Browsing by Author "Chao, Shih-Chun"

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Blepharitis as an early sign of metabolic syndrome: a nationwide population-based study
(2018-09-01)
Lee, Chia-Yi
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Chen, Hung-Chi
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Lin, Hui-Wen
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Huang, Jing-Yang
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Chao, Shih-Chun
Background To investigate the relationship between blepharitis and metabolic syndrome (MetS) by using the Longitudinal Health Insurance Database (LHID) of Taiwan. Methods This retrospective cohort study was conducted using data collected from the LHID for the period from 2009 to 2013. This study enrolled patients who received a diagnosis of blepharitis according to the International Classification of Diseases, Ninth Revision, diagnostic code. The exclusion criteria were legal blindness, eyeball removal, ocular tumours prior to the diagnosis of blepharitis, and patients diagnosed with blepharitis and initiated antibiotic treatment concurrently. An age-matched, gender-matched and disease-matched population without blepharitis served as the control group. Multivariate analysis with a multiple Cox regression model was applied to analyse the data. Results In this study, a total of 10 093 patients with blepharitis were included in the study group, and another 40 372 participants without blepharitis were included in the control group. Conditional logistic regression revealed a higher cumulative probability of hyperlipidaemia and coronary arterial disease. After adjustment, patients with blepharitis had a higher probability of developing new MetS than controls. According to subgroup analysis, hyperlipidaemia and coronary artery diseases were significantly correlated with the prior development of blepharitis. However, hypertension and diabetes mellitus and insulin resistance showed no correlation with blepharitis. Conclusion Blepharitis is significantly related to MetS and can serve as an early sign of MetS. Additional studies should examine the relationship between blepharitis and MetS in terms of severity.
Concurrent injection of dexamethasone intravitreal implant and anti-angiogenic agent in patients with macular edema A retrospective cohort study
(2017-11-01)
Lin, Hung-Yu
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Lee, Chia-Yi
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Huang, Jing-Yang
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Yang, Shun-Fa
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Chao, Shih-Chun
To evaluate the safety and efficiency in macular edema patients who concurrently received a single injection of a dexamethasone intravitreal implant (DEX, 0.7mg) and ranibizumab (2.3 mg). A retrospective cohort study was conducted, and medical records from 2012 to 2016 were reviewed. Patients who received concurrent DEX and ranibizumab injections with a follow-up period of at least 3 months were enrolled in the study group. An age and gender-matched group received ranibizumab injections and was designated the control group. The best-corrected visual acuity (BCVA), central macular thickness (CMT) and intraocular pressure (IOP) were included in the analysis. Steroid-induced ocular hypertension (SIOH) is defined as either an elevation of more than 10 mmHg from baseline or a single IOP measurement of more than 30 mmHg. A total of 26 patients were enrolled in the current study with 13 patients in each group. Both the BCVA (P=.04) and CMT (P<.01) achieved significant improvement after the follow-up period in the study group. The IOP increased after the injection but no significant elevation was observed throughout the follow-up period in the study group (P=.15). For SIOH, 1 patient in the study group had an elevated IOP of 10 mmHg (7.7%) at 2 postoperative months, and no single IOP measurement of more than 30 mmHg was obtained. Five patients (38.5%) in the study group received medical treatment that successfully retarded their IOP elevation, and no individuals required surgical management. In the control group, there were no significant fluctuations concerning BCVA, CMT, and IOP, and no ocular hypertension was observed. According to the inter-group analysis, the CMT and BCVA recovered more significantly in the study group than in the control group. Concurrent injection of DEX and ranibizumab is a preliminary method that shows effectiveness in treating ME. Furthermore, safety is also guaranteed, with moderate levels of severity and transient IOP elevation being observed. A future large-scale study is necessary to evaluate the long-term effects and safety of this combined treatment.
Correlation between Basal Macular Circulation and Following Glaucomatous Damage in Progressed High-Tension and Normal-Tension Glaucoma
(2019-01-01)
Lee, Chia-Yi
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Liu, Chin-Hsing
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Chen, Hung-Chi
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Sun, Chi-Chin
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Yao, Yen-Po
Objectives: Evaluate the correlation between basal macular circulation and late structural damage in progressed high-tension glaucoma (HTG) and normal-tension glaucoma (NTG) via optical coherence tomography angiography (OCTA). Methods: Patients who received an OCTA examination were divided into progressed HTG, progressed NTG, and well-controlled HTG (control) groups. Superficial macular vessel density (SmVD), deep macular vessel density (DmVD), foveal avascular zone (FAZ), and flow area of the outer retina and choriocapillaris were obtained by one OCTA device. Associations between macular angiography and glaucoma parameters, including the visual field, retinal nerve fiber layer, and ganglion cell complex, were analyzed. Results: A total of 60 eyes from 60 patients were enrolled. The progressed HTG and NTG groups had lower SmVD than the control group, while the progressed NTG group had lower DmVD and a larger FAZ than the control group. The flow area of the outer retina in the progressed HTG group was lower than that of the control. A significant correlation between SmVD and glaucoma parameters was found in the progressed HTG group, while a similar correlation between SmVD and DmVD to glaucoma parameters was observed in the progressed NTG group. Conclusion: The progressed HTG and NTG patients showed an impaired vascular intake before significant disease development compared to well-controlled cases.
Early Macular Angiography among Patients with Glaucoma, Ocular Hypertension, and Normal Subjects
(2019-01-01)
Chao, Shih-Chun
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Yang, Shang-Jung
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Chen, Hung-Chi
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Sun, Chi-Chin
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Liu, Chin-Hsin
Purpose. To evaluate early macular circulation in open-angle glaucoma (OAG), normal-tension glaucoma (NTG), ocular hypertension (OHT), and healthy subjects via optical coherence tomography angiography (OCTA). Methods. A retrospective cross-sectional study was conducted. Medical records were reviewed, and the patients who received OCTA examinations were divided into the OAG, NTG, OHT, and normal groups. The ophthalmic data including best-corrected visual acuity, spherical equivalent, intraocular pressure, central corneal thickness, central foveal thickness, visual field deviation, retinal nerve fiber layers thickness, and ganglion cell complex thickness were obtained from medical documents. For the macular area, the superficial vessel density (VD), deep VD, foveal avascular zone (FAZ), flow area of the outer retina, and flow area of the choriocapillaris were measured via OCTA and analyzed using the default vascular density analysis program in the same OCTA device. Results. A total of 70 eyes from 70 patients were analyzed in the current study. Significant differences in the intraocular pressure, central corneal thickness, visual field deviation, retinal fiber layer thickness, and ganglion cell complex thickness were observed in the patients in the glaucoma group at their last visits. The OAG and NTG groups evinced a lower superficial VD than did the control group, while the NTG group had a lower deep VD than the control group. The NTG group also had a larger FAZ than did the OHT group. The flow area of the outer retina in the OAG group was low relative to those of the OHT and control groups. No difference in choriocapillaris perfusion was observed among the groups. Conclusion. The OAG and NTG patients demonstrated impaired vasculature before significant disease development could be observed. Furthermore, the differences in macular circulation may be associated with differences in the courses of disease between the glaucoma and OHT patients.
Effect of Uveitis on the Development of Keratopathy: A Population-Based Cohort Study
(2018-10-01)
Nien, Chan-Wei
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Lee, Chia-Yi
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Chao, Shih-Chun
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Hsu, Hung-Jui
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Huang, Jing-Yang
PURPOSE. The purpose of this study was to evaluate the effect of uveitis on the development of various keratopathies via the use of the National Health Insurance Research Database (NHIRD) in Taiwan. METHODS. Approximately 1 million patients were randomly sampled from the registry of the NHIRD. Patients diagnosed with uveitis by ophthalmologists were enrolled in the study group after exclusion. Each individual in the study group was age and sex matched to four nonuveitis individuals who serve as the control group. In addition to keratopathy, other possible risk factors and medications were included in the multivariate model, and the effects of different subtypes of uveitis for developing keratopathies were also analyzed. RESULTS. A total of 4773 uveitis patients (2662 male and 2111 female) and 19,092 non-uveitis patients (10,648 male and 8444 female) were enrolled. There were 406 events of keratopathy in the study group, and another 764 events occurred in the control group. A higher incidence rate was found in the study group after adjustment (adjusted hazard ratio [aHR]: 1.772), with a greater cumulative probability (P < 0.0001). For the subgroup analysis, anterior uveitis (aHR = 1.765) and panuveitis (aHR = 3.386) increased the risk of developing keratopathies. Moreover, male sex was associated with a higher aHR than female sex for developing keratopathies in the study group. CONCLUSIONS. The presence of uveitis significantly elevates the risk for developing keratopathy.
Effects of Lutein and Zeaxanthin on LPS-Induced Secretion of IL-8 by Uveal Melanocytes and Relevant Signal Pathways
(2015-01-01)
Chao, Shih-Chun
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Vagaggini, Tommaso
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Nien, Chan-Wei
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Huang, Sheng-Chieh
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Lin, Hung-Yu
The effects of lutein and zeaxanthin on lipopolysaccharide-(LPS-) induced secretion of IL-8 by uveal melanocytes (UM) were tested in cultured human UM. MTT assay revealed that LPS (0.01-1 mu g/mL) and lutein and zeaxanthin (1-10 mu M) did not influence the cell viability of cultured UM. LPS caused a dose-dependent increase of secretion of IL-8 by cultured UM. Lutein and zeaxanthin did not affect the constitutive secretion of IL-8. However, lutein and zeaxanthin decreased LPS-induced secretion of IL-8 in cultured UM in a dose-dependent manner. LPS significantly increased NF-kappa B levels in cell nuclear extracts and p-JNK levels in the cell lysates from UM, but not p-p38 MAPK and p-ERG. Lutein or zeaxanthin significantly reduced LPS-induced increase of NF-kappa B and p-JNK levels, but not p38 MAPK and ERG levels. The present study demonstrated that lutein and zeaxanthin inhibited LPS-induced secretion of IL-8 in cultured UM via JNK and NF-kappa B signal pathways. Theanti-inflammatory effects of lutein and zeaxanthin might be explored as a therapeutic approach in the management of uveitis and other inflammatory diseases of the eye.
Effects of Lutein on Hyperosmoticity-Induced Upregulation of IL-6 in Cultured Corneal Epithelial Cells and Its Relevant Signal Pathways
(2016-01-01)
Chao, Shih-Chun
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Nien, Chan-Wei
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Iacob, Codrin
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Hu, Dan-Ning
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Huang, Sheng-Chieh
Dry eye is a common disorder characterized by deficiency of tear. Hyperosmoticity of tear stimulates inflammation and damage of ocular surface tissues and plays an essential role in the pathogenesis of dry eye. Cultured human corneal epithelial (CE) cells were used for the study of effects of lutein and hyperosmoticity on the secretion of IL-6 by CE cells. Cell viability of CE cells was not affected by lutein at 1-10 mu M as determined by MTT assay. Hyperosmoticity significantly elevated the secretion of IL-6 by CE cells as measured by ELISA analysis. The constitutive secretion of IL-6 was not affected by lutein. Lutein significantly and dose-dependently inhibited hyperosmoticity-induced secretion of IL-6. Phosphorylated-(p)-p38 MAPK, p-JNK levels in cell lysates and NF-kappa B levels in cell nuclear extracts were increased by being exposed to hyperosmotic medium. JNK, p38, and NF-kappa B inhibitors decreased hyperosmoticity-induced secretion of IL-6. Lutein significantly inhibited hyperosmoticity-induced elevation of NF-kappa B, p38, and p-JNK levels. We demonstrated that lutein inhibited hyperosmoticity-induced secretion of IL-6 in CE cells through the deactivation of p38, JNK, and NF-kappa B pathways. Lutein may be a promising agent to be explored for the treatment of dry eye.
Femtosecond laser-assisted cataract surgery in patients with phakic intraocular lenses and low endothelial cell counts: a case report
(2017-10-03)
Lee, Chia-Yi
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Chao, Shih-Chun
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Sun, Chi-Chin
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Lin, Hung-Yu
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電機工程學系
Background: Phakic intraocular lens (PIOL) implantation has been used to correct myopia and myopic astigmatism, although corneal decompensation can occur after implantation. Femtosecond laser-assisted cataract surgery (FLACS) has gained in popularity due to its lower postoperative astigmatism and endothelial loss. Herein, we report the use of FLACS in patients who previously received PIOL implantation and have a low corneal endothelial cell count. Case presentation: Two patients with a previous iris-claw PIOL implantation were enrolled. The preoperative corrected distance visual acuity (CDVA) and diopter sphere (DS) were 20/32 and -0.25 D in patient 1 and 20/32 and -3.00 D in patient 2. Specular microscope examination revealed an endothelial cell density (ECD) of 1532/mm(2) in patient 1 and 1620/mm(2) in patient 2. Capsulotomy was performed smoothly using a femtosecond laser. Postoperative CDVA improved in both eyes, with a difference of DS less than 1 D from the preoperative estimation. Specular microscope examination revealed a decreased endothelial cell density (ECD) in patient 2, but no signs of corneal decompensation were detected. Conclusions: The influence of using PIOL on capsulotomies performed via FLACS, in combination with preoperative refraction calculation, is minimal. A mild decrease in ECD may occur, but there is a low probability of severe corneal decompensation, even in patients with a low endothelial cell count.
Incidence of Non-Traumatic Subconjunctival Hemorrhage in a Nationwide Study in Taiwan from 2000 to 2011
(2015-07-16)
Hu, Dan-Ning
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Mou, Chih-Hsin
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Chao, Shih-Chun
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Lin, Ching-Yang
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Nien, Chan-Wei
Objective To determine the nationwide incidence of non-traumatic subconjunctival hemorrhage (NTSCH) in Taiwan from 2000-2011 and to analyze the risk factors for NTSCH using a case-control analysis. Methods This is a population-based cohort administrative database study. Randomly selected 1,000,000 residents from the Taiwan National Health Insurance Research Database in 2000 and followed for 12 years to determine the population incidence of NTSCH. Individuals with the first diagnosis of subconjunctival hemorrhage were identified by the corresponding International Classification of Diseases code (ICD) 372.72. Traumatic subconjunctival hemorrhages (ICD-9 codes 921, 871, 850-854 and 959.01) were excluded. The association of NTSCH with various demographic factors, comorbidities and use of medications was studied by a population based case-control analysis using data of 2008-2011. Results A total of 67,720 patients with a first-time diagnosis of NTSCH were identified during the 12 years period. The mean annual incidence was 65 per 10,000 individuals (crude incidence) and 60 per 10,000 individuals (age-and sex-standardized incidence). The incidence rate of NTSCH was higher in women than in men, [men-women ratio: 0.80 (95% confidence interval: 0.78-0.81)]. The age-specific incidence decreased from childhood to the group of teenagers, after which it increased to a maximal value of 136.2 per 10,000 people in the age group of 60-69 years. Case-control analysis showed that comorbidities of hypertension, purpura and thrombocytopenia, and the use of aspirin were significantly associated with the risk of NTSCH. Conclusions This study indicates that NTSCH is a common eye disease that occurs once in 167 individuals in a general East Asian population per year. It occurs more often in women than in men and the age-specific incidence peaked in the age group of 60-69 years. Hypertension, purpura and thrombocytopenia, and the use of aspirin are the major risk factors for NTSCH.
Inhibition effect of curcumin on UVB-induced secretion of pro-inflammatory cytokines from corneal limbus epithelial cells
(2017-06-18)
Chao, Shih-Chun
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Hu, Dan-Ning
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Roberts, Joan
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Shen, Xilun
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Lee, Chia-Yi
AIM: To study the effects of curcumin on the secretion of interleukin (IL) -6 and IL-8 by corneal limbus epithelial cells. METHODS: Human corneal limbus epithelial cells were isolated and cultured from donor eyes and irradiated by UVB at different dosages with or without curcumin. MTT test was used for studying the effects of UVB and curcumin on the cell viability. The role of mitogen-activated protein kinase (MAPK) and nuclear factor-kappa B (NF-kappa B) pathways on the UVB-induced secretion of IL-6 and IL-8 were tested by addition of their inhibitors to the culture with or without UVB-radiation. Levels of various signal pathways, IL-6 and IL-8 in the cells and in the conditioned culture medium were measured by ELISA analysis. RESULTS: UVB at 20 mJ/cm(2) or less and curcumin at 20 mu mol/L or less did not affect the cell viability of cultured limbus epithelial cells (P>0.05). UVB irradiation at 10 and 20 mJ/cm(2) induced a significant increase of secretion of IL-6 and IL-8 and upregulated NF-kappa B and phosphorylated MAPK pathways of cultured limbus epithelial cells (P<0.05). Various signal pathway inhibitors, including SP600125 (JNK inhibitor), SB203580 (p38 MAPK inhibitor) and BAY11-7082 (NF-kappa B inhibitor) significantly decreased the UVB-induced secretion of IL-6 and IL-8 secretion (P<0.05). Curcumin at 5-20 mu mol/L significantly inhibited UVB-induced secretion of IL-6 and IL-8 by limbus epithelial cells in a dose-dependent manner; while curcumin alone did not affect the secretion of IL-6 and IL-8. The upregulation of NF-kappa B and MAPK pathways induced by UVB treatment was significantly inhibited by curcumin, suggesting that NF-kappa B and MAPK pathways are involved in the inhibitory effect of curcumin on UVB-induced production of IL-6 and IL-8. CONCLUSION: Curcumin may be a promising agent to be explored for the prevention and treatment of pterygium.
Overexpression of urokinase-type plasminogen activator in pterygia and pterygium fibroblasts
(2011-01-06)
Chao, Shih-Chun
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Hu, Dan-Ning
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Yang, Pei-Yu
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Lin, Ching-Yang
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Yang, Shun-Fa
Purpose: Urokinase-type plasminogen activator (uPA) is a protease involved in tissue remodeling and cell migration. Little is known about the expression of uPA in pterygium. The purpose of this study was to investigate the expression of uPA mRNA and activities in various stages of surgically excised pterygia specimens and cultured pterygium fibroblasts and to compare them with normal conjunctival tissues and fibroblasts. Methods: The expression of uPA mRNA and activity in 15 pterygium tissues and cultured fibroblasts from pterygium were measured using quantitative RT-PCR and zymography. Five normal conjunctiva specimens and cultured conjunctival fibroblasts were tested as the controls. Results: The expression of uPA mRNA and activities in pterygia and pterygium fibroblasts were significantly greater than those of the normal samples (p<0.05) and were closely related to the progression of pterygium. The amounts of uPA mRNA and activities in early, moderate, and advanced pterygia were 100%, 208%, and 311% and 100%, 157%, and 280% of the early stage specimens, respectively. The amounts of uPA mRNA and the activities in cultured pterygium fibroblasts isolated from early, moderate, and advanced pterygium specimens were 100%, 219%, and 457% and 100%, 198% and 355% of early stage fibroblasts, respectively. Conclusions: Overexpression of uPA was present in pterygium and their fibroblasts. The expression of uPA by pterygium increased significantly following the progression of the pterygium. The increased expression of uPA may covert plasminogen to plasmin, degrade extracellular matrixes, stimulate cell migration, induce angiogenesis, and plays an important role in the development and progression of pterygium.
Subtoxic Levels of Apigenin Inhibit Expression and Secretion of VEGF by Uveal Melanoma Cells via Suppression of ERK1/2 and PI3K/Akt Pathways
(2013)
Chao, Shih-Chun
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Huang, Sheng-Chieh
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Hu, Dan-Ning
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Lin, Hung-Yu
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資訊工程學系
The effects of apigenin on the expression of VEGF in uveal melanoma cells have not been reported. We studied this effect and relevant signaling pathways in two human uveal melanoma cell lines (SP6.5 and C918). ELISA assay revealed that the constitutive secretion of VEGF by uveal melanoma cells was 21-fold higher than that in normal uveal melanocytes. Apigenin at subtoxic levels (1-5 mu M) significantly suppressed the secretion of VEGF in a dose-and time-dependent manner in melanoma cells. VEGF levels in the conditioned culture media from SP6.5 and C918 cell lines treated with 5 mu M apigenin for 24 h reduced to 29% and 21% of those in cells not treated with apigenin, respectively. RT-PCR analysis found that apigenin also decreased the expression of VEGF mRNA in melanoma cells. ELISA study of various signal pathways showed that apigenin significantly decreased phosphorylated Akt and ERK1/2 but increased phosphorylated JNK1/2 and p38 MAPK levels in melanoma cells. PI3K/Akt or ERK1/2 inhibitors significantly decreased, but JNK1/2 and p38 MAPK inhibitors did not influence the secretion of VEGF by melanoma cells, suggesting that apigenin suppresses the secretion of VEGF mainly through the inhibition of PI3K/Akt and ERK1/2 pathways.
Swimming Pool Associated Vittaforma-Like Microsporidia Linked to Microsporidial Keratoconjunctivitis Outbreak, Taiwan
(2019-11-01)
Chen, Jung-Sheng
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Hsu, Tsui-Kang
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Hsu, Bing-Mu
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Chao, Shih-Chun
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Huang, Tung-Yi
We analyzed 2 batches of environmental samples after a microsporidial keratoconjunctivitis outbreak in Taiwan. Results indicated a transmission route from a parking lot to a foot washing pool to a swimming pool and suggested that accumulation of mud in the foot washing pool during the rainy season might be a risk factor.
Ultraviolet-A Irradiation Upregulated Urokinase-Type Plasminogen Activator in Pterygium Fibroblasts through ERK and JNK Pathways
(2013-02-01)
Chao, Shih-Chun
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Hu, Dan-Ning
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Yang, Pei-Yu
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Lin, Ching-Yang
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Nien, Chan-Wei
PURPOSE. Effects of ultraviolet (UV) B on the pterygium and its cells have been studied previously, whereas little is known on the effects of UVA. Urokinase-type plasminogen activator (uPA) is a protease involved in tissue remodeling and cell migration, and its levels are increased in pterygium. The purpose of our study was to investigate the effects of UVA on the expression of uPA in cultured pterygium fibroblasts. METHODS. Cultured fibroblasts from early-stage pterygia and normal conjunctiva were irradiated with different dosages of UVA and compared to nonirradiated cells. uPA activities in the medium and uPA mRNA in the cells were measured by casein zymography and RT-PCR, respectively. Total and phosphorylated p38 mitogen-activated protein kinase (MAPK), extracellular signal-related kinase (ERK), and c-Jun N-terminal kinase (JNK) levels of cells treated with and without UVA were measured by Western blotting. Inhibitors of p38 (SB203580), ERK (UO1026), and JNK (SP600125) were added before the irradiation of UVA to test their effects. RESULTS. UVA irradiation increased the uPA mRNA levels in pterygium fibroblasts and the uPA activities in cultured medium, which was accompanied with an increase in phosphorylated ERK and JNK. The ERK and JNK inhibitor, but not p38 MAPK inhibitors, significantly decreased the UVA-induced expression of uPA by pterygium fibroblasts. Normal conjunctival fibroblasts were less sensitive to UVA irradiation compared to the pterygium fibroblasts. CONCLUSIONS. UVA stimulated the production of uPA, a key factor in the modulation of extracellular matrixes, inflammatory processes, and angiogenesis. This may have a role in the development and progression of pterygium. (Invest Ophthalmol Vis Sci. 2013;54:999-1007) DOI:10.1167/iovs.12-10469
Y The Correlation of Central Serous Chorioretinopathy and Subsequent Cardiovascular Diseases of Different Types: A Population-Based Cohort Study
(2019-12-02)
Hsu, Hung-Jui
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Lee, Chia-Yi
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Chao, Shih-Chun
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Nien, Chan-Wei
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Tzeng, Shih-Hao
The aim of the present study was to survey the relationship between central serous chorioretinopathy (CSC) and several cardiovascular diseases (CVDs) with different severities using the National Health Insurance Research Database. A retrospective cohort study was conducted. Subjects with CSC were enrolled according to the relevant diagnostic codes, and an age- and gender-matched population was used as the control group with a 1:4 ratio. The main outcome being considered was the development of CVD after CSC exposure. Cox proportional hazard regression was applied to calculate the adjusted hazard ratio (aHR) of CSC and CVD of different types. A total of 2865 patients that were diagnosed with CSC were enrolled in the study group, while another 11,460 non-CSC subjects were selected as the control group. There were 171 events of CVD which occurred in the study group, while another 557 cases were found in the control group. No significant differences were observed among the CVD cases between the study and control group, whether they had an acute or chronic form, according to the aHR. In the subgroup analysis, there was a significantly higher risk of CVD development in the male population aged from 40 to 59 years (aHR: 1.351, confidence interval (CI): 1.063-1.716), which was mainly due to the higher risk of mild CVD (aHR: 1.391, CI: 1.062-1.822). On the contrary, there was no significant difference in CVD development in any of the age subgroups of the female population. In conclusion, the existence of CSC is correlated with a higher rate of chronic CVD occurrence in the middle-aged male population.