Browsing by Author "Lee, Chia-Yi"

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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.
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.
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.
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.