Purpose: This study investigated the results of antinuclear antibody (ANA) testing in Korean patients with uveitis, examining its relationship with the clinical course of uveitis and systemic diseases. Methods: We conducted a retrospective analysis of the medical records of 64 patients with noninfectious uveitis who underwent ANA testing and were followed for at least 6 months at the Department of Ophthalmology at Seoul St. Mary's Hospital from January 2006 to December 2021. Patients were divided into ANA-positive and ANA-negative groups and correlations between uveitis-related factors and ANA status were assessed. Results: Among the 516 patients tested for ANA, 6.58% (34/516) were positive. The initial visual acuity (logMAR) before treatment was significantly better in the ANA-positive group (0.21 ± 0.20) than in the ANA-negative group (0.59 ± 0.68) (p = 0.002). However, the final visual acuity after treatment showed no statistically significant difference between the two groups. Additionally, no statistically significant differences were observed in terms of immune deficiency status, types of associated rheumatic disease, rheumatoid factor positivity, erythrocyte sedimentation rate, C-reactive protein (define) levels, or treatment modalities. No significant correlation was found between ANA titers and the severity of uveitis. Conclusions Relationships between ANA positivity and the etiology, treatment outcomes, and systemic diseases associated with uveitis are unclear. Routine ANA testing is not recommended for the diagnosis of uveitis.

Purpose: This study aimed to investigate the association between autonomic dysfunction and choroidal microvasculature in patients with type 2 diabetes. Methods: We conducted a retrospective single-center study of patients with type 2 diabetes who attended Seoul St. Mary’s Hospital between January 2018 and December 2022. Clinical features, laboratory findings, heart rate variability, and the findings of ophthalmic examinations were analyzed. Results: Seventy-four patients were divided into no diabetic retinopathy (no DR; 28 patients), non-proliferative DR (28 patients), and proliferative DR (PDR; 18 patients) groups. The standard deviation of the NN-interval (SDNN) index, best-corrected visual acuity (BCVA), and choroidal vascularity index (CVI) differed significantly in the PDR group (p < 0.01). Univariate regression analysis revealed that the urine albumin-to-creatinine ratio and SDNN were significantly associated with CVI (p < 0.05). However, only the SDNN was significantly associated with CVI (p = 0.026) in the multivariate regression analysis. This association did not remain significant after Bonferroni correction for two comparisons (α = 0.025). CVI showed a significant correlation with SDNN (r = 0.254, p = 0.029) and BCVA (r = -0.424, p < 0.001). Conclusions Given the significant association between autonomic dysfunction and choroidal microvascular changes, it is recommended that patients presenting with either condition undergo comprehensive evaluation for the other in type 2 diabetes.

Background: With increasing life expectancy, the number of older adults with multiple chronic conditions requiring complex medication regimens is growing, raising concerns about polypharmacy and potentially inappropriate medication (PIM) use. This study investigated trends in polypharmacy and PIM use among 66-year-olds in South Korea from 2012 to 2021, considering participant characteristics, to inform interventions and policies. Methods: A repeated cross-sectional study was conducted using the National Health Insurance Services database covering approximately 97% of Koreans. We included 3,397,044 individuals aged 66 who underwent the National Screening Program for Transitional Ages between 2012 and 2021. Polypharmacy was defined as the use of ≥5 medications for ≥90 days annually, hyper-polypharmacy as ≥10 medications, and PIM use as ≥1 PIM for ≥28 days. Trends were analyzed by sex, frailty, comorbidity, income, insurance type, and residence. Results: Polypharmacy prevalence increased from 32.0% in 2012 to 35.4% in 2021, and hyper-polypharmacy also rose. PIM use slightly decreased from 55.7% to 53.7%. Higher rates of polypharmacy and PIM use were observed among rural residents, medical aid beneficiaries, and those with lower income. Despite improvements in comorbidity and frailty, socioeconomic disparities widened, particularly among medical aid beneficiaries. Frequently prescribed PIMs included NSAIDs, PPIs, muscle relaxants, and anxiolytics/hypnotics. Conclusion While PIM use slightly decreased over the study period, it remained above 50%, and polypharmacy prevalence increased among older adults in Korea. Socioeconomic disparities in medication use persist, highlighting the need for targeted interventions and policies to promote safe medication use among vulnerable groups.

Clear cell renal cell carcinoma (ccRCC) is a disease with a wide variety of clinical progressions such as the rate of disease progression or the degree of metastasis. About 30% of ccRCC patients suffer from metastatic diseases, and about 30% develop metastasis after diagnosis. In the case of metastatic RCC, early prediction of the disease is important because of the poor prognosis, but ccRCC-specific molecular markers for clinical use are not available yet. As an alternative, liquid biopsy, which can find molecules released from tumor tissues in circulating blood and obtain information on metastatic dissemination and recurrence of ccRCC, is emerging. In this article, we will introduce molecules such as cell free DNA, cell free RNA, protein, and exosomes available as circulating biomarkers for liquid biopsy. We will also introduce some promising technologies that can compensate for the limitations of liquid biopsy.

Purpose: To investigate the clinical features of non-affected fellow eyes in patients with unilateral facial port-wine stain (PWS) and ipsilateral secondary glaucoma. Methods: We performed a retrospective analysis of the medical records of 35 patients with unilateral facial PWS glaucoma and those of controls (35 subjects without both facial PWS and glaucoma) between September 1996 and May 2020. We noted patients’ age at the glaucoma diagnosis (for unilateral facial PWS glaucoma patients) or at the initial examination (for controls), cup-to-disc ratio (CDR), and intraocular pressure (IOP). We compared the clinical features between the glaucoma-free eyes in patients with unilateral facial PWS glaucoma and the controls. Results: The mean age at the glaucoma diagnosis for unilateral facial PWS glaucoma patients was 0.56 ± 0.99 years (range, 0.08-4). The mean IOP of the glaucoma-free eyes was 16.68 ± 5.73 mmHg (range, 9-22.9), and the mean CDR was 0.37 ± 0.14 (range, 0.15-0.80) at glaucoma diagnosis. The mean IOP of the glaucoma-free eyes was 14.14 ± 6.29 mmHg (range, 8.1-26.7), and the mean CDR was 0.37 ± 0.12 (range, 0.26-0.82) at final examination. When comparing glaucoma-free eyes of the unilateral facial PWS glaucoma patients with the control group (mean age, 11.2 ± 7.4 years), the mean CDR was significantly greater (0.37 ± 0.12 vs. 0.30 ± 0.08; p = 0.014) but there was no significant difference in the mean IOP (14.14 ± 6.29 mmHg vs. 14.57 ± 2.49 mmHg; p = 0.712). Conclusions The glaucoma-free eyes of unilateral facial PWS glaucoma patients showed greater CDR compared to the non-facial PWS and non-glaucoma controls. Additional longitudinal studies are needed to investigate the clinical course of those eyes, whether the risk of developing glaucoma is increased.

Purpose: To compare the ocular biometry and postoperative refractive outcomes using two devices; the swept-source opticalcoherence tomography biometer (Argos) versus the partial coherence interferometer (IOL Master®500, Carl Zeiss Meditec AG,Jena, Germany). Methods: The axial length (AL), anterior chamber depth (ACD) and keratometry (K) in 221 cataract eyes were measured withArgos and IOL Master®500. One month after surgery, refraction of the respective eyes was conducted and the mean absoluteerror (MAE) calculated for analysis of the refractive outcomes. Results: Measurement was not possible in 13 eyes with the IOL Master®500 but was possible with Argos. Measurement was notpossible in one eye with either biometer. Agreement in measured ocular biometry between the two devices by intraclass correlationcoefficient (ICC) and Bland-Altman plot (ICC AXL = 0.999, ACD = 0.975, K = 0.978) was excellent. The AL and ACD measuredwith Argos were significantly longer than measured with IOL Master®500 (p= 0.005, p= 0.000). The MAE showed no significantdifference between the Argos and IOL Master®500 (p= 0.087). Conclusions The measurement of ocular biometry was better in Argos than in IOL Master®500. The accuracy of the intraocularlens power calculations of Argos was clinically acceptable and compatible with a conventional device.

Objectives: . This study was conducted to compare clinicopathologic and radiologic factors between benign and malignant thyroid nodules and to evaluate the diagnostic performance of shear wave elastography (SWE) combined with B-mode ultrasonography (US) in differentiating malignant from benign thyroid nodules. Methods: . This retrospective study included 92 consecutive patients with 95 thyroid nodules examined on B-mode US and SWE before US-guided fine-needle aspiration biopsy or surgical excision. B-mode US findings (composition, echogenicity, margin, shape, and calcification) and SWE elasticity parameters (maximum [Emax], mean, minimum, and nodule-to-normal parenchymal ratio of elasticity) were reviewed and compared between benign and malignant thyroid nodules. The diagnostic performance of B-mode US and SWE for predicting malignant thyroid nodules was analyzed. The optimal cutoff values of elasticity parameters for identifying malignancy were determined. Diagnostic performance was compared between B-mode US only, SWE only, and the combination of B-mode US with SWE. Results: . On multivariate logistic regression analysis, age (odds ratio [OR], 0.90; P=0.028), a taller-than-wide shape (OR, 11.3; P=0.040), the presence of calcifications (OR, 15.0; P=0.021), and Emax (OR, 1.22; P=0.021) were independent predictors of malignancy in thyroid nodules. The combined use of B-mode US findings and SWE yielded improvements in sensitivity, the positive predictive value, the negative predictive value, and accuracy compared with the use of B-mode US findings only, but with no statistical significance. Conclusion . When SWE was combined with B-mode US, the diagnostic performance was better than when only B-mode US was used, although the difference was not statistically significant.

No abstract available.
Choroid ; Hypopigmentation ; Vitiligo

PURPOSE: To investigate the risk factors of diabetic nephropathy in patients with diabetic retinopathy requiring panretinal photocoagulation (PRP) and the visual prognosis. METHODS: A retrospective review of electronic medical records was conducted at Seoul St. Mary's Hospital, comprising 103 patients with type 2 diabetes mellitus and diabetic retinopathy who underwent PRP from 1996 to 2005. Patients with type 1 diabetes mellitus, non-diabetic renal disease, non-diabetic retinal disease, visually significant ocular disease, high-risk proliferative diabetic retinopathy, and advanced diabetic retinopathy were excluded. The patients were divided into three groups: no nephropathy (group 1, n = 45), microalbuminuria (group 2, n = 16), and advanced nephropathy (group 3, n = 42). Duration of diagnosis of retinopathy and nephropathy, glycosylated hemoglobin, visual acuity, complications, and treatment history were investigated. RESULTS: The mean glycosylated hemoglobin of group 3 (8.4 ± 1.2) was higher than that of group 1 (7.7 ± 1.0) or group 2 (7.7 ± 1.0) (p = 0.04). Mean interval from PRP to diagnosis of nephropathy was 8.8 ± 6.0 years in group 2 and 8.7 ± 4.9 years in group 3. The significant decrease in visual acuity in group 3 (28 eyes, 35.9%) was significantly higher than that in group 1 (15 eyes, 18.1%, p = 0.01) or group 2 (6 eyes, 20.7%, p = 0.03). Only vitreous hemorrhage showed a significantly higher incidence in groups 2 and 3 than in group 1 (p = 0.02). Multivariate regression analysis revealed that female sex and lower glycosylated hemoglobin were significantly associated with a protective effect on development of nephropathy. CONCLUSIONS: In the clinical setting, many patients with PRP-requiring diabetic retinopathy develop nephropathy an average of 8 to 9 years after PRP. Male sex and higher glycosylated hemoglobin could be risk factors of nephropathy.
Diabetes Mellitus, Type 1 ; Diabetes Mellitus, Type 2 ; Diabetic Nephropathies ; Diabetic Retinopathy ; Diagnosis ; Electronic Health Records ; Female ; Hemoglobin A, Glycosylated ; Humans ; Incidence ; Light Coagulation ; Male ; Prognosis ; Retinal Diseases ; Retrospective Studies ; Risk Factors ; Seoul ; Visual Acuity ; Vitreous Hemorrhage