Public effect of the 2022 Colorectal Cancer Awareness Campaign delivered through a metaverse platform.

Purpose: The Korean Society of Coloproctology has been conducting Colorectal Cancer Awareness Campaign, also known as the Gold Ribbon Campaign, every September since 2007. The 2022 campaign was held through a metaverse platform targeting the younger age group under the slogan of raising awareness of early-onset colorectal cancer (CRC). This study aimed to analyze the impact of the 2022 campaign on a metaverse platform. Methods: Anonymized survey data were collected from participants in the metaverse campaign from September 1 to 15, 2022. The satisfaction score of the participants was evaluated by sex, age group, and previous campaign participation status. Results: During the campaign, 2,770 people visited the metaverse. Among them, 455 people participated in the survey (response rate, 16.4%). Approximately 95% of the participants reported being satisfied with the information provided by the campaign, understood the necessity of undergoing screening for and prevention of early-onset CRC, and were familiar with the structure of the metaverse. The satisfaction score for campaign information tended to decrease as the participants' age increased. When the participants' overall level of satisfaction with the metaverse platform was assessed, teenagers scored particularly lower than the other age groups. The satisfaction scores for CRC information provided in the metaverse, as well as the scores for recognizing the seriousness and necessity of screening for early-onset CRC, indicated a high positive tendency (P<0.001). Conclusion: Most of the 2022 Gold Ribbon Campaign participants were satisfied with the metaverse platform. Medical society should pay attention to increasing participation in and satisfaction with future public campaigns.

Risk factors for visual field progression of normal-tension glaucoma in patients with myopia.

OBJECTIVE: To identify risk factors for visual field progression of normal-tension glaucoma (NTG) in patients with myopia. DESIGN: Longitudinal, observational study. PARTICIPANTS: Fifty-one eyes of 51 NTG patients with myopia (less than -0.75D based on spherical equivalence) who had undergone visual field (VF) testing at least once per year for ≥6 years between November 2005 and December 2013. METHODS: Progression was defined using event-based guided progression analysis. Risk factors were analyzed using the Cox proportional hazards model and further tested for independence in a multivariate model. RESULTS: The mean observation period was 7.0 ± 1.3 years, and 16 of 51 subjects showed progression. In the univariate analysis, abnormal retinal nerve fibre layer (RNFL) colour codes (yellow or red sector) at the 11, 10, and 7 o'clock positions on optical coherence tomography showed significant associations with the VF progression (p = 0.03, 0.03, and 0.01, respectively). In the final multivariate models, the abnormal RNFL colour code of the 7 o'clock sector (inferotemporal sector) was the only significant risk factor for progression (hazard ratio = 4.07 and 4.37; 95% CI, 1.11-14.92 and 1.27-15.04; p = 0.03 and 0.02, respectively). CONCLUSIONS: Inferotemporal RNFL thinning could be a risk factor for progression in NTG patients with myopia.

Estimated Prevalence of Glaucoma in South Korea Using the National Claims Database.

Purpose. To estimate the prevalence of glaucoma and costs associated with glaucoma care in South Korea between 2008 and 2013 using the Korean national claims database. Design. Retrospective cross-sectional study from a national claims database. Methods. Patients who were diagnosed with glaucoma between 2008 and 2013 were retrospectively identified in the national claims database using glaucoma diagnostic codes. For each year, the prevalence of glaucoma and direct medical costs associated with glaucoma care were estimated. Result. The prevalence of glaucoma in patients ≥40 years of age increased from 0.79% in 2008 to 1.05% in 2013. The number of patients with glaucoma increased by 54% between 2008 and 2013 (9% average annual increase). The prevalence of glaucoma increased with age and was higher in males than in females. The cost to care for glaucoma patients increased from $16.5 million in 2008 to $29.2 million in 2013, which translated into an 81% increase over the 6 years examined (12.7% average annual increase). Conclusion. The estimated prevalence and socioeconomic burden of glaucoma have steadily increased each year in South Korea. Nevertheless, many glaucoma patients remain undiagnosed in the present study using national claims database.

Protective effect of etanercept, an inhibitor of tumor necrosis factor-α, in a rat model of retinal ischemia.

BACKGROUND: To assess the neuroprotective effect of etanercept (Enbrel®) which is a commercialized Tumor necrosis factor-α (TNF-α) inhibitor on axonal injury in an animal model of acute ischemia. METHODS: Acute ischemia was induced by intraocular pressure elevation in 36 rats. The treatment groups underwent subcutaneous injection of etanercept (0.3 or 1.0 mg/kg) three times per week up to 4 weeks. The control groups were treated in the same manner using the same volume of phosphate-buffered saline (PBS). Optic nerve damage was evaluated by counting the number of axons under a transmission electron microscope. Microglial cell activity was assessed using Iba1 and CD68. RESULTS: After induction of ischemia, the ratio of preserved axons was significantly greater in the 2-week 1.0-mg/kg etanercept-treated group than in the PBS-treated group (p = 0.062). The 4-week 0.3-mg/kg and 1.0-mg/kg etanercept-treated groups also showed significantly higher ratios of preserved axons than did the PBS-treated group (p = 0.021 and 0.003, respectively). The expression of Iba1 and CD68 in the optic nerve was lower in the etanercept-treated groups than in the PBS-treated groups. Immunohistochemical staining using rabbit anti-Iba1 antibody showed that the amount of microglia at the optic nerve head was noticeably lower in the etanercept-treated groups than in the PBS-treated groups. CONCLUSIONS: Etanercept significantly suppressed optic nerve injury in this rat model of acute ischemia. This in vivo study suggests that etanercept might be a novel neuroprotective treatment agent for TNF-α-related disease.

Cigarette Smoke Extract Causes Injury in Primary Retinal Ganglion Cells via Apoptosis and Autophagy.

AIMS: To investigate whether tobacco smoke directly injures retinal ganglion cells (RGCs) and to evaluate the mechanisms of cell death. METHODS: Primary rat RGCs were harvested from 3- or 4-day-old newborn rats and exposed to cigarette smoke extract (CSE). Cell viability was determined by adenosine 5'-triphosphate (ATP) assay. Apoptosis was evaluated by terminal deoxynucleotidyl transferase (TdT)-mediated deoxyuridine triphosphate (dUTP) nick-end labeling (TUNEL) and real-time reverse transcription polymerase chain reaction (RT-PCR) for Bcl-2 family. Autophagy was also assessed by Western immunoblots for light chain (LC) 3B. RESULTS: When the primary RGCs were exposed to CSE for 2 h, cell viability decreased in a dose-dependent manner, as measured by ATP assay. In the presence of 0.05% CSE, the RGC viability was 77.68% ± 7.60% compared to the control cells; in the presence of 1.0% CSE, viability was 47.48% ± 2.56% of the control cells. As determined by TUNEL, CSE increased the apoptotic RGCs in a dose-dependent manner. In the presence of 0.05% CSE, the apoptosis was 26.55% ± 1.97% of the control cells; in the presence of 2.5% CSE, it was 41.07% ± 3.75% of the control cells. When apoptosis was evaluated using real-time RT-PCR, exposure to 0.05% CSE resulted in significantly increased expression of Bad, Bax, Bcl-2, and Bcl-XL mRNA. When autophagy was assessed by Western immunoblots, exposure to 0.05% CSE significantly increased the expression of LC3B II. CONCLUSIONS: Our data suggest that CSE directly injures primary RGCs, and both cell death mechanisms of apoptosis and autophagy seem to be related to this CSE-induced RGC damage.

Effect of trabeculectomy on the accuracy of intraocular lens calculations in patients with open-angle glaucoma.

BACKGROUND: The objective of the study is to examine the effect of trabeculectomy on intraocular lens power calculations in patients with open-angle glaucoma (OAG) undergoing cataract surgery. DESIGN: The design is retrospective data analysis. PARTICIPANTS: There are a total of 55 eyes of 55 patients with OAG who had a cataract surgery alone or in combination with trabeculectomy. METHODS: We classified OAG subjects into the following groups based on surgical history: only cataract surgery (OC group), cataract surgery after prior trabeculectomy (CAT group), and cataract surgery performed in combination with trabeculectomy (CCT group). MAIN OUTCOME MEASURES: Differences between actual and predicted postoperative refractive error. RESULTS: Mean error (ME, difference between postoperative and predicted SE) in the CCT group was significantly lower (towards myopia) than that of the OC group (P = 0.008). Additionally, mean absolute error (MAE, absolute value of ME) in the CAT group was significantly greater than in the OC group (P = 0.006). Using linear mixed models, the ME calculated with the SRK II formula was more accurate than the ME predicted by the SRK T formula in the CAT (P = 0.032) and CCT (P = 0.035) groups. CONCLUSIONS: The intraocular lens power prediction accuracy was lower in the CAT and CCT groups than in the OC group. The prediction error was greater in the CAT group than in the OC group, and the direction of the prediction error tended to be towards myopia in the CCT group. The SRK II formula may be more accurate in predicting residual refractive error in the CAT and CCT groups.

Retinal Nerve Fiber Layer Thickness is Decreased in Patients With Hematologic Malignancy.

PURPOSE: To investigate whether retinal nerve fiber layer (RNFL) thickness is decreased in patients with hematologic malignancy using optical coherence tomography (OCT). PATIENTS AND METHODS: This prospective, observational cross-sectional study included 65 eyes from 34 patients with hematologic malignancy and 72 healthy control eyes. OCT-measured RNFL thickness parameters (average, 4 quadrants, and 12 clock-hour thickness) and RNFL defect in red-free photo were compared between patients with hematologic malignancy and controls. RESULTS: Among average, quadrant, and clock-hour map, the only 11-o'clock RNFL in patients with hematologic malignancy was statistically thinner than in controls (P=0.021). The RNFL defect was detected in 21/65 (32.3%) patients with hematologic malignancy and in 5/72 (6.9%) controls (P<0.001). In patients with hematologic malignancy, the mean RNFL thickness was significantly lower in the severe and moderate anemia groups compared with the mild anemia group (P=0.011). In the generalized estimating equations model, the mean hemoglobin level was associated with RNFL thickness while correcting for inter-eye correlation, age, and refraction error (coefficient=3.685, P=0.006). CONCLUSIONS: The RNFL defect was frequently observed, and the RNFL was thinner in severe anemic patients with hematologic malignancy. These results suggest that chronic anemia may be a factor of RNFL loss.

Risk Factors of Disease Progression After Cataract Surgery in Chronic Angle-closure Glaucoma Patients.

PURPOSE: To evaluate clinical risk factors of disease progression after cataract surgery using phacoemulsification with posterior chamber intraocular lens implantation, in eyes with chronic angle-closure glaucoma (CACG) and coexisting cataract. DESIGN: Retrospective study. METHODS: The data of 56 eyes of 45 CACG patients who had undergone uncomplicated phacoemulsification with posterior chamber intraocular lens implantation were retrospectively analyzed. Disease progression was defined as glaucomatous optic nerve change or visual field (VF) deterioration according to the European Glaucoma Society guideline. Correlations between VF progression and various preoperative and postoperative factors were determined by χ and independent t tests. Linear regression analysis [(odds ratio (OR)] was used to determine predictive risk factors for disease progression using univariate and multivariate analyses. RESULTS: The mean postoperative follow-up period was 45.13 ± 17.54 (24 to 84) months. Fourteen eyes (25%) with cataracts diagnosed with CACG progressed after phacoemulsification, but the remaining 42 eyes (75%) did not. According to univariate analysis, disease progression was significantly associated with older age, more number of preoperative/postoperative antiglaucoma drugs, higher scores of preoperative pattern standard deviation, and lower scores of preoperative and postoperative visual field index (VFI) (P<0.05). Using multivariate analysis, a lower score of preoperative VFI (OR: 0.86, P=0.044) and lower postoperative intraocular pressure (IOP) reduction, which was not sustained below 20% less than the preoperative mean IOP, were significantly correlated with disease progression after cataract surgery (OR: 8.44, P=0.048). CONCLUSIONS: CACG patients with low preoperative VFI and high postoperative IOP are at risk for disease progression even after uncomplicated cataract surgery.

Frequency, Type and Cause of Artifacts in Swept-Source and Cirrus HD Optical Coherence Tomography in Cases of Glaucoma and Suspected Glaucoma.

PURPOSE: To evaluate and compare the frequency, type and cause of imaging artifacts incurred when using swept-source optical coherence tomography (SS OCT) and Cirrus HD OCT in the same patients on the same day. MATERIALS AND METHODS: From left eye OCT results of 72 patients, disc area and macular area data could be compared between the two types of OCT. For each scan, the final printout report and source data were examined. For comparison between the two types of OCT, only source image data were used because of differences in the final printout report format. RESULTS: There were no significant differences in the artifact frequencies between the two groups in either area (disc area: 35.9% of SS OCT, 42.2% of Cirrus OCT, p = 0.523; Macular area: 24.2% of SS OCT, 22.7% of Cirrus OCT, p = 1.00). The overall results of artifact comparison between the two types of OCTs also showed no significant differences. Boundary misidentification was the most common type of artifact observed, and ocular pathology was the most common cause of artifact in both types of OCTs. Among ocular pathologies, the epiretinal membrane (ERM) was the most common cause of OCT artifact production in both types of OCTs. CONCLUSIONS: There was no significant difference in the frequency, type and cause of artifacts between SS OCT and Cirrus HD OCT. Artifacts in OCT can influence the interpretation of OCT results. In particular, ERM around the optic disc could contribute to OCT artifacts and should be considered in glaucoma diagnosis or during patient follow-up using OCT.

Relationship between Peripapillary Retinal Nerve Fiber Layer Thickness Measured by Optical Coherence Tomography and Visual Field Severity Indices.

PURPOSE: Though there are many reports regarding the structure-function relationship in glaucoma, they are too complicated to apply to the routine clinical setting. The aim of this study was to investigate the direct relationship between peripapillary retinal nerve fiber layer (RNFL) thickness measured by optical coherence tomography (OCT) and visual field (VF) severity indices computed by standard automated perimetry. METHODS: This cross-sectional comparative study included 104 glaucomatous patients and 59 healthy subjects. Peripapillary RNFL thickness was measured by spectral domain (SD) and time domain (TD) OCTs. Four glaucoma VF severity indices, including mean deviation (MD), pattern standard deviation (PSD), Collaborative Initial Glaucoma Treatment Study (CIGTS) VF score, and Advanced Glaucoma Intervention Study (AGIS) VF score, were calculated using standard automated perimetry. The Pearson's correlation coefficients (r) between the average and quadrants of peripapillary RNFL thicknesses and the four VF severity indices were calculated. RESULTS: In glaucomatous eyes, the r value between the average RNFL thickness measured by SD OCT and each VF severity index were 0.562, -0.514, -0.577, and -0.567 for the MD, PSD, CIGTS VF score, and AGIS VF score, respectively (all p < 0.001). Among each quadrant, the inferior RNFL thickness showed the largest r value; 0.587, -0.552, -0.613, and -0.598 for the MD, PSD, CIGTS VF score, and AGIS VF score, respectively (all p < 0.001). Measurements by TD OCT showed similar strengths of association with SD OCT. CONCLUSIONS: Moderate correlation was identified between peripapillary RNFL thicknesses measured by SD/TD OCT and glaucoma VF severity indices. Among each quadrant, the inferior RNFL thickness showed the greatest association with glaucoma VF severity indices. There was no significant difference according to the type of VF severity index or the type of OCTs.

Artificial Neural Network Approach for Differentiating Open-Angle Glaucoma From Glaucoma Suspect Without a Visual Field Test.

PURPOSE: To increase the effectiveness of treating open-angle glaucoma (OAG), we tried to find a screening method of differentiating OAG from glaucoma suspect (GS) without a visual field (VF) test. METHODS: Data were collected from the Korean National Health and Nutrition Examination Survey (KNHANES) conducted in 2010. Of 8958 participants, 386 suspected OAG subjects underwent a VF test. For the training dataset, five OAG risk prediction models were created using multivariate logistic regression and an artificial neural network (ANN) with various clinical variables. Informative variables were selected by an algorithm of consistency subset evaluation, and cross validation was used to optimize performance. The test dataset was used subsequently to assess OAG-prediction performance using the area under the curve (AUC) of the receiver-operating characteristic. RESULTS: Among five OAG risk prediction models, an ANN model with nine noncategorized factors had the greatest AUC (0.890). It predicted OAG with an accuracy of 84.0%, sensitivity of 78.3%, and specificity of 85.9%. It included four nonophthalmologic factors (sex, age, menopause, and duration of hypertension) and five ophthalmologic factors (IOP, spherical equivalent refractive errors, vertical cup-to-disc ratio, presence of superotemporal retinal nerve fiber layer [RNFL] defect, and presence of inferotemporal RNFL defect). CONCLUSIONS: Though VF tests are considered the most important examination to distinguish OAG from GS, they sometimes are impractical to conduct for small private eye clinics and during large scale medical check-ups. The ANN approach may be a cost-effective screening tool for differentiating OAG patients from GS subjects.

Brimonidine reduces TGF-beta-induced extracellular matrix synthesis in human Tenon's fibroblasts.

BACKGROUND: Brimonidine is a highly selective α2 adrenergic agonist that has been widely used in anti-glaucoma eyedrops. The aim of this study was to investigate its putative anti-fibrotic role in the fibrosis caused by activated Tenon's fibroblasts. METHODS: Primary cultured human Tenon's fibroblasts were exposed to 2.0 ng/mL of transforming growth factor-ß1 (TGF-ß1) for up to 48 h. In the presence of various concentrations of brimonidine (from 0.0 to 10.0 µM), the expression levels of fibronectin, collagen types I and III, and ß-actin were determined by Western immunoblots. The expression of phosphorylated SMAD2/3 (p-SMAD2/3) was then evaluated using immunofluorescence. RESULTS: TGF-ß1 significantly increased the synthesis of fibronectin and collagens in human Tenon's fibroblasts; however brimonidine treatment distinctly attenuated the TGF-ß1-induced production of extracellular matrix (ECM) proteins. TGF-ß1 also changed the cellular morphology to be plump, while brimonidine treatment returned the cells to a spindle shape, similar to control fibroblasts. Regarding p-SMAD2/3, brimonidine treatment did not show any apparent changes in its expression. CONCLUSIONS: Our data revealed that brimonidine reduces TGF-ß-induced ECM synthesis in human Tenon's fibroblasts in vitro. This finding implies that topical administration of brimonidine may be helpful in reducing the fibrosis caused by the long-term use of topical anti-glaucoma medications.

Surgical results of trabeculectomy and Ahmed valve implantation following a previous failed trabeculectomy in primary congenital glaucoma patients.

PURPOSE: To compare the surgical results of trabeculectomy and Ahmed glaucoma valve implantation after a previous failed trabeculectomy. METHODS: A retrospective comparative case series review was performed on 31 eye surgeries in 20 patients with primary congenital glaucoma who underwent trabeculectomy or Ahmed glaucoma valve implantation after a previous failed trabeculectomy with mitomycin C. RESULTS: The preoperative mean intraocular pressure was 25.5 mmHg in the trabeculectomy group and 26.9 mmHg in the Ahmed glaucoma valve implantation group (p = 0.73). The 48-month postoperative mean intraocular pressure was 19.6 mmHg in the trabeculectomy group and 20.2 mmHg in the Ahmed glaucoma valve implantation group (p = 0.95). The 12-month trabeculectomy success rate was 69%, compared with 64% for Ahmed glaucoma valve implantation, and the 48-month success rates were 42% and 36% for trabeculectomy and valve implantation, respectively. The success rates following the entire follow-up period were not significantly different between the two groups (p > 0.05 by log rank test). Postoperative complications occurred in 25% of the trabeculectomy-operated eyes and 9% of the Ahmed-implanted eyes (p = 0.38). CONCLUSIONS: There was no significant difference in surgical outcome between the trabeculectomy and Ahmed glaucoma valve implantation groups, neither of which had favorable results. However, the trabeculectomy group demonstrated a higher prevalence of adverse complications such as post-operative endophthalmitis.

Comparison of three types of images for the detection of retinal nerve fiber layer defects.

PURPOSE: To compare the clinical effectiveness of three types of images for detecting retinal nerve fiber layer (RNFL) defects. METHODS: Three image sets of 100 subjects (9 normal control subjects, 16 glaucoma suspects, and 75 glaucoma patients) were produced using color fundus photography, typical red-free RNFL photography, and blue reflectance RNFL photography with confocal scanning laser ophthalmoscopy (CSLO). A total of 300 images were rated twice in random order by five independent evaluators who were masked to the patient characteristics; each image was rated as normal, having a diffuse RNFL defect, or showing a wedge RNFL defect. Intraobserver and interobserver agreement, sensitivity, specificity, accuracy, and area under the curve were assessed. An additional analysis was performed for identifying differences in two black-and-white RNFL photographs. RESULTS: The results showed high intraobserver agreement, with relatively low interobserver agreements among the five evaluators. Blue reflectance RNFL photography with CSLO demonstrated the best performance in sensitivity, specificity, accuracy, and area under the curve. Blue reflectance RNFL images showed better accuracy than red-free RNFL images especially in subjects with wedge defects and in advanced glaucomatous cases. CONCLUSIONS: The RNFL images produced using blue reflectance with CSLO showed the best performance for the detection of RNFL defects, especially in cases with wedge defects and advanced glaucoma stages.

The neuroprotective effect of maltol against oxidative stress on rat retinal neuronal cells.

PURPOSE: Maltol (3-hydroxy-2-methyl-4-pyrone), formed by the thermal degradation of starch, is found in coffee, caramelized foods, and Korean ginseng root. This study investigated whether maltol could rescue neuroretinal cells from oxidative injury in vitro. METHODS: R28 cells, which are rat embryonic precursor neuroretinal cells, were exposed to hydrogen peroxide (H2O2, 0.0 to 1.5 mM) as an oxidative stress with or without maltol (0.0 to 1.0 mM). Cell viability was monitored with the lactate dehydrogenase assay and apoptosis was examined by the terminal deoxynucleotide transferase-mediated terminal uridine deoxynucleotidyl transferase nick end-labeling (TUNEL) method. To investigate the neuroprotective mechanism of maltol, the expression and phosphorylation of nuclear factor-kappa B (NF-κB), extracellular signal-regulated kinase (ERK), c-Jun N-terminal kinase (JNK), and p38 were evaluated by Western immunoblot analysis. RESULTS: R28 cells exposed to H2O2 were found to have decreased viability in a dose- and time-dependent manner. However, H2O2-induced cytotoxicity was decreased with the addition of maltol. When R28 cells were exposed to 1.0 mM H2O2 for 24 hours, the cytotoxicity was 60.69 ± 5.71%. However, the cytotoxicity was reduced in the presence of 1.0 mM maltol. This H2O2-induced cytotoxicity caused apoptosis of R28 cells, characterized by DNA fragmentation. Apoptosis of oxidatively-stressed R28 cells with 1.0 mM H2O2 was decreased with 1.0 mM maltol, as determined by the TUNEL method. Western blot analysis showed that treatment with maltol reduced phosphorylation of NF-κB, ERK, and JNK, but not p38. The neuroprotective effects of maltol seemed to be related to attenuated expression of NF-κB, ERK, and JNK. CONCLUSIONS: Maltol not only increased cell viability but also attenuated DNA fragmentation. The results obtained here show that maltol has neuroprotective effects against hypoxia-induced neuroretinal cell damage in R28 cells, and its effects may act through the NF-κB and mitogen-activated protein kinase signaling pathways.

Effect of Goniosynechialysis During Phacoemulsification on IOP in Patients With Medically Well-controlled Chronic Angle-Closure Glaucoma.

PURPOSE: To evaluate and compare the efficacy and safety of combined phacoemulsification and goniosynechialysis (PEGS) to phacoemulsification alone (PE) in patients with medically well-controlled chronic angle-closure glaucoma (CACG) with cataracts. MATERIALS: Thirty eyes diagnosed with CACG and requiring cataract surgery from January 2008 to October 2010 were prospectively randomized, 15 each to PE and PEGS. Changes in peripheral anterior synechiae (PAS), intraocular pressure (IOP), anterior chamber depth, and number of antiglaucoma drugs from baseline to 2 months after the operation were analyzed, as were the type and number of complications. RESULTS: The PE group showed decreases in PAS (118.67±95.38 degrees) and IOP (2.33±2.38 mm Hg) and a significant reduction in the number of antiglaucoma drugs (0.53±0.83, P<0.05) from before to 2 months after surgery. The PEGS group showed similar decreases in PAS (114.00±90.95 degrees), and IOP (4.53±4.16 mm Hg) and number of antiglaucoma drugs (1.20±1.32) (P<0.05). However, the amount of decline in both the groups did not show any significantly difference in PAS, reduction of IOP, or number of antiglaucoma drugs (P>0.05), The increase in anterior chamber depth from baseline to 2 months after surgery was significantly greater in the PEGS group (P=0.003). CONCLUSIONS: The IOP-lowering effects of PEGS do not differ significantly from those of PE in medically well-controlled CACG patients with cataract. These results suggest that additional goniosynechialysis during phacoemulsification is not necessary in such patients.

Effect of Korean Red Ginseng supplementation on dry eye syndrome in glaucoma patients - A randomized, double-blind, placebo-controlled study.

BACKGROUND: Many patients with glaucoma have difficulty using antiglaucoma eye drops because of dry eye symptom. In this prospective, randomized, double-blind, placebo-controlled study, we evaluated the effect of Korean Red Ginseng on dry eye syndrome in patients with glaucoma treated with antiglaucoma eye drops. METHODS: Forty-nine participants were allocated to the Korean Red Ginseng (3 g/day; n = 24) or placebo (n = 25) groups for 8 weeks. Tear film stability, fluorescein corneal staining, conjunctival hyperemia, tear production, grade of meibomian gland dysfunction, and dry eye questionnaire (Ocular Surface Disease Index) were evaluated at baseline and on completion of the treatment. RESULTS: Almost all patients displayed dry eye symptoms and signs at baseline. After the 8-week intervention, Korean Red Ginseng supplementation significantly improved the tear film stability and total Ocular Surface Disease Index score, as compared to placebo (p < 0.01). CONCLUSION: Korean Red Ginseng supplementation may provide an additional treatment option for dry eye and patients with glaucoma using antiglaucoma eye drops.