While prior research suggests a relationship between obstructive sleep apnea (OSA) and non-arteritic anterior ischemic optic neuropathy (NAION), detailed associations remain unclear. This study investigated how polysomnography (PSG) parameters of OSA are associated with clinical features of acute NAION. We conducted a retrospective analysis of 66 patients diagnosed with concurrent NAION and OSA between 2015 and 2023. Data on demographics, medical history, PSG results, ophthalmologic evaluations, and follow-up outcomes were analyzed. Univariate and multivariate linear regression analyses were performed to assess associations between OSA characteristics and NAION manifestations, adjusting for key confounders. The cohort included 30 men and 36 women (mean age: 60 years). Comorbidities included hypertension (51.6

Background:Optic disc tilt is a morphological change in myopic eyes that complicates clinical interpretation and artificial intelligence (AI)-based analysis of fundus images. Accurate detection of optic disc tilt is necessary to avoid misinterpretation of disc morphology and enhance diagnostic reliability across different disease types. Objective:This study developed and externally validated an end-to-end AI-based pipeline for optic disc segmentation and quantitative tilt classification in color fundus photographs (CFPs), offering an objective alternative to manual segmentation and subjective clinical assessments. Methods:We trained a nnU-Net-based optic disc segmentation model on the Standardized Multi-Channel Dataset for Glaucoma (SMDG; n=3103 CFPs) and externally validated it on the Samsung Medical Center (SMC) dataset (n=2448 CFPs from n=1370 patients). Model generalizability was assessed using both a fixed 80:20 random split and 5-fold cross-validation. Tilt was classified using the ratio of the long-axis diameter to the short-axis diameter, with a ratio of ≥1.3 indicating tilt. Segmentation performance was evaluated using the Dice similarity coefficient, intersection over union, and pixel accuracy on the SMDG dataset and using the clinical acceptance rate determined by 2 independent ophthalmologists on the external SMC dataset. Results:Using the SMDG dataset, nnU-Net achieved consistently high performance, with mean Dice similarity coefficients of 0.956 (SD 0.042) across 5-fold cross-validation and 0.961 (SD 0.055) for the best-performing single-fold model across 8 datasets. On the SMC dataset, 2 independent expert reviews yielded mean clinical acceptance rates of 98.61% and 98.86% across disease types, with acceptance rates ranging from 81.63% and 93.88% for edema to 99.59% and 99.17% for pallor, respectively. Tilt was detected in 7.5% (186/2448) of images, with rates of 9.7% (118/1215) for normal images, 3.9% (35/894) for glaucoma, 7.8% (19/241) for pallor, and 14.2% (14/98) for edema. Segmentation errors were observed in 1.39% (34/2448) and 1.14% (28/2448) of cases by the 2 reviewers, mainly due to edema-related swelling, peripapillary atrophy, and vessel confusion. Conclusions:Our pipeline provides objective and reproducible detection of optic disc tilt in CFPs, with strong generalizability to clinical images. By replacing manual segmentation and subjective assessments, the pipeline supports tilt-aware AI diagnostics and scalable screening for myopia-related conditions, with future refinements needed to address edema-related challenges.

INTRODUCTION:Parkinson's disease (PD) often presents with prodromal symptoms before motor manifestations. The relationship between ocular motor cranial neuropathy (OMCN) and subsequent PD risk remains unexplored. This study investigates whether OMCN is associated with increased risk of developing PD. METHODS:Using Korean National Health Insurance Service data (2010-2017), 19,859 patients with newly diagnosed OMCN and 99,295 age- and sex-matched controls were analyzed. Multivariable Cox proportional hazards regression models estimated hazard ratios (HRs) for incident PD, with a 1-year lag period applied to minimize reverse causality. RESULTS:After adjusting for confounding factors (age, sex, lifestyle, and comorbidities), OMCN patients demonstrated significantly higher risk of developing PD (HR: 1.550, 95% confidence interval: 1.278-1.880) over an average follow-up of 4.35 years. This association remained robust across all subgroup analyses regardless of age, sex, or the presence of metabolic comorbidities. CONCLUSIONS:OMCN is associated with increased subsequent PD risk, suggesting it may serve as an early indicator of neurodegeneration. These findings highlight the importance of neurological monitoring in OMCN patients and may contribute to earlier PD detection and intervention strategies.

This study compared refractive errors in children with intermittent exotropia (IXT) against the general population using two large nationwide datasets: the Korean Intermittent Exotropia Multicenter Study (KIEMS), involving 2,744 patients aged 5-18 years, and the Korean National Health Examination Survey (KNHANES), involving 1,224 participants. Age-specific spherical equivalent (SE) distributions in IXT patients were generally similar to the general population. While the non-dominant eye in IXT patients tended to be more myopic than the dominant eye, it did not exceed the myopia levels observed in the more myopic eyes of the general population. However, IXT patients exhibited a significantly higher rate of anisometropia, particularly in those older than 9 years (P<0.001). Linear regression analysis revealed that refractive profiles, including SE and interocular differences, had a very weak linear relationship with exotropia angles ($R^2=0.000-0.005$). Additionally, convergence insufficiency type IXT was more myopic than other types, while poor distance control was associated with less myopia (P<0.05). In conclusion, children with IXT show a higher prevalence of anisometropia but not a significantly higher incidence of myopia compared to the general population. Furthermore, refractive profiles in IXT are not strongly correlated with the magnitude of exotropia angle.

Studies have highlighted complex bidirectional relationships between autoimmune diseases and depressive disorders. Given that early mental health interventions have substantial public health implications, this study investigated association between optic neuritis, an autoimmune inflammatory disorder of the optic nerve, and risk of developing depressive disorders. Utilizing extensive national health insurance data encompassing almost the entire Korean population, this cohort study included 11,745 patients with optic neuritis and 58,725 age- and sex- matched controls between 2010 and 2017. The diagnosis of optic neuritis was confirmed using ICD-10 code H46 and patient medical records. The association with depression risk identified by ICD-10 codes F32 and F33 was assessed using Cox proportional hazards regression models after adjusting for demographics, lifestyle variables, and other comorbidities. Newly diagnosed optic neuritis was associated with an increased risk of depression (hazard ratio = 1.349, 95% confidence interval: 1.277-1.426), independent of potential confounding factors. Subgroup analysis revealed a stronger association for individuals under 50 years, males, current smokers, and those without hypertension. This association suggests that autoimmune neuroinflammatory responses impact mental health differently across demographics. These findings underscore the importance of implementing routine depression screening and developing targeted early intervention strategies for patients with optic neuritis, particularly for those with a high-risk of depression.

The association between allergic diseases and optic neuritis (ON) remains insufficiently characterized. This nationwide cohort study investigated the relationship between major allergic diseases (atopic dermatitis, asthma, and allergic rhinitis) and the risk of ON development. We performed a population-based cohort study utilizing data from the Korean National Health Insurance Service database. The study included 4,052,827 individuals aged 20 years or older who participated in health screenings in 2009. All participants were monitored until December 2018 or until ON diagnosis. Cox proportional hazards models were applied to estimate hazard ratios (HRs) for ON, adjusting for relevant confounders. Over a median follow-up duration of 8.2 years, 3,640 individuals (0.09%) were diagnosed with ON. After adjusting for confounders, individuals with allergic diseases exhibited a statistically significant increased ON risk compared to those without allergic diseases (adjusted HR 1.317, 95% confidence interval [CI] 1.216-1.426, p < 0.0001). Among the specific allergic diseases, allergic rhinitis showed the highest association (adjusted HR 1.335, 95% CI 1.229-1.450, p < 0.0001), whereas asthma and atopic dermatitis did not demonstrate statistically significant associations after adjustment. These results highlight potential common pathogenic mechanisms and underscore the importance of future studies to clarify the biological pathways connecting allergic diseases and ON.

This study investigates whether ocular motor cranial neuropathy (OMCN) can predict the onset of thyroid cancer given its association with common cardiovascular risk factors including obesity, diabetes mellitus (DM), hypertension, and dyslipidemia. We conducted a retrospective, nationwide, population-based cohort study utilizing data from the Korean National Health Insurance Service. Individuals comprised those aged ≥ 20 years diagnosed with OMCN between 2010 and 2017. Exclusions were based on pre-existing conditions, inability to match controls, or incomplete data. The study involved 118,686 participants, with 19,781 in the OMCN group and 98,905 controls, matched for age and sex. Patients with OMCN showed a significantly higher risk of developing thyroid cancer (hazard ratio [HR] = 1.392 [95% confidence interval, 1.075–1.802]) compared to controls after adjusting for potential confounding factors. This association was more pronounced in participants with DM and women (HR = 2.288 in DM vs. HR = 1.209 in non-DM, p = 0.0450; HR = 1.677 in females vs. HR = 0.824 in males, p = 0.0246). The findings suggest OMCN as a potential early predictor of thyroid cancer risk, particularly in diabetic and female patients. Further research is needed to explore the underlying mechanisms linking cardiovascular risk factors to the relationship between OMCN and thyroid cancer. Proactive management of these risk factors in OMCN patients may contribute to thyroid cancer prevention.

The purpose of this study was to evaluate the association between glycaemic status and the incidence of third, fourth, and sixth cranial nerve palsy (CNP). This is a retrospective nationwide population-based cohort study using South Korean National Health Insurance Service (NHIS) data since 2009. Health check-up data of 4,067,842 individuals aged from 20 to 90 years in the period from 1 January 2009 to 31 December 2018 were analysed. The subjects were classified according to glycaemic status as follows: non-diabetes, impaired fasting glucose (IFG), newly detected diabetes, diabetes duration <5 years, and diabetes duration ≥5 years. The primary endpoint of this study was the incidence of third, fourth or sixth CNP. Hazard ratio (HR) and 95

We aimed to investigate regional corneal thickness changes in patients with congenital glaucoma and enlarged corneas. Medical records of patients with primary congenital glaucoma (PCG) and two control groups of pediatric patients with intermittent exotropia and adult myopic normal tension glaucoma (NTG) patients were reviewed. Anterior segment optical coherence tomography (AS-OCT) was used to measure corneal thickness at seven locations along the 3-9 o'clock meridian: the center, midpoint of the 2-5-mm pericentral zone, corneo-limbal junction, and scleral spur on temporal and nasal sides. Finally, this study included 40 eyes (26 patients) in the PCG group and 78 eyes (42 patients) in the control groups. The PCG group exhibited significantly thinner corneas at the corneo-limbal junction and scleral spur compared to the control groups (all P < 0.001). In particular, thinning was most marked at the corneo-limbal junction (in average, 572.3 ± 76.1 vs. 690.5 ± 38.2 μm). In contrast, the mid-pericentral and central thicknesses were not different between the groups. The angle-to-angle distance was significantly larger in the PCG group compared to the two control groups (13.9 ± 0.8, 12.0 ± 0.2, and 12.0 ± 0.6 mm, all P < 0.001). In conclusion, patients with PCG exhibit predominant peripheral corneal thinning, particularly at the corneo-limbal junction, in addition to the increased corneal diameter. These findings provide in vivo evidence that the corneo-limbal junction and limbus are particularly susceptible to deformation from increased intraocular pressure in the young and elastic eyes.

Autoimmune mechanisms are associated with both congestive heart failure (CHF) and atrial fibrillation (AF). Optic neuritis (ON) is known to elevate the risk of systemic autoimmune disorders. However, it remains uncertain whether ON serves as a risk factor for CHF and AF. This study aimed to investigate the association between ON and the risk of CHF and AF in a nationwide, population-based cohort. The research utilized data from Korea's National Health Insurance Service, analyzing 15,587 patients newly diagnosed with ON and 77,935 age- and sex-matched controls from 2010 to 2017. Factors of demographics, medical history, lifestyle, and lab results were considered. CHF and AF incidences were identified through ICD-10 codes and analyzed using Cox regression models adjusted for confounders. During the 4-year follow-up, CHF and AF were diagnosed in 3.39 and 0.86% of participants, respectively. ON patients showed higher risks of CHF [hazard ratio (HR) = 1.341] and AF (HR = 1.215) after adjusting for potential confounders. Notably, stronger associations for CHF risk were found in patients younger than 50 years and those in the lowest income quartile. The findings provide compelling evidence of an independent association between ON and increased risks of CHF and AF, especially in younger individuals, suggesting a role of autoimmune processes in ON under these cardiovascular conditions. The study highlights the need for early cardiac evaluation in ON patients and suggests that timely interventions could improve prognosis. Further research is necessary to understand the pathophysiological links between ON and cardiovascular disorders.

Optic disc tilt is a morphological change in myopic eyes that complicates clinical interpretation and artificial intelligence (AI)-based analysis of fundus images. Accurate detection of optic disc tilt is necessary to avoid misinterpretation of disc morphology and enhance diagnostic reliability across different disease types. This study developed and externally validated an end-to-end AI-based pipeline for optic disc segmentation and quantitative tilt classification in color fundus photographs (CFPs), offering an objective alternative to manual segmentation and subjective clinical assessments. We trained a nnU-Net-based optic disc segmentation model on the Standardized Multi-Channel Dataset for Glaucoma (SMDG; 3,103 CFPs) and externally validated it on the Samsung Medical Center dataset (2,448 CFPs; 1,958 patients). Tilt was classified using the ratio of the long-distance diameter to short-distance diameter, with a ratio ≥ 1.3 indicating tilt. Segmentation performance was evaluated using the dice similarity coefficient (DSC), intersection over union (IoU), and pixel accuracy on the SMDG and the clinical acceptance rate via expert review. Using the SMDG, nnU-Net achieved outstanding performance (mean ± SD: DSC, 0.961 ± 0.055; IoU, 0.927 ± 0.057) across eight datasets. With the SMC dataset, expert review showed a mean clinical acceptance rate of 98.61% across disease types, ranging from 86.40% (edema) to 99.59% (pallor). Tilt was detected in 7.5% (186/2,448) of images, with rates of 9.7% (normal), 3.9% (glaucoma), 7.8% (pallor), and 14.2% (edema). Segmentation errors occurred in 1.4% (34/2,448) of cases, mainly due to edema-related swelling, peripapillary atrophy, and vessel confusion. Our pipeline provides objective and reproducible detection of optic disc tilt on CFPs, with strong generalization to clinical images. Replacing manual segmentation and subjective assessments, the pipeline supports tilt-aware AI diagnostics and scalable screening for myopia-related conditions, with future refinements needed for edema-related challenges.

Our limited understanding of dementia’s complex pathogenesis confines treatment options primarily to symptom management rather than targeting underlying disease processes, underscoring the need for innovative treatment and preventive strategies. This study aimed to examine the relationship between optic neuritis (ON), an autoimmune inflammatory condition of the optic nerve, and the risk of developing dementia. This nationwide, population-based cohort study was conducted in Korea, analyzing a cohort of 15,286 ON patients newly diagnosed between 2010 and 2017 who were age and sex matched against 76,430 controls without ON. Primary outcomes were incident cases of Alzheimer’s disease, vascular dementia, or other types of dementia. Cox proportional hazards regression models were employed to assess the association between ON and dementia risk after adjusting for demographic characteristics, lifestyle factors, and other comorbidities. Dementia risk was assessed through hazard ratios (HRs), with an average follow-up period of 3.06 years. ON patients shows greater risks of all-cause dementia (HR: 1.258) and Alzheimer’s disease (HR: 1.264). Associations between ON and dementia are prominent in younger patients and current smokers. This research suggests that autoimmunity, particularly in the form of ON, may significantly contribute to dementia development. This study implies that younger ON patients who smoke could be at a high risk of developing dementia, emphasizing the need for preventative strategies and additional research to establish causality. This work broadens the scope of known dementia risk factors and opens new avenues for research into autoimmune mechanisms as targets for therapeutic intervention. This study investigated whether people with optic neuritis, an inflammation of the eye’s optic nerve often caused by autoimmune responses, have a higher risk of developing dementia later in life. Researchers analyzed health records of over 91,000 Korean adults aged 40 and older, comparing those with and without optic neuritis over a 12-year period. The results showed that people with optic neuritis had a significantly higher risk of developing all-cause dementia, particularly Alzheimer’s disease. This suggests that autoimmune processes affecting the optic nerve might also impact brain health. These findings highlight a potential link between autoimmunity and neurodegeneration, which could help doctors identify at-risk patients earlier and develop better prevention strategies for dementia. Kim et al. investigate the link between optic neuritis, an autoimmune inflammation of the optic nerve, and dementia risk in a cohort of 91,716 Korean adults. Individuals with optic neuritis have a significantly higher dementia risk, suggesting autoimmune processes may serve as early indicators of neurodegeneration and prevention targets.

This study aimed to quantitatively assess the thickness of the peripapillary retinal nerve fiber layer (pRNFL) thickness, as well as the microvascular alterations in the macula and peripapillary regions, in optic nerve hypoplasia (ONH) patients compared to normal controls. This was achieved through the utilization of spectral-domain optical coherence tomography (SD-OCT) and optical coherence tomography angiography (OCTA), with a specific focus on elucidating the association between these structural alterations and visual acuity. We included a total of 17 eyes of 12 ONH patients, and 34 eyes of age-matched 34 healthy controls. The pRNFL thickness was quantified using SD-OCT, while OCTA facilitated the visualization and measurement of the microvascular structure images of the superficial retinal capillary plexus (SRCP), deep retinal capillary plexus (DRCP), and radial peripapillary capillary (RPC) segment in the macula and peripapillary area. pRNFL thickness was measured for eight sectors (superior, temporal, inferior, nasal, superotemporal, superonasal, inferotemporal, and inferonasal). SRCP, DRCP, and RPC were measured for four sectors (superior, temporal, inferior, and nasal). Age, gender, and spherical equivalent refractive errors were statistically adjusted for the analysis. Associations of structural parameters with visual acuity in ONH patients were analyzed using Spearman correlation analysis. pRNFL thickness was significantly thinner in ONH patients than in controls for all sectors. Vessel densities of temporal and nasal sectors in DRCP were significantly higher in ONH patients, but vessel densities of the inferior sector in RPC were significantly lower than those in controls. For all sectors, pRNFL thickness was strongly associated with visual acuity in ONH patients. ONH patients showed significant pRNFL thinning and microvascular alterations compared to controls, and pRNFL thickness was strongly associated with visual function. OCT and OCTA are useful tools for evaluating optic disc hypoplasia and its functional status.

BACKGROUND AND OBJECTIVES:While emerging theories suggest that vascular dysfunction may occur concurrently with the amyloid cascade in Alzheimer disease (AD) pathogenesis, the role of vascular components as primary neurodegeneration triggers remains uncertain. The aim of this retrospective, population-based cohort study conducted in Korea was to explore the link between nonarteritic anterior ischemic optic neuropathy (NAION) and dementia risk. METHODS:In this nationwide, population-based, retrospective cohort study, we identified newly diagnosed NAION from 2010 to 2017 in the Korean National Health Insurance Service database. The primary outcome was new dementia diagnoses confirmed by new ICD-10 claims coupled with antidementia medication prescriptions. We assessed dementia risk using hazard ratios (HRs) with 95% CIs over an average 2.69-year follow-up after a 1-year lag period. RESULTS:The cohort consisted of 42,943 patients with NAION and 214,715 age-matched and sex-matched controls without NAION (mean age 61.37 years ± 10.75 SD, 55.48% female). The study found a higher risk of all-cause dementia (ACD; HR 1.28, 95% CI 1.20-1.36), AD (HR 1.27, 95% CI 1.18-1.36), vascular dementia (VaD; HR 1.31, 95% CI 1.09-1.58), and other dementia (HR 1.39, 95% CI 1.11-1.73) among patients with NAION, regardless of other potential confounding factors such as age, sex, lifestyle behaviors, economic status, and preexisting health conditions. In subgroup analysis, the associations between NAION and ACD were stronger in the younger age group (HR 1.83 for those younger than 65 years vs 1.23 for those 65 years or older; p for interaction <0.001). Moreover, the association of NAION with both ACD and VaD was particularly strong among current smokers. DISCUSSION:We found a significant association between NAION and increased risk for ACD, AD, VaD, and other dementia even after adjusting for potential confounders such as lifestyle, health conditions, and demographic factors within a nationwide cohort. This study highlights the potential role of vascular pathology in dementia progression and suggests that NAION may serve as a robust predictor for dementia, highlighting the need for comprehensive neurologic assessment in patients with NAION. Further research is needed to clarify the association between NAION and dementia risk.

BACKGROUND/OBJECTIVES:The risk of depression in patients with non-arteritic anterior ischemic optic neuropathy (NAION) has yet to be thoroughly researched. This study aimed to investigate the association between NAION and the onset of depression using a large-scale nationwide cohort in South Korea. METHODS:This is a retrospective, nationwide cohort study involving 145,020 subjects without NAION and 29,004 individuals with a previous NAION diagnosis. Follow-up clinical data were collected until December 31, 2017. Multivariable adjustment models were employed to account for potential confounding factors. RESULTS:The incidence of new-onset depression was significantly higher among NAION patients (incidence, 38.09 per 1000 person-years) than among non-NAION individuals (incidence, 29.91 per 1000 person-years). After adjusting for demographic factors, socioeconomic status, and comorbid diseases, the association remained significant (aHR = 1.271; 95% CI = 1.226-1.317). Notably, a subgroup analysis highlighted a particularly pronounced risk of depression in NAION patients aged 40 to 64 compared to those aged 65 or older (aHR = 1.34 vs. 1.207; interaction P = 0.0038). CONCLUSION:Our findings demonstrate a significant association between NAION and an increased risk of depression, especially in relatively younger patients aged 40 to 64 years. These results highlight the importance of regular monitoring and early intervention for depressive symptoms in patients with NAION.

Background and Objective: Understanding whether cranial nerve palsy (CNP) acts as an independent risk factor for kidney cancer could have important implications for patient care, early detection, and potentially the development of preventive strategies for this type of cancer in individuals with CNP. This study aimed to examine the risk of kidney cancer following the onset of ocular motor CNP and assess whether CNP could be considered an independent risk factor for kidney cancer. Materials and Methods: A population-based cohort study was conducted using data from the National Sample Cohort (NSC) database of Korea’s National Health Insurance Service which was collected from 2010 to 2017. Follow-up was until kidney cancer development, death, or 31 December 2018. Cox proportional hazard regression analysis was performed to determine hazard ratios (HRs) for kidney cancer according to CNP status. Participants aged 20 years or more diagnosed with CNP from 2010 to 2017 were included. Exclusions comprised individuals with specific pre-existing conditions, inability to match a control group, and missing data, among others. CNP patients were age–sex matched in a 1:5 ratio with control cases. The primary outcome was incidence of kidney cancer during the follow-up period. Results: This study comprised 118,686 participants: 19,781 in the CNP group, and 98,905 in the control group. Compared to the control group, participants with CNP had a higher risk of kidney cancer (adjusted HR in model 4, 1.599 [95% CI, 1.116–2.29]). After a 3-year lag period, the CNP group had a significantly higher risk (adjusted HR in model 4, 1.987 [95% CI, 1.252–3.154]). Conclusions: Ocular motor CNP may be an independent risk factor for kidney cancer, as indicated by a higher incidence of kidney cancer in CNP patients. Further research is needed to elucidate the underlying mechanisms and explore potential preventive measures for kidney cancer in patients with ocular motor CNP.

Background:The clinical implications of myelin oligodendrocyte glycoprotein autoantibodies (MOG-Abs) are increasing. Establishing MOG-Ab assays is essential for effectively treating patients with MOG-Abs. We established an in-house cell-based assay (CBA) to detect MOG-Abs to identify correlations with patients' clinical characteristics.Methods:We established the CBA using HEK 293 cells transiently overexpressing full-length human MOG, tested it against 166 samples from a multicenter registry of central nervous system (CNS) inflammatory disorders, and compared the results with those of the Oxford MOG-Ab-based CBA and a commercial MOG-Ab CBA kit. We recruited additional patients with MOG-Abs and compared the clinical characteristics of MOG-Ab-associated disease (MOGAD) with those of neuromyelitis optica spectrum disorder (NMOSD).Results:Of 166 samples tested, 10 tested positive for MOG-Abs, with optic neuritis (ON) being the most common manifestation (4/15, 26.7%). The in-house and Oxford MOG-Ab CBAs agreed for 164/166 (98.8%) samples (κ=0.883, P<0.001); two patients (2/166, 1.2%) were only positive in our in-house CBA, and the CBA scores of the two laboratories correlated well (r=0.663, P<0.001). The commercial MOG-Ab CBA kit showed one false-negative and three false-positive results. The clinical presentation at disease onset differed between MOGAD and NMOSD; ON was the most frequent manifestation in MOGAD, and transverse myelitis was most frequent in NMOSD.Conclusions:The in-house CBA for MOG-Abs demonstrated reliable results and can potentially be used to evaluate CNS inflammatory disorders. A comprehensive, long-term study with a large patient population would clarify the clinical significance of MOG-Abs.

Background: The objective of this study was to evaluate the prognostic value of optical coherence tomography (OCT) parameters in patients with ethambutol-induced optic neuropathy (EON) and establish their optimal cut-off values for predicting visual acuity outcomes. Methods: A retrospective cross-sectional study was conducted on 64 eyes of 32 patients with EON who underwent OCT. Peripapillary retinal nerve fiber layer (pRNFL) and macular ganglion cell-inner plexiform layer (mGCIPL) thickness were measured using Cirrus high-definition OCT (HD-OCT) within 3 months after EON diagnosis. Visual acuity of patients was recorded and analyzed at the first visit, the 1-year visit, and the latest visit. Prognostic capacities of OCT parameters for visual prognosis were evaluated and their optimal cut-off values for predicting final visual acuity were established. Results: Increased pRNFL thickness was significantly associated with better visual acuity at 1 year postdiagnosis and the latest visit. A significant association was established between increased pRNFL thickness and a higher rate of recovery to visual acuity >20/25 at 1 year postdiagnosis. Receiver-operating characteristic curves identified ideal cut-off values for OCT parameters as follows: pRNFL thickness of 83 μm (sensitivity 100%, specificity 48.3%) and mGCIPL thickness of 74 μm (sensitivity 100%, specificity 83.3%) for visual acuity >20/25 at 1 year, mGCIPL thickness of 61 μm (sensitivity 85.7%, specificity 71.4%) for visual acuity >20/40 at 1 year, with corresponding AUCs exceeding 0.7. Conclusions: Both pRNFL and mGCIPL thickness possess potential values for predicting visual outcomes in patients with EON. Future research should continue to explore the utility of OCT parameters in EON prognosis.

This study compared the thickness of each intraretinal layer in patients with neurofibromatosis 1 (NF1) and controls to analyze the association between intraretinal layer thickness and visual function. The macular spectral-domain optical coherence tomography volumetric dataset obtained from 68 eyes (25 adult eyes, 43 pediatric eyes) with NF1 without optic glioma and 143 control eyes (100 adult eyes, 43 pediatric eyes) was used for image auto-segmentation. The intraretinal layers segmented from the volumetric data included the macular retinal nerve fiber layer (RNFL), ganglion cell-inner plexiform layer (GCIPL), inner nuclear layer, outer plexiform layer, outer nuclear layer, and photoreceptor layer. Cases and controls were compared after adjusting for age, sex, refractive error, and binocular use. The association between retinal layer thickness and visual acuity was also analyzed. The GCIPL was significantly thinner in both adult and pediatric patients with NF1 compared with healthy controls. Average RNFL and GCIPL thicknesses were associated with visual acuity in adult patients with NF1. In pediatric patients, average GCIPL thickness was associated with visual acuity. These results suggest that changes in the inner retinal layer could be a biomarker of the structural and functional status of patients with NF1.

Background This cohort study aims to examine the relationship between the occurrence of cranial nerve palsy (CNP) affecting the third, fourth, or sixth cranial nerve and the subsequent risk of stroke, with a particular focus on the modulating effect of age on this association. Methods and Results We established a cohort of individuals diagnosed with third, fourth, or sixth CNP who underwent national health screening within 2 years of diagnosis from 2010 to 2017. A control group was matched by sex and age at a ratio of 1:5. Participants were followed until December 31, 2019. We use multivariable Cox proportional hazards regression analyses to assess the association between ocular motor CNP and subsequent stroke stratified by age. Covariates including lifestyle, health behavior, underlying comorbidities, and Charlson comorbidity index score were also adjusted. Compared with the control group, the ocular motor CNP group had a higher risk of stroke after adjusting for potential confounders (hazard ratio [HR], 1.23 [95% CI,, 1.08–1.39]). The risk of stroke increased by 8.91 times in individuals with ocular motor CNP who were in their 30s (HR, 8.91 [95% CI, 1.63–48.66]). The risk increased by 2.49 times in those who were in their 40s, 1.78 times in those who were in their 50s, and 1.32 times in those who were in their 60s (HRs, 2.49, 1.78, and 1.32 [95% CI, 1.39–4.45, 1.31–2.42, and 1.08–1.62], respectively). However, for those who were in their 20s, 70s, or 80s, the incidence of stroke did not significantly increase. Conclusions Our study establishes an association between ocular motor CNP and an increased risk of stroke, particularly in young adults.