Background and Purpose— Our aim was to evaluate the risk of subsequent stroke development after retinal artery occlusion (RAO). Methods— National registry data were collected from the Korean National Health Insurance Service, comprised 1 025 340 random subjects. Patients diagnosed with RAO in 2002 and 2003 were excluded. The RAO group was composed of patients with an initial diagnosis of either central or other RAO between January 2004 and December 2013 (n=401). The comparison group was composed of randomly selected patients (5 per RAO patient; n=2003) who were matched to the RAO group according to sociodemographic factors and year of RAO diagnosis. Each sampled patient was tracked until 2013. Cox proportional hazard regression was used. Results— Stroke occurred in 15.0% of the RAO group and in 8.0% of the comparison group ( P < 0.001). RAO was associated with an increased risk of stroke occurrence (hazard ratio, 1.78; 95% confidence interval, 1.32–2.41). The magnitude of the RAO effect for stroke was larger among younger adults aged <65 years (hazard ratio, 3.11) than older adults aged ≥65 years (hazard ratio, 1.26). However, the risk of subsequent stroke was significantly increased in older adults aged ≥65 years at the 4-year follow-up (hazard ratio, 1.58; 95% confidence interval, 1.01–2.48). Conclusions— RAO was significantly associated with subsequent stroke after adjusting for comorbidities and sociodemographic factors. These findings are limited by uncontrolled confounding factors and need to be replicated by other observational studies.
Background/aims Although studies using optical coherence tomography (OCT) reported that the retinal nerve fibre layer (RNFL) thickness of myopic eyes was thinner than those of normal controls, it was unclear if this finding indicated the difference in actual structural thickness or that created by sources affecting accuracy of OCT measurement. This study's aim was to evaluate the effect of refraction power on the measurement of the RNFL thickness using spectral-domain OCT. Methods OCT scans to measure RNFL thickness were repeated in 15 cycloplegic eyes of 15 participants, while different refraction powers were induced by wearing soft contact lenses of eight different dioptres (À6 to +8). Results Measured RNFL thicknesses decreased significantly with soft contact lenses of higher plus dioptres and increased with those of more minus dioptres. This finding was consistent with or without controlling factors including the signal strength and testeretest variability of the machine. Measurement of peripapillary RNFL thicknesses was not varied between scans performed with and without plano contact lenses. Conclusions In spectral-domain OCT, RNFL thickness was underestimated in eyes with increasing negative refraction power and overestimated with increasing positive refraction power.
Purpose: To determine the age-and sex-specific prevalence and incidence of demyelinating optic neuritis and the risk of multiple sclerosis (MS) in pediatric and adult populations in South Korea. Design: A nationwide, population-based, retrospective study using data from the Korean National Health Claims database from 2010 to 2016. Participants: The entire South Korean population aged 65 years of age or younger (n ¼ 44 700 564). All patients with optic neuritis from the entire Korean population were included. Methods: Patients aged 14 years of age or younger were classified as pediatric patients, and those aged 15 to 65 years were classified as adults. Each group was analyzed separately. Patients with optic neuritis had a subsequent diagnosis, including idiopathic, MS, neuromyelitis optica (NMO), and acute disseminated encephalomyelitis. Prevalence and incidence, conversion rate to MS, and treatment modalities (steroids, plasmapheresis, interferon-b, and immunosuppressants) were estimated. Main Outcome Measures: Prevalence and incidence of optic neuritis, and conversion rate to MS. Results: Among 44 700 564 individuals, 531 pediatric patients (50.7% female) and 7183 adults (53.3% female) were identified as having optic neuritis. Annual incidence was 1.04 (95% confidence interval [CI], 1.01e1.07) per 100 000 pediatric individuals and 3.29 (95% CI, 3.28e3.30) per 100 000 adults. Peak incidence was observed at 10 to 14 years in the pediatric population and at 30 to 34 years and 50 to 54 years in the adult population. Conversion rate to MS was 13.8% in the pediatric population and 11.4% in the adult population. Fourteen percent of all patients were treated with chronic immunosuppressants, 38% of patients with NMO underwent plasmapheresis, and 50% of patients with MS were treated with interferon-b. Conclusions: This is a nationwide epidemiologic study of optic neuritis in individuals of all ages in South Korea. The incidence of optic neuritis and subsequent risk of MS in the pediatric population are comparable to those reported in western countries but are lower in the adult population than in western countries. The incidence rate in adults was 3.2-fold higher than in the pediatric population, and the overall MS conversion rate in the entire Korean population was estimated to be 10.6%. Ophthalmology 2020;127:417-425 ª 2019 by the American Academy of Ophthalmology
LS is a group of mitochondrial disorders with variable ophthalmologic manifestations, the most frequent being strabismus in this study. Ptosis could be an initial sign in patients with LS and these patients can be easily misdiagnosed as having juvenile myasthenia gravis.
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