teaching.A pilot study involving 18 ophthalmologists was conducted to compare the 3D microscope with the traditional optical microscope in performing microsurgical steps.Although the mean total operating time to complete five tasks was longer using the 3D microscope than the optical microscope (545 vs 410 seconds, p=0.0009), a downward trend was observed for the mean duration for each task using the 3D microscope.The rapid learning curve reflects the ease of learning and fast adaptation to the new instrument.Operating times may improve with more practice.
