Jia-Horung Hung, MD, PhD

All Publications

• Detecting Inflammation in Fundus Photographs Using Machine Learning. Ophthalmology science Mohammadi, S. S., Yavari, N., Saengsirinavin, A. O., Hung, J. H., Yoo, W. S., Añover, F. A., Mobasserian, A., Gupta, A. S., Akhavanrezayat, A., Tuong Than, N. T., Or, C., Thng, Z. X., Karaca, I., Gill, M. K., Nguyen, Q. D. 2026; 6 (2): 101000

  Abstract

  To utilize a machine learning model for employing ultra-widefield fundus photograph (UWFFP) as a surrogate marker for ultra-widefield fluorescein angiography (UWFFA) in detecting posterior segment inflammation.An evaluation of technology.Not applicable.Ultra-widefield fundus photographs were extracted and grouped based on the corresponding UWFFA images, which served as the ground truth, into those with signs of inflammation and those without. Vertex AI was used to train a machine learning model to detect the presence of inflammation using the UWFFPs. Furthermore, 2 masked dual fellowship-trained vitreoretinal and uveitis specialists, 1 glaucoma specialist, and 1 comprehensive ophthalmologist independently evaluated 20 additional UWFFPs, comparing their findings with the model's results.Area under the precision-recall curve, sensitivity, specificity, and comparative accuracy between the machine learning model and expert human graders.A total of 302 UWFFPs, comprising 113 with inflammation and 189 without, were used to train a single-label image classification model. The trained model demonstrated an area under the curve of 0.943, sensitivity of 90.91%, and specificity of 84.21%. It correctly diagnosed the presence of inflammation in 95% of the extra UWFFPs, compared to the masked dual fellowship-trained vitreoretinal and uveitis specialists, glaucoma specialist, and comprehensive ophthalmologist, who achieved accuracies of 85%, 80%, 70%, and 65%, respectively.The index study demonstrated that UWFFPs could be employed as a noninvasive and more accessible imaging modality for detecting posterior segment inflammation using machine learning techniques.Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

  View details for DOI 10.1016/j.xops.2025.101000

  View details for PubMedID 41567569

  View details for PubMedCentralID PMC12816852

• Analysis of full-field electroretinography parameters and potential for monitoring functional retinal deterioration in unilateral retinal vasculitis. The British journal of ophthalmology Park, S., Yoo, W. S., Karaca, I., Khojasteh, H., Akhavanrezayat, A., Uludag, G., Tran, A. N., Lyu, X., Yasar, C., Ongpalakorn, P., Mobasserian, A., Bromeo, A. J., Ghoraba, H., Shin, Y. U., Thng, Z. X., Gupta, A. S., Khatri Kc, A., Hung, J. H., Or, C., Do, D. V., Nguyen, Q. D. 2025

  Abstract

  To elucidate changes of full-field electroretinography (ffERG) tests in active unilateral retinal vasculitis, using the unaffected fellow eye as an internal control. Despite no significant differences in best corrected visual acuity (p=0.100) or central subfield macular thickness (p=0.084) at baseline, ffERG showed significant reductions in five of eight amplitudes (i.e. DA10 a-wave, p<0.001) and delays in six of eight implicit times (i.e. light-adapted Flicker, p=0.002). At follow-up ffERG, following management for retinal vasculitis, the implicit times normalised, coinciding with inflammation reduction. However, the amplitude reductions persisted. In ffERG, the implicit time might be a sensitive biomarker for retinal vasculitis activity and the amplitude might be one for permanent functional loss.

  View details for DOI 10.1136/bjo-2025-328457

  View details for PubMedID 41448867

• Proteomic profile of faricimab-associated occlusive retinal vasculitis. Eye (London, England) Hung, J. H., Iyer, I., Thng, Z. X., Shows, N., Yavari, N., Mitsios, A., Powers, C. A., Leib, R., Liu, F., Lazo, J. P., Gupta, A. S., El Feky, D., Than, N. T., Agarwal, D. R., Akhavanrezayat, A., Mobasserian, A., Elaraby, O., Or, C., Lin, J., Dong Nguyen, Q. 2025

  View details for DOI 10.1038/s41433-025-04175-5

  View details for PubMedID 41436660

  View details for PubMedCentralID 7464130

• Ocular manifestations of hydatid disease: a case report. BMC ophthalmology Zhang, X., Feng, K., Han, L., Khatri, A., Hung, J. H., Li, Y., Zhang, P., Liu, J., Nguyen, Q. D., Ma, Z. 2025; 25 (1): 693

  Abstract

  Hydatid disease, caused by Echinococcus species, is a parasitic infection that rarely affects the eye. However, reports of ocular lesions associated with systemic hydatid disease, in the absence of hydatid cysts in the eye, are scarce.A 22-year-old male presented with blurred vision for one month. He had a 7-year history of systemic hydatid disease and had been undergoing long-term albendazole treatment. Retinal examination revealed two choroidal elevations near the nasal ora serrata in the right eye. Fluorescein angiography confirmed the presence of bilateral retinal vasculitis. To address the choroidal elevations, a transscleral choroidal approach was performed, followed by pars plana vitrectomy. Notably, no hydatid cysts were found during the surgery. Instead, a dark green lesion was observed beneath the retina and within the choroidal tissue. Histopathological analysis of the surgical specimens confirmed the absence of hydatid cysts in both the vitreous and the dark green lesion. Additionally, next-generation sequencing of samples from the vitreous and dark green lesion yielded negative results for Echinococcus DNA. The diagnosis of bilateral retinal vasculitis, alongside systemic hydatid disease was confirmed. After surgery and subsequent steroid therapy, the patient's ocular inflammation and choroidal lesions showed significant improvement.The ocular manifestations of systemic hydatid disease are not solely due to the presence of intraocular hydatid cysts; they can also include ocular inflammation in the absence of cysts, as seen in this case. Surgical resection of the large choroidal lesion, combined with steroid treatment, significantly improved the patient's ocular condition.

  View details for DOI 10.1186/s12886-025-04497-8

  View details for PubMedID 41437010

  View details for PubMedCentralID PMC12729079

• Weighing dose-related benefits and risks of hydroxychloroquine treatment in systemic lupus erythematosus patients. Arthritis & rheumatology (Hoboken, N.J.) Li, B. M., Hung, J. H., Yang, P. C., Lin, S. J., Lai, E. C., Weng, M. Y. 2025

  Abstract

  To weigh higher-dose HCQ (>=400 mg/d) and lower-dose HCQ (<400 mg/d) for effectiveness and safety among patients with systemic lupus erythematosus (SLE).This nationwide study retrieved data from Taiwan's National Health Insurance Research Database, from 2010 to 2021. We included SLE patients aged over 10 years, initiating HCQ, with no other systemic autoimmune disease at baseline and no historical outcomes of interest. Patients were classified into higher-dose (>=400 mg per day) or lower-dose (<400 mg per day) treatment strategies based on the dosage of their first HCQ prescription. The outcomes were coronary artery disease (CAD), ischemic stroke, venous thromboembolism (VTE), end-stage renal disease, malignancy, and HCQ retinopathy.878 (3.77%) patients on higher-dose HCQ and 22,405 (96.22%) on lower-dose HCQ were included. After inverse probability weighting, higher-dose HCQ was associated with lower risks of CAD (HR 0.86, 95% CI 0.80-0.93) and VTE (HR 0.40, 95% CI 0.33-0.49). We found no dose-related difference in the risk of ischemic stroke, ESRD, malignancy and HCQ retinopathy through a mean follow-up of 6 years, except for the HCQ retinopathy among SLE patients aged over 45 years (HR 1.87, 95% CI 1.45-2.42).For SLE patients, higher-dose HCQ improves effectiveness with reduced risks of CAD and VTE. There was no dose-related difference in the risk of HCQ retinopathy, for SLE patients aged younger than 45 years. Our study emphasizes the need for weighing the benefits and risks of optimal HCQ dosage in managing SLE.

  View details for DOI 10.1002/art.70022

  View details for PubMedID 41423344

• Utilization of an automated machine learning approach for the detection of granular corneal dystrophy via slit lamp photographs. BMC ophthalmology Yavari, N., Mohammadi, S. S., Sokol, J. T., Feky, D. E., Rajabi, M., Hung, J. H., Or, C., Elaraby, O., Anover, F. A., Saengsirinavin, A. O., Akhavanrezayat, A., Mobasserian, A., Than, N. T., Guo, J., Bai, Y., Yasar, C., Afshari, N. A., Lin, C. C., Nguyen, Q. D. 2025; 25 (1): 657

  Abstract

  This study aims to apply automated machine learning (AutoML) techniques for the diagnosis of granular corneal dystrophy (GCD), a rare inherited condition characterized by progressive protein deposition in the corneal stroma.Patients diagnosed with GCD who had slit-lamp photographs of the affected eye(s) were enrolled in the study. Individuals with concomitant corneal conditions, ungradable imaging data, or uncertain diagnoses were excluded from the study. Slit-lamp photos depicting the GCD and non-GCD were obtained from the Byers Eye Institute, Stanford University. Image processing included resizing and cropping, focusing solely on the cornea. A deep learning model was subsequently deployed, utilizing Vertex-AI, the AutoML platform developed by Google (Menlo Park, CA). The area under the precision‒recall curve (AUPRC) was plotted, and the sensitivity, specificity, positive predictive value (PPV), accuracy (AC), and F1 score were calculated.The model was trained on a dataset comprising 223 images, consisting of 72 GCD and 151 non-GCD images. One hundred seventy six images were used for training, 24 were used for validation, and 23 were used for testing the model. The AUPRC for the model was 0.995 and precision and recall were both 95.70% at a confidence threshold of 0.5. The sensitivity, specificity, PPV, AC, and F1 score of the model were 93.30%, 100%, 100%, 95.70%, and 0.965, respectively.A clinician-derived AutoML model successfully identified GCD from slit lamp photographs with high accuracy.

  View details for DOI 10.1186/s12886-025-04324-0

  View details for PubMedID 41275196

  View details for PubMedCentralID PMC12642381

• Comparison of Flanged Intrascleral Haptic Fixation and 2-point Transscleral Gore-Tex Sutured IOL Fixation: A 12-Month Cohort Study. Journal of cataract and refractive surgery Chang, C., Hung, J., Chang, Y., Lee, Y. 2025

  Abstract

  PURPOSE: To compare the short-term and long-term visual and refractive outcomes between flanged intrascleral haptic fixation (FIHF) and 2-point transscleral polymethylmethacrylate (PMMA) intraocular lens (IOL) fixation using Gore-Tex sutures in patients lacking capsular support.SETTING: National Cheng Kung University Hospital, a tertiary referral center in Tainan, Taiwan.DESIGN: Retrospective cohort study using propensity score matching to minimize baseline differences between groups.METHODS: Medical records of adult patients who underwent FIHF or Gore-Tex sutured IOL fixation between 2014 and 2024 were reviewed. Patients with <12 months follow-up or conditions affecting visual prognosis were excluded. Postoperative corrected distance visual acuity (CDVA), refractive cylinder, and complications were analyzed.RESULTS: A total of 92 eyes (46 FIHF, 36 sutured) were identified; after matching, 34 eyes in each group were analyzed. After matching, the FIHF group demonstrated significantly better CDVA than the sutured IOL group at 1 month (mean logMAR, 0.73 vs. 1.08; p = 0.003) and 3 months (0.62 vs. 0.94; p = 0.009) postoperatively. Cylindrical power at 3 months was significantly lower in the FIHF group (1.94 vs. 3.69 diopter, p = 0.009), indicating less surgically induced astigmatism. No significant differences were observed in CDVA, complication rates or refractive outcomes at 12 months.CONCLUSION: FIHF may facilitate earlier reduction in astigmatism, thereby promoting faster visual recovery, particularly in cases of IOL subluxation or dislocation, compared with sutured IOL fixation. However, no significant differences were observed between the two groups in terms of visual acuity, refractive status, or complication rates at one year postoperatively.

  View details for DOI 10.1097/j.jcrs.0000000000001816

  View details for PubMedID 41150884

• The relationship between retinal vascular tortuosity and retinal vasculitis. Journal of ophthalmic inflammation and infection Zhang, X., Anover, F. A., Hung, J. H., Than, N. T., Mobasserian, A., Saengsirinavin, A. O., Yavari, N., Feky, D. E., Tram Tran, A. N., Elaraby, O., Guo, J., Karaca, I., Yoo, W. S., Akhavanrezayat, A., Or, C. M., Do, D. V., Nguyen, Q. D. 2025; 15 (1): 65

  View details for DOI 10.1186/s12348-025-00512-7

  View details for PubMedID 41028280

  View details for PubMedCentralID 7944954

• Assessing and monitoring abnormal retinal blood circulation for early detection of pre-structural damage and enhanced diabetic retinopathy staging using non-invasive, high-resolution biophotonic imaging technology. Eye (London, England) Basiri, A., Luo, C., Shokoohi-Yekta, M., Leng, T., Taheri, H., Jan Noordmans, H., Bryan, J., Soheilypour, M., Amiri, P., Or, C., Hung, J. H., ElHassan, A. A., Dong Nguyen, Q. 2025

  Abstract

  Biophotonic imaging technology offers a non-invasive solution for objectively and quantitatively staging diabetic retinopathy (DR) and detecting pre-DR before structural damage occurs. Integrating this technology into clinical practice enables more accurate staging, early risk management, and prediction of treatment outcomes, ultimately reducing DR-related structural damage. The platform featured a novel physics-based retinal oximetry algorithm, built on Saccadic-Phase Spatial Frequency Domain Imaging (SP-SFDI). This technology measured an oxygen saturation analogue (αSO2) in tissue with high resolution, detecting oxygenation changes <3% using two snapshots capturing phase shifts in spatially modulated light. Its first application, BioxyDR™, focused on measuring αSO2 in the superficial retinal vasculature for accurate DR staging and early detection. For clinical validation, the study included 63 DR patients, 60 diabetes mellitus (DM) patients without DR (DM no DR), and 18 controls (no DM, no known ocular diseases). Retinal venous αSO2 significantly differed (p = 0.007) between controls and patient groups, including proliferative (PDR) and non-proliferative DR (NPDR). 100% of controls and DR patients were correctly classified per standard-of-care (SOC) criteria. Among DM no DR patients, 8 were classified as pre-DR, and 7 (87%) developed DR within 18 months. Notably, all patients classified as not pre-DR (100%) remained DR-free. Initial studies across various ocular diseases showed distinct classifications based on venous and arterial αSO2. Taken together, these findings suggest that venous αSO2 measured with SP-SFDI may serve as a biomarker for DR progression, with higher αSO2 levels indicating greater disease severity. αSO2 also shows promise as a metric for staging pre-DR.

  View details for DOI 10.1038/s41433-025-04032-5

  View details for PubMedID 41015611

  View details for PubMedCentralID 4249724

• Characteristics of patients who developed transient anti-adalimumab antibodies. Journal of ophthalmic inflammation and infection Elaraby, O., Feky, D. E., Yasar, C., Yoo, W. S., Khatri, A., Elmegid, D. A., Hung, J. H., Ganbold, B., Thng, Z. X., Yavari, N., Saengsirinavin, A. O., Than, N. T., Anover, F. A., Hamouda, A. M., Mohammadi, S. S., Karaca, I., Akhavanrezayat, A., Tran, A. T., Guo, J., Bai, Y., Nguyen, Q. D., Or, C. 2025; 15 (1): 69

  Abstract

  Adalimumab is a monoclonal antibody approved for the treatment of autoimmune diseases and non-infectious uveitis (NIU). It targets tumor necrosis factor alpha, a key mediator in inflammation. However, the development of anti-adalimumab antibodies (AAA) can reduce therapeutic efficacy and prompt treatment modifications. This study aimed to describe the clinical characteristics of patients with transient AAA and compare them to patients with persistent AAA, testing whether serum antibody and drug levels differ between groups.We conducted a retrospective cohort study using the Stanford Research Repository (STARR) to identify patients treated with adalimumab for autoimmune conditions between June 2006 and May 2024 who developed AAA. Patients whose AAA became undetectable on follow-up testing were compared to an age-, sex-, and disease-matched cohort with persistent AAA. Demographics, diagnoses, treatment details, serum adalimumab and AAA levels, and concomitant immunomodulatory therapy (IMT) were analyzed. Among 190 AAA-positive patients, 18 (9.47%) demonstrated antibody resolution over a median follow-up of 6.5 months. These patients had lower median AAA levels (39.55 ng/mL vs. 92.35 ng/mL, p=0.020) and higher adalimumab levels (6.25 μg/mL vs. 1.55 μg/mL, p=0.018) than controls. AAA resolution was negatively correlated with AAA levels (p=0.018) and positively correlated with adalimumab levels (p=0.016).Therapeutic monitoring of AAA and drug levels may help guide personalized therapeutic strategies and support continued treatment in selected patients.

  View details for DOI 10.1186/s12348-025-00520-7

  View details for PubMedID 40993500

  View details for PubMedCentralID 4223868

• Cobalt-induced Retinopathy: Unveiling the hidden risk of knee prosthesis. American journal of ophthalmology case reports Saengsirinavin, A., Hung, J., Khatri, A., Nguyen, C. D., Seangsirinavin, P., Anover, F. A., Yavari, N., El-Feky, D., Than, N. T., Elaraby, O., Zhang, X., Tran, A. N., Yasar, C., Mobasserian, A., Karaca, I., Akhavanrezayat, A., Or, C. M., Nguyen, Q. D. 2025; 39: 102369

  Abstract

  Purpose: To report a case of cobalt-induced retinopathy from a knee prosthesis and to outline the diagnostic challenges and management approach.Observation: A 67-year-old female presented with chronic bilateral visual disturbances, including blurred vision and photopsia, which began shortly after receiving a cobalt-containing knee prosthesis (DePuy Sigma Total Knee System, recalled by FDA in 2014, Recall No. Z-0423-2014). Ophthalmic evaluation revealed bilateral chorioretinitis, cystoid macular edema, and optic disc inflammation. Removal of the cobalt-containing prosthesis, along with aggressive immunosuppressive therapy, led to significant improvement in visual acuity and retinal function, as confirmed by fluorescein angiography, electroretinography, and Goldmann visual field testing.Conclusion: This case adds to the limited literature on cobalt-induced retinopathy by demonstrating that even small prosthetic implants, such as knee prostheses, can lead to systemic cobalt toxicity with significant ocular complications. Early diagnosis, combined with prompt removal of the affected prosthesis and management of inflammation, is crucial for restoring vision and preventing further damage.

  View details for DOI 10.1016/j.ajoc.2025.102369

  View details for PubMedID 40678736

• Evaluation of the Appropriateness and Readability of ChatGPT-4 Responses to Patient Queries on Uveitis. Ophthalmology science Mohammadi, S. S., Khatri, A., Jain, T., Thng, Z. X., Yoo, W. S., Yavari, N., Bazojoo, V., Mobasserian, A., Akhavanrezayat, A., Tuong Than, N. T., Elaraby, O., Ganbold, B., El Feky, D., Nguyen, B. T., Yasar, C., Gupta, A., Hung, J. H., Nguyen, Q. D. 2025; 5 (1): 100594

  Abstract

  To compare the utility of ChatGPT-4 as an online uveitis patient education resource with existing patient education websites.Evaluation of technology.Not applicable.The term "uveitis" was entered into the Google search engine, and the first 8 nonsponsored websites were selected to be enrolled in the study. Information regarding uveitis for patients was extracted from Healthline, Mayo Clinic, WebMD, National Eye Institute, Ocular Uveitis and Immunology Foundation, American Academy of Ophthalmology, Cleveland Clinic, and National Health Service websites. ChatGPT-4 was then prompted to generate responses about uveitis in both standard and simplified formats. To generate the simplified response, the following request was added to the prompt: 'Please provide a response suitable for the average American adult, at a sixth-grade comprehension level.' Three dual fellowship-trained specialists, all masked to the sources, graded the appropriateness of the contents (extracted from the existing websites) and responses (generated responses by ChatGPT-4) in terms of personal preference, comprehensiveness, and accuracy. Additionally, 5 readability indices, including Flesch Reading Ease, Flesch-Kincaid Grade Level, Gunning Fog Index, Coleman-Liau Index, and Simple Measure of Gobbledygook index were calculated using an online calculator, Readable.com, to assess the ease of comprehension of each answer.Personal preference, accuracy, comprehensiveness, and readability of contents and responses about uveitis.A total of 497 contents and responses, including 71 contents from existing websites, 213 standard responses, and 213 simplified responses from ChatGPT-4 were recorded and graded. Standard ChatGPT-4 responses were preferred and perceived to be more comprehensive by dually trained (uveitis and retina) specialist ophthalmologists while maintaining similar accuracy level compared with existing websites. Moreover, simplified ChatGPT-4 responses matched almost all existing websites in terms of personal preference, accuracy, and comprehensiveness. Notably, almost all readability indices suggested that standard ChatGPT-4 responses demand a higher educational level for comprehension, whereas simplified responses required lower level of education compared with the existing websites.This study shows that ChatGPT can provide patients with an avenue to access comprehensive and accurate information about uveitis, tailored to their educational level.The author(s) have no proprietary or commercial interest in any materials discussed in this article.

  View details for DOI 10.1016/j.xops.2024.100594

  View details for PubMedID 39435137

  View details for PubMedCentralID PMC11492124

• Herpetic gingivostomatitis mimicking Stevens-Johnson syndrome in an immunosuppressed adolescent with idiopathic chorioretinitis. IDCases Saengsirinavin, A. O., Lee, C. N., Yavari, N., Anover, F. A., Thng, Z. X., Hung, J. H., John, C. Z., El Feky, D., Elaraby, O., Zhang, X., Yasar, C., Mobasserian, A., Akhavanrezayat, A., Than, N. T., Or, C., Nguyen, Q. D. 2025; 41: e02321

  Abstract

  We present the case of an 18-year-old male with bilateral idiopathic chorioretinitis maintained on immunosuppressive therapy with prednisone, adalimumab, and mycophenolate mofetil, who developed ulcers and bleeding of the lip mucosa after taking nonsteroidal anti-inflammatory drugs (NSAIDs) and amoxicillin/clavulanate for a suspected ear infection. The clinical presentation initially mimicked Stevens-Johnson syndrome (SJS), but further evaluation confirmed the diagnosis of herpetic gingivostomatitis. This case highlights the diagnostic challenges in differentiating between drug eruptions and infectious etiologies in immunosuppressed patients. Despite its severity, prompt recognition and antiviral therapy can lead to full recovery.

  View details for DOI 10.1016/j.idcr.2025.e02321

  View details for PubMedID 40703959

  View details for PubMedCentralID PMC12283547

• Posterior Scleritis: demographics, clinical presentations, and outcomes of patients in Northern California Vatte, B., Oh, A., Shows, N., Yavari, N., Elfeqi, D., Hung, J., Akhavanrezayat, A., Mobasserian, A., Than, N., Guo, J., Sendino, I., Rajabi, M., Tran, A., Or, C., Nguyen, Q., Saengsirinavin, A. ASSOC RESEARCH VISION OPHTHALMOLOGY INC. 2025

  View details for Web of Science ID 001560032400017

• Surgical removal of subretinal cysticercosis in conjunction with administration of intravenous methylprednisolone: A case report. American journal of ophthalmology case reports Banstola, A., Iyer, S., Akhavanrezayat, A., Jain, T., Kharel, M., Gupta, A. S., Hung, J. H., Yoo, W. S., Nguyen, Q. D., Khatri, A. 2025; 38: 102280

  Abstract

  Intraocular cysticercosis in the sub-macular location is a rare but potentially blinding disease. The management requires immediate surgical management and anti-parasitic medications. We present a case of subretinal cysticercosis that was managed with a novel method of intravenous methylprednisolone administration before and after it was surgically removed.A 17-year-old Indian female patient presented to our clinic with a history of vision deterioration through the last 27 days in her left eye (OS). Best-corrected visual acuity (BCVA) was 20/20 in the right eye (OD) and hand motion OS. Fundus examination showed a healthy-appearing OD and a whitish glow in the macular region OS. She was diagnosed with subretinal cysticercosis and underwent pars plana vitrectomy with in toto removal of the cyst along with pre/post-surgical intravenous methylprednisolone and anti-parasitic medications. A significant visual recovery of 20/60 was achieved three weeks following the surgery in OS.The index case shows a favorable visual recovery in a patient with a subfoveal cyst of relatively long duration. We hypothesize that intravenous methylprednisolone in conjunction with routine treatment may have led to favorable visual outcomes.

  View details for DOI 10.1016/j.ajoc.2025.102280

  View details for PubMedID 40040883

  View details for PubMedCentralID PMC11879664

• Real-world 6-month outcomes of repository corticotropin injection in noninfectious posterior uveitis unresponsive to immunomodulatory therapy Than, N., Hung, J., Anover, F., Akhavanrezayat, A., Saengsirinavin, A., Zhang, X., Yavari, N., Mobasserian, A., Elfeqi, D., Tran, A., Bromeo, A., Thng, Z., Guo, J., Doan, H., Or, C., Nguyen, Q. ASSOC RESEARCH VISION OPHTHALMOLOGY INC. 2025

  View details for Web of Science ID 001560076500040

• Long-term efficacy and tolerability of subcutaneous repository corticotropin injection in patients with ocular inflammatory diseases Tran, A., Yavari, N., Saengsirinavin, A., Akhavanrezayat, A., Hung, J., Sendino, I., Mobasserian, A., Zhang, X., Rajabi, M., Than, N., El Feky, D., Vatte, B., Guo, J., Karaca, I., Or, C., Nguyen, Q. ASSOC RESEARCH VISION OPHTHALMOLOGY INC. 2025

  View details for Web of Science ID 001560076500020

• New insights into scleritis: comprehensive analysis of demographics, clinical features, treatment approaches, and complications in a Northern California tertiary referral center Saengsirinavin, A., Oh, A., Nguyen, C., Vatte, B., Anover, F., Than, N., Hung, J., Akhavanrezayat, A., Mobasserian, A., Yavari, N., Tran, A., Bai, Y., Guo, J., El Feky, D., Or, C., Nguyen, Q. ASSOC RESEARCH VISION OPHTHALMOLOGY INC. 2025

  View details for Web of Science ID 001560032400040

• Efficacy, Immunogenicity and Safety of Various Biosimilar Tumor Necrosis Factor Inhibitors in Ocular inflammatory diseases Elfeqi, D., Yavari, N., Mobasserian, A., Akhavanrezayat, A., Than, N., Saengsirinavin, A., Hung, J., Yasar, C., Zhang, X., Bai, Y., Guo, J., Tran, A., Shows, N., Rajabi, M., Or, C., Nguyen, Q. ASSOC RESEARCH VISION OPHTHALMOLOGY INC. 2025

  View details for Web of Science ID 001560034400026

• Fedratinib related ocular inflammatory diseases in patients with myelofibrosis: An analysis from TriNetX database Shows, N., Yavari, N., El Feky, D., Hung, J., Saengsirinavin, A., Mobasserian, A., Akhavanrezayat, A., Sendino, I., Zhang, X., Than, N., Tran, A., Vatte, B., Yasar, C., Bai, Y., Guo, J., Spencer, D., Nguyen, Q., Or, C. ASSOC RESEARCH VISION OPHTHALMOLOGY INC. 2025

  View details for Web of Science ID 001560032400009

• Blau syndrome-related systemic and ocular manifestations and management: An analysis from TriNetX database Yavari, N., El Feky, D., Hung, J., Anover, F., Saengsirinavin, A., Akhavanrezayat, A., Mobasserian, A., Rajabi, M., Yasar, C., Than, N., Tran, A., Guo, J., Bai, Y., Vatte, B., Nguyen, Q., Or, C. ASSOC RESEARCH VISION OPHTHALMOLOGY INC. 2025

  View details for Web of Science ID 001560196200028

• Longitudinal Analysis of Choriocapillaris Flow Voids in Intermediate Age-Related Macular Degeneration and Geographic Atrophy Janjua, K., Shaik, M., Hung, J., Ahmed, M. I., Halim, M., Baluyot, S., Guzman, H., Yamaguchi, T., Esmaeelpour, M., Leng, T., Do, D., Yucel, H., Sepah, Y. ASSOC RESEARCH VISION OPHTHALMOLOGY INC. 2025

  View details for Web of Science ID 001560813500002

• Impact of Steroid Prophylaxis and Immunomodulatory Therapy on Inflammation, Visual Outcomes, and Complications Following Cataract Surgery in Uveitic Patients: A Retrospective Analysis Mobasserian, A., Hung, J., Elfeqi, D., Karaca, I., Akhavanrezayat, A., Yavari, N., Saengsirinavin, A., Than, N., Anover, F., Rajabi, M., Guo, J., Tran, A., Bai, Y., Vatte, B., Nguyen, Q., Or, C. ASSOC RESEARCH VISION OPHTHALMOLOGY INC. 2025

  View details for Web of Science ID 001558957000014

• Efficacy and safety of biologics in pediatric non-infectious retinal vasculitis. American journal of ophthalmology Karaca, I., Thng, Z. X., Bromeo, A., Mobasserian, A., Hung, J. H., Akhavanrezayat, A., Than, N. T., Yasar, C., Yavari, N., Feky, D. E., Elaraby, O., Tran, A. N., Zhang, X., Saengsirinavin, A. O., Anover, F. A., Bai, Y., Guo, J., Or, C. M., Do, D. V., Nguyen, Q. D. 2025

  Abstract

  To assess the efficacy and safety of adalimumab (ADA) injections (Group 1), infliximab (IFX) (Group 2), and tocilizumab (TCZ) (Group 3) infusions in pediatric non-infectious retinal vasculitis (RV).Retrospective interventional case series.Pediatric patients who were diagnosed with non-infectious RV and treated with biologics (ADA, IFX, TCZ) for ≥6 months were included. Chart review of 11 patients (18 eyes), 17 patients (30 eyes), and 7 patients (11 eyes) in Group 1, 2 and 3, respectively, was performed to assess clinical characteristics, central subfield thickness (CST), and fluorescein angiography (FA) score using the Angiographic Scoring for the Uveitis Working Group (ASUWOG) system.Mean age was 13.5±4.3 years in Group 1, 11.8±2.5 years in Group 2, and 13.9±4.1 years in Group 3 (p=0.332). Eight patients (72.7%, 13 eyes) in Group 1, and 14 patients (82.4%, 24 eyes) in Group 2 were biologic-naïve, whereas in Group 3 all patients were treated with ADA and/or IFX prior to TCZ. Mean FA scores were significantly reduced from 6.8±2.6, 13.4±4.8, and 12.8±4.0 at baseline to 0.9±2.3, 3.6±4.6, and 4.4±3.9 at final visit in Group 1, 2, and 3, respectively (p<0.05). Complete RV resolution was observed in 12 (66.7%), 13 (43.3%), and 1 (9.1%) eyes; mean time to complete resolution was 11.0±5.0, 13.3±5.8, and 23 months in Group 1, 2, and 3, respectively. No significant adverse events were observed in any group, except hair loss in one patient which led to discontinuation of IFX infusions after 20 cycles of therapy.ADA, IFZ, and TCZ are effective and safe treatment options for pediatric non-infectious RV as objectively shown by FA scoring. TCZ appears as an effective therapy for patients with JIA-associated RV or those who failed TNF-α inhibitors.

  View details for DOI 10.1016/j.ajo.2025.05.002

  View details for PubMedID 40374140

• Subconjunctival dexamethasone implant (Ozurdex) in the management of refractory Non-Infectious anterior scleritis. Journal of ophthalmic inflammation and infection Ganbold, B., Nguyen, B. T., Hung, J., Mobasserian, A., Thng, Z. X., Ghoraba, H., Yavari, N., Feky, D. E., Yasar, C., Saengsirinavin, A., Zhang, X., Anover, F. A., Mohammadi, S. S., Tuong, N., Than, T., Khatri, A., Elaraby, O., Akhavanrezayat, A., Gupta, A. S., Yoo, W. S., Nguyen, Q. D., Or, C. 2025; 15 (1): 40

  Abstract

  OBJECTIVE: To report a case series of non-infectious anterior scleritis resistant to multiple lines of conventional therapies which were eventually successfully treated with off-label subconjunctival dexamethasone implant (Ozurdex) injection (SDI).METHODS: A retrospective case series of 4 patients (6 eyes).RESULTS: In the index case series, the patients had a mean age of 57.2 years (range 36 to 82 years, SD 19.2 years) with 50% being female. Two patients had underlying autoimmune diseases: rheumatoid arthritis (n=1), and granulomatosis with polyangiitis (GPA) (n=1). The other patients were diagnosed with idiopathic anterior scleritis after extensive systemic investigations (n=2). The mean follow-up duration and the mean number of concomitant therapies prior to SDI was 27 (SD 17.7) months and 2 (SD 0.81), respectively. In all patients, symptom resolution and significant improvement in disease activity were achieved after SDI, persisting for an extended period following the resorption of the implant. No scleral melt, infection or ocular hypertension were noted following SDI.CONCLUSION: SDI may be a safe and effective therapeutic option for resistant non-infectious anterior scleritis.

  View details for DOI 10.1186/s12348-025-00494-6

  View details for PubMedID 40327197

• Correlation Between Fixed-Luminance Flicker Full-Field Electroretinogram Response and Macular Cone Density in Healthy Individuals. Life (Basel, Switzerland) Mohammadi, S. S., Yoo, W. S., Yavari, N., Khojasteh Jafari, H., Or, C., Mobasserian, A., Bazojoo, V., Akhavanrezayat, A., El Feky, D., Elaraby, O., Hung, J. H., Yasar, C., Gupta, A., Jain, T., Ganbold, B., Nguyen, T. B., Khatri, A., Thng, Z. X., Do, D., Nguyen, Q. D. 2025; 15 (5)

  Abstract

  This is the studyto investigate the correlation between macular cone density (MCD) and flicker electroretinogram (ERG) response in healthy eyes. In this exploratory study, 23 eyes from 12 healthy subjects were enrolled in this study. The fixed-luminance flicker full-field electroretinogram (ffERG) responses of the retina and MCDs at 24 locations were measured using the Diopsys® NOVA™ system and the rtx1 adaptive optics retinal camera, respectively. Regression analysis was employed to evaluate the correlations. The mean age of the subjects was 30 ± 3 years. The average magnitudes of the flicker response and phase response were 13.44 ± 4.88 μV and 332.63 ± 22.12°, respectively. The MCDs for all 24 locations were 15,043 ± 3511 cones/mm². Among all locations, regression analysis revealed a significant correlation only at one specific location (0, -4°) between cone density and both the mean magnitude and phase of the flicker response, with p-values of 0.005 and 0.004, respectively.In conclusion, we identified a significant correlation between MCD and ffERG responses at a specific retinal locus (0, -4°). This finding may be attributed to the distribution of different cone types throughout the retina and the possibility that various cone types may contribute differently to ERG. Further studies are required to investigate this finding.

  View details for DOI 10.3390/life15050694

  View details for PubMedID 40430123

  View details for PubMedCentralID PMC12113241

• Inherited retinal diseases-associated uveitis. Survey of ophthalmology Hung, J. H., Jain, T., Khatri, A., Nguyen, T. B., Nguyen, C. D., Yavari, N., Mobasserian, A., Karaca, I., Saeed Mohammadi, S., Gupta, A. S., Or, C. M., Akhavanrezayat, A., Yasar, C., Saengsirinavin, A. O., Than, N. T., Anover, F. A., Elaraby, O., El Feky, D., Yoo, W. S., Zhang, X., Thng, Z. X., Diana, V. D., Nguyen, Q. D. 2025

  Abstract

  Inherited retinal diseases (IRDs) are genetic disorders characterized by progressive photoreceptor function loss, often leading to significant visual impairment. Uveitis has been increasingly recognized in the clinical course of some IRDs. Despite advances in understanding the genetic causes and pathophysiology of IRDs, gaps remain in understanding the roles of inflammation and autoimmunity in IRD and IRD-associated uveitis. This review discusses IRD-associated uveitis, including anterior, intermediate, posterior, and panuveitis, as well as complications such as cystoid macular edema and retinal vasculitis. In patients with IRD-associated uveitis, mutations affecting protein function in cilia or photoreceptor outer segments suggest a universal autoimmunity mechanism triggered by the immunogenicity of shedding photoreceptor discs. Notably, in patients where uveitis is the initial sign, CRB1 mutations are often implicated, likely due to the compromised blood-retina barrier function or external limiting membrane. Other mechanisms leading to uveitis preceding IRD diagnosis include ALPK1 mutations, which activate the proinflammatory NF-κB pathway, CAPN5 mutations, which lead to dysfunction of the innate and adaptive immune systems, and VCAN1 mutations, which elicit immunogenicity due to irregularities in vitreous modeling. Understanding these mechanisms could enhance the development of innovative treatments that target personalized inflammation pathways in IRDs.

  View details for DOI 10.1016/j.survophthal.2025.03.011

  View details for PubMedID 40157547

• IgG4-related ophthalmic disease presenting as posterior scleritis in a pediatric patient. Journal of ophthalmic inflammation and infection Karaca, I., Bromeo, A. J., Mobasserian, A., Akhavanrezayat, A., DeBoer, C., Thng, Z. X., Hung, J. H., Yoo, W. S., Khatri, A., Yavari, N., Nguyen, B. T., El Feky, D., Yasar, C., Elaraby, O., Saengsirinavin, A. O., Zhang, X., Anover, F. A., Gupta, A. S., Do, D. V., Or, C., Nguyen, Q. D. 2025; 15 (1): 34

  Abstract

  To report IgG4-related ophthalmic disease (IgG4-ROD) presenting as posterior scleritis in a pediatric patient.A 7-year-old girl presented with proptosis, painful eyelid swelling, and restricted extraocular movements (EOM) of her left eye (OS). Visual acuity (VA) was 20/20 in right eye (OD) and counting fingers (CF) at 1 foot in OS. Slit lamp examination revealed 2 + anterior chamber (AC) cells, optic disc edema (ODE) with elevated appearance of macula in OS. Optical coherence tomography (OCT) showed significant subretinal fluid (SRF) in macula, B-scan ultrasound (US) demonstrated T-sign in OS. Orbital MRI was also consistent with posterior scleritis and periorbital inflammation. Extensive systemic work-up was unremarkable. Thus, the patient was started on intravenous methylprednisolone (IVMP) 30 mg/kg/day for 3 days, along with topical therapy in OS, which led to an improvement of proptosis, EOM restriction, AC cells, as well as ODE and SRF in macula in OS. Fluorescein angiography (FA) showed leakage from optic disc in OS. The patient was then switched to oral prednisone with slow tapering and started on methotrexate (MTX). Given the recurrence of proptosis and painful eyelid swelling on systemic steroid tapering, serum IgG4 levels were ordered and found to be elevated at 149.9 mg/dL (range, 1-99). Therefore, the patient was diagnosed as 'possible' IgG4-ROD (based on diagnostic criteria) and started on infliximab (7.5 mg/kg) and IVMP monthly infusions with continuation of MTX 20 mg weekly and slower tapering of oral prednisone, which led to resolution of clinical findings, improvement of VA to 20/20 in OS.Posterior scleritis may be the initial presentation of IgG4-ROD in children. Refractory course is not uncommon. Biologics are effective in the long-term control of inflammation.

  View details for DOI 10.1186/s12348-025-00459-9

  View details for PubMedID 40146480

  View details for PubMedCentralID PMC11950618

• Impact of photodynamic therapy combined with Anti-VEGF vs. Anti-VEGF monotherapy on choriocapillaris vessel density in polypoidal choroidal vasculopathy PHOTODIAGNOSIS AND PHOTODYNAMIC THERAPY Kuo, P., Hsu, S., Huang, Y., Chang, C., Chang, Y., Hung, J., Lai, C., Lee, Y. 2025; 52: 104531

  Abstract

  To compare the choriocapillaris vessel density between intravitreal ranibizumab (Lucentis) (IVR) plus photodynamic therapy (PDT) and intravitreal aflibercept (Eylea) (IVA) monotherapy in patients experiencing polypoidal choroidal vasculopathy (PCV).An observational, retrospective cohort study.Adults with treatment-naïve PCV.IVR plus PDT or IVA monotherapy.After propensity-score (PS) matching, study outcomes were compared at 1 month after the final treatment. The primary outcome was a choriocapillaris vessel density, recognized by optical coherence tomography angiography (OCTA). The secondary outcomes included best corrected visual acuity (BCVA), presence of retinal hemorrhage, central macular thickness (CMT) and subfoveal choroidal thickness (SFCT), assessed by optical coherence tomography (OCT).Initially, 23 patients receiving IVR plus PDT, and 75 patients receiving IVA monotherapy were included. After PS-matching, 19 eyes of 19 patients receiving IVR plus PDT and 38 eyes of 38 patients receiving IVA monotherapy were analyzed. A significantly lower choriocapillaris vessel density in the IVR plus PDT group than the IVA monotherapy group (41.9 % vs. 52.2 %, p = 0.009) was demonstrated. The similarity of the BCVA, occurrence and severity of retinal hemorrhage, CMT, and SFCT between two treatment groups was exhibited.The choriocapillaris vessel density was significantly reduced in PCV patients treated with IVR plus PDT compared to those receiving IVA monotherapy.

  View details for DOI 10.1016/j.pdpdt.2025.104531

  View details for Web of Science ID 001440360000001

  View details for PubMedID 39993696

• Evaluation of the Appropriateness and Readability of ChatGPT-4 Responses to Patient Queries on Uveitis OPHTHALMOLOGY SCIENCE Mohammadi, S., Khatri, A., Jain, T., Thng, Z., Yoo, W., Yavari, N., Bazojoo, V., Mobasserian, A., Akhavanrezayat, A., Than, N., Elaraby, O., Ganbold, B., El Feley, D., Nguyen, T., Yasar, C., Gupta, A., Hung, J., Nguyen, Q. 2025; 5 (1)

  View details for DOI 10.1016/j.xops.2024.100594

  View details for Web of Science ID 001332430600001

• Tocilizumab for Cystoid Macular Edema Secondary to Immune Recovery Uveitis in a Patient with Contraindications to Long-Term Systemic Corticosteroid. The Yale journal of biology and medicine Nguyen, B. T., Hung, J. H., Thng, Z. X., El Feky, D., Mobasserian, A., Saengsirinavin, A. O., Zhang, X., Anover, F. A., Mohammadi, S. S., Than, N. T., Khatri, A., Yavari, N., Ganbold, B., Yasar, C., Elaraby, O., Akhavanrezayat, A., Yoo, W. S., Gupta, A. S., Nguyen, Q. D. 2024; 97 (4): 423-430

  Abstract

  Purpose: To report a case of cystoid macular edema (CME) secondary to immune recovery uveitis (IRU) in a patient with previous history of cytomegalovirus (CMV) retinitis and leukemia, which was successfully treated with tocilizumab (TCZ), an interleukin-6 (IL-6) receptor antagonist. Method: The clinical records of the case were reviewed, focusing on demographics, image findings, and clinical course. Results: A 17-year-old female with a past medical history of T-cell acute lymphoblastic leukemia (T-ALL) undergoing chemotherapy for two years presented with active CMV retinitis. She was successfully treated with intravitreal foscarnet injections and systemic ganciclovir. After 5 months of systemic valganciclovir maintenance and following cessation of chemotherapy, the patient developed bilateral CME and vasculitis, and was diagnosed with IRU. CME management was challenging due to a history of bilateral avascular necrosis of the femoral head resulting from prolonged systemic corticosteroid use. Two cycles of monthly TCZ infusions were administered at the dosage of 8mg/kg. Subsequently, the CME and retinal vasculitis resolved significantly without any evidence of inflammation in the anterior chamber and vitreous. Conclusion: The index case report demonstrated the safety and efficacy of the IL-6 receptor antagonist TCZ in treating CME associated with IRU in a non-HIV CMV retinitis patient.

  View details for DOI 10.59249/NQRT7239

  View details for PubMedID 39703613

  View details for PubMedCentralID PMC11650910

• Cataract Surgery and Incidence of Retinal Vascular Occlusion: Population-Based Cohort Study Using a Target Trial Emulation Framework AMERICAN JOURNAL OF OPHTHALMOLOGY Wang, L., Yang, A., Su, Y., Hsu, S., Huang, Y., Lee, C., Shao, S., Lin, S., Hung, J., Lai, E. 2024; 268: 143-154

  Abstract

  Previous studies suggested an association between cataract surgery and retinal vascular occlusion. However, the association may be attributable to detection bias because postoperative monitoring may be more frequent for those who receive cataract surgery than for those who do not.Population-based cohort study using target trial emulation framework.We included patients with cataract aged 50 years and older receiving cataract surgery or nonsurgical interventions identified from the Taiwan National Health Insurance Research Database between 2003 and 2018, matched by propensity score. The primary outcome was retinal vascular occlusion. Cox proportional hazards models were used to compare surgery and control groups. Additional analyses were restricted to patients who had undergone fundoscopic examination within 6 months prior to cataract surgery to address the issue of detection bias.We included 577,129 cataract surgery and control pairs. We found the hazard ratio (HR) for retinal vascular occlusion after cataract surgery was 1.23 (95% confidence interval (CI): 1.17-1.29), compared with the control group. Secondary outcome analyses yielded similar results for retinal artery occlusion (HR: 1.13, 95% CI: 1.02-1.26) and retinal vein occlusion (HR: 1.26, 95% CI: 1.20-1.33). However, no risk of retinal vascular occlusion was observed among patients who had received fundoscopic examinations (HR: 1.06, 95% CI: 0.98-1.15) at baseline.Our study underscored the importance of conducting complete baseline fundoscopic examinations before cataract surgery to clarify whether postoperative conditions are due to patients' underlying diseases or unintended complications of cataract surgery.

  View details for DOI 10.1016/j.ajo.2024.07.029

  View details for Web of Science ID 001304559800001

  View details for PubMedID 39097255

• Risk of age-related macular degeneration in men receiving 5α-reductase inhibitors: a population-based cohort study AGE AND AGEING Su, Y., Shen, C., Shao, S., Lai, C., Hsu, S., Lee, C., Liu, C., Hung, J., Lai, E. 2024; 53 (7)

  Abstract

  Recent studies suggest that 5α-reductase inhibitors (5ARIs) for benign prostate hyperplasia (BPH) result in abnormal retinal anatomical alteration.To compare age-related macular degeneration (AMD) incidence in BPH patients receiving 5ARIs or tamsulosin.Retrospective, population-based cohort study using new-user and active-comparator design.General population.Males with BPH, newly receiving 5ARIs or tamsulosin from 2010 to 2018.Data were extracted from Taiwan's National Health Insurance Research Database. We used Cox proportional hazards model with 1:4 propensity score (PS) matching, based on intention-to-treat analysis to determine the risk of incident AMD. Sensitivity analyses included an as-treated approach and weighting-based PS methods. We also separately reported the risks of incident AMD in patients receiving finasteride and dutasteride to determine risk differences among different 5ARIs.We included 13 586 5ARIs users (mean age: 69 years) and 54 344 tamsulosin users (mean age: 68.37 years). After a mean follow-up of 3.7 years, no differences were observed in the risk of incident AMD between 5ARIs and tamsulosin users [hazard ratio (HR): 1.06; 95% confidence intervals (95% CI): 0.98-1.15], with similar results from sensitivity analyses. However, increased risk of incident age-related macular degeneration was observed in patients receiving dutasteride [HR: 1.13; 95% CI: 1.02-1.25], but not in those receiving finasteride [HR: 0.99; 95% CI: 0.87-1.12], in the subgroup analyses.We found no difference between 5ARIs and tamsulosin regarding the incidence of AMD in BPH patients. However, the risk profiles for AMD differed slightly between dutasteride and finasteride, suggesting that the potency of androgen inhibition is a factor related to AMD incidence.

  View details for DOI 10.1093/ageing/afae155

  View details for Web of Science ID 001282250100003

  View details for PubMedID 39046116

• Microperimetry and optical coherence tomography findings in nonparaneoplastic autoimmune retinopathy Ngoc Than, Thng, Z., Akhavanrezayat, A., Mobasserian, A., Khatri, A., Jain, T., Yoo, W., Hung, J., Bromeo, A., Mohammadi, S., Anh Tran, Lyu, X., Khiem Nguyen, Elfeqi, D., Hien Luong Doan, Quan Dong Nguyen ASSOC RESEARCH VISION OPHTHALMOLOGY INC. 2024

  View details for Web of Science ID 001312354900061

• Correlation between optical coherence tomography parameters and fluorescein angiography grades in patients with retinal vasculitis Anh Ngoc Tram Tran, Karaca, I., Thng, Z., Lyu, X., Yoo, W., Khatri, A., Mohammadi, S., Hung, J., Mobasserian, A., Yasar, C., Akhavanrezayat, A., Ngoc Than, Bazojoo, V., Anover, F., Quan Dong Nguyen, Anh Ngoc Tram Tran, Karaca, I., Thng, Z., Lyu, X., Yoo, W., Khatri, A., Mohammadi, S., Hung, J., Mobasserian, A., Yasar, C., Akhavanrezayat, A., Ngoc Than, Bazojoo, V., Anover, F., Quan Dong Nguyen ASSOC RESEARCH VISION OPHTHALMOLOGY INC. 2024

  View details for Web of Science ID 001313316204129

• Utilization of automated machine learning approach toward detection of granular corneal dystrophy using slit lamp photographs Yavari, N., Mohammadi, S., Mobasserian, A., Elaraby, O., Bazojoo, V., Akhavanrezayat, A., Khatri, A., Jain, T., Thng, Z., Nguyen, K., Yoo, W., Yasar, C., Hung, J., Nguyen, Q., AAfshari, N., Lin, C. ASSOC RESEARCH VISION OPHTHALMOLOGY INC. 2024

  View details for Web of Science ID 001313316201076

• Importance of repeated aqueous humor analyses in suspected viral anterior uveitis using polymerase chain reaction Yoo, W., Kim, S., Kwon, L., Thng, Z., Akhavanrezayat, A., Mobasserian, A., Mohammadi, S., Ngoc Than, Yasar, C., Anh Ngoc Tram Tran, Nguyen, K., Elaraby, O., El Feky, D., Hung, J., Gupta, A., Quan Dong Nguyen ASSOC RESEARCH VISION OPHTHALMOLOGY INC. 2024

  View details for Web of Science ID 001312227708315

• Treatment outcomes of patients with non-paraneoplastic autoimmune retinopathy Yasar, C., Thng, Z., Akhavanrezayat, A., Or, C., Mobasserian, A., Mohammadi, S., Yavari, N., Ngoc Trong Tuong Than, Anh Ngoc Tram Tran, Khiem Sy Nguyen, Elaraby, O., Elfeqi, D., Hung, J., Gupta, A., Khatri, A. K. C., Quan Dong Nguyen ASSOC RESEARCH VISION OPHTHALMOLOGY INC. 2024

  View details for Web of Science ID 001312227708303

• Evaluation of the effect of modifying indocyanine green solvent on its toxicity to the corneal endothelial cells Rubio, A., Hung, J., Lin, S., Hsu, I., Chang, Y., Hsu, S., Thng, Z., Akhavanrezayat, A., Mohammadi, S., Yoo, W., Yasar, C., Tran, A., Gupta, A., Wu, L., Nguyen, Q. ASSOC RESEARCH VISION OPHTHALMOLOGY INC. 2024

  View details for Web of Science ID 001312227706053

• Characteristics of Patients with Adalimumab therapy that were Anti-adalimumab Antibodies Positive but Later turned Negative Or, C., Hung, J., Khatri, A., Bazojoo, V., Akhavanrezayat, A., Nguyen, Q. ASSOC RESEARCH VISION OPHTHALMOLOGY INC. 2024

  View details for Web of Science ID 001312227707240

• Evaluation of the appropriateness and readability of ChatGPT responses to patient queries on uveitis Mohammadi, S., Khatri, A. K. C., Jain, T., Thng, Z., Yoo, W., Yavari, N., Mobasserian, A., Bazojoo, V., Akhavanrezayat, A., Tran, A., Yasar, C., Elaraby, O., Gupta, A., Hung, J., El Feky, D., Nguyen, Q. ASSOC RESEARCH VISION OPHTHALMOLOGY INC. 2024

  View details for Web of Science ID 001312227701052

• Patient treatment preference in noninfectious intermediate, posterior, panuveitis, episcleritis, or scleritis Mobasserian, A., Ongpalakorn, P., Ghoraba, H., Thng, Z., Yavari, N., Akhavanrezayat, A., Mohammadi, S., Karaca, I., Than, N., Yasar, C., Tran, A., Elfeqi, D., Elaraby, O., Hung, J., Gupta, A., Nguyen, Q. ASSOC RESEARCH VISION OPHTHALMOLOGY INC. 2024

  View details for Web of Science ID 001312227707225

• Functional and protein structure analysis of a novel <i>FZD4</i> mutation c.428T>C in a family with familial exudative vitreoretinopathy Hung, J., Hsu, C., Chang, Y., Chuang, W., Lin, P., Kuo, Y., Thng, Z., Akhavanrezayat, A., Mobasserian, A., Mohammadi, S., Yoo, W., Elaraby, O., El Feky, D., Gupta, A., Wu, L., Nguyen, Q. ASSOC RESEARCH VISION OPHTHALMOLOGY INC. 2024

  View details for Web of Science ID 001313316203323

• Photopic negative response in uveitis patients using Diopsys® ffERG Elfeqi, D., Akhavanrezayat, A., Thng, Z., Khowaja, A., Yoo, W., Mobasserian, A., Mohammadi, S., Than, N., Tran, A., Nguyen, K., Elaraby, O., Hung, J., Gupta, A., Khatri, A. K. C., Jain, T., Nguyen, Q. ASSOC RESEARCH VISION OPHTHALMOLOGY INC. 2024

  View details for Web of Science ID 001313316200183

• Visual acuity and intraocular pressure after cataract extraction in phacomorphic angle closure Anover, F., Florcruz, N., Akhavanrezayat, A., Yoo, W., Yavari, N., Mohammadi, S., Ngoc Trong Tuong Than, Yasar, C., Elaraby, O., El Feky, D., Hung, J., Basojoo, V., Jain, T., Mobasserian, A., Karaca, I., Quan Dong Nguyen, Anover, F., Florcruz, N., Akhavanrezayat, A., Yoo, W., Yavari, N., Mohammadi, S., Ngoc Trong Tuong Than, Yasar, C., Elaraby, O., El Feky, D., Hung, J., Basojoo, V., Jain, T., Mobasserian, A., Karaca, I., Quan Dong Nguyen ASSOC RESEARCH VISION OPHTHALMOLOGY INC. 2024

  View details for Web of Science ID 001313316204061

• Importance of Baseline Fluorescein Angiography for Patients Presenting to Tertiary Uveitis Clinic. American journal of ophthalmology Karaca, I., Bromeo, A., Ghoraba, H., Lyu, X., Thng, Z. X., Yasar, C., Akhavanrezayat, A., Yavari, N., Kirimli, G. U., Than, N. T., Shin, Y., Gupta, A. S., Khatri, A., Mohammadi, S. S., Hung, J. H., Or, C., Do, D. V., Nguyen, Q. D. 2024

  Abstract

  To ascertain whether the use of ultra-wide-field fluorescein angiography (UWFFA) at baseline visit alters the assessment of disease activity and localization, as well as the management of patients presenting to a tertiary uveitis clinic.Retrospective comparison of diagnostic approaches.Baseline visits of 158 patients who presented to the Uveitis Clinic at the Byers Eye Institute at Stanford between 2017 and 2022 were evaluated by three uveitis-trained ophthalmologists (I.K., A.B., and H.G.). Each eye had undergone clinical examination along with ultra-wide-field fundus photography (UWFFP) (Optos Plc, Dunfermline, Scotland, UK), spectral-domain optical coherence tomography (SD-OCT, Spectralis Heidelberg, Heidelberg Engineering, Heidelberg, Germany) and UWFFA (Optos Plc, Dunfermline, Scotland, UK) at the baseline visit. Investigators were asked to successively determine disease activity, localization of disease (anterior, posterior or both), and management decisions based on clinical examination and UWFFP and SD-OCT (Set 1) and Set 1 plus UWFFA (Set 2). The primary outcome was the percentage of eyes whose management changed based on the availability of UWFFA, compared with Set 1.The mean age of the patients was 46.9±22.4 (range, 7-96) and 91 (57.6%) were female. With Set 1 alone, 138 (55.2%) eyes were found to have active disease; localization was anterior in 58 (42.0%) eyes, posterior in 53 (38.4%) eyes and anterior + posterior in 27 (19.6%) eyes. With Set 2, 169 eyes of 107 patients had active anterior, posterior or pan-uveitis. In comparison with Set 1, assessment with Set 2 identified additional 31 (18.3%) eyes with active disease (p=0.006), and additional 31 (18.3%) eyes having disease in both anterior + posterior segments (p<0.001). Regarding the primary outcome, management was changed in 68 (27.4%) eyes in Set 2, compared to Set 1.Baseline UWFFA may alter assessment of disease activity, localization, and management decisions compared to clinical examination with only UWFFP and SD-OCT for eyes with uveitis. Thus, UWFFA may be considered as an essential tool in the evaluation of uveitis patients at the baseline visit.

  View details for DOI 10.1016/j.ajo.2024.04.016

  View details for PubMedID 38701875

• Heterochromia caused by Waardenburg syndrome in a 2-month-old infant CANADIAN MEDICAL ASSOCIATION JOURNAL Lin, P., Hung, J., Huang, Y. 2024; 196 (9): E296

  View details for DOI 10.1503/cmaj.231616

  View details for Web of Science ID 001182176600002

  View details for PubMedID 38467409

  View details for PubMedCentralID PMC10927287

• Induction of Petite Colonies in Candida glabrate via Rose Bengal-Mediated Photodynamic Therapy JOVE-JOURNAL OF VISUALIZED EXPERIMENTS Yang, C., Hung, J., Wu, C., Wang, Z., Wang, S., Liaw, H., Lin, I., Yu, C., Wong, T. 2024

  Abstract

  Facing a 40% mortality rate in candidemia patients, drug-resistant Candida and their petite mutants remain a major treatment challenge. Antimicrobial photodynamic therapy (aPDT) targets multiple fungal structures, unlike antibiotics/antifungals, potentially thwarting resistance. Traditional methods for inducing petite colonies rely on ethidium bromide or fluconazole, which can influence drug susceptibility and stress responses. This study investigated the application of green light (peak 520 nm) and rose bengal (RB) photosensitizer to combat a drug-resistant Candida glabrata isolate. The findings revealed that aPDT treatment significantly inhibited cell growth (≥99.9% reduction) and effectively induced petite colony formation, as evidenced by reduced size and loss of mitochondrial redox indicator staining. This study provides initial evidence that aPDT can induce petite colonies in a multidrug-resistant C. glabrata strain in vitro, offering a potentially transformative approach for combating resistant fungal infections.

  View details for DOI 10.3791/66549

  View details for Web of Science ID 001205397000014

  View details for PubMedID 38619255

• TIMP3/Wnt axis regulates gliosis of Müller glia BIOCHIMICA ET BIOPHYSICA ACTA-MOLECULAR BASIS OF DISEASE Hung, J., Tsai, P., Aala, W. F., Chen, C., Chiou, S., Wong, T., Tsai, K., Hsu, S., Wu, L. 2024; 1870 (4): 167087

  Abstract

  Previous studies have confirmed the expression of tissue inhibitor of metalloproteinase-3 (TIMP3) in Müller glia (MG). However, the role of TIMP3 in MG remains unknown.A mouse model of laser-induced retinal damage and gliosis was generated using wild-type C57BL/6 mice. TIMP3 and associated proteins were detected using Western blotting and immunofluorescence microscopy. RNA sequencing (GSE132140) of mouse laser-induced gliosis was utilized for pathway analysis. TIMP3 overexpression was induced in human MG. Human vitreous samples were obtained from patients with proliferative diabetic retinopathy (PDR) and healthy controls for protein analysis.TIMP3 levels increased in mouse eyes after laser damage. Morphology and spatial location of TIMP3 indicated its presence in MG. TIMP3-overexpressing MG showed increased cellular proliferation, migration, and cell nuclei size, suggesting TIMP3-induced gliosis for retinal repair. Glial fibrillary acidic protein (GFAP) and vimentin levels were elevated in TIMP3-overexpressing MG and laser-damaged mouse retinas. RNA sequencing and Western blotting suggested a role for β-catenin in mediating TIMP3 effects on the retina. Human vitreous samples from patients with PDR showed a positive correlation between TIMP3 and GFAP levels, both of which were elevated in patients with PDR.TIMP3 is associated with MG gliosis to enhance the repair ability of damaged retinas and is mediated by the canonical Wnt/β-catenin. Changes in TIMP3 could potentially be used to control gliosis in a range of retinal diseases However, given the multifaceted nature of TIMP3, care must be taken when developing treatments that aim solely to boost the function of TIMP3.National Cheng Kung University Hospital, Taiwan (NCKUH-10604009 and NCKUH-11202007); the Ministry of Science and Technology (MOST 110-2314-B-006-086-MY3).

  View details for DOI 10.1016/j.bbadis.2024.167087

  View details for Web of Science ID 001197417600001

  View details for PubMedID 38369214

• Double-Needle Haptic Repositioning: A Troubleshooting Technique for Flanged Intraocular Lens Fixation RETINA-THE JOURNAL OF RETINAL AND VITREOUS DISEASES Hung, J., Wang, L., Hsu, S., Hsu, S., Yamane, S. 2023; 43 (12): 2064-2067

  Abstract

  Haptic repositioning during flanged intraocular lens (IOL) fixation can be difficult, and the haptic requiring repositioning may be at increased risk of excessive bending or breakage. This study aimed to report double-needle haptic repositioning technique outcomes for the aforementioned difficulty during flanged IOL fixation.This retrospective case series included seven eyes requiring haptic repositioning during flanged IOL fixation. The method features reinsertion of an already externalized haptic into the needle lumen followed by a needle-haptic complex internalized through the original tract into the eyeball. Thus, an adequate configuration for contralateral haptic can be achieved for insertion into the needle lumen to create a double-needle condition before both haptics are successfully externalized.The median follow-up duration was 24 months (range, 4-24 months). Postoperatively, the IOL was well-centered, and corrected distance visual acuity improved from 20/320 (20/4,000-20/70) to 20/50 (20/250-20/20). No intraoperative or postoperative complications were noted.The technique produced encouraging results in patients undergoing haptic repositioning during flanged IOL fixation. This technique could potentially reduce haptic overbending risk and facilitate haptic adjustment. Further studies are needed to confirm the feasibility of the technique.

  View details for DOI 10.1097/IAE.0000000000003625

  View details for Web of Science ID 001107654900007

  View details for PubMedID 36161994

• Acute Kidney Injury from Intravitreal Anti-vascular Endothelial Growth Factor Drugs: A Systematic Review and Meta-analysis of Randomized Controlled Trials BIODRUGS Tsao, Y., Chen, T., Wang, L., Lee, C., Lee, W., Hsu, S., Lai, C., Shao, S., Hung, J., Lai, E. 2023; 37 (6): 843-854

  Abstract

  Several observational studies have reported acute kidney injury from intravitreal anti-vascular endothelial growth factor (anti-VEGF) drugs for retinal diseases. However, systematic reviews and meta-analyses of randomized controlled trials on this critical topic are scant.To evaluate acute kidney injury risk associated with intravitreal anti-VEGF drugs in patients with retinal diseases.We searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials on 12 July, 2023, and included randomized controlled trials reporting acute kidney injury between anti-VEGF drugs (e.g., aflibercept, bevacizumab, brolucizumab, and ranibizumab) and controls for retinal diseases (e.g., age-related macular degeneration, polypoidal choroidal vasculopathy, diabetic retinopathy/diabetic macular edema, retinal vein occlusion, and myopic choroidal neovascularization). Data were synthesized by a fixed-effects model for pooling odds ratios (ORs) using the Peto method.We included 13 randomized controlled trials (four and nine trials for aflibercept and ranibizumab, respectively) with a total of 4282 participants. The meta-analysis indicated intravitreal anti-VEGF drugs did not increase the acute kidney injury risk, compared with controls (odds ratio [OR]: 1.00, 95% confidence interval [CI] 0.49-2.04, I2: 0%), and no differences in the acute kidney injury risk were observed between different anti-VEGF drugs (OR: 1.10, 95% CI 0.27-4.43, I2: 0% for aflibercept; OR: 0.97, 95% CI 0.42-2.22, I2: 0% for ranibizumab) and between different retinal diseases (OR: 4.61, 95% CI 0.07-284.13, I2: not applicable for age-related macular degeneration; OR: 0.90, 95% CI 0.42-1.93, I2: 0% for diabetic retinopathy/diabetic macular edema; OR: 1.57, 95% CI 0.16-15.88, I2: 0% for retinal vein occlusion).Intravitreal anti-VEGF drugs were not associated with an acute kidney injury risk, regardless of which anti-VEGF drugs (aflibercept or ranibizumab) or retinal diseases (age-related macular degeneration, diabetic retinopathy/diabetic macular edema, or retinal vein occlusion) were involved.PROSPERO CRD42021267854.

  View details for DOI 10.1007/s40259-023-00621-6

  View details for Web of Science ID 001060731200002

  View details for PubMedID 37676536

  View details for PubMedCentralID 4845743

• Diagnosis, Treatment, and Prevention of Noninfectious Acute Anterior Uveitis with or without Human Leukocyte Antigen B27 in Adults-Expert Consensus in Taiwan OCULAR IMMUNOLOGY AND INFLAMMATION Chao, Y., Hung, J., Lin, C., Kuo, H., Chen, S., Hwang, Y., Li, K., Lin, C., Hwang, D., Sheu, S. 2024; 32 (2): 226-233

  Abstract

  Anterior uveitis is the most common anatomical type of uveitis. Patients with noninfectious anterior uveitis may develop various ocular complications and eventually visual impairment. Appropriately differentiating the etiologies can help clinicians to predict the outcome, arrange clinical follow-up, and decide the treatment or prevention strategy. Adequate treatment and effective prevention strategies can reduce the frequency of recurrence and the risk of developing complications. Human leukocyte antigen (HLA)-B27 is the most common positive finding in patients with noninfectious AAU in many countries including Taiwan.To report a consensus from experienced uveitis specialists and rheumatologists was made in Taiwan.A panel of nine ophthalmologists from nine different referral centers with expertise in the management of uveitis and an experienced rheumatologist was held on January 16, 2022. A comprehensive literature review was performed. Differential diagnoses for etiologies, general treatments, and prevention strategies were discussed. Each statement in the consensus was made only if more than 70% of the experts agreed.A flow chart and seven statements regarding the differential diagnoses for etiologies, treatments and preventions, and co-management with rheumatologists were included in the consensus.This article discusses the general diagnosis, treatment, and prevention of noninfectious acute anterior uveitis, with or without HLA-B27, in adults for general ophthalmologists to improve overall outcomes of these patients.

  View details for DOI 10.1080/09273948.2023.2165113

  View details for Web of Science ID 000920880700001

  View details for PubMedID 36701640

• Ocular toxoplasmosis in a patient with acquired immunodeficiency syndrome LANCET INFECTIOUS DISEASES Chang, C., Hung, J., Hsu, S. 2023; 23 (1): 130

  View details for DOI 10.1016/S1473-3099(22)00737-X

  View details for Web of Science ID 000911084000001

  View details for PubMedID 36395783

• Eyelid and scleral thermal injury following phacoemulsification in silicone oil: a case report (vol 22, pg 420, 2022) BMC OPHTHALMOLOGY Lee, Y., Chen, S., Hung, J. 2022; 22 (1): 467

  View details for DOI 10.1186/s12886-022-02706-2

  View details for Web of Science ID 000914941200001

  View details for PubMedID 36461027

  View details for PubMedCentralID PMC9717495

• Overweight and Obesity as Risk Factors for Recurrent Herpetic Stromal Keratitis during Long-Term Antiviral Prophylaxis VIRUSES-BASEL Hsu, C., Hung, J., Lin, I., Tseng, S., Lin, S., Huang, Y. 2022; 14 (12)

  Abstract

  Although past research has shown an association between obesity and herpes simplex virus infection, the relationship between body mass index (BMI) and herpetic stromal keratitis (HSK) recurrence has never been investigated. In this study, we included HSK patients who received oral valacyclovir as prophylactic treatment between January 2016 and January 2021. Recurrence, possible risk factors, and the time to recurrence were recorded during follow-ups. Among the 56 patients included in this study, recurrence was reported in 21 (37.5%) patients. The age at disease onset and mean follow-up time were not significantly different in the recurrence and non-recurrence groups. However, in the Cox regression analysis, BMI ≥ 24 kg/m2 was noted as the variable having significant correlation with recurrence (p = 0.01 in univariate analysis and p = 0.001 in multivariate analysis). In conclusion, overweight and obesity were revealed as risk factors for HSK recurrence in patients receiving long-term antiviral prophylaxis. Further studies are needed to determine the appropriate acyclovir concentrations in the blood or aqueous humour in order to achieve desirable prophylactic effects, especially in the overweight and obese patients.

  View details for DOI 10.3390/v14122812

  View details for Web of Science ID 000904114800001

  View details for PubMedID 36560816

  View details for PubMedCentralID PMC9781937

• Eyelid and scleral thermal injury following phacoemulsification in silicone oil: a case report BMC OPHTHALMOLOGY Lee, Y., Chen, S., Hung, J. 2022; 22 (1): 420

  Abstract

  Phacoemulsification has been the mainstay method for extracapsular cataract extraction surgery in the anterior segment; for cases of posterior drop of lens fragments into the vitreous, a posterior segment phacoemulsification instrument (fragmatome; Alcon, Inc., Fort Worth, TX) can be employed to remove the dislocated lens materials. Studies have reported on thermal injury to the cornea during phacmoemulsification of the anterior segment. However, few studies have investigated thermal burn in the simultaneous sclera and eyelid induced by the fragmatome. Currently, there is no reports and lack of optimal strategy for the management of nucleus drop in a vitreous cavity filled with silicon oil.We present the case of a 53-year-old male patient with a thermal burn wound on the upper eyelid and sclera following phacoemulsification for a dropped lens in a silicone oil-filled vitreous. We further designed an experiment to verify our hypothesis that thermal injury could be induced by the high temperature of the metal tip during phacoemulsification in silicone oil. In our experiment, during 420 s of continuous ultrasonic wave, the temperature of the fragmatome tip in the balanced salt solution (BSS) increased from 22.0 to 24.0 ºC, while the temperature of the fragmatome tip in the silicone oil group increased from 22.0 to 43.0 ºC.The temperature of the fragmatome tip increased significantly in silicone oil compared to BSS in the experiment. Thus, physicians should be aware of possible thermal complications when using fragmatome in eyes filled with silicone oil.

  View details for DOI 10.1186/s12886-022-02646-x

  View details for Web of Science ID 000879006400001

  View details for PubMedID 36333675

  View details for PubMedCentralID PMC9636749

• Dilated choroidal vascular channels in pachychoroid neovasculopathy CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY Hung, J., Yang, C., Yang, C., Ho, T., Lai, T., Hsieh, Y. 2023; 51 (1): 44-57

  Abstract

  To elucidate the pattern of the choroidal vasculature in exudative pachychoroid neovasculopathy (PNV) and its correlation with the clinical course and treatment outcomes.The retrospective study included consecutive patients in National Taiwan University Hospital between 2014 and 2020 who fulfilled the criteria for exudative PNV defined as active type 1 macular neovascularization (MNV) on optical coherence tomography angiography (OCTA) and with leakage on fluorescein angiography (FA) or indocyanine green angiography (ICGA) associated with pachychoroid features. The corrected distance visual acuity (CDVA), FA, ICGA, and OCT images obtained by Optovue (Optovue Inc, Freemont CA, USA) spectral domain OCT were evaluated at baseline and various time points during the 12-month treatment period. The correlations between the choroidal vascular patterns, specifically those with or without dilated choroidal vascular channels (DCVC) revealed by ICGA, and baseline characteristics and treatment outcomes were evaluated using multiple regression models.The study enrolled 34 eyes of 31 patients. The average age was 59.0 ± 9.3 years, and 20 participants were men. ICGA revealed DCVCs in 21 eyes, while the remaining 13 eyes did not have DCVCs. At baseline, DCVC group was older (p = 0.03) and had a longer duration of visual symptoms (p = 0.02), with a higher vessel density (defined as the percentage of the measured area occupied by flow area) of MNV (p = 0.04), higher proportion of ellipsoid zone disruption (p = 0.01), and poorer CDVA (p = 0.03). After the 12-month treatment period, the frequency of requirement of anti-VEGF injections (p < 0.01) was higher, and the risk for CDVA <20/40 was higher (adjusted OR: 5.29, 95% CI: 1.24-22.48, p = 0.02) in eyes with DCVCs.For PNV, eyes with DCVCs were associated with higher vessel density of macular neovascularization and poorer CDVA at baseline, and had poorer visual and anatomical outcomes although more anti-VEGF injections were given.

  View details for DOI 10.1111/ceo.14178

  View details for Web of Science ID 000874356500001

  View details for PubMedID 36258650

• Vitreoretinal surgery in the management of infectious and non-infectious uveitis - a narrative review GRAEFES ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY Hung, J., Rao, N. A., Chiu, W., Sheu, S. 2023; 261 (4): 913-923

  Abstract

  This study aims to conduct a narrative review about the current role of vitreoretinal surgery in the management of infectious and non-infectious uveitis.This review was performed based on a search of the PubMed database or on relevant published papers according to our current knowledge.A total of 91 articles were identified in the literature review. With the advance of microincision vitrectomy surgery (MIVS), pars plana vitrectomy (PPV) has gained increasing popularity in the management of infectious and non-infectious uveitis. For diagnostic purposes, larger amounts of sample can be obtained by MIVS than traditional vitreous aspiration using needles. For treatment purposes, PPV removes vitreous opacities, decreases inflammatory cytokines and mediators of inflammation, and tackles related complications, including hypotony, epiretinal membrane, macular holes, and retinal detachment. Achieving optimum control of inflammation prior to surgery is important for surgical interventions for non-emergent therapeutic indications and complications of uveitis. Peri-operative inflammation management is essential for decreasing the risk of surgical intervention. An overall complication rate of 42-54% was reported with cataract to be the leading cause of complications.Most reports affirm the role of PPV in the management of infectious and non-infectious uveitis, although the quality of data remains limited by a lack of applying standardized reporting outcomes, limitations in study design, and a paucity of prospective data.

  View details for DOI 10.1007/s00417-022-05862-9

  View details for Web of Science ID 000865907600001

  View details for PubMedID 36220982

  View details for PubMedCentralID 3979536

• In vivo confocal microscopy for eyes with Behcet's disease: a missing piece of the puzzle GRAEFES ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY Huang, Y., Hung, J. 2022; 260 (12): 3779-3780

  View details for DOI 10.1007/s00417-022-05848-7

  View details for Web of Science ID 000862903100003

  View details for PubMedID 36171458

  View details for PubMedCentralID 5882821

• Comparative anatomical outcomes of high-flow vs. low-flow phacoemulsification cataract surgery: A systematic review and meta-analysis FRONTIERS IN MEDICINE Kuo, P., Hung, J., Su, Y., Fang, C., Lee, C., Huang, Y., Shao, S., Lai, E. 2022; 9: 1021941

  Abstract

  Phacoemulsification is an effective and widely performed technique in cataract surgery, but the comparative anatomical outcomes, including endothelial cell loss (ECL), central corneal thickness (CCT), and central macular thickness (CMT), between high-flow and low-flow phacoemulsification cataract surgery remain unclear.This study followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. Random-effects models were applied to measure pooled mean differences (MD) with 95% confidence intervals (CI) of anatomical outcomes between high-flow and low-flow phacoemulsification cataract surgery. We judged overall certainty of evidence (CoE) based on Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria.We included six randomized controlled trials (RCTs) totaling 477 participants. The meta-analysis showed similar changes associated with these two surgery types in both ECL at postoperative days 2-14 (MD: -1.63%; 95% CI: -3.73 to 0.47%; CoE: very low), days 15-42 (MD: -0.65%; 95% CI -2.96 to 1.65%; CoE: very low) and day 43 to month 18 (MD: -0.35%; 95% CI: -1.48 to 0.78%; CoE: very low), and CCT at postoperative day 1 (MD: -16.37 μm; 95% CI: -56.91 to 24.17 μm; CoE: very low), days 2-14 (MD: -10.92 μm; 95% CI: -30.00 to 8.16 μm; CoE: very low) and days 15-42 (MD: -2.76 μm; 95% CI: -5.75 to 0.24 μm; CoE: low). By contrast, low-flow phacoemulsification showed less increase in CMT at postoperative days 15-42 (MD, -4.58 μm; 95% CI: -6.3 to -2.86 μm; CoE: low).We found similar anatomical outcomes, except in CMT, for both high-flow and low-flow phacoemulsification cataract surgery. Future head-to-head RCTs on visual outcomes should confirm our findings.PROSPERO, identifier: CRD42022297036.

  View details for DOI 10.3389/fmed.2022.1021941

  View details for Web of Science ID 000868277600001

  View details for PubMedID 36250089

  View details for PubMedCentralID PMC9554630

• Comparison of Sodium-Glucose Cotransporter 2 Inhibitors vs Glucagonlike Peptide-1 Receptor Agonists and Incidence of Dry Eye Disease in Patients With Type 2 Diabetes in Taiwan JAMA NETWORK OPEN Su, Y., Hung, J., Chang, K., Sun, C., Huang, Y., Lee, C., Hung, M., Lai, C., Shao, S., Lai, E. 2022; 5 (9): e2232584

  Abstract

  Sodium-glucose cotransporter 2 (SGLT2) inhibitors have been found to improve low-grade systemic and tissue inflammation; however, the association between SGLT2 inhibitor use and the incidence of dry eye disease (DED) has not been explored.To investigate the association between SGLT2 inhibitor use and dry eye disease in patients with type 2 diabetes (T2D).A retrospective cohort analysis of the largest multi-institutional electronic medical records database in Taiwan was conducted to identify patients with T2D newly receiving SGLT2 inhibitors or glucagonlike peptide-1 receptor agonists (GLP-1 RAs) from 2016 to 2018. Data analysis was performed from March 1 to May 31, 2022. Propensity scores with inverse probability of treatment weighting were generated to enable homogeneous comparisons between the 2 groups.Treatment with SGLT2 inhibitors or GLP-1 RAs.Incident dry eye disease, which was defined by clinical diagnoses, plus the related drug prescription. Cox proportional hazards regression models were used to estimate hazard ratios with 95% CIs for the risk of DED.A total of 10 038 and 1077 T2D patients newly receiving SGLT2 inhibitors (mean [SD] age, 59.5 [12.1] years; 5689 [56.7%] men) or GLP-1 RAs (mean [SD] age, 58.5 [41.2] years; 587 [54.5%] men), respectively, were included in the analysis. The incidence of DED was lower in patients newly receiving SGLT2 inhibitors (9.0 events per 1000 person-years) compared with those receiving GLP-1 RAs (11.5 events per 1000 person-years), yielding a hazard ratio of 0.78 (95% CI, 0.68-0.89). Subgroup analyses indicated that the lowered DED risks associated with SGLT2 inhibitors in patients with T2D were similar across different age, sex, blood glucose level, and kidney function groups. Results from the sensitivity analyses (including the propensity score-matching approach, on-treatment analyses, and different follow-up periods of 1, 2, and 3 years) were similar to the main analyses.The findings of this study suggest that patients with T2D newly receiving SGLT2 inhibitors may have a lower risk for DED compared with those receiving GLP-1 RAs. Prospective studies are needed to analyze these results.

  View details for DOI 10.1001/jamanetworkopen.2022.32584

  View details for Web of Science ID 000860814400003

  View details for PubMedID 36136333

  View details for PubMedCentralID PMC9500553

• Step-wise diagnostic approach for patients with uveitis- Experts consensus in Taiwan JOURNAL OF MICROBIOLOGY IMMUNOLOGY AND INFECTION Hwang, D., Hung, J., Chang, Y., Chen, C., Chen, S., Cheng, C., Hwang, Y., Kuo, H., Li, A., Lin, C., Yang, C., Sheu, S., Lin, C. 2022; 55 (4): 573-580

  Abstract

  Uveitis is a sight-threatening disease that can be associated with many different etiologies. Successful treatment of uveitis relies on accurate diagnosis and prompt efficient therapy. History taking, physical and ocular examinations, systemic evaluations, and response to treatment provide crucial information to differentiate possible etiologies involved in the pathophysiology of intraocular inflammation. This article provides recommendations for a step-wise approach to patients with uveitis in Taiwan based on an expert meeting and consensus. Systemic evaluations for uveitis should be performed step-by-step and include investigation of patients' general systemic conditions, ruling out infectious etiologies, and obtaining evidential biomarkers to diagnose a specific disease entity.

  View details for DOI 10.1016/j.jmii.2022.02.003

  View details for Web of Science ID 000862802900002

  View details for PubMedID 35361552

• A systematic approach to reduce intraocular pressure for the treatment of glaucoma BIOTECHNOLOGY PROGRESS Huang, Y., Hsu, Y., Yu, Y., Huang, H., Tsai, R., Cheng, Y., Chou, Y., Sun, S., Wang, L., Lin, J., Chen, C., Hung, J., Ng, I. 2022; 38 (6): e3285

  Abstract

  Glaucoma is the leading cause of irreversible blindness due to increased intraocular pressure (IOP) in the eye. We have developed a novel treatment option for glaucoma based on a real-time IOP-dependent nitric oxide synthase (NOS) and packed in a therapeutic contact lens to reduce the IOP. First, 1.6 nmole nitric oxide was produced from the genetic chassis, which was optimized for isopropyl β-d-1-thiogalactopyranoside (IPTG) induction in a T7 expression system. For biosafety concerns to human being, the csgAD genes responsible for curli biofilm formation in Escherichia coli were co-expressed with NOS in the designated NOSAD strain to strengthen the adherence of cells to the contact lens, thereby preventing the contamination into the eyes. Moreover, NOSAD is a diaminopimelic acid (DAP) auxotrophic strain, which cannot survive without supplementation of DAP and reached the critical consideration of biosafety to the environment. We also demonstrated that the nitric oxide diffusion was 3.6-times enhanced from penetration into the aqueous humor of porcine eyes. The deformation ratio of the contact lens was correlated to the change of IOP by using a digital image correlation (DIC) system in a porcine eye model. The novel systematic approach provides an alternative treatment for glaucoma patients in the future.

  View details for DOI 10.1002/btpr.3285

  View details for Web of Science ID 000824664700001

  View details for PubMedID 35801317

• Risk of dialysis in patients receiving intravitreal anti-vascular endothelial growth factor treatment: a population-based cohort study AGING-US Yang, S., Su, Y., Lim, C., Huang, J., Hsu, S., Wu, L., Chang, Y., Hung, J. 2022; 14 (12): 5116-5130

  Abstract

  We utilized the Longitudinal Health Insurance Database which was stemmed from the Taiwan's National Health Insurance Research Database to conduct a retrospective cohort study investigating the risk of becoming dialysis dependent after receiving intravitreal anti-vascular endothelial growth factor (VEGF) agents for retinal diseases. Patients newly receiving intravitreal ranibizumab or aflibercept from 2000 to 2017 for age-related macular degeneration, polypoidal choroidal vasculopathy, diabetic macular edema, retinal vein occlusions, or myopic choroid neovascularization were included as the study group, and patients with same retinal diseases but did not receive intravitreal anti-VEGFs served as controls extracted by age- and sex-matched (1:4) and further propensity score matching (PSM). Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the risk of dialysis. A cohort of 2447 anti-VEGF users and 2447 controls by PSM were evaluated. Higher dialysis risks were observed among patients newly receiving anti-VEGF agents compared to controls (adjusted HR: 1.849; 95% CI: 1.378-2.482) in the PSM cohort. For subgroup analysis, patients newly receiving anti-VEGF treatment for diabetic macular edema had significant risk (adjusted HR: 1.834; 95% CI: 1.448-2.324) of becoming dialysis-dependent, while patients in other subgroups demonstrated similar risks as the controls. In conclusion, intravitreal anti-VEGF agents might increase the risk of becoming dialysis-dependent, especially in patients who are treated for diabetic macular edema.

  View details for Web of Science ID 000829754900015

  View details for PubMedID 35724264

  View details for PubMedCentralID PMC9271293

• Purification and biofabrication of 5-aminolevulinic acid for photodynamic therapy against pathogens and cancer cells BIORESOURCES AND BIOPROCESSING Lee, Y., Yi, Y., Lin, Y., Chen, C., Hung, J., Lin, J., Ng, I. 2022; 9 (1): 68

  Abstract

  5-Aminolevulinic acid (5-ALA) is a non-proteinogenic amino acid which has involved in heme metabolism of organisms, and has been widely applied in agriculture, and medical fields nowadays. 5-ALA is used in the elimination of pathogens or cancer cells by photodynamic therapy (PDT) owing to the photosensitizer reaction which releases the reactive oxygen species (ROS). Currently, biofabrication of 5-ALA is regarded as the most efficient and eco-friendly approach, but the complicated ingredient of medium causes the nuisance process of purification, resulting in low recovery and high producing cost. In this study, hydrogen chloride, sodium acetate, and ammonia were examined to maximize the recovery of 5-ALA from ion-exchange chromatography (IEC), thus a 92% recovery in 1 M ammonia at pH 9.5 was obtained. Afterward, the activated carbon was used for decolorization to further remove the pigments from the eluent. Four organic solvents, i.e., diethyl ether, methanol, ethanol, and acetone were compared to extract and form 5-ALA precipitation. The purified 5-ALA was verified to eliminate 74% of A549 human lung cancer and 83% of A375 melanoma skin cancer cell. Moreover, Proteus hauseri, Aeromonas hydrophila, Bacillus cereus, and Staphylococcus aureus were killed via anti-microbial PDT with 1% 5-ALA and reached 100% killing rate at optimal condition. With the addition of 0.05% 5-ALA during the culture, the growth of microalgae Chlorella sorokiniana was improved to against a common aquatic pathogen, A. hydrophila. The broad application of 5-ALA was demonstrated in this study for the first time.

  View details for DOI 10.1186/s40643-022-00557-9

  View details for Web of Science ID 000812226000001

  View details for PubMedID 38647835

  View details for PubMedCentralID PMC10992327

• Oral short-chain fatty acids administration regulates innate anxiety in adult microbiome-depleted mice NEUROPHARMACOLOGY Wu, J., Sun, C., Lai, T., Liou, C., Lin, Y., Xue, J., Wang, H., Chai, L., Lee, Y., Chen, S., Chang, A. Y. W., Hung, J., Hsu, C., Wu, W. 2022; 214: 109140

  Abstract

  Anxiety is characterized by feelings of tension and worry even in the absence of threatening stimulus. Pathological condition of anxiety elicits defensive behavior and aversive reaction ultimately impacting individuals and society. The gut microbiota has been shown to contribute to the modulation of anxiety-like behavior in rodents through the gut-brain axis. Several studies observed that germ-free (GF) and the broad spectrum of antibiotic cocktail (ABX)-treated rodents display lowered anxiety-like behavior. We speculate that gut microbial short-chain fatty acids (SCFA) modulate the innate anxiety response. Herein, we administered SCFA in the drinking water in adult mice treated with ABX to deplete the microbiota and tested their anxiety-like behavior. To further augment the innate fear response, we enhanced the aversive stimulus of the anxiety-like behavior tests. Strikingly, we found that the anxiety-like behavior in ABX mice was not altered when enhanced aversive stimulus, while control and ABX mice supplemented with SCFA displayed increased anxiety-like behavior. Vagus nerve serves as a promising signaling pathway in the gut-brain axis. We determined the role of vagus nerve by subdiaphragmatic vagotomy (SDV) in ABX mice supplemented with SCFA. We found that the restored anxiety-like behavior in ABX mice by SCFA was unaffected by SDV. These findings suggest that gut microbiota can regulate anxiety-like behavior through their fermentation products SCFA.

  View details for DOI 10.1016/j.neuropharm.2022.109140

  View details for Web of Science ID 000813431500003

  View details for PubMedID 35613660

• Trends in diabetic eye disorders and associated comorbidities in Taiwan: a 10-year nationwide population-based cohort study BRITISH JOURNAL OF OPHTHALMOLOGY Lin, C., Lee, C., Huang, J., Hsu, S., Hung, J., Yang, S. 2023; 107 (9): 1303-1310

  Abstract

  In-depth analysis is needed to investigate trends in diabetic retinopathy (DR), diabetic macular oedema (DME) and associated comorbidities in patients with type 2 diabetes mellitus (T2DM) so that we can better understand their prevalence and incidence.A retrospective population-based study was conducted using data from Taiwan's National Health Insurance Research Database from 2005 to 2015, and T2DM, DR and associated comorbidities were identified based on diagnostic codes. We used a standardised incidence rate with age and sex adjustment to estimate the prevalence and incidence of DR, proliferative DR (PDR), advanced PDR (aPDR) and DME, while the difference in each study period was calculated as the annual percentage change. We used the absolute standardised difference to analyse changes in related comorbidities in different periods.The population of patients with DM increased over 50% between 2005 and 2015, while the prevalence and incidence of DR decreased, as did the incidence of PDR and aPDR. However, the prevalence and incidence of DME increased over the course of 10 years, with an upward trend in all forms of DR. The percentage of patients with hyperlipidaemia in DME and all DR increased, and the percentage of patients with end-stage renal disease (ESRD) was also elevated in DME.The prevalence and incidence of DR, PDR and aPDR decreased with time in patientsT2DM, while the ratio of DME increased gradually. The incidence of hyperlipidaemia also increased in all forms of diabetic eye disorders, while ESRD increased solely in DME.

  View details for DOI 10.1136/bjophthalmol-2021-320917

  View details for Web of Science ID 000780910900001

  View details for PubMedID 35396213

• Immediate Ocular Changes After Light-Emitting Diode Displays Exposure-A Preliminary Study FRONTIERS IN MEDICINE Lin, C., Hung, J., Huang, Y. 2022; 9: 848794

  Abstract

  Computer vision syndrome (CVS) is one of the most frequently encountered problems among video display terminals (VDT) users, but little is known regarding the short-term effect after exposure to light-emitting diodes (LED). The purpose of this study was to determine if short-term exposure to LED leads to changes in corrected distance visual acuity (CDVA), lipid layer thickness (LLT), blink rates, partial blink ratio, and computer vision syndrome questionnaire (CVS-Q) score.Prospective, cross-sectional study.In this study, participants were recruited at the National Cheng-Kung University Hospital, a tertiary referral center in southern Taiwan, for examination. Participants were asked to complete the CVS-Q and undergo a series of ocular examinations, including CDVA, LLT, blink rates and partial blink ratio before and after watching an LED display for 15 min. Main Outcome Measures were changes in CDVA, LLT, blink rates, partial blink ratio, and CVS-Q measurements.In total, 120 eyes from 60 participants (mean age: 35.7 ± 9.4 years) were included; 31 participants were men (51.7%), and 29 were women (48.3%). The CDVA, LLT, blink rates, and partial blink ratio did not change after watching the LED display. The CVS-Q score significantly improved after short-term LED exposure (P < 0.001). A subgroup analysis of subjects with a baseline LLT of <60 nm or ≥60 nm determined that LLT significantly decreased in individuals with a baseline LLT of ≥60 nm (P = 0.016).Short-term use of LED displays reduced LLT in individuals with a baseline LLT of ≥60 nm, despite the visual symptoms of CVS improved subjectively. Therefore, digital device users should be aware of the potential negative effects of LED exposure on the eyes.

  View details for DOI 10.3389/fmed.2022.848794

  View details for Web of Science ID 000788579000001

  View details for PubMedID 35445041

  View details for PubMedCentralID PMC9015093

• Rose Bengal-Mediated Photodynamic Therapy to Inhibit <i>Candida albicans</i> JOVE-JOURNAL OF VISUALIZED EXPERIMENTS Hung, J., Wang, Z., Lo, Y., Lee, C., Chang, Y., Chang, R., Huang, C., Wong, T. 2022

  Abstract

  Invasive Candida albicans infection is a significant opportunistic fungal infection in humans because it is one of the most common colonizers of the gut, mouth, vagina, and skin. Despite the availability of antifungal medication, the mortality rate of invasive candidiasis remains ~50%. Unfortunately, the incidence of drug-resistant C. albicans is increasing globally. Antimicrobial photodynamic therapy (aPDT) may offer an alternative or adjuvant treatment to inhibit C. albicans biofilm formation and overcome drug resistance. Rose bengal (RB)-mediated aPDT has shown effective cell killing of bacteria and C. albicans. In this study, the efficacy of RB-aPDT on multidrug-resistant C. albicans is described. A homemade green light-emitting diode (LED) light source is designed to align with the center of a well of a 96-well plate. The yeasts were incubated in the wells with different concentrations of RB and illuminated with varying fluences of green light. The killing effects were analyzed by the plate dilution method. With an optimal combination of light and RB, 3-log growth inhibition was achieved. It was concluded that RB-aPDT might potentially inhibit drug-resistant C. albicans.

  View details for DOI 10.3791/63558

  View details for Web of Science ID 000830430700030

  View details for PubMedID 35404353

• Association between sodium glucose co-transporter 2 inhibitors and incident glaucoma in patients with type 2 diabetes: A multi-institutional cohort study in Taiwan DIABETES & METABOLISM Shao, S., Su, Y., Lai, E., Chang, K., Lee, C., Hung, M., Lai, C., Huang, F., Hung, J. 2022; 48 (1): 101318

  Abstract

  Type 2 diabetes (T2D) is an important risk factor for glaucoma, and sodium-glucose co-transporter 2 (SGLT2) inhibitors have been shown to protect the optic nerves. We therefore aimed to evaluate the association between SGLT2 inhibitors and incident glaucoma.This retrospective cohort study analyzed the largest multi-institutional electronic medical records database in Taiwan, containing data of over a million individuals. We included T2D patients newly prescribed SGLT2 inhibitors or glucagon-like peptide-1 receptor agonists (GLP-1 RAs) from 2016 to 2018. Our primary outcome was incident glaucoma diagnosis between initiation of SGLT2 inhibitors or GLP-1 RAs, and 31st March 2021. After applying inverse probability of treatment weighting (IPTW) to increase homogeneity between the two treatment groups, we estimated hazard ratios (HR) with 95% confidence intervals (CI) for the risk of glaucoma, based on Cox proportional hazards regression models.We included 9,927 and 1,065 T2D patients who had been newly prescribed SGLT2 inhibitors or GLP-1 RAs, respectively. Lower risk of incident glaucoma was observed in patients receiving SGLT2 inhibitors (7.9 events per 1,000 person-years), compared to those receiving GLP-1 RAs (10.0 events per 1,000 person-years), with an HR of 0.81 (95% CI: 0.69-0.95). Multiple sensitivity analyses and a negative control outcome analysis confirmed the robustness of our main findings.This study suggests that T2D patients newly prescribed SGLT2 inhibitors have a reduced risk of incident glaucoma, compared to those prescribed GLP-1 RAs, in clinical practice. Future prospective studies are suggested to confirm this association.

  View details for DOI 10.1016/j.diabet.2022.101318

  View details for Web of Science ID 000758467500003

  View details for PubMedID 35017100

• Long-Term Outcome of Treatment with 2% Topical Ganciclovir Solution in Cytomegalovirus Anterior Uveitis and Corneal Endotheliitis INFECTION AND DRUG RESISTANCE Chen, P., Lin, I., Chi, Y., Lai, C., Hung, J., Tseng, S., Huang, Y. 2022; 15: 3395-3403

  Abstract

  This study aimed to evaluate the therapeutic efficacy and long-term outcomes of treatment with topical 2% ganciclovir solution in immunocompetent patients with aqueous humor polymerase chain reaction (PCR)-proven cytomegalovirus (CMV) anterior uveitis and corneal endotheliitis.We retrospectively reviewed the findings for immunocompetent patients diagnosed with CMV uveitis or endotheliitis based on clinical manifestations and polymerase chain reaction (PCR) examination results and treated with topical 2% ganciclovir solution at National Cheng Kung University Hospital. Clinical outcome measurements included evaluations of the response rate, relapses, resolution of anterior chamber inflammation, visual acuity, and intraocular pressure.The study included 38 eyes of 32 patients. Long-term administration of topical 2% ganciclovir significantly decreased keratic precipitates (p = 0.001), anterior chamber cells (p = 0.001), and reduced intraocular pressure (p < 0.001). Only one eye was unresponsive to topical ganciclovir treatment, and the recurrence decreased to 0.13 relapses per year. The presence of keratic precipitates and higher intraocular pressure at the initial presentation were significantly associated with recurrence (p = 0.036 and p = 0.001, respectively).Long-term use of topical 2% ganciclovir solution is effective, safe, and applicable when commercialized ganciclovir gel is not available.

  View details for DOI 10.2147/IDR.S370905

  View details for Web of Science ID 000821691500001

  View details for PubMedID 35791348

  View details for PubMedCentralID PMC9250767

• Recent Advances in Photodynamic Therapy against Fungal Keratitis PHARMACEUTICS Hung, J., Lee, C., Hsu, H., Ng, I., Wu, C., Yu, C., Lee, N., Chang, Y., Wong, T. 2021; 13 (12)

  Abstract

  Fungal keratitis is a serious clinical infection on the cornea caused by fungi and is one of the leading causes of blindness in Asian countries. The treatment options are currently limited to a few antifungal agents. With the increasing incidence of drug-resistant infections, many patients fail to respond to antibiotics. Riboflavin-mediated corneal crosslinking (similar to photodynamic therapy (PDT)) for corneal ectasia was approved in the US in the early 2000s. Current evidence suggests that PDT could have the potential to inhibit fungal biofilm formation and overcome drug resistance by using riboflavin and rose bengal as photosensitizers. However, only a few clinical trials have been initiated in anti-fungal keratitis PDT treatment. Moreover, the removal of the corneal epithelium and repeated application of riboflavin and rose bengal are required to improve drug penetration before and during PDT. Thus, an improvement in trans-corneal drug delivery is mandatory for a successful and efficient treatment. In this article, we review the studies published to date using PDT against fungal keratitis and aim to enhance the understanding and awareness of this research area. The potential of modifying photosensitizers using nanotechnology to improve the efficacy of PDT on fungal keratitis is also briefly reviewed.

  View details for DOI 10.3390/pharmaceutics13122011

  View details for Web of Science ID 000736880100001

  View details for PubMedID 34959293

  View details for PubMedCentralID PMC8709008

• Risk of diabetic macular oedema with sodium-glucose cotransporter-2 inhibitors in type 2 diabetes patients: A multi-institutional cohort study in Taiwan DIABETES OBESITY & METABOLISM Su, Y., Shao, S., Lai, E., Lee, C., Hung, M., Lai, C., Hsu, S., Hung, J. 2021; 23 (9): 2067-2076

  Abstract

  To investigate the risk of diabetic macular oedema (DMO) associated with the use of sodium-glucose cotransporter-2 (SGLT2) inhibitors in patients with type 2 diabetes mellitus (T2DM).We conducted a retrospective cohort study by analysing a large multi-institutional electronic medical records database in Taiwan. We included adult patients with T2DM without DMO newly receiving either SGLT2 inhibitors or glucagon-like peptide-1 receptor agonists (GLP-1RAs) during the period 2016 to 2018. We used propensity scores with inverse probability of treatment weighting to generate comparable groups. The study outcome was incident DMO, determined by clinical diagnosis during outpatient visits or admissions. We followed patients from the index date to either DMO occurrence, last clinical visit, patient death, or December 31, 2020. We performed Cox proportional hazards regression models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the risk of DMO.We included 9986 new users of SGLT2 inhibitors (mean [SD] age 59.6 (12.1) years, median [interquartile range {IQR}] glycated haemoglobin [HbA1c] 70 (61-81)mmol/mol, estimated glomerular filtration rate [eGFR] 89.1 [71.4-108.7] mL/min/1.73 m2 and urine albumin-creatinine ratio [UACR] 26.1 [9.7-117.6] mg/g) and 1067 new users of GLP-1RAs (mean [SD] age 58.4 (41.5) years, median [IQR] HbA1c 73 [64-84] mmol/mol, eGFR 91.6 [68.6-114.0] mL/min/1.73 m2 and UACR 37.6 [11.1-153.2] mg/g) with similar baseline characteristics. Lower DMO risks were observed among patients newly receiving SGLT2 inhibitors (7.9/1000 person-years), compared to those receiving GLP-1RAs (10.7/1000 person-years) with an HR of 0.75 (95% CI 0.64-0.88).Our findings suggest use of SGLT2 inhibitors was associated with lower risk of DMO in T2DM patients in clinical practice, compared to use of GLP-1RAs. Future studies are necessary to confirm this observation.

  View details for DOI 10.1111/dom.14445

  View details for Web of Science ID 000659055300001

  View details for PubMedID 34047442

• Pseudoxanthoma elasticum with null cell adenoma of the pituitary gland: A case report with multimodal imaging study KAOHSIUNG JOURNAL OF MEDICAL SCIENCES Su, Y., Wu, C., Huang, M., Hung, J. 2021; 37 (9): 828-830

  View details for DOI 10.1002/kjm2.12402

  View details for Web of Science ID 000657617300001

  View details for PubMedID 34085378

  View details for PubMedCentralID PMC11896205

• Topical gentamicin ointment induces <i>LAMB3</i> nonsense mutation readthrough and improves corneal erosions in a patient with junctional epidermolysis bullosa CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY Hung, J., Hou, P., Huang, F., Hsu, C. 2021; 49 (3): 309-312

  View details for DOI 10.1111/ceo.13912

  View details for Web of Science ID 000626608400001

  View details for PubMedID 33634938

• A Novel Pathogenic <i>HSPG2</i> Mutation in Schwartz-Jampel Syndrome FRONTIERS IN NEUROLOGY Lin, P., Hung, J., Hsu, C., Chang, Y., Sun, Y. 2021; 12: 632336

  Abstract

  Schwartz-Jampel syndrome is a rare autosomal recessive disease caused by mutation in the heparan sulfate proteoglycan 2 (HSPG2) gene. Its cardinal symptoms are skeletal dysplasia and neuromuscular hyperactivity. Herein, we identified a new pathogenic mutation site (NM_005529.6:c.1125C>G; p.Cys375Trp) of HSPG2 leading to Schwartz-Jampel syndrome by whole-exome sequencing. This mutation carried by the asymptomatic parents was previously registered in a single-nucleotide polymorphism database of the National Institutes of Health as a coding sequence variant rs543805444. The pathogenic nature of this missense mutation was demonstrated by in silico pathogenicity assessment, clinical presentations, and cellular function of primary fibroblast derived from patients. Various in silico software applications predicted the mutation to be pathogenic [Sorting Intolerant From Tolerant (SIFT), 0; Polyphen-2, 1; CADD (Combined Annotation Dependent Depletion), 23.7; MutationTaster, 1; DANN (deleterious annotation of genetic variants using neural networks); 0.9]. Needle electromyography revealed extensive complex repetitive discharges and multiple polyphasic motor unit action potentials in axial and limb muscles at rest. Short exercise test for myotonia showed Fournier pattern I. At cellular levels, mutant primary fibroblasts had reduced levels of secreted perlecan and impaired migration ability but normal capability of proliferation. Patients with this mutation showed more neuromuscular instability and relatively mild skeletal abnormality comparing with previously reported cases.

  View details for DOI 10.3389/fneur.2021.632336

  View details for Web of Science ID 000631392900001

  View details for PubMedID 33767660

  View details for PubMedCentralID PMC7985266

• Unilateral Vision Loss After Hyaluronic Acid Injection: A Case Report. Annals of plastic surgery Hung, J. H., Wang, C. T., Lee, C. N., Shieh, S. J. 2021; 86 (2S Suppl 1): S127-S131

  Abstract

  Vascular occlusion causing vision loss is a rare yet one of the most devastating complications of facial esthetic fillers. In this article, we present a case of unilateral blindness and superficial skin necrosis in a 31-year-old woman after the injection of hyaluronic acid for esthetic purposes. The delicate ocular fundal findings of ophthalmic artery occlusion were demonstrated by ophthalmoscopy, optical coherence tomography, and fluorescein angiography. Magnetic resonance imaging also showed subsequent ischemic changes in the optic nerve and posterior scleral wall after ophthalmic artery occlusion. Despite management including intraocular pressure-lowering agents, globe massage, and anticoagulation with acetylsalicylic acid and hyperbaric oxygen therapy, her final vision was not restored. Given the lack of effective treatments, this report depicts the comprehensive ocular fundal findings of an ophthalmic artery occlusion after esthetic hyaluronic acid filler injection, and highlights the importance of a preventive approach to avoid such catastrophic complications.

  View details for DOI 10.1097/SAP.0000000000002624

  View details for PubMedID 33346533

• OCT Angiography of Retinal Arterial Macroaneurysm. Ophthalmology. Retina Lin Md, C., Hung Md, J. 2020; 4 (12): 1180

  View details for DOI 10.1016/j.oret.2020.05.007

  View details for PubMedID 33279010

• Microsporidial stromal keratitis: characterisation of clinical features, ultrastructural study by electron microscopy and efficacy of different surgical modalities BRITISH JOURNAL OF OPHTHALMOLOGY Huang, H., Wu, C., Lin, S., Lin, W., Huang, F., Hung, J., Tseng, S. 2020; 104 (11): 1613-1620

  Abstract

  To report the clinical manifestations, ultrastructure and evaluate the efficacy of therapeutic lamellar keratectomy (TLK) and penetrating keratoplasty (PK) for microsporidial stromal keratitis (MSK).Fourteen MSK cases between 2009 and 2018 were recruited. Each patient's clinical presentation, light microscopy, histopathology, PCR and electron microscopy (EM) of corneal samples were reviewed.The patients were 70.0±4.7 years old (average follow-up, 4.5 years). Time from symptoms to presentation was 10.6±13.0 weeks. The corneal manifestations were highly variable. Corneal scrapings revealed Gram stain positivity in 12 cases (85.7%) and modified Ziehl-Neelsen stain positivity in 9 (64.3%). Histopathology revealed spores in all specimens, while sequencing of small subunit rRNA-based PCR products identified Vittaforma corneae in 82% of patients. EM demonstrated various forms of microsporidial sporoplasm in corneal keratocytes. All patients were treated with topical antimicrobial agents or combined with oral antiparasitic medications for >3 weeks. As all patients were refractory to medical therapy, they ultimately underwent surgical intervention (TLK in 7, PK in 6 and 1 received TLK first, followed by PK). Postoperatively, the infection was resolved in 78.6% of the patients. Nevertheless, a high recurrence rate (21.4%) was noted during 3-year follow-up, with only two patients retained a final visual acuity ≥20/100.MSK usually presents with a non-specific corneal infiltration refractory to antimicrobial therapy. The diagnosis relies on light microscopic examinations on corneal scrapings and histopathological analyses. Surgical intervention is warranted by limiting the infection; however, it was associated with an overall poor outcome.

  View details for DOI 10.1136/bjophthalmol-2019-315094

  View details for Web of Science ID 000609961300001

  View details for PubMedID 32051138

• Postoperative <i>Mycobacteroides</i> <i>abscessus</i> subsp. <i>abscessus</i> endophthalmitis: Clinical analysis of 12 clustered adults and a proposed therapeutic algorithm JOURNAL OF MICROBIOLOGY IMMUNOLOGY AND INFECTION Hung, J., Ko, W., Chen, C., Lin, S., Wu, C., Hsu, S., Teng, Y., Wang, S., Tseng, S., Huang, F., Lai, C., Chen, C., Lai, C., Chen, P., Huang, E. 2020; 53 (5): 766-777

  Abstract

  Postoperative endophthalmitis caused by nontuberculous mycobacterium is a rare but devastating complication after intraocular surgery. However, optimal treatment strategies remain undetermined in view of its rarity.We investigated the cases of culture-proven postoperative Mycobacteroides abscessus subsp. abscessus endophthalmitis in southern Taiwan, focusing on clinical manifestations and microbiological study, and aimed to describe clinical staging and to propose a therapeutic modality for this disease.Twelve cases, including two published cases, were treated in two medical centers in southern Taiwan between Aug. 2011 and Dec. 2016, and all ever received cataract surgery at one clinic. Their disease courses could be categorized into four distinct stages, i.e., the initial, quiescent, recurrent, and end stage, and some cases experienced 1-4 cycles of quiescent-recurrent stages. Although all eyes ended up with phthisis or were eviscerated, the affected eyes receiving pars plana vitrectomy (PPV) tended to become quiescent and survived longer than those without PPV (adjusted hazard ratio: 13.9, p < 0.05). Eight isolates of eight patients were available for microbiological study. All isolates were susceptible to amikacin, and inducible clarithromycin resistance was observed in 100% of isolates.Despite the preservation of vision in postoperative M.abscessus endophthalmitis remained a challenge, a stage-based approach is proposed, which may facilitate decision-makings for the future study.

  View details for DOI 10.1016/j.jmii.2018.12.011

  View details for Web of Science ID 000576693200015

  View details for PubMedID 30661953

• Risk of Glaucoma in Patients Receiving Hemodialysis and Peritoneal Dialysis: A Nationwide Population-Based Cohort Study INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH Lim, C., Lee, C., Huang, F., Huang, J., Hung, J., Yang, S. 2020; 17 (18)

  Abstract

  This paper investigated the incidence and risk of newly diagnosed glaucoma after the initiation of maintenance dialysis in Taiwan. A case-control study was conducted using the National Health Insurance Research Database (NHIRD) in Taiwan. There were 3949 patients with dialysis in the study group and 78,980 non-dialysis subjects matched by age and sex in the comparison group. The incidence of newly diagnosed glaucoma after the initiation of maintenance dialysis was analyzed based on the diagnostic code for glaucoma. Patients with dialysis had a higher risk of glaucoma (adjusted hazard ratio (aHR): 1.270; 95% confidence interval (CI): 1.035-1.560) than patients without dialysis. The incidence rate of glaucoma was 8.18 per 10,000 person months in the dialysis group, which was higher than that in the non-dialysis group (5.01 per 10,000 person months). Patients with dialysis exhibited a significantly higher risk of angle-closure glaucoma (ACG) (aHR: 1.550; 95% CI: 1.074-2.239). In contrast, there was no significant risk of developing open-angle glaucoma or normal-tension glaucoma in dialysis patients. Our data suggest that dialysis patients are more susceptible to ACG. Regular ophthalmic examinations may be useful in patients with dialysis to identify high-risk individuals with glaucoma, and preventive measures can be applied to avoid permanent vision loss as soon as intraocular pressure (IOP) elevation is identified.

  View details for DOI 10.3390/ijerph17186774

  View details for Web of Science ID 000581350900001

  View details for PubMedID 32957502

  View details for PubMedCentralID PMC7559152

• Trend of Neovascular Glaucoma in Taiwan: A 15-year Nationwide Population-based Cohort Study OPHTHALMIC EPIDEMIOLOGY Lin, P., Lee, C., Huang, F., Huang, J., Hung, J., Yang, S. 2020; 27 (5): 390-398

  Abstract

  To determine the trends in epidemiological data in patients with neovascular glaucoma (NVG) in Taiwan.The data were obtained from the 2016 version of the Longitudinal Health Insurance Database, which contains data on two million randomly sampled patients. Patients with NVG diagnostic codes were enrolled in this study, after which we separated the study population according to different time periods. The demographic data, systemic and ocular comorbidities and treatments that were applied to manage NVG were collected from the database.The overall age-standardized prevalence was 52.48 per 100,000 individuals, and the age-standardized incidence was 4.33 per 100,000 person-years in patients with NVG. In general, men had a higher prevalence and incidence, and the incidence was observed to fluctuate. The patients with the highest educational levels accounted for less than 5% of the NVG patients, and the patients with the highest income levels accounted for less than 15% of the NVG patients. Systemic comorbidities in NVG patients, especially metabolic syndrome, were observed to increase. The percentage of the patients receiving anti-vascular endothelial growth factor treatments increased by more than two-fold after 2008, whereas reductions in trabeculectomy and cyclodestruction procedures were observed.The prevalence of NVG was observed to increase in men, and the incidence fluctuated during the study period. Furthermore, the systemic comorbidities, and the use of anti-vascular endothelial growth factor treatment increased; the latter may be associated with a decrease in the use of incisional glaucoma surgery for NVG in recent years.

  View details for DOI 10.1080/09286586.2020.1755445

  View details for Web of Science ID 000531933300001

  View details for PubMedID 32326791

• Tailored internal limiting membrane flap technique for primary macular hole GRAEFES ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY Hung, J., Horng, Y., Chu, H., Li, M., Sheu, S. 2020; 258 (4): 759-766

  Abstract

  To investigate the outcomes of primary full-thickness macular hole (MH) after surgical intervention with tailored internal limiting membrane (ILM) flap technique.Patients were reviewed for their clinical characteristics and surgical outcomes. The technique included incomplete circular peeling of the perifoveal ILM which was then trimmed according to the size of the MH. Fluid-gas exchange was done without further manipulation.Nineteen eyes of 19 patients were included. The patients were in average 61 years old (range 41-83) and had an average follow-up period of 11.0 months. At baseline visit, minimal linear diameter of the MH was 311.6 μm (range 80-768). After a single surgery, the MH closed in all cases with improvement of mean visual acuity (from 0.9 to 0.4 logarithm of the minimum angle of resolution units, p < 0.0001, Wilcoxon signed-rank test). At the final visit, 15 (78.9%) eyes achieved a visual acuity ≥ 20/40. Outer retinal gliosis was found to be associated with less favorable postoperative visual acuity. Factors related to the formation of outer retinal gliosis were worse preoperative visual acuity and a large MH with a diameter > 400 μm.Tailored ILM flap technique is an effective method for favorable anatomical and visual outcomes for treatment of primary MH.

  View details for DOI 10.1007/s00417-019-04596-5

  View details for Web of Science ID 000519535900007

  View details for PubMedID 31900649

• Scleritis and anterior uveitis may herald the development of an epibulbar tumor in patients with extranodal Rosai-Dorfman disease: a case report BMC OPHTHALMOLOGY Lee, Y., Chao, S., Lee, C., Hung, J. 2019; 19: 144

  Abstract

  Rosai-Dorfman disease is a rare non-Langerhans cell histiocytosis. Ocular involvement is even rarer, mostly involving the orbit and eyelids, although marginal corneal ulcers, uveitis, and epibulbar masses have also been reported, and is characterized by multiple recurrences. However, the disease course and optimal treatment strategies remain undetermined, in light of the rarity of this disease.We reported a 36-year-old male patient with the extranodal form of Rosai-Dorfman disease, presenting with scleritis and anterior uveitis in the left eye, who experienced subsequent development of an epibulbar tumor in the same eye. The patient was also complicated by a relapsing facial nodule on the right cheek. After the pathological diagnosis of Rosai-Dorfman disease was obtained, the patient underwent surgical excision of the epibulbar tumor and the facial nodule, accompanied by systemic immunosuppression therapy. At the last follow-up, the patient was asymptomatic without signs of recurrence.This report highlights the progression of ocular manifestations of Rosai-Dorfman disease and emphasizes the importance of systemic therapy.

  View details for DOI 10.1186/s12886-019-1158-2

  View details for Web of Science ID 000475739700003

  View details for PubMedID 31291929

  View details for PubMedCentralID PMC6617840

• Potassium hydroxide as a microscopic evaluation tool for ocular <i>Demodex</i> infestation CANADIAN JOURNAL OF OPHTHALMOLOGY-JOURNAL CANADIEN D OPHTALMOLOGIE Tsai, T., Lee, C., Tseng, S., Hung, J. 2018; 53 (6): E216-E218

  View details for DOI 10.1016/j.jcjo.2018.03.016

  View details for Web of Science ID 000451770300002

  View details for PubMedID 30502994

• Major ocular trauma in Taiwan: 2002-2004 versus 2012-2014 (vol 8, 7081, 2018) SCIENTIFIC REPORTS Chang, Y., Teng, Y., Huang, Y., Liu, M., Hung, J., Hsu, S., Huang, F., Shih, M., Chen, W., Lai, C., Hsiao, S., Wang, S., Tseng, S. 2018; 8: 13566

  Abstract

  A correction to this article has been published and is linked from the HTML and PDF versions of this paper. The error has not been fixed in the paper.

  View details for DOI 10.1038/s41598-018-31648-3

  View details for Web of Science ID 000443747300001

  View details for PubMedID 30185828

  View details for PubMedCentralID PMC6125408

• Major ocular trauma in Taiwan: 2002-2004 versus 2012-2014 SCIENTIFIC REPORTS Chang, Y., Teng, Y., Huang, Y., Liu, M., Hung, J., Hsu, S., Huang, F., Shih, M., Chen, W., Lai, C., Hsiao, S., Wang, S., Tseng, S. 2018; 8: 7081

  Abstract

  We investigated the temporal changes in major eye injuries in Taiwan by reviewing the medical records of all patients with ocular trauma hospitalized at the National Cheng Kung University Hospital during 2002-2004 and 2012-2014. A total of 169 eyes (161 patients) during 2002-2004 and 121 eyes (120 patients) during 2012-2014 were enrolled (mean ± SD age: 41.9 ± 20.8 years in 2002-2004, and 51.8 ± 19.3 years in 2012-2014). Males accounted for ~75% of patients. The most frequent injury-causing object was metallic material (~24%), and blunt traumas were most frequently attributable to traffic accidents and falls. The most common locations of injuries for males and females were the workplace and home, respectively. Open-globe injuries occurred in ~70% of eyes, requiring primary repair, cataract extraction, and/or intraocular lens implantation. The frequencies of fall injury, lacrimal system laceration, lens injury, corneal/scleral foreign bodies, and use of intracameral antibiotics increased from 2002-2004 to 2012-2014, while those of closed-globe injury, vitreous haemorrhage, optic nerve injury, and medical treatment decreased. The final visual acuity remained poor (≤20/200) in >1/3 of injured eyes. Despite therapeutic advancements, major eye injuries still pose a high risk for poor visual outcome.

  View details for DOI 10.1038/s41598-018-25030-6

  View details for Web of Science ID 000431401700014

  View details for PubMedID 29728657

  View details for PubMedCentralID PMC5935687

• Orbital complications of paranasal sinusitis in Taiwan, 1988 through 2015: Acute ophthalmological manifestations, diagnosis, and management PLOS ONE Chang, Y., Chen, P., Hung, J., Chen, H., Laim, C., Ou, C., Chang, C., Wang, C., Cheng, H., Tseng, S. 2017; 12 (10): e0184477

  Abstract

  Paranasal sinusitis is widespread and can lead to orbital complications, blindness, and death. However, the correlation between ophthalmological findings and disease staging remains unclear. This study aimed to investigate the staging, acute ophthalmological manifestations, diagnosis, management, and outcomes of orbital complications of paranasal sinusitis during a 27-year period.We retrospectively reviewed the medical records of all patients with orbital complications of paranasal sinusitis hospitalized at the National Cheng Kung University Hospital, a medical center in Taiwan during 1988-2015. Sex, age, symptoms, history, ophthalmological findings, laboratory and imaging findings, treatments, and outcomes were analyzed by staging.Eighty-three patients aged 9 days to 80 years had stage I (preseptal cellulitis, n = 39 patients), II (postseptal orbital cellulitis, n = 8), III (subperiosteal abscess, n = 16), IV (orbital abscess, n = 8), or V (intracranial involvement, n = 12) complications. Peak incidences occurred in patients aged 0-19 and 60-69 years. Chronic sinusitis and diabetes mellitus were common preexisting diseases. Extraocular movement limitation and proptosis predicted postseptal (stage II or more) involvement. The likelihood of elevated intraocular pressure increased with stage. Reduced visual acuity and presence of relative afferent pupillary defect indicated consideration of magnetic resonance imaging to investigate possible intracranial extension. Ipsilateral maxillary (81.7%) and ethmoidal (75.6%) sinuses were the most common sources of infection, and the most frequently implicated pathogens were coagulase-negative Staphylococcus spp. (25.3%) and Staphylococcus aureus (20.5%). All patients received intravenous antimicrobial therapy (multi-drug therapy in 88.0%), and 55.4% underwent surgery, most commonly endoscopic sinus surgery. One (1.2%) diabetic man with stage V complications died of fungal sinusitis with intracranial invasion. Five (6.0%) patients, all stage V, lost vision despite intensive treatment. The average length of hospital stay was 13.8 days (range 2-72 days), and significantly longer stays were associated with stages II-V as compared to stage I.Orbital infection originating from paranasal sinusitis can cause vision loss and death due to intracranial extension. Acute ophthalmological findings predict staging and prognosis. Cooperative consultation between ophthalmologists, otorhinolaryngologists, and neurologists is essential. Urgent diagnostic studies and aggressive antimicrobial therapy are indicated, and surgery should be considered.

  View details for DOI 10.1371/journal.pone.0184477

  View details for Web of Science ID 000412131900004

  View details for PubMedID 28972988

  View details for PubMedCentralID PMC5626037

• Ocular ischemic syndrome CANADIAN MEDICAL ASSOCIATION JOURNAL Hung, J., Chang, Y. 2017; 189 (23): E804

  View details for DOI 10.1503/cmaj.160459

  View details for Web of Science ID 000403166100005

  View details for PubMedID 28606978

  View details for PubMedCentralID PMC5468106

• Motorized injector-assisted intrascleral intraocular lens fixation KAOHSIUNG JOURNAL OF MEDICAL SCIENCES Hung, J., Wang, S., Teng, Y., Hsu, S. 2017; 33 (3): 137-143

  Abstract

  For eyes with deficient capsular support, intraocular lens (IOL) implantation has long been a technical challenge. Recently, intrascleral fixation of the haptics of a three-piece posterior chamber IOL has become a popular option. In this procedure, externalization of the leading haptic during IOL injection is a stressful step. We present a modified technique to improve the ease and safety of this step. Our modified technique involves IOL injection with a motorized injector with several important modifications described here. With these modifications, a surgeon can easily maintain the correct orientation of the IOL in a well-controlled manner during IOL injection. The records of 13 patients who underwent this technique were retrospectively evaluated. Corrected-distance visual acuity improved significantly after surgery (p<0.05). No postoperative retinal detachment, endophthalmitis, IOL decentration, or vitreous hemorrhage was noted during the follow-up period. In conclusion, the motorized injector-assisted intrascleral IOL fixation technique is a safe and effective alternative to the conventional procedure. This technique makes the process of leading haptic externalization easier and more controllable.

  View details for DOI 10.1016/j.kjms.2017.01.001

  View details for Web of Science ID 000398079600005

  View details for PubMedID 28254116

• A cluster of endophthalmitis caused by <i>Mycobacterium abscessus</i> after cataract surgery JOURNAL OF MICROBIOLOGY IMMUNOLOGY AND INFECTION Hung, J., Huang, Y., Chang, T., Tseng, S., Shih, M., Wu, J., Huang, F. 2016; 49 (5): 799-803

  Abstract

  We report two cases of postoperative endophthalmitis after cataract surgery caused by the same strain of Mycobacterium abscessus confirmed by arbitrarily primed polymerase chain reaction, sequencing of the erythromycin ribosome methyltransferase gene and pulsed-field gel electrophoresis. The outcomes were poor despite aggressive treatments. This is the first report of nontuberculous mycobacteria as a causative pathogen for a cluster of endophthalmitis.

  View details for DOI 10.1016/j.jmii.2014.02.001

  View details for Web of Science ID 000388267800024

  View details for PubMedID 24657068

• A cluster of Mycobacterium massiliense keratitis in foundry workers. Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases Hung, J. H., Chang, T. C., Wu, J. J., Lai, C. C., Huang, F. C., Huang, Y. H. 2016; 22 (4): 386.e5-386.e8

  Abstract

  Three consecutive workers from the same foundry had Mycobacterium massiliense keratitis. The strains isolated from each patient were identical. This is the first report of a non-surgery-related outbreak of non-tuberculous mycobacterial ocular infection. An investigation revealed that injured cornea with exposure to aerosolized non-tuberculous mycobacteria might account for this outbreak.

  View details for DOI 10.1016/j.cmi.2015.12.014

  View details for PubMedID 26721784

• Conjunctival geographic ulcer: An overlooked sign of herpes simplex virus infection JOURNAL OF CLINICAL VIROLOGY Hung, J., Chu, C., Lee, C., Hsu, C., Lee, J., Wang, J., Chang, K., Huang, F. 2015; 64: 40-44

  Abstract

  Herpes simplex virus (HSV) ocular infection causes significant visual burden worldwide. Despite the fact that dendritic or geographic corneal ulcers are typical findings in HSV epithelial keratitis, conjunctival ulcer as a sign of HSV infection has rarely been reported. Although easily overlooked, this important sign could be enhanced by fluorescein staining. We report two cases of conjunctival geographic ulcers proven to be HSV infection by viral isolation and polymerase chain reaction (PCR). One patient had bilateral disease and blepharitis, and the other had unilateral involvement without skin lesions. With timely diagnosis and proper management, excellent visual outcome can be expected.

  View details for DOI 10.1016/j.jcv.2015.01.002

  View details for Web of Science ID 000352273600008

  View details for PubMedID 25728077

• Central retinal vein occlusion and subsequent neovascular glaucoma after adalimumab treatment for psoriasis CLINICAL AND EXPERIMENTAL DERMATOLOGY Hsu, C., Cheng, C., Hung, J., Li, M. L., Huang, F., Yang, W., Lee, J. 2014; 39 (1): 72-73

  View details for DOI 10.1111/ced.12158

  View details for Web of Science ID 000328573800022

  View details for PubMedID 23692635