Analyzing shifts in age-related macular degeneration research trends since 2014: A bibliometric study with triple-map Sankey diagrams (TMSD).

BACKGROUND: Age-related macular degeneration (AMD) is the primary cause of vision impairment in older adults, especially in developed countries. While many articles on AMD exist in the literature, none specifically delve into the trends based on document categories. While bibliometric studies typically use dual-map overlays to highlight new trends, these can become congested and unclear with standard formats (e.g., in CiteSpace software). In this study, we introduce a unique triple-map Sankey diagram (TMSD) to assess the evolution of AMD research. Our objective is to understand the nuances of AMD articles and show the effectiveness of TMSD in determining whether AMD research trends have shifted over the past decade. METHODS: We collected 7465 articles and review pieces related to AMD written by ophthalmologists from the Web of Science core collection, accumulating article metadata from 2014 onward. To delve into the characteristics of these AMD articles, we employed various visualization methods, with a special focus on TMSD to track research evolution. We adopted the descriptive, diagnostic, predictive, and prescriptive analytics (DDPP) model, complemented by the follower-leading clustering algorithm (FLCA) for clustering analysis. This synergistic approach proved efficient in identifying and showcasing research focal points and budding trends using network charts within the DDPP framework. RESULTS: Our findings indicate that: in countries, institutes, years, authors, and journals, the dominant entities were the United States, the University of Bonn in Germany, the year 2021, Dr Jae Hui Kim from South Korea, and the journal "Retina"; in accordance with the TMSD, AMD research trends have not changed significantly since 2014, as the top 4 categories for 3 citing, active, and cited articles have not changed, in sequence (Ophthalmology, Science & Technology - Other Topics, General & Internal Medicine, Pharmacology & Pharmacy). CONCLUSION: The introduced TMSD, which incorporates the FLCA algorithm and features in 3 columns-cited, active, and citing research categories-offers readers clearer insights into research developments compared to the traditional dual-map overlays from CiteSpace software. Such tools are especially valuable for streamlining the visualization of the intricate data often seen in bibliometric studies.

Allyl isothiocyanate induces DNA damage and inhibits DNA repair-associated proteins in a human gastric cancer cells in vitro.

Allyl isothiocyanate (AITC) is abundant in cruciferous vegetables and it present pharmacological activity including anticancer activity in many types of human cancer cells in vitro and in vivo. Currently, no available information to show AITC affecting DNA damage and repair-associated protein expression in human gastric cancer cells. Therefore, in the present studies, we investigated AITC-induced cytotoxic effects on human gastric cancer in AGS and SNU-1 cells whether or not via the induction of DNA damage and affected DNA damage and repair associated poteins expressions in vitro. Cell viability and morphological changes were assayed by flow cytometer and phase contrast microscopy, respectively, the results indicated AITC induced cell morphological changes and decreased total viable cells in AGS and SNU-1 cells in a dose-dependently. AITC induced DNA condensation and damage in a dose-dependently which based on the cell nuclei was stained by 4', 6-diamidino-2-phenylindole present in AGS and SNU-1 cells. DNA damage and repair associated proteins expression in AGS and SNU-1 cells were measured by Western blotting. The results indicated AITC decreased nuclear factor erythroid 2-related factor 2 (NRF2), heme oxygenase-1 (HO-1), glutathione, and catalase, but increased superoxide dismutase (SOD (Cu/Zn)), and nitric oxide synthase (iNOS) in AGS cells, however, in SNU-1 cells are increased HO-1. AITC increased DNA-dependent protein kinase (DNA-PK), phosphorylation of gamma H2A histone family member X on Ser139 (γH2AXpSer139 ), and heat shock protein 90 (HSP90) in AGS cells. AITC increased DNA-PK, mediator of DNA damage checkpoint protein 1 (MDC1), γH2AXpSer139 , topoisomerase II alpha (TOPIIα), topoisomerase II beta (TOPIIß), HSP90, and heat shock protein 70 (HSP70) in SNU-1 cells. AITC increased p53, p53pSer15 , and p21 but decreased murine double minute 2 (MDM2)pSer166 and O6 -methylguanine-DNA methyltransferase (MGMT) in AGS cells; however, it has a similar effect of AITC except increased ataxia telangiectasia and Rad3 -related protein (ATR)pSer428 , checkpoint kinase 1 (CHK1), and checkpoint kinase 2 (CHK2) in SNU-1 cells. Apparently, both cell responses to AITC are different, nonetheless, all of these observations suggest that AITC inhibits the growth of gastric cancer cells may through induction off DNA damage in vitro.

PW06 Triggered Fas-FADD to Induce Apoptotic Cell Death In Human Pancreatic Carcinoma MIA PaCa-2 Cells through the Activation of the Caspase-Mediated Pathway.

Pancreatic cancer has higher incidence and mortality rates worldwide. PW06 [(E)-3-(9-ethyl-9H-carbazol-3-yl)-1-(2,5-dimethoxyphenyl) prop-2-en-1-one] is a carbazole derivative containing chalcone moiety which was designed for inhibiting tumorigenesis in human pancreatic cancer. This study is aimed at investigating PW06-induced anticancer effects in human pancreatic cancer MIA PaCa-2 cells in vitro. The results showed PW06 potent antiproliferative/cytotoxic activities and induced cell morphological changes in a human pancreatic cancer cell line (MIA PaCa-2), and these effects are concentration-dependent (IC50 is 0.43 µM). Annexin V and DAPI staining assays indicated that PW06 induced apoptotic cell death and DNA condensation. Western blotting indicated that PW06 increased the proapoptotic proteins such as Bak and Bad but decreased the antiapoptotic protein such as Bcl-2 and Bcl-xL. Moreover, PW06 increased the active form of caspase-8, caspase-9, and caspase-3, PARP, releasing cytochrome c, AIF, and Endo G from mitochondria in MIA PaCa-2 cells. Confocal laser microscopy assay also confirmed that PW06 increased Bak and decreased Bcl-xL. Also, the cells were pretreated with inhibitors of caspase-3, caspase-8, and caspase-9 and then were treated with PW06, resulting in increased viable cell number compared to PW06 treated only. Furthermore, PW06 showed a potent binding ability with hydrophobic interactions in the core site of the Fas-Fas death domains (FADD). In conclusion, PW06 can potent binding ability to the Fas-FADD which led to antiproliferative, cytotoxic activities, and apoptosis induction accompanied by the caspase-dependent and mitochondria-dependent pathways in human pancreatic cancer MIA PaCa-2 cells.

Using the Kano model to associate the number of confirmed cases of COVID-19 in a population of 100,000 with case fatality rates: An observational study.

BACKGROUND: An important factor in understanding the spread of COVID-19 is the case fatality rate (CFR) for each county. However, many of research reported CFRs on total confirmed cases (TCCs) rather than per 100,000 people. The disparate definitions of CFR in COVID-19 result in inconsistent results. It remains uncertain whether the incident rate and CFR can be compared to identify countries affected by COVID-19 that are under (or out of) control. This study aims to develop a diagram for dispersing TCC and CFR on a population of 100,000 (namely, TCC100 and CFR100) using the Kano model, to examine selected countries/regions that have successfully implemented preventative measures to keep COVID-19 under control, and to design an app displaying TCC100 and CFR100 for all infected countries/regions. METHODS: Data regarding confirmed cases and deaths of COVID-19 in countries/regions were downloaded daily from the GitHub website. For each country/region, 3 values (TCC100, CFR100, and CFR) were calculated and displayed on the Kano diagram. The lower TCC100 and CFR values indicated that the COVID-19 situation was more under control. The app was developed to display both CFR100/CFR against TCC100 on Google Maps. RESULTS: Based on 286 countries/regions, the correlation coefficient (CC) between TCC100 and CFR100 was 0.51 (t = 9.76) in comparison to TCC100 and CFR with CC = 0.02 (t = 0.3). As a result of the traditional scatter plot using CFR and TCC100, Andorra was found to have the highest CFR100 (=6.62%), TCC100 (=935.74), and CFR (=5.1%), but lower CFR than New York (CFR = 7.4%) and the UK (CFR = 13.5%). There were 3 representative countries/regions that were compared: Taiwan [TCC100 (=1.65), CFR100 (=2.17), CFR (=1%)], South Korea [TCC100 (=20.34), CFR100 (=39.8), CFR (=2%), and Vietnam [TCC100 (=0.26), CFR100 (=0), CFR (=0%)]. CONCLUSION: A Kano diagram was drawn to compare TCC100 against CFT (or CFR100) to gain a better understanding of COVID-19. There is a strong association between a higher TCC100 value and a higher CFR100 value. A dashboard was developed to display both CFR100/CFR against TCC100 for countries/regions.

Bisdemethoxycurcumin suppresses human brain glioblastoma multiforme GBM 8401 cell migration and invasion via affecting NF-κB and MMP-2 and MMP-9 signaling pathway in vitro.

Human glioblastoma (GBM) is one of the common cancer death in adults worldwide, and its metastasis will lead to difficult treatment. Finding compounds for future to develop treatment is urgent. Bisdemethoxycurcumin (BDMC), a natural product, was isolated from the rhizome of turmeric (Curcuma longa), which has been shown to against many human cancer cells. In the present study, we evaluated the antimetastasis activity of BDMC in human GBM cells. Cell proliferation, cell viability, cellular uptake, wound healing, migration and invasion, and western blotting were analyzed. Results indicated that BDMC at 1.5-3 µM significantly decreased the cell proliferation by MTT assay. BDMC showed the highest uptake by cells at 3 h. After treatment of BDMC at 12-48 h significantly inhibited cell motility in GBM 8401 cells by wound healing assay. BDMC suppressed cell migration and invasion at 24 and 48 h treatment by transwell chamber assay. BDMC significantly decreased the levels of proteins associated with PI3K/Akt, Ras/MEK/ERK pathways and resulted in the decrease in the expressions of NF-κB, MMP-2, MMP-9, and N-cadherin, leading to the inhibition of cell migration and invasion. These findings suggest that BDMC may be a potential candidate for the antimetastasis of human GBM cells in the future.

Phenethyl Isothiocyanate Suppresses the Proinflammatory Cytokines in Human Glioblastoma Cells through the PI3K/Akt/NF-κB Signaling Pathway In Vitro.

Phenethyl isothiocyanate (PEITC), extracted from cruciferous vegetables, showed anticancer activity in many human cancer cells. Our previous studies disclosed the anticancer activity of PEITC in human glioblastoma multiforme (GBM) 8401 cells, including suppressing the cell proliferation, inducing apoptotic cell death, and suppressing cell migration and invasion. Furthermore, PEITC also inhibited the growth of xenograft tumors of human glioblastoma cells. We are the first to investigate PEITC effects on the receptor tyrosine kinase (RTK) signaling pathway and the effects of proinflammatory cytokines on glioblastoma. The cell viability was analyzed by flow cytometric assay. The protein levels and mRNA expressions of cytokines, including tumor necrosis factor-α (TNF-α), interleukin-1ß (IL-1ß), and interleukin-6 (IL-6), were determined by enzyme-linked immunosorbent assay (ELISA) reader and real-time polymerase chain reaction (PCR) analysis, respectively. Furthermore, nuclear factor-kappa B- (NF-κB-) associated proteins were evaluated by western blotting. NF-κB expression and nuclear translocation were confirmed by confocal laser microscopy. NF-κB binding to the DNA was examined by electrophoretic mobility shift assay (EMSA). Our results indicated that PEITC decreased the cell viability and inhibited the protein levels and expressions of IL-1ß, IL-6, and TNF-α genes at the transcriptional level in GBM 8401 cells. PEITC inhibited the binding of NF-κB on promoter site of DNA in GBM 8401 cells. PEITC also altered the protein expressions of protein kinase B (Akt), extracellular signal-regulated kinase (ERK), and NF-κB signaling pathways. The inflammatory responses in human glioblastoma cells may be suppressed by PEITC through the phosphoinositide 3-kinase (PI3K)/Akt/NF-κB signaling pathway. Thus, PEITC may have the potential to be an anti-inflammatory agent for human glioblastoma in the future.

Citation trends in ophthalmology articles and keywords in mainland China, Hong Kong, and Taiwan since 2013 using temporal bar graphs (TBGs): Bibliometric analysis.

BACKGROUND: We selected authors from mainland China, Hong Kong, and Taiwan (CHT) to examine citation trends on articles and keywords. The existence of suitable temporal bar graphs (TBGs) for displaying citation trends is unknown. It is necessary to enhance the traditional TBGs to provide readers with more information about the citation trend. The purpose of this study was to propose an advanced TBG that can be applied to understand the most worth-reading articles by ophthalmology authors in the CHT. METHODS: Using the search engine of the Web of Science core collection, we conducted bibliometric analyses to examine the article citation trends of ophthalmology authors in CHT since 2013. A total of 6695 metadata was collected from articles and review articles. Using radar plots, the Y-index, and the combining the Y-index with the CJAL scores (CJAL) scores, we could determine the dominance of publications by year, region, institute, journal, department, and author. A choropleth map, a dot plot, and a 4-quadrant radar plot were used to visualize the results. A TBG was designed and provided for readers to display citation trends on articles and keywords. RESULTS: We found that the majority of publications were published in 2017 (2275), Shanghai city (935), Sun Yat-Sen University (China) (689), the international journal Ophthalmology (1399), the Department of Ophthalmology (3035), and the author Peizeng Yang (Chongqing) (65); the highest CAJL scores were also from Guangdong (2767.22), Sun Yat-Sen University (China) (2147.35), and the Ophthalmology Department (7130.96); the author Peizeng Yang (Chongqing) (170.16) had the highest CAJL; and the enhanced TBG features maximum counts and recent growth trends that are not included in traditional TBGs. CONCLUSION: Using the Y-index and the CJAL score compared with research achievements of ophthalmology authors in CHT, a 4-quadrant radar plot was provided. The enhanced TBGs and the CJAL scores are recommended for future bibliographical studies.

Tetrandrine Enhances H2O2-Induced Apoptotic Cell Death Through Caspase-dependent Pathway in Human Keratinocytes.

BACKGROUND: Tetrandrine, a bis-benzylisoquinoline alkaloid, induces apoptosis of many types of human cancer cell. Hydrogen peroxide (H2O2) is a reactive oxygen species inducer; however, there are no reports to show whether pre-treatment of tetrandrine with H2O2 induces more cell apoptosis than H2O2 alone. Thus, the present study investigated the effects of tetrandrine on H2O2-induced cell apoptosis of human keratinocytes, HaCaT, in vitro. MATERIALS AND METHODS: HaCaT cells were pre-treated with and without tetrandrine for 1 h, and then treated with H2O2 for examining cell morphological changes and cell viability using contrast-phase microscopy and propidium iodide (PI) exclusion assay, respectively. Cells were measured apoptotic cell death by using annexin V/PI double staining and further analyzed by flow cytometer. Cells were further assessed for DNA condensation using 2-(4-amidinophenyl)-6-indolecarbamidine staining. Western blotting was used to measure expression of apoptosis-associated proteins and confocal laser microscopy was used to measure the protein expression and nuclear translocation from the cytoplasm to nuclei. RESULTS: Pre-treatment of tetrandrine for 1 h and treatment with H2O2 enhanced H2O2-induced cell morphological changes and reduced cell viability, whilst increasing apoptotic cell death and DNA condensation. Furthermore, tetrandrine significantly increased expression of reactive oxygen species-associated proteins such as superoxide dismutase (Cu/Zn) and superoxide dismutase (Mn) but significantly reduced the level of catalase, which was also confirmed by confocal laser microscopy. It also increased expression of DNA repair-associated proteins ataxia telangiectasia mutated, ataxia-telangectasia and Rad3-related, phospho-P53, P53 and phosphorylated histone H2AX, and of pro-apoptotic proteins BCL2 apoptosis regulator-associated X-protein, caspase-3, caspase-8, caspase-9 and poly ADP ribose polymerase in HaCaT cells. CONCLUSION: These are the first and novel findings showing tetrandrine enhances H2O2-induced apoptotic cell death of HaCaT cells and may provide a potent approach for the treatment of proliferated malignant keratinocytes.

Age and axial length on peripapillary retinal nerve fiber layer thickness measured by optical coherence tomography in nonglaucomatous Taiwanese participants.

PURPOSE: This study investigates the influence of age and axial length (AL) on the peripapillary retinal nerve fiber layer (RNFL) thickness, as measured by optical coherence tomography (OCT). METHODS: Healthy patients visiting an eye clinic at a county hospital were recruited. All participants underwent comprehensive ophthalmologic examinations, and their retinas were scanned using 3D OCT-1000. In total, 223 patients with 446 eyes were included. The mean age and AL were 42.07 ± 13.16 (21-76) years and 25.38 ± 1.73 (21.19-30.37) mm, respectively. RESULTS: The average RNFL thickness decreased by 2.71 µm for every 10-year increase in age (P < 0.001). Age-related RNFL thinning was more significant in participants older than 41 years (-0.24µm/year; P = 0.015). The earliest sector showing a significant decline in RNFL thickness was after 35 years of age (-0.70µm/year; P = 0.011) at the superior quadrant and at the 1-2 o'clock hour (-1.42µm/year; P = 0.009). Meanwhile, the maximal rate of age-associated RNFL decay was observed in these two regions as well. The reduction of RNFL with age progression did not differ in eyes with long AL (> 27 mm; -0.16µm/year) or those with short AL (< 25 mm; -0.22µm/year). For every 1-mm-greater AL, RNFL was thinner by 1.78 µm (P < 0.001). The inferior quadrant showed the greatest tendency of RNFL decline with longer AL (4.46 µm/mm; P < 0.001). CONCLUSIONS: The factors of age and AL should be considered when interpreting the results. Significantly age-associated RNFL thinning was found in participants older than 41 years. Reduction of RNFL thickness with increasing age was not affected by AL. Topographic variations in RNFL thinning were observed in that the maximal decline of RNFL thickness with advancing age at the superior quadrant whereas with elongation of AL at the inferior quadrant.

Association Between Statin Use and Open-angle Glaucoma in Hyperlipidemia Patients: A Taiwanese Population-based Case-control Study.

The aim of the study was to investigate the association between statin use and open-angle glaucoma (OAG) risk in hyperlipidemia patients.We used the research database of the Taiwan National Health Insurance program to conduct a population-based case-control study. A total of 1276 patients with newly diagnosed OAG were identified from 2004 to 2011. Controls comprised of 12,760 patients without glaucoma and were frequency-matched for age, sex, history of diabetes mellitus, and year of hyperlipidemia diagnosis at a 1:10 ratio. Accumulated defined daily doses (DDDs) of statins prescribed during follow-up were calculated. Average statin use was calculated as the sum of DDDs divided by the duration from the initial statin prescription date to the index date (per year), and was subdivided into 3 levels: <30, 30 to 119, and ≥120 DDDs. Comorbidity, including hypertension, depression, and the Charlson comorbidity index, the frequency of eye care visits, and the use of nonstatin cholesterol-lowering drugs, were all considered as confounding factors.For the group with statin use, the adjusted odds ratio of OAG was 1.02 (95% confidence interval 0.90-1.15) when compared with the group without statin use. Subanalysis showed that a high dosage of statin use (≥120 DDD/y) resulted in a1.24-fold increased risk of OAG (odds ratio 1.24, 95% confidence interval 1.03-1.49). The incidence of OAG was increased with the increase of the dosage of statin use (P for trend = 0.0458).Clinicians should be cautious of hyperlipidemia patients with a high dosage of statin use because it might be associated with an increased risk of OAG. Ophthalmologist consultation is necessary for this high-risk group.

beta-Naphthoflavone protects from peritonitis by reducing TNF-alpha-induced endothelial cell activation.

ß-Naphthoflavone (ß-NF), a ligand of the aryl hydrocarbon receptor, has been shown to possess anti-oxidative properties. We investigated the anti-oxidative and anti-inflammatory potential of ß-NF in human microvascular endothelial cells treated with tumor necrosis factor-alpha (TNF-α). Pretreatment with ß-NF significantly inhibited TNF-α-induced intracellular reactive oxygen species, translocation of p67(phox), and TNF-α-induced monocyte binding and transmigration. In addition, ß-NF significantly inhibited TNF-α-induced ICAM-1 and VCAM-1 expression. The mRNA expression levels of the inflammatory cytokines TNF-α and IL-6 were reduced by ß-NF, as was the infiltration of white blood cells, in a peritonitis model. The inhibition of adhesion molecules was associated with suppressed nuclear translocation of NF-κB p65 and Akt, and suppressed phosphorylation of ERK1/2 and p38. The translocation of Egr-1, a downstream transcription factor involved in the MEK-ERK signaling pathway, was suppressed by ß-NF treatment. Our findings show that ß-NF inhibits TNF-α-induced NF-kB and ERK1/2 activation and ROS generation, thereby suppressing the expression of adhesion molecules. This results in reduced adhesion and transmigration of leukocytes in vitro and prevents the infiltration of leukocytes in a peritonitis model. Our findings also suggest that ß-NF might prevent TNF-α-induced inflammation.

Retinal nerve fibre layer thickness and optic nerve head size measured in high myopes by optical coherence tomography.

BACKGROUND: The retinal nerve fibre layer (RNFL) thickness is reportedly decreased in myopia; however, magnification adjustment is an important consideration when using optical coherence tomography (OCT) to evaluate myopic eyes. In this study, RNFL thickness and optic nerve head (ONH) size were measured in highly myopic eyes with and without magnification adjustments. The measurements were compared with magnification-adjusted OCT measurements of emmetropic control eyes. METHODS: In this cross-sectional study, RNFL thickness (global circle and quadrants) and ONH size (disc and rim areas) were measured in one eye of each of 70 participants with high myopia. Magnification-adjusted measurements taken in the high myopes were then compared with magnification-adjusted measurements taken in 70 emmetropic controls. RESULTS: Comparisons of magnification-adjusted measurements between highly myopic and emmetropic control eyes showed that the highly myopic eyes had significantly thicker global and temporal RNFLs (p < 0.05), significantly thinner nasal RNFL (p < 0.05), and significantly larger disc and rim areas (p < 0.05). Superior and inferior RNFL thickness measurements did not differ significantly between the two groups (p > 0.05). CONCLUSION: The OCT measurements obtained with magnification adjustment show global and temporal RNFL thicknesses and ONH size increase in highly myopic eyes.

Dextromethorphan attenuates LPS-induced adhesion molecule expression in human endothelial cells.

OBJECTIVE: This study examines the effect of Dextromethorphan (d-3-methoxy-17-methylmorphinan; DXM), a commonly used cough-suppressing drug, on the expression of VCAM-1 and ICAM-1 in human umbilical vein endothelial cells (HUVECs) stimulated with lipopolysaccharide (LPS). METHODS: The effect of DXM on expression of cell adhesion molecules induced by LPS was evaluated by monocyte bindings in vitro and ex vivo and transmigration assays. The signaling pathways involved in the inflammation inhibitory effect of DXM were analyzed by Western blot and immunofluorescent stain. RESULTS: Pretreatment of HUVECs with DXM inhibited LPS-induced adhesion of THP-1 cells in vitro and ex vivo, and reduced transendothelial migration of these cells. Furthermore, treatment of HUVECs with DXM can significantly decrease LPS-induced expression of ICAM-1 and VCAM-1. DXM abrogated LPS-induced phosphorylation of ERK and Akt. The translocation of early growth response gene-1 (Egr-1), a downstream transcription factor involved in the mitogen-activated kinase (MEK)-ERK signaling pathway, was suppressed by DXM treatment. Furthermore, DXM inhibited LPS-induced IκBα degradation and nuclear translocation of p65. CONCLUSIONS: Dextromethorphan inhibits the adhesive capacity of HUVECs by reducing the LPS-induced ICAM-1 and VCAM-1 expression via the suppression of the ERK, Akt, and NF-κB signaling pathways. Thus, DXM is a potential anti-inflammatory therapeutic that may modulate atherogenesis.

Effects of age and disc area on optical coherence tomography measurements and analysis of correlations between optic nerve head and retinal nerve fibre layer.

BACKGROUND: The aim here was to investigate whether optic nerve head (ONH) parameters or retinal nerve fibre layer (RNFL) thickness correlate with age or disc area and whether the neuroretinal rim correlates with RNFL thickness. METHODS: This cross-sectional study enrolled 133 healthy subjects and analysed one randomly selected eye of each subject. All measurements of ONH parameters (including neuroretinal rim, disc and cup areas and cup-to-disc ratios) and RNFL thickness (global and quadrants) were taken by a single experienced operator using optical coherence tomography (OCT). RESULTS: Of the rim parameters analysed, average nerve width (the height of the nerve fibre bundle) was independent of age or disc area (p > 0.05). Disc area correlated positively with cup area (p < 0.05) but not with cup-to-disc ratios (p > 0.05). Of the RNFL thickness measurements analysed, temporal RNFL was independent of both age and disc area (p > 0.05). According to the analysis of the correlation between RNFL thickness and neuroretinal rim, global or non-temporal RNFL correlated positively with horizontal integrated rim width (p < 0.05, F > 4.000) and temporal RNFL was independent of all rim parameters (p > 0.05, F < 4.000). CONCLUSION: Aging effect on neuroretinal rim loss or RNFL thickness change is non-uniform, and age is not a constant confounder when using OCT. The temporal RNFL is independent of age, disc area and neuroretinal rim.

Etiology of ocular diseases in elderly Amis aborigines in Eastern Taiwan (The Amis Eye Study).

PURPOSE: To determine the incidence of and risk factors associated with major ocular diseases in the elderly Amis population of Taiwan. METHODS: This population-based cross-sectional study is the most current survey of ocular diseases among elderly Amis. The overall response rate was 61.2%, with 2316 participants screened. All ocular examinations were performed using a mobile ophthalmology setup staffed by an ophthalmologist with 30 years of experience. RESULTS: The mean age of the participants was 71.65 years. Cataracts were the most common ocular disease (82.6%), followed by pterygium (44.1%), arteriosclerotic changes in retinal vessels (35.7%), hypertensive retinopathy (18.5 %), age-related macular degeneration (5.2%), optic neuropathy (4.6%), corneal opacity (4.6%), and diabetic retinopathy (3.3%). Glaucoma (1.0%) and high myopia (0.39%) were minor ocular diseases among elderly Amis. The prevalence of diabetes was 15.4% and that of hypertension was 40.0%. CONCLUSIONS: Treatable diseases such as cataracts and pterygium were the most common ocular diseases in the Amis tribes. The relatively low incidence of glaucoma was likely due to the unique genetic background of this population.

Analysis of actual corneal flap thickness and confounding factors between first and second operated eyes.

BACKGROUND AND OBJECTIVE: To calculate the actual corneal flap thickness during laser in-situ keratomileusis. PATIENTS AND METHODS: Fifty-four women and 26 men with refractive error were enrolled in the study. Flaps were created using a MK-2000 microkeratome (Nidek, Gamagori, Japan) with a 130-microm head. The comparisons between both operated eyes of a patient and the correlations between flap thickness and confounding factors were analyzed. RESULTS: The average flap thicknesses were 134.0 + or - 16.5 and 112.3 + or - 14.4 microm in the first and second operated eye groups, respectively, and the data showed a significant difference between the two groups (P < .001). There were positive correlations between central corneal thickness and flap thickness (first group, P = .017; second group, P = .041). CONCLUSION: The flap thicknesses of the first operated eye group were thicker than those of the second operated eye group and there was a positive correlation between the flap thickness and central corneal thickness. The coefficient of variation of the flap thickness was greater in the second group than in the first group.

Intraocular pressure assessment in both eyes of the same patient after laser in situ keratomileusis.

PURPOSE: To measure intraocular pressure (IOP) after laser in situ keratomileusis (LASIK) in both eyes of the same patient and analyze the correlation between IOP measurement and keratometric (K) power, central corneal thickness (CCT), and laser ablation depth. SETTING: Private practice, Kaohsiung, Taiwan. METHODS: This prospective cohort study enrolled patients with myopia or myopic astigmatism. In all patients, the targeted post-LASIK spherical equivalent was within +/-0.25 diopter. The IOP was measured using noncontact tonometry; K power, by autokeratorefractometry; and CCT, by ultrasound pachymetry. Laser ablation depth was determined using the excimer laser's software, and the ratio of laser ablation depth to decreased IOP was calculated. Correlations were determined by stepwise multiple regression analysis and the Mann-Whitney U test. RESULTS: High preoperative IOP was significantly associated with high postoperative IOP (P<.001) and with a large decrease in IOP (P<.001). Thus, 62.7% and 37.5% of postoperative IOP and decreased IOP measurements, respectively, were explainable by the preoperative IOP. Postoperative IOP (P = .904), decreased IOP after LASIK (P = .479), and the ratio of laser ablation depth to decreased IOP (P = .971) did not significantly differ and were positively correlated (P<.001) between eyes of the same patient. CONCLUSIONS: The IOP measurement reduction after LASIK was greater in cases of higher preoperative IOP and smaller in cases of lower preoperative IOP. The IOP measurements after LASIK were not significantly associated with laser ablation depth, and the measurements were similar and proportional in eyes of the same patient.

Homonymous hemianopia caused by solitary skull metastasis of hepatocellular carcinoma.

We report a patient who developed a complete left homonymous hemianopia from mass effect of a solitary skull metastasis of hepatocellular carcinoma (HCC). After chemoembolization and resection, the visual field defect improved markedly. This is the first reported case demonstrating this phenomenon in HCC. It supports aggressive treatment of a solitary skull metastasis in this setting.

Analysis of retinal nerve fiber layer and macular thickness measurements in healthy Taiwanese individuals using optical coherence tomography (Stratus OCT).

PURPOSE: To investigate the reproducibility of peripapillary retinal nerve fiber layer (RNFL) and macular thickness measurements in healthy Taiwanese subjects using optical coherence tomography (Stratus OCT). METHODS: Fifty-two eyes of 52 healthy Taiwanese subjects (32 females and 20 males) were enrolled in the cross-sectional study. A randomly chosen single eye from each healthy subject underwent thickness measurements using OCT, before and after pupillary dilation, by 3 trained and experienced operators. Average measurements of peripapillary RNFL and macular thickness were calculated. Comparisons of thickness measurements before and after pupillary dilation, and among the 3 operators were performed. RESULTS: The RNFL thickness measurements were higher in the inferior peripapillary area by RNFL scan (average: 107.4+/-17.8 microm) and the macular thickness measurements showed a ring-shaped hump in the 3 mm perifoveal area by macular scan (average: 252.8+/-8.9 microm). Comparing the peripapillary RNFL and macular thickness before and after pupillary dilation, there was no significant difference (P>0.05) in average, superior, inferior, temporal, or nasal peripapillary areas, in total macular volume and foveal thickness, nor in 1, 3, and 6-mm perifoveal areas, whether before or after pupillary dilation and irrespective of which operator performed the measurements. CONCLUSIONS: The inferior RNFL area and the 3-mm perifoveal area showed higher thickness measurements in the peripapillary region and macular region, respectively. The thickness measurements performed using OCT showed no significant differences before and after pupillary dilation, and showed good reproducibility.

Comparison of vitrectomy alone and combined vitrectomy, phacoemulsification and intraocular lens implantation for proliferative diabetic retinopathy.

There have been concerns that there may be an increased incidence of iris neovascularization (NV) following lens removal in patients with proliferative diabetic retinopathy (PDR). In this study, we retrospectively compared vitrectomy alone and vitrectomy combined with phacoemulsification (phacovitrectomy) and intraocular lens implantation regarding both complications and results. Fifty-three eyes for vitrectomy group and 31 eyes for phacovitrectomy group were included. Postoperative iris and angle NV were found in eight (15.1%) eyes in the first group and no (0%) eyes in the second. The incidence was significantly lower (p < 0.05) in the phacovitrectomy group. The final vision gain of one or more lines was found in 17 (32.1%) and 21 (67.7%) eyes, respectively. There was significantly better vision improvement in the phacovitrectomy group. We consider the combined procedure to be useful as an alternative surgical treatment for patients with PDR and cataract formation.