PURPOSE: To assess the clinical efficacy for early detection of glaucoma using custom-built image software visualizing translucent retinal nerve fiber layer thickness (RNFLT) that is graphed based on a normative database. METHODS: This prospective study was conducted using a normative database constructed with RNFLT data of 151 healthy Korean eyes. The reference lines of the mean, the lower 5%, and the lower 1% limit were visualized as a translucent RNFLT graph produced by our software after inputting each subject's major retinal artery position and overlaying the results onto the RNFLT measurements. Fifty-eight additional healthy control and 79 early-glaucoma eyes were collected for the validation group. If a subject's RNFLT graph was outside the reference line of the lower 1% limit, the graph was defined as abnormal. The lower 1% limit, which was generated by three criteria (criterion 1, built-in software; criterion 2, axial-length data; criterion 3, major retinal artery data), was used to address the difference of agreement with a standard answer. RESULTS: For criteria 1, 2, and 3, the accuracy of our custom-built software was significantly higher than that of the manufacturer's database (kappa of 0.475 vs. 0.852 vs. 0.940; sensitivity of 62.0% vs. 91.1% vs. 97.5%, respectively) maintaining high specificity (87.9% vs. 94.8% vs. 96.6%, respectively). CONCLUSIONS: The custom-built imaging software with the constructed RNFLT normative database showed high clinical efficiency for early detection of glaucoma with negligible user-related variability.
Glaucoma ; Nerve Fibers ; Prospective Studies ; Retinal Artery ; Retinaldehyde ; Sensitivity and Specificity ; Tomography, Optical Coherence ; Treatment Outcome

Purpose: Recently, high-protein diets have become highly popular, and the market for protein products has steadily increased in Korea together with the development of various types of such products. However, there is limited information on the consumption of protein supplements (PS) or protein-fortified foods (PF). Thus, this study aimed to evaluate the use of PS/PF among young adults in Jeju. Methods: A total of 350 adults (140 men and 210 women) aged 19–39 years voluntarily participated in this study from June 2022 to May 2023. PS/PF use was measured using a questionnaire. Dietary intake was assessed using a 24-hour dietary recall. Results: Approximately 31.4% of the participants (n = 110) had consumed PS/PF for more than 2 weeks during the past year and 71.8% of them (n = 79) were still consuming these products (PS/PF consumers). The PS/PF consumers tended to be male and physically active (p < 0.05 for all). The most frequent reason for PS/PF use was muscle gain (59.5%), followed by protein supplementation (19.0%) and body fat loss (13.9%), and the most frequent type of PS/PF consumed was powders (70.6%), followed by drinks (17.7%) and bars (8.8%). The PS/PF consumers tended to consume a high-protein low-carbohydrate diet compared to the non-consumers. The prevalence of consuming dietary protein less than the estimated average requirement (EAR) was significantly lower in PS/PF consumers (13.9%) compared to non-consumers (25.4%; p = 0.0316). Conclusion These findings indicate that the necessity of protein supplementation should be determined based on the current dietary protein intake and individual requirements. The study also provides the basic information for establishing guidelines for appropriate protein intake.

Atypical antipsychotics, which have better efficacy and fewer side effects compared to first-generation antipsychotics, are being used increasingly for the treatment of schizophrenia. However, adverse events such as weight gain, diabetes mellitus and abnormal lipid profile have been reported in patients treated with these agents. Diabetic ketoacidosis (DKA) is a rare side effect of atypical antipsychotics, but deserves attention due to its severity. Although various atypical antipsychotics have been reported as causing DKA, there have been no reports showing an association with DKA and paliperidone, which is a recently developed antipsychotic agent. Here, we report two cases of DKA in patients with paliperidone therapy. Both cases had no history of diabetes before use of paliperidone, and DKA was manifested within 2 years of starting paliperidone therapy. Like other atypical antipsychotics, use of paliperidone warrants monitoring for metabolic derangements including DKA.
Antipsychotic Agents ; Diabetes Mellitus ; Diabetic Ketoacidosis* ; Humans ; Schizophrenia* ; Weight Gain