Taiwan Journal of Ophthalmology

We presented our observation with dexamethasone (DEX) implant in six eyes of three patients with Vogt-Koyanagi-Harada (VKH) disease who experienced hepatic dysfunction due to the systemic immunosuppressive therapy during their follow-up. Three cases who could not continue with the azathioprine (AZA) or adalimumab (ADA) treatment due to elevated liver enzymes were given consecutive bilateral DEX implant injections during the follow-up. In the first case , oral AZA was discontinued due to an elevation of the liver enzymes at the 2nd month of AZA treatment, and then she received five bilateral DEX implant administrations during the follow-up of 61 months without any intraocular pressure rise or disease recurrence...

The crystalline lens is an important structure in the eye that starts to develop as early as the 22nd day of gestation, with further differentiation that continues after the induction. Congenital anomalies of the lens may involve the size, shape, and position of the lens. They may sometimes be associated with anterior segment dysgenesis or persistence of the tunica vasculosa lentis and hyperplastic vitreous and hyaloid system. Manifestations of anomalies of the lens shape are usually seen in early or late childhood however may sometimes be delayed into adulthood based on the level of visual impairment or the presence or absence of any syndromic associations...

Primary congenital glaucoma (PCG) occurs worldwide and has a broad range of ocular manifestations. It poses a therapeutic challenge to the ophthalmologist. A proper diagnostic evaluation under anesthesia is advisable for all children who do not cooperate for an office examination. Medical therapy only serves as a supportive role, and surgical intervention remains the principal therapeutic modality. Angle incision surgery such as goniotomy or trabeculotomy ab externo is the preferred choice of surgery in the Caucasian population...

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We report an unusual case of metastatic esophageal carcinoma to the vitreous associated with focal retinitis in a 44-year-old male. A 44-year-old male patient, known case of locally advanced esophageal carcinoma, presented with a 3-day history of left eye floaters. The initial diagnosis was inflammatory vitreo-retinitis that responded to systemic steroids. Four months later, the patient presented with relapsed intraocular inflammation, vitreous biopsy using a 25G needle was performed, and cytology confirmed the presence of metastatic carcinoma consistent with his primary esophageal cancer...

PURPOSE: The purpose of the study was to describe the visual outcomes of anterior chamber iris-claw intraocular lens (IOL) implantation in pediatric ectopia lentis. MATERIALS AND METHODS: A retrospective review was conducted on the medical records of children with ectopia lentis who underwent primary anterior iris-claw IOL implantation at a national referral hospital in Indonesia in the years 2013-2020. Primary outcomes include visual acuity (VA) and postoperative complications...

PURPOSE: In recent years, there has been a significant shift from this destructive procedure to a reconstructive procedure such as anterior lamellar recession (ALR) and bilamellar tarsal rotation (BLTR). The aim is to report the outcomes and success rates of ALR compared to BLTR in patients with upper lid cicatricial trichiasis. MATERIALS AND METHODS: Our study is a prospective, interventional, comparative study that was conducted at the Ophthalmology Department of Al-Azhar University Hospital, New Damietta, Egypt...

Although retinal pigment epithelium (RPE) tears are common in patients with chronic conditions such as exudative age-related macular degeneration or may occur in response to anti-vascular endothelial growth factor or laser treatment, a spontaneous RPE tear can occur in patients with acute and new-onset bullous central serous chorioretinopathy (CSCR). We present a rare case of a healthy young Asian man with unilateral massive subretinal fluid (SRF). An idiopathic acute-onset bullous CSCR with an RPE tear was diagnosed through ancillary examinations...

PURPOSE: This study aimed to evaluate the incidence of conjunctival and pharyngeal swab sample positivity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in asymptomatic preterm and term infants. We aimed to detect asymptomatic carrier potential in infants. MATERIALS AND METHODS: Patients screened for retinopathy of prematurity (ROP) at our clinic between January and June 2021 were recruited for this study. For all study cases, the previous history of possible exposure or contact with SARS-CoV-2, previous history of coronavirus disease-19 (COVID-19), or contact with any COVID-19 case was excluded...

PURPOSE: To study the visual outcomes and higher order aberrations in eyes implanted with Hybrid EDOF IOL, particularly in Indian eyes. MATERIALS AND METHODS: This is retrospective case series where subjects aged between 40-65 years and were implanted with LUCIDIS IOL by single surgeon were included. Subjects with Pre surgery corneal astigmatism > 1.50 D, corneal guttae, IOP >22mmHg, any ocular Co morbidities, Intra or post operative complication were excluded...

Citrobacter koseri is a rarely reported ocular pathogen. It may induce severe peripheral corneal inflammation and subsequent perforation by canaliculitis. Timely detection of the reservoir of this pathogen would halt its progression. The purpose of this study was to report a rare presentation of C. koseri chronic canaliculitis complicated with perforating peripheral ulcerative keratitis (PUK). A 71-year-old female who had several episodes of C. koseri conjunctivitis in the past 6 months was admitted to our infection ward under the impression of fever that was suspected to be related to urinary tract infection...

PURPOSE: The purpose of this study was to evaluate the safety and efficacy of one trabecular microbypass stent (first generation iStent) combined with phacoemulsification cataract surgery (phaco) in eyes with open-angle glaucoma (OAG) in a Taiwanese population. MATERIALS AND METHODS: One trabecular microbypass stent was implanted after phacoemulsification cataract surgery by one surgeon. Intraocular pressure (IOP), medications, corrected distance visual acuity, complications, and adverse events were evaluated...

PURPOSE: The purpose of this study is to report the clinical characteristics of macular telangiectasia type 2 (MacTel 2) in Taiwan. MATERIALS AND METHODS: Retrospective analysis of patients diagnosed with MacTel 2 over a 7-year period in Changhua Christian Hospital. Best-corrected visual acuity (BCVA), fundus photography, fluorescein angiography, optical coherence tomography (OCT), and OCT angiography (OCTA) images were reviewed. Differences in BCVA and central macular thickness (CMT) were compared between the initial/baseline and final visits...

A 64-year-old female developed refractory red-eye with itching and watery discharge 2 weeks after being injured by a comb in the left eye. It presented as diffuse pinkish thickening of the bulbar conjunctiva. Biopsy and histological examinations revealed granulomatous inflammation with microgranuloma. Acid-fast-positive bacilli were found within the tissue, which was identified by culture 5 weeks later as Mycobacterium Abscessus . The orbital computed tomography with contrast medium showed irregular enhancement with an ill-defined margin along the inferior sclera...

PURPOSE: In this study, we describe our experience of sympathetic ophthalmia (SO) at a tertiary referral center in Taiwan. MATERIALS AND METHODS: We retrospectively analyzed records of patients diagnosed with SO from January 2011 to December 2020. RESULTS: We collected data of 15 patients diagnosed with SO (eight males, seven females). Six patients developed SO after ocular penetrating trauma, and nine developed SO after ocular surgery, including seven with vitrectomy, one with penetrating keratoplasty, and one with cataract surgery...

PURPOSE: The purpose is to compare the effects of cyclosporine (CsA) on the steroid-refractory mixed-type dry eye (MTDE) and aqueous deficient dry eye (ADDE). MATERIALS AND METHODS: We retrospectively enrolled 71 patients with levels 3 and 4 dry eye that were refractory to artificial tears and topical steroids. The effects were analyzed using the ocular surface disease index (OSDI) and standard patient evaluation of eye dryness (SPEED) questionnaires, Schirmer test II, blink patterns, lipid layer thickness (LLT), meibomian gland expressibility (MGE) and extent of meibomian gland (MG) dropout (meiboscale)...

This is a retrospective series of five eyes of four cases with diabetic macular edema (DME) secondary to large capillary aneurysms. Larger capillary aneurysms were identified noninvasively based on the presence of white rim in color photograph. On optical coherence tomography (OCT), the larger capillary aneurysms were seen as vertically oval structures with heterogeneous lumen and hyperreflective margin. Two of the four eyes were treated with intravitreal therapy with poor response before considering laser photocoagulation...

Corneal transplantation is the only surgical option to improve symptoms and vision in patients with severe corneal opacification. With the evolution and development of keratoplasty techniques, corneal surgeons can perform customized keratoplasty, with complex graft-host junctions to promote wound healing and accelerate visual rehabilitation. Femtosecond laser (FSL) enable customization of the thickness and shape of the graft has been used for trephination of both donor and recipient corneas and for creating special wound configurations...

Femtosecond laser (FSL) applications in corneal surgery have increased since its inception. Corneal surgery has undergone a tremendous transformation thanks to the introduction of FSL technology. This laser makes precise, three-dimensional incisions while causing minimal damage to surrounding tissue. This review updates and summarizes current and upcoming FSL applications in corneal surgery, current commercially available FSL, and its respective applications. Refractive surgery applications include laser in-situ keratomileusis flaps, refractive corneal lenticule extraction such as small incision lenticule extraction, astigmatic keratotomy, intracorneal ring segments tunnels for keratoconus including corneal allogenic intrastromal ring segments, and presbyopia treatments with intrastromal pockets for corneal inlays and intrastromal incisions (INTRACOR)...

The aim of the study is to report a case of corneal epithelial changes in a patient with refractory multiple myeloma (MM) who was treated with belantamab mafodotin (BM). A 55-year-old man diagnosed with refractory MM was referred to our hospital for treatment with BM, an antibody-drug conjugate targeting B-cell maturation antigen. After 33 days of treatment, the patient experienced a bilateral reduction in visual acuity (VA), along with dry eye symptoms such as itchy eyes and a sensation of having a foreign body...