Purpose. To evaluate the effectiveness and optical quality of 3.0% topical diquafosol versus 0.05% cyclosporine A in dry eye patients following cataract surgery. Methods. In total, 40 eyes of 40 patients newly diagnosed with dry eye syndrome 1 week after cataract surgery were randomized to receive either 3.0% diquafosol ophthalmic solution six times daily or 0.05% cyclosporine A twice daily for 3 months. Outcome measures were tear film break-up time (TBUT), results on Schirmer 1 test, ocular surface staining score, the ocular surface disease index (OSDI) score, and higher-order aberrations (HOAs). Measurements were taken at baseline and at 1, 2, and 3 months. Results. In the diquafosol group, TBUT showed higher outcomes than the cyclosporine A group at 1 and 3 months. Both groups showed increased scores on Schirmer 1 test. The ocular surface staining score decreased in all periods in both groups. Vertical coma and total HOAs decreased more in the cyclosporine A group than in the diquafosol group at 3 months. Conclusion. Both 3.0% diquafosol and 0.05% cyclosporine A were effective in treating dry eye after cataract surgery. Diquafosol was more effective in increasing the tear secretion, but cyclosporine A was more effective in improving optical aberrations.
The objective of this study was to evaluate the association between serum vitamin D deficiency and age-related macular degeneration (AMD) in Koreans through a clinical case–control pilot study. The study included 96 patients: 30 with late AMD, 32 with early AMD, and 34 normal controls. The patients with late AMD were divided into 2 subgroups based on the presence or absence of subretinal fibrosis on optical coherence tomography (OCT) images. We measured 25-hydroxyvitamin D levels in the serum of all patients during the same season to rule out seasonal variation of serum vitamin D level. Serum vitamin D deficiency was defined as a serum 25-hydroxyvitamin D level below 20 ng/mL. Serum vitamin D deficiency had a tendency to increase the risk of early AMD, although with borderline significance [odds ratio (OR) = 3.59; 95% confidence interval (95% CI) 0.95–13.58; P = .060]. It was significantly associated with a greater risk of late AMD (OR = 3.61; 95%CI 1.04–12.51; P = .043). Among the 2 subgroups of patients with late AMD, those with subretinal fibrosis present on the OCT images showed a greater risk of serum vitamin D deficiency than the normal controls (OR = 7.54; 95% CI 1.34–42.51). However, there was no significant association between serum vitamin D deficiency and late AMD without subretinal fibrosis (OR = 1.89; 95% CI 0.40–8.92). Serum vitamin D deficiency may increase the risk of early and late AMD in Koreans, and may also be associated with subretinal fibrosis in this population.
Anti-dementia medications are widely prescribed to patients with Alzheimer’s dementia (AD) in South Korea. This study investigated the pattern of medical management in newly diagnosed patients with AD using a standardized data format—the Observational Medical Outcome Partnership Common Data Model from five hospitals. We examined the anti-dementia treatment patterns from datasets that comprise > 5 million patients during 2009–2019. The medication utility information was analyzed with respect to treatment trends and persistence across 11 years. Among the 8653 patients with newly diagnosed AD, donepezil was the most commonly prescribed anti-dementia medication (4218; 48.75%), followed by memantine (1565; 18.09%), rivastigmine (1777; 8.98%), and galantamine (494; 5.71%). The rising prescription trend during observation period was found only with donepezil. The treatment pathways for the three cholinesterase inhibitors combined with N-methyl-d-aspartate receptor antagonist were different according to the drugs (19.6%; donepezil; 28.1%; rivastigmine, and 17.2%; galantamine). A 12-month persistence analysis showed values of approximately 50% for donepezil and memantine and approximately 40% for rivastigmine and galantamine. There were differences in the prescribing pattern and persistence among anti-dementia medications from database using the Observational Medical Outcome Partnership Common Data Model on the Federated E-health Big Data for Evidence Renovation Network platform in Korea.
Purpose:Recently, the introduction of spectral-domain optical coherence tomography (SD-OCT) has enabled measurement of retinal thickness in the posterior pole in 64 sectors. SD-OCT was used to evaluate the diagnostic effectiveness in detecting glaucomatous abnormality of visual field sensitivity. A normal value for retinal thickness was determined and then compared in corresponding local sectors. Methods: Thirty healthy controls and 30 glaucoma subjects were evaluated. Macular thickness values from the 4 adjacent square cells in an 8 x 8 posterior pole retinal thickness map were averaged for a mean retinal thickness (MRT) value. A normative database was prepared using the data from the healthy eyes of this study to determine the diagnostic criteria for MRT. If the MRT value was <5% (Criteria A) or <1% (Criteria B) of the normative database, it was considered to be abnormal. The abnormalities of the MRT value for each diagnostic criteria were compared with the visual field sensitivity results in the corresponding positions. Results: The concordance of abnormalities between MRT and visual field sensitivity at 16 measured points was low in both criteria A (Kappa value; -0.418~0.429) and B (Kappa value; -0.363~0.444). Based on the results of the visual field at each focal point, the sensitivities and specificities of MRT values using the 2 criteria ranged from 0% to 100%. Conclusions: In this study, MRT values showed low correlation and diagnostic ability to detect decreased sensitivity of the visual field in corresponding points, when customized criteria derived from a normative database were applied. J Korean Ophthalmol Soc 2014;55(6):860-867
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