BACKGROUND/OBJECTIVES: This study aimed to use plasma metabolites to identify clusters of breast cancer survivors and to compare their dietary characteristics and health-related factors across the clusters using unsupervised machine learning. SUBJECTS/METHODS: A total of 419 breast cancer survivors were included in this crosssectional study. We considered 30 plasma metabolites, quantified by high-throughput nuclear magnetic resonance metabolomics. Clusters were obtained based on metabolites using 4 different unsupervised clustering methods: k-means (KM), partitioning around medoids (PAM), self-organizing maps (SOM), and hierarchical agglomerative clustering (HAC). The t-test, χ2 test, and Fisher’s exact test were used to compare sociodemographic, lifestyle, clinical, and dietary characteristics across the clusters. P-values were adjusted through a false discovery rate (FDR). RESULTS: Two clusters were identified using the 4 methods. Participants in cluster 2 had lower concentrations of apolipoprotein A1 and large high-density lipoprotein (HDL) particles and smaller HDL particle sizes, but higher concentrations of chylomicrons and extremely large very-low-density-lipoprotein (VLDL) particles and glycoprotein acetyls, a higher ratio of monounsaturated fatty acids to total fatty acids, and larger VLDL particle sizes compared with cluster 1. Body mass index was significantly higher in cluster 2 compared with cluster 1 (FDR adjusted-PKM < 0.001; PPAM = 0.001; PSOM < 0.001; and PHAC = 0.043). CONCLUSION The breast cancer survivors clustered on the basis of plasma metabolites had distinct characteristics. Further prospective studies are needed to investigate the associations between metabolites, obesity, dietary factors, and breast cancer prognosis.

Purpose: To report a case of macular serous retinal detachment and macular thinning associated with optic disc pit maculopathy successfully treated with vitrectomy, fovea-sparing internal limiting membrane (ILM) peeling, and inverted ILM flap technique.Case summary: A 27-year-old male patient presented with a 1-month history of decreased right eye vision. Corrected visual acuity in the right eye was 0.025 at initial visit. Fundus examination revealed an oval, deep-seated defect in the inferotemporal portion of the optic nerve and a chorioretinal coloboma located inferior to the optic nerve with a one-third disc diameter. Optical coherence tomography (OCT) showed severe macular serous detachment and central foveal thinning. Surgical treatment comprised vitrectomy, ILM peeling preserving an amount of ILM equivalent to the diameter of one disc in the central fovea and covering the optic disc pit with an inverted ILM flap from its nasal portion. The flap was fixed with a dispersible viscoelastic material and intravitreal 20% sulfur hexafluoride gas injection. The patient was maintained in a facedown position for 3 days postoperatively. After 15 months, the best-corrected visual acuity of the right eye improved to 0.63. Repeat OCT revealed resolution of retinoschisis and serous retinal detachment, with the ILM flap effectively covering the optic disc pit. Conclusions Fovea-sparing ILM peeling with an inverted ILM flap on the nasal side over the optic disc pit in patients with thin inner retinal layers and excessive serous retinal detachment effectively prevent the occurrence of macular holes and treat optic disc pit maculopathy.

BACKGROUND/OBJECTIVES: This study aimed to use plasma metabolites to identify clusters of breast cancer survivors and to compare their dietary characteristics and health-related factors across the clusters using unsupervised machine learning. SUBJECTS/METHODS: A total of 419 breast cancer survivors were included in this crosssectional study. We considered 30 plasma metabolites, quantified by high-throughput nuclear magnetic resonance metabolomics. Clusters were obtained based on metabolites using 4 different unsupervised clustering methods: k-means (KM), partitioning around medoids (PAM), self-organizing maps (SOM), and hierarchical agglomerative clustering (HAC). The t-test, χ2 test, and Fisher’s exact test were used to compare sociodemographic, lifestyle, clinical, and dietary characteristics across the clusters. P-values were adjusted through a false discovery rate (FDR). RESULTS: Two clusters were identified using the 4 methods. Participants in cluster 2 had lower concentrations of apolipoprotein A1 and large high-density lipoprotein (HDL) particles and smaller HDL particle sizes, but higher concentrations of chylomicrons and extremely large very-low-density-lipoprotein (VLDL) particles and glycoprotein acetyls, a higher ratio of monounsaturated fatty acids to total fatty acids, and larger VLDL particle sizes compared with cluster 1. Body mass index was significantly higher in cluster 2 compared with cluster 1 (FDR adjusted-PKM < 0.001; PPAM = 0.001; PSOM < 0.001; and PHAC = 0.043). CONCLUSION The breast cancer survivors clustered on the basis of plasma metabolites had distinct characteristics. Further prospective studies are needed to investigate the associations between metabolites, obesity, dietary factors, and breast cancer prognosis.

Purpose: To report a case of macular serous retinal detachment and macular thinning associated with optic disc pit maculopathy successfully treated with vitrectomy, fovea-sparing internal limiting membrane (ILM) peeling, and inverted ILM flap technique.Case summary: A 27-year-old male patient presented with a 1-month history of decreased right eye vision. Corrected visual acuity in the right eye was 0.025 at initial visit. Fundus examination revealed an oval, deep-seated defect in the inferotemporal portion of the optic nerve and a chorioretinal coloboma located inferior to the optic nerve with a one-third disc diameter. Optical coherence tomography (OCT) showed severe macular serous detachment and central foveal thinning. Surgical treatment comprised vitrectomy, ILM peeling preserving an amount of ILM equivalent to the diameter of one disc in the central fovea and covering the optic disc pit with an inverted ILM flap from its nasal portion. The flap was fixed with a dispersible viscoelastic material and intravitreal 20% sulfur hexafluoride gas injection. The patient was maintained in a facedown position for 3 days postoperatively. After 15 months, the best-corrected visual acuity of the right eye improved to 0.63. Repeat OCT revealed resolution of retinoschisis and serous retinal detachment, with the ILM flap effectively covering the optic disc pit. Conclusions Fovea-sparing ILM peeling with an inverted ILM flap on the nasal side over the optic disc pit in patients with thin inner retinal layers and excessive serous retinal detachment effectively prevent the occurrence of macular holes and treat optic disc pit maculopathy.

BACKGROUND/OBJECTIVES: This study aimed to use plasma metabolites to identify clusters of breast cancer survivors and to compare their dietary characteristics and health-related factors across the clusters using unsupervised machine learning. SUBJECTS/METHODS: A total of 419 breast cancer survivors were included in this crosssectional study. We considered 30 plasma metabolites, quantified by high-throughput nuclear magnetic resonance metabolomics. Clusters were obtained based on metabolites using 4 different unsupervised clustering methods: k-means (KM), partitioning around medoids (PAM), self-organizing maps (SOM), and hierarchical agglomerative clustering (HAC). The t-test, χ2 test, and Fisher’s exact test were used to compare sociodemographic, lifestyle, clinical, and dietary characteristics across the clusters. P-values were adjusted through a false discovery rate (FDR). RESULTS: Two clusters were identified using the 4 methods. Participants in cluster 2 had lower concentrations of apolipoprotein A1 and large high-density lipoprotein (HDL) particles and smaller HDL particle sizes, but higher concentrations of chylomicrons and extremely large very-low-density-lipoprotein (VLDL) particles and glycoprotein acetyls, a higher ratio of monounsaturated fatty acids to total fatty acids, and larger VLDL particle sizes compared with cluster 1. Body mass index was significantly higher in cluster 2 compared with cluster 1 (FDR adjusted-PKM < 0.001; PPAM = 0.001; PSOM < 0.001; and PHAC = 0.043). CONCLUSION The breast cancer survivors clustered on the basis of plasma metabolites had distinct characteristics. Further prospective studies are needed to investigate the associations between metabolites, obesity, dietary factors, and breast cancer prognosis.

Purpose: To report a case of macular serous retinal detachment and macular thinning associated with optic disc pit maculopathy successfully treated with vitrectomy, fovea-sparing internal limiting membrane (ILM) peeling, and inverted ILM flap technique.Case summary: A 27-year-old male patient presented with a 1-month history of decreased right eye vision. Corrected visual acuity in the right eye was 0.025 at initial visit. Fundus examination revealed an oval, deep-seated defect in the inferotemporal portion of the optic nerve and a chorioretinal coloboma located inferior to the optic nerve with a one-third disc diameter. Optical coherence tomography (OCT) showed severe macular serous detachment and central foveal thinning. Surgical treatment comprised vitrectomy, ILM peeling preserving an amount of ILM equivalent to the diameter of one disc in the central fovea and covering the optic disc pit with an inverted ILM flap from its nasal portion. The flap was fixed with a dispersible viscoelastic material and intravitreal 20% sulfur hexafluoride gas injection. The patient was maintained in a facedown position for 3 days postoperatively. After 15 months, the best-corrected visual acuity of the right eye improved to 0.63. Repeat OCT revealed resolution of retinoschisis and serous retinal detachment, with the ILM flap effectively covering the optic disc pit. Conclusions Fovea-sparing ILM peeling with an inverted ILM flap on the nasal side over the optic disc pit in patients with thin inner retinal layers and excessive serous retinal detachment effectively prevent the occurrence of macular holes and treat optic disc pit maculopathy.

BACKGROUND/OBJECTIVES: This study aimed to use plasma metabolites to identify clusters of breast cancer survivors and to compare their dietary characteristics and health-related factors across the clusters using unsupervised machine learning. SUBJECTS/METHODS: A total of 419 breast cancer survivors were included in this crosssectional study. We considered 30 plasma metabolites, quantified by high-throughput nuclear magnetic resonance metabolomics. Clusters were obtained based on metabolites using 4 different unsupervised clustering methods: k-means (KM), partitioning around medoids (PAM), self-organizing maps (SOM), and hierarchical agglomerative clustering (HAC). The t-test, χ2 test, and Fisher’s exact test were used to compare sociodemographic, lifestyle, clinical, and dietary characteristics across the clusters. P-values were adjusted through a false discovery rate (FDR). RESULTS: Two clusters were identified using the 4 methods. Participants in cluster 2 had lower concentrations of apolipoprotein A1 and large high-density lipoprotein (HDL) particles and smaller HDL particle sizes, but higher concentrations of chylomicrons and extremely large very-low-density-lipoprotein (VLDL) particles and glycoprotein acetyls, a higher ratio of monounsaturated fatty acids to total fatty acids, and larger VLDL particle sizes compared with cluster 1. Body mass index was significantly higher in cluster 2 compared with cluster 1 (FDR adjusted-PKM < 0.001; PPAM = 0.001; PSOM < 0.001; and PHAC = 0.043). CONCLUSION The breast cancer survivors clustered on the basis of plasma metabolites had distinct characteristics. Further prospective studies are needed to investigate the associations between metabolites, obesity, dietary factors, and breast cancer prognosis.

BACKGROUND/OBJECTIVES: This study aimed to use plasma metabolites to identify clusters of breast cancer survivors and to compare their dietary characteristics and health-related factors across the clusters using unsupervised machine learning. SUBJECTS/METHODS: A total of 419 breast cancer survivors were included in this crosssectional study. We considered 30 plasma metabolites, quantified by high-throughput nuclear magnetic resonance metabolomics. Clusters were obtained based on metabolites using 4 different unsupervised clustering methods: k-means (KM), partitioning around medoids (PAM), self-organizing maps (SOM), and hierarchical agglomerative clustering (HAC). The t-test, χ2 test, and Fisher’s exact test were used to compare sociodemographic, lifestyle, clinical, and dietary characteristics across the clusters. P-values were adjusted through a false discovery rate (FDR). RESULTS: Two clusters were identified using the 4 methods. Participants in cluster 2 had lower concentrations of apolipoprotein A1 and large high-density lipoprotein (HDL) particles and smaller HDL particle sizes, but higher concentrations of chylomicrons and extremely large very-low-density-lipoprotein (VLDL) particles and glycoprotein acetyls, a higher ratio of monounsaturated fatty acids to total fatty acids, and larger VLDL particle sizes compared with cluster 1. Body mass index was significantly higher in cluster 2 compared with cluster 1 (FDR adjusted-PKM < 0.001; PPAM = 0.001; PSOM < 0.001; and PHAC = 0.043). CONCLUSION The breast cancer survivors clustered on the basis of plasma metabolites had distinct characteristics. Further prospective studies are needed to investigate the associations between metabolites, obesity, dietary factors, and breast cancer prognosis.

Objective: To investigate the efficacy of cancer antigen 125 (CA125) and human epididymis protein 4 (HE4) in predicting survival outcomes based on breast cancer gene (BRCA) mutational status in epithelial ovarian cancer. Methods: Medical records of 448 patients diagnosed with epithelial ovarian cancer at a single tertiary institution in Korea were retrospectively analyzed. Area under the curve, sensitivity, specificity, and accuracy were assessed using the CA125 and HE4 values after surgery and 3 cycles of chemotherapy to predict 1-year survival based on the BRCA mutational status.Kaplan–Meier analysis was used to obtain progression-free and overall survival to evaluate CA125 and HE4 effectiveness in predicting survival outcomes. Results: A total of 423 patients were analyzed, including 180 (42.6%) who underwent interval debulking surgery (IDS) and 243 (57.4%) who underwent primary debulking surgery (PDS).BRCA mutations were observed in 37 (15.2%) and 44 (22.4%) patients in the PDS and IDS groups, respectively. CA125 and HE4 normalization demonstrated the highest specificity in patients with or without BRCA mutations, with specificities of 97.1% and 99.1% in the PDS group and 78.6% and 86.2% in the IDS group, respectively. Normalizing HE4 alone may be an effective prognostic marker, with an area under the curve of 0.774 and specificity of 75.0%, in patients with BRCA mutations. Conclusion Normalizing both biomarkers emerged as the most effective predictive marker for the 1-year recurrence rate, regardless of BRCA mutational status. A negative HE4 value can be a useful predictor for 1-year recurrence-free survival in patients with BRCA mutations.

Purpose: To evaluate the clinical outcomes of 25-gauge microincision vitrectomy for vitreoretinal diseases in patients who have undergone glaucoma drainage implant surgery for the treatment of neovascular glaucoma. Methods: We retrospectively examined the preoperative and postoperative best corrected visual acuity (BCVA), intraocular pressure (IOP), and complications of patients with previous Ahmed valve implantation surgery who underwent vitrectomy and were available for follow-up for at least 6 months. Results: A total of 20 eyes had Ahmed valve implantation for neovascular glaucoma, of which 16 eyes (80%) had proliferative diabetic retinopathy, and 4 eyes (20%) had central retinal vein occlusion. All eyes underwent 25-gauge microincision vitrectomy for the treatment of vitreous hemorrhage unresponsive to conservative treatment. BCVA (logarithm of minimal angle of resolution, logMAR) improved from 1.08 ± 0.29 preoperatively to 0.61 ± 0.32 (p = 0.004) postoperatively. Mean IOP increased from 16.2 ± 3.4 mmHg preoperatively to 17.4 ± 2.8 mmHg at 6 months postoperatively (p = 0.569), with no significant change. There were no cases of exposed body or tube of Ahmed valve after surgery, and vitreous hemorrhage (7 eyes, 31.8%) was the most common complication. Conclusions With a carefully chosen incision site, 25-gauge microincision vitrectomy is an effective treatment method to treat vision-threatening complications such as vitreous hemorrhage in eyes previously implanted with a glaucoma drainage device, with minimal impact on elevated intraocular pressure.