Myopia, particularly high myopia, is a significant risk factor for several ocular pathologies including cataract, glaucoma, and retinal detachment. Excessive axial elongation associated with high myopia can induce biomechanical stretching, increasing the risk of serious complications like posterior staphyloma and myopic maculopathy. Global meta-analyses estimate that approximately 10 million people were visually impaired due to myopic maculopathy in 2015, with 3 million being blind. Recent nationwide surveys in South Korea revealed a prevalence of 65.4% for myopia and 6.9% for high myopia in children and adolescents, highlighting the urgent need for effective management. Delaying the onset and slowing the progression of myopia during childhood and adolescence is crucial for reducing the potential lifetime risk of these complications. This consensus statement, prepared by the Korean Myopia Society for the Korean Association for Pediatric Ophthalmology and Strabismus (KAPOS), reviews the current evidence for myopia control interventions and provides management strategies applicable to the South Korean clinical setting. Key interventions covered include lifestyle modifications (outdoor time, near work adjustment), optical methods (myopia-control spectacle lenses, dual-focus soft contact lenses, orthokeratology), and pharmacologic treatment (low-concentration atropine), as well as combination therapies. The statement also addresses patient selection, treatment outcome evaluation using spherical equivalent and axial length changes, and the crucial aspects related to treatment cessation and the rebound effect.

Purpose: To investigate the recent prescription patterns among South Korean pediatric ophthalmologists to control myopia progression. Methods: An online survey was distributed to the members of the Korean Association of Pediatric Ophthalmology and Strabismus (KAPOS) between August 22 and 31, 2023. Respondents selected treatment modalities that they prescribed to slow myopia progression. Multiple responses were allowed, and prescribing patterns were analyzed by respondents’ characteristics, including years since board certification, practice type, practice location, and average number of pediatric myopia patients seen per week. Results: Of 167 active members, 119 (71.3%) completed the survey, and 118 provided full responses. Most respondents practiced in Seoul or metropolitan areas (75.4%), worked in hospitals (73.7%), had >10 years of clinical experience (68.9%), and treated >20 pediatric myopia patients weekly (62.2%). With multiple responses allowed, 0.125% atropine eye drops (75.6%) were most commonly prescribed, followed by orthokeratology lenses (57.1%). When grouped into mutually exclusive categories (topical atropine only, optical interventions only, both and neither), the largest proportion of respondents (63.0%) selected both pharmacological and optical treatments. Treatment patterns did not differ by experience or location, but significant differences were observed by practice type and weekly pediatric myopia patient volume. Private practitioners more often prescribed orthokeratology, dual-focus soft contact lenses, and selected both pharmacologic and optical treatments, whereas hospital practitioners more commonly selected topical atropine alone. Those treating a higher volume of pediatric myopia patients showed a greater tendency to select both pharmacologic and optical treatments. Conclusions In this survey of KAPOS members, topical atropine, particularly the 0.125% commercial formulation, was the most commonly prescribed single modality for myopia control. Topical atropine and optical interventions emerged as the most common treatment strategies, particularly in private clinics. These findings indicate a trend towards more proactive and multimodal approaches to myopia control compared with earlier practice patterns in South Korea.

Childhood myopia has become a significant global public health concern, especially in urbanized regions, with adolescent prevalence rates at 80–90%. This increase poses clinical challenges and significant socioeconomic burdens, necessitating effective prevention strategies. Recent research has demonstrated that genetic predisposition and environmental exposure, such as increased screen time, intensive near work, and reduced outdoor activity, are crucial in the onset and progression of myopia. Parental myopia and specific loci identified through genome-wide association studies (GWASs) contribute to susceptibility and disease severity; however, environmental factors can accelerate or attenuate these genetic risks. Emerging strategies have focused on integrating genomic and epigenetic information to advance personalized prevention and treatment. Therefore, childhood myopia arises from the complex gene–environment interactions. Ongoing research and policy innovation are essential to safeguard the vision and health of future generations.

Methods: Retrospective study of 120 patients (223 fusion levels) who underwent ACDF between 2016 and 2021. Spacer types included structural allografts, PEEK, titanium, and ceramic cages. Radiographic measurements of subsidence were obtained from immediate (≤8 weeks) and long-term (≥6 months) postoperative lateral cervical radiographs. Multivariable linear regression was used to assess the association between spacer type and subsidence, adjusting for patient demographics, surgical levels, smoking history, and osteopenia. Results: The mean age of patients was 53.6±10.9 years and 41.7% were male; 47.5% had a smoking history and 20.8% had osteopenia. There were 38 one-level (31.7%), 61 two-level (50.8%), and 21 three-level fusions (17.5%). Spacer distribution included 62 structural allografts (51.7%), 27 PEEK (22.5%), 20 titanium (16.7%), and 11 ceramic (9.2%) cages. On multivariable analysis, PEEK cages were associated with significantly less anterior subsidence (β=−0.972, p <0.001) and posterior subsidence (β=−0.666, p=0.001) compared to allografts, and greater preservation of segmental lordosis (β=1.393, p=0.024). No significant differences in subsidence were found between titanium, ceramic, and allograft spacers. Conclusions PEEK cages showed reduced subsidence and better preservation of cervical lordosis compared to structural allografts, while titanium and ceramic cages did not differ significantly from structural allografts. These results suggest that PEEK cages may help minimize subsidence-related complications and improve outcomes.

Objective: : Posterior endoscopic cervical foraminotomy (PECF) is a minimally invasive surgical technique for treating cervical radiculopathy. Traditionally, PECF is performed under general anesthesia in the prone position, but concerns over anesthesia-related complications have led to the exploration of local anesthesia in the lateral decubitus position as an alternative. This study aims to compare the clinical outcomes, safety, and efficacy of PECF performed under local anesthesia in the lateral decubitus position versus general anesthesia in the prone position. Methods: : We conducted a retrospective analysis of 13 patients who underwent PECF under local anesthesia in the lateral decubitus position. The outcomes were compared with data from 357 patients across eight studies who underwent PECF under general anesthesia in the prone position. Outcomes measures included Visual analog scale (VAS) pain scores, Oswestry disability index (ODI), length of stay (LOS), minimally clinically important difference (MCID), and complications. Results: : Patients in the local anesthesia group demonstrated significant reductions in neck pain (VAS-N : 4.93±1.32 to 1.49±0.52, p<0.001) and arm pain (VAS-A : 8.69±0.75 to 1.85±1.46, p<0.001), achieving a mean pain reduction of 78.8%. These improvements were comparable to the general anesthesia group (VAS-N : 4.80 to 1.28; VAS-A : 6.71 to 1.23). Functional outcomes improved significantly in both groups, with ODI scores improving from 54.76% to 9.82% locally and from 39.92% to 9.62% in the general group. Although LOS was slightly longer for the local anesthesia group (5.85±3.20 vs. 4.81±2.17 days, p=0.18), post-procedure monitoring time was significantly shorter (3.2 vs. 7.4 hours, p<0.001). The local anesthesia group reported zero complications (0%; 95% confidence interval [CI], 0–22.8%) compared to an 8.68% complication rate (95% CI, 5.8–11.6%) in the general anesthesia cohort (p=0.612). Conclusion : PECF under local anesthesia in the lateral decubitus position provides comparably effective pain relief and functional improvement comparable to general anesthesia, though the difference in complication rates was not statistically significant and requires larger studies for confirmation. This technique may be particularly advantageous for patients at higher risk for anesthesia-related complications. Further research is warranted to validate these findings in larger, prospective studies.

Purpose: Pattern electroretinogram (PERG) is used to evaluate the function of retinal ganglion cells. However, the amplitude of PERG is quite small, making the examination challenging to perform. Waveform noise may be minimized by applying various filters. We aimed to investigate the effect of 50-Hz filters on PERG test results. Methods: This is the retrospective observational study. PERG tests were performed using the RETI-scan system according to the International Society for Clinical Electrophysiology of Vision guidelines. Three types of 50-Hz filters (soft, middle, and hard) were applied. The differences in parameters (N35 peak time, P50 peak time, N95 peak time, P50 amplitude, N95 amplitude, and N95 to P50 ratio) were analyzed. Based on the provided normal range, the changes from normal to abnormal range or vice versa were investigated. Results: A total of 24 waveforms were analyzed. After filtering, the P50 and N95 amplitudes showed a significant reduction of 8% to 15% (P50 amplitude: 5.1 ± 2.7 μV without filter, 4.6 ± 2.3 μV with 50-Hz soft filter, 4.3 ± 2.1 μV with 50-Hz middle filter, 4.3 ± 2.1 μV with 50-Hz hard filter; N95 amplitude: 7.2 ± 4.2 μV without filter, 6.6 ± 3.8 μV with 50-Hz soft filter, 6.3 ± 3.6 μV with 50-Hz middle filter, 6.1 ± 3.6 μV with 50-Hz hard filter). This pattern was more prominent in normal subjects. All latencies except the N35 peak time exhibited no differences between the tests. The N95 to P50 ratio decreased after 50-Hz middle and hard filtering. Considering the normative data, switching between normal and abnormal results was rare. Conclusions Although peak time was not significantly affected, amplitude was significantly reduced after using 50-Hz filters. Thus, 50-Hz filters can smoothen the waveform. Nevertheless, caution must be exercised while taking readings.

Endoscopic spine surgery (ESS) is growing in popularity worldwide. An expanding body of literature demonstrates rapid functional recovery with reduced morbidity compared to open techniques. Both full endoscopic spine surgery, or uniportal endoscopy, and unilateral biportal endoscopy (UBE) can be employed in conjunction with various navigation and enabling technologies for assistance with localization of anatomic orientation and assessment of the intraoperative target spinal pathology. This review article describes various navigation technologies in ESS, including 2-dimensional (2D) fluoroscopic imaging, 2D fluoroscopic navigation, 3-dimensional C-arm navigation, augmented reality, and spinal robotics. Employment of enabling navigation and emerging technology with the registration of patient-specific anatomy enables clear delineation of anatomic landmarks and facilitation of a successful procedure. Additionally, avoidance of common pitfalls during use of navigation systems in ESS is discussed in this review.

Purpose: Physiological aging is associated with microvascular dysfunction, including in the penis, and this may contribute to age-related erectile dysfunction (ED). Low-intensity extracorporeal shockwave therapy (Li-ESWT) is a non-invasive intervention for ED, but its effect on penile microvascular function, remains unclear. Our objectives are to (i) evaluate the effect of Li-ESWT (specifically radial type ESWT [rESWT]) on penile microvascular perfusion (PMP) in aging rats, (ii) elucidate a possible mechanism, and (iii) evaluate its impact on angiogenic and smooth muscle biomarkers in cavernosal tissue. Materials and Methods: Male rats (n=9; 15–18 months) were anesthetized and subjected to rESWT while monitoring PMP. The nitric oxide (NO) pathway involvement was assessed by measuring the effect of rESWT on PMP following an intracavernosal injection of N(G)-nitroarginine methyl ester (L-NAME) (NO synthase inhibitor). To elucidate the cellular mechanism, another group of rats received repeated rESWT (n=4) or no treatment (n=4) three times/week for two weeks. Rats were euthanized at the end of the study and penile tissues were analyzed for angiogenic markers (vascular endothelial growth factor-A [VEGF-A], endothelial nitric oxide synthase [eNOS]) and smooth muscle content (α-actin) using immunostaining, Western blot, and quantitative polymerase chain reaction (qPCR). Results: rESWT resulted in more than a 2-fold increase in PMP (from 68.5 arbitrary units; 163.7 AU). L-NAME injection produced a <40%–50% decrease (185.3 to 101.0 AU) in rESWT-induced PMP response. Immunostaining revealed increased α-actin, eNOS, and VEGF-A in the cavernosum and these findings were confirmed by qPCR and Western blot results. Conclusions rESWT improved PMP, which may be mediated via increased VEGF expression, which stimulates the NO/cyclic guanosine monophosphate pathway, resulting in sustained PMP. rESWT devices could offer a safe, non-invasive treatment for age-related ED.

Endoscopic spine surgery (ESS) is growing in popularity worldwide. An expanding body of literature demonstrates rapid functional recovery with reduced morbidity compared to open techniques. Both full endoscopic spine surgery, or uniportal endoscopy, and unilateral biportal endoscopy (UBE) can be employed in conjunction with various navigation and enabling technologies for assistance with localization of anatomic orientation and assessment of the intraoperative target spinal pathology. This review article describes various navigation technologies in ESS, including 2-dimensional (2D) fluoroscopic imaging, 2D fluoroscopic navigation, 3-dimensional C-arm navigation, augmented reality, and spinal robotics. Employment of enabling navigation and emerging technology with the registration of patient-specific anatomy enables clear delineation of anatomic landmarks and facilitation of a successful procedure. Additionally, avoidance of common pitfalls during use of navigation systems in ESS is discussed in this review.

Purpose: Physiological aging is associated with microvascular dysfunction, including in the penis, and this may contribute to age-related erectile dysfunction (ED). Low-intensity extracorporeal shockwave therapy (Li-ESWT) is a non-invasive intervention for ED, but its effect on penile microvascular function, remains unclear. Our objectives are to (i) evaluate the effect of Li-ESWT (specifically radial type ESWT [rESWT]) on penile microvascular perfusion (PMP) in aging rats, (ii) elucidate a possible mechanism, and (iii) evaluate its impact on angiogenic and smooth muscle biomarkers in cavernosal tissue. Materials and Methods: Male rats (n=9; 15–18 months) were anesthetized and subjected to rESWT while monitoring PMP. The nitric oxide (NO) pathway involvement was assessed by measuring the effect of rESWT on PMP following an intracavernosal injection of N(G)-nitroarginine methyl ester (L-NAME) (NO synthase inhibitor). To elucidate the cellular mechanism, another group of rats received repeated rESWT (n=4) or no treatment (n=4) three times/week for two weeks. Rats were euthanized at the end of the study and penile tissues were analyzed for angiogenic markers (vascular endothelial growth factor-A [VEGF-A], endothelial nitric oxide synthase [eNOS]) and smooth muscle content (α-actin) using immunostaining, Western blot, and quantitative polymerase chain reaction (qPCR). Results: rESWT resulted in more than a 2-fold increase in PMP (from 68.5 arbitrary units; 163.7 AU). L-NAME injection produced a <40%–50% decrease (185.3 to 101.0 AU) in rESWT-induced PMP response. Immunostaining revealed increased α-actin, eNOS, and VEGF-A in the cavernosum and these findings were confirmed by qPCR and Western blot results. Conclusions rESWT improved PMP, which may be mediated via increased VEGF expression, which stimulates the NO/cyclic guanosine monophosphate pathway, resulting in sustained PMP. rESWT devices could offer a safe, non-invasive treatment for age-related ED.