Background: Interest in healthy aging has grown with the increase in the older population. Nutritional intake is crucial in frailty. Therefore, we aimed to investigate the relationship between frailty and multivitamin and mineral supplements (MVMS), which can easily provide micronutrients. Methods: The Korea National Health and Nutrition Examination Survey (KNHANES) conducted from 2018 to 2019 included 3,395 adults aged ≥65 years. Of these, 1,511 who did not consume dietary supplements (DS, non-DS group) and 415 who took MVMS (MVMS group) were included in the study. We modified Fried’s definition of frailty to fit the KNHANES data. Using multivariate logistic regression, we examined the association between MVMS use and frailty, which varied with satisfaction with total energy intake. Additional subgroup analyses were performed based on age, sex, and income. Results: MVMS reduced most micronutrient deficiencies compared to obtaining nutrients solely through food. The overall analysis revealed no association between MVMS use and frailty (odds ratio [OR], 0.75; 95% confidence interval [CI], 0.52–1.09). However, a subanalysis revealed that participants with a low income (≤25%) who took MVMS had decreased odds for frailty (OR, 0.55; 95% CI, 0.35–0.88) compared with the non-DS group. Furthermore, a significant association between using MVMS and frailty was confirmed in the group with low income and energy intake below the recommended daily allowance, with a low OR of 0.52 (95% CI, 0.30–0.90). Conclusion MVMS use was significantly associated with frailty among the low-income and low-daily energy intake groups.

Background: Interest in healthy aging has grown with the increase in the older population. Nutritional intake is crucial in frailty. Therefore, we aimed to investigate the relationship between frailty and multivitamin and mineral supplements (MVMS), which can easily provide micronutrients. Methods: The Korea National Health and Nutrition Examination Survey (KNHANES) conducted from 2018 to 2019 included 3,395 adults aged ≥65 years. Of these, 1,511 who did not consume dietary supplements (DS, non-DS group) and 415 who took MVMS (MVMS group) were included in the study. We modified Fried’s definition of frailty to fit the KNHANES data. Using multivariate logistic regression, we examined the association between MVMS use and frailty, which varied with satisfaction with total energy intake. Additional subgroup analyses were performed based on age, sex, and income. Results: MVMS reduced most micronutrient deficiencies compared to obtaining nutrients solely through food. The overall analysis revealed no association between MVMS use and frailty (odds ratio [OR], 0.75; 95% confidence interval [CI], 0.52–1.09). However, a subanalysis revealed that participants with a low income (≤25%) who took MVMS had decreased odds for frailty (OR, 0.55; 95% CI, 0.35–0.88) compared with the non-DS group. Furthermore, a significant association between using MVMS and frailty was confirmed in the group with low income and energy intake below the recommended daily allowance, with a low OR of 0.52 (95% CI, 0.30–0.90). Conclusion MVMS use was significantly associated with frailty among the low-income and low-daily energy intake groups.

Background: Despite the critical importance of sleep medicine within neurology, notable gaps in education and clinical practice persist among neurologists. This study aims to explore the extent of involvement and the challenges faced by Korean neurologists in sleep medicine, focusing on awareness of polysomnography training program, the operation of sleep study facilities, and educational exposure. Methods: An online survey collected responses from 233 neurologists, focusing on their demographics, knowledge of and involvement in sleep medicine, operation of sleep study facilities, and participation in residency training. Results: The findings indicated that 84.9% of neurologists were aware of polysomnography training program, primarily through professional societies. Nonetheless, 15.1% reported unfamiliarity with these initiatives, with 72.7% of this subgroup expressing interest in sleep medicine yet lacking access to information. In terms of clinical practice, 74 neurologists operated sleep study facilities, with 63% intending to expand. Key operational challenges included staff management, maintaining patient volumes, and inadequate institutional support. Among respondents from teaching hospitals, only 36 out of 114 reported active resident involvement in sleep study interpretations, predominantly hindered by excessive workloads and insufficient staffing. Conclusions A significant number of neurologists have an interest in sleep medicine; however, substantial challenges impede effective education and clinical practice. These results underscore the need for improved educational resources and institutional support to enhance the growth and effectiveness of sleep medicine practices among neurologists.

Purpose: We present a case of anterior displacement of the lens-iris diaphragm associated with Vogt–Koyanagi–Harada (VKH) disease.Case summary: A 35-year-old woman presented with decreased vision in her right eye. Examination revealed corrected visual acuity of 0.6 in the right eye and 1.0 in the left eye. Intraocular pressure (IOP) was 14 and 16 mmHg in the right and left eye, respectively. Spherical equivalent (SE) was -17.25 D in the right eye and -9.75 D in the left eye. Slit lamp examination and three-dimensional anterior segment photography revealed anterior displacement of the lens-iris diaphragm in both eyes. Two days later, the left eye developed similar symptoms with an SE of -15.5 D. Fundus examination revealed serous retinal detachment and fluorescein fundus photography demonstrated focal leakage leading to the diagnosis of atypical VKH disease. The patient was treated with oral corticosteroids and her symptoms resolved after 3 weeks. The Final SE was -10.25 D in the right eye and -9.75 D in the left eye. Conclusions We suggest there is an association between atypical VKH and anterior lens-iris diaphragm displacement in the absence of elevated IOP; early myopic shift may be associated with this presentation. Therefore, patients with isolated lens-iris diaphragm displacement, particularly those without a history of medications should be monitored for the possibility of developing VKH disease.

Purpose: We investigated the relationship between metabolic syndrome and open-angle glaucoma (OAG) in postmenopausal women using data from the Korea National Health and Nutrition Examination Survey (KNHANES). Methods: A multiple logistic regression analysis was conducted on postmenopausal women from KNHANES from 2010 to 2012, divided into open angle glaucoma and non-glaucoma groups. The analysis adjusted for age, intraocular pressure, education level, income level, physical activity, smoking, and alcohol consumption. Results: The odds ratio (OR) for OAG was 1.801 (95% confidence interval [CI] 1.071-3.030) in the presence of metabolic syndrome. Among the components of metabolic syndrome, hypertriglyceridemia had an OR of 1.779 (95% CI 1.148-2.758). When hypertriglyceridemia was accompanied by hyperglycemia, the OR was 2.032 (95% CI 1.154-3.578). The OR was 1.839 (95% CI 1.209-2.797) when hypertriglyceridemia was accompanied by hypertension. For the combination of hypertriglyceridemia, hyperglycemia, and hypertension, the OR was 1.962 (95% CI 1.102-3.493). When hypertriglyceridemia, hyperglycemia, and waist circumference over 80 cm were present, the OR was 1.863 (95% CI 1.003-3.458). Lastly, the combination of hypertriglyceridemia, hyperglycemia, and low HDL cholesterol resulted in an OR of 1.976 (95% CI 1.096-3.562). Conclusions In postmenopausal women, the presence of metabolic syndrome was associated with OAG, but the number of metabolic syndrome components was not related. Among the components of metabolic syndrome, only elevated triglycerides were associated with OAG.

Purpose: To evaluate the short-term efficacy and safety of latanoprostene bunod 0.024% in patients with primary open-angle glaucoma. Methods: A retrospective study was conducted from September 2022 to September 2023, involving 29 eyes from patients diagnosed with primary open-angle glaucoma. The study analyzed the intraocular pressure (IOP)-lowering effects of latanoprostene bunod 0.024% at 1 and 3 months after administration. Additionally, adverse events reported by patients at each visit were documented. Results: The mean age of patients at the start of treatment was 64.46 years. The baseline IOP was 17.46 ± 4.03 mmHg, which significantly decreased to 15.07 ± 4.23 mmHg (p = 0.002) at 1 month (29 eyes) and 14.93 ± 3.86 mmHg (p = 0.002) at 3 months (28 eyes) after latanoprostene bunod administration. After 1 month, 9 patients reported adverse events, including conjunctival hyperemia (1 eye, 3.5%), itching (2 eyes, 6.9%), foreign body sensation (2 eyes, 6.9%), stinging (2 eyes, 6.9%), ocular pain (2 eyes, 6.9%), and deepening of the upper eyelid sulcus (1 eye, 3.5%). The patient who experienced deepening of the upper eyelid sulcus discontinued treatment. After 3 months, 2 eyes with itching discontinued treatment due to conjunctival allergy. Conclusions Latanoprostene bunod 0.024% demonstrated short-term efficacy in reducing IOP and a manageable safety profile in patients with primary open-angle glaucoma.

Purpose: To report a case of infectious keratitis and endophthalmitis caused by two types of antibiotic-resistant bacteria.Case summary: A 62-year-old female patient presented to our clinic with left ocular pain for 2 weeks and was diagnosed with herpetic keratitis and anterior uveitis. At the initial presentation, slit lamp biomicroscopy revealed round stromal infiltration and edema in the paracentral part of the cornea, a 2 × 2-mm epithelial defect, and hypopyon. Ocular ultrasonography showed vitreous opacities. She was empirically treated with topical 0.5% moxifloxacin, 2% tobramycin, and 5% ceftazidime administered hourly. Intravitreal vancomycin/ceftazidime administration was performed on days 2 and 7 following treatment. Corneal culture revealed extended-spectrum β-lactamase-producing Klebsiella pneumoniae and methicillin-resistant Staphylococcus aureus on day 4 after treatment. Consequently, 2% tobramycin was replaced with 1% vancomycin. The corneal lesion gradually improved and healed completely with a residual corneal opacity at 4 weeks after treatment. Conclusions Polymicrobial bacterial keratitis caused by antibiotic-resistant bacteria represents a treatment challenge. Therefore, culture is essential to obtain microbiological evidence and guide appropriate antibiotic selection.

Purpose: To compare the macular and peripapillary vascular parameters between the primary angle closure suspect (PACS) eyes and normal control eyes using optical coherence tomography angiography (OCTA). Methods: In this retrospective study, 42 PACS subjects and 38 normal individuals are included. Vessel density (VD) and perfusion density (PD) of the macular area and peripapillary area, and fovea avascular zone parameter were analyzed using OCTA and compared between two groups after adjustment for the axial length. Results: There were no statistically significant differences in sex ratio, age, refractive errors and intraocular pressures between both groups. In the peripapillary area, inferior VD and PD in the outer zone were significantly lower in the PACS eyes, while the retinal nerve fiber layer thicknesses were similar between groups (p = 0.032, 0.026). In the macular superficial capillary plexus, inferior VD and PD in the inner zone, inferior VD and PD, nasal VD and PD in the outer zone were significantly lower in the PACS eyes, whereas ganglion cell inner plexiform layer thickness were similar between both groups (all p < 0.005). Conclusions The VDs and PDs of retinal capillaries in PACS eyes, which have no glaucomatous changes in the retinal nerve fiber layer and optic nerve disc, were significantly lower compared to normal eyes.