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Purpose: To evaluate the association between dry eye disease (DED) and various psychiatric and systemic diseases in an adult Korean population aged 40 years or older. Methods: Population-based cross-sectional data of 6,732 participants aged ≥ 40 years was extracted from the Korea National Health and Nutrition Examination Survey 2017-2018 (KNHANES VII). Data including DED, demographic variables, behavioral factors, psychiatric conditions, and systemic diseases was analyzed to determine the prevalence and psychiatric and systemic risk factors for DED. Results: The weighted prevalence of DED was 7.9 ± 0.4% (mean ± SE). Multivariate analysis showed that female sex and urban residence were associated with an increased risk of DED. The prevalence of DED was lower in patients aged ≥70 years than in those aged 40–69 years. Psychological conditions including perceived stress and depression were associated with the risk of DED. Systemic conditions, such as rheumatoid arthritis, degenerative arthritis, osteoporosis, ischemic heart disease, and chronic renal failure had association with an increased risk of DED. Conclusion: DED may be associated with several psychiatric and systemic conditions, which highlights the need for an integrated approach to manage these diseases for optimal treatment of DED.

PURPOSE To investigate whether subconjunctival hemorrhage (SCH) raises the risk of subsequent stroke or acute myocardial infarction (AMI) in the general population. METHODS Using the National Health Insurance Service-National Sample Cohort database records from 2002 to 2013. Of 1,025,340 individuals in the database, we included 703,090 aged ≥ 20 years old without any history of SCH, cerebrovascular diseases, and ischemic heart diseases in the analyses. Of these, we identified 46,251 cases of incident SCH and regarded it as a time-varying covariate. We performed sensitivity analyses using 1:4 propensity score (PS)-based matched controls. To adjust for potential confounders, we investigated Cox regression models using defined demographic information, comorbidities, co-medications, and the Charlson Comorbidity Index score. RESULTS The SCH group showed higher incidence probability of stroke or AMI than the general population (3.17% versus 2.71%, respectively; p

We retrospectively evaluate the actual anterior-posterior (AP) corneal radius ratio in eyes with previous laser correction for myopia (M-LVC) according to axial length (AL) using biometry data exported from swept-source optical coherence tomography between January 2018 and October 2021 in a tertiary hospital (1,018 eyes with a history of M-LVC and 19,841 control eyes). The AP ratio was significantly higher in the LVC group than in the control group. Further, it was significantly positively correlated with AL in the LVC group. We also investigated the impact of the AP ratio and AL on the absolute prediction error (APE) in 39 eyes that underwent cataract surgery after M-LVC. The APE was significantly lower in the Barrett True-K with total keratometry (Barrett True-TK) than in the Haigis-L formula on eyes with AL above 26 mm. In eyes with AL of 26–28 mm, the percentage of prediction error within ± 1 D for Barrett True-TK and Barrett True-K was significantly higher than that for Haigis-L. In conclusion, in eyes with previous M-LVC, AP ratio increases with AL. The Barrett True-K or Barrett True-TK formulas are recommended rather than Haigis-L formula in M-LVC eyes longer than 26 mm.

BackgroundDown-sloping sensorineural hearing loss (SNHL) in people in their teens and 20s hampers efficient learning and communication and in-depth social interactions. Nonetheless, its aetiology remains largely unclear, with the exception of some potential causative genes, none of which stands out especially in people in their teens and 20s. Here, we examined the role and genotype–phenotype correlation of lipoxygenase homology domain 1 (LOXHD1) in down-sloping SNHL through a cohort study.MethodsBased on the Seoul National University Bundang Hospital (SNUBH) genetic deafness cohort, in which the patients show varying degrees of deafness and different onset ages (n=1055), we have established the ‘SNUBH Teenager–Young Adult Down-sloping SNHL’ cohort (10–35 years old) (n=47), all of whom underwent exome sequencing. Three-dimensional molecular modelling, minigene splicing assay and short tandem repeat marker genotyping were performed, and medical records were reviewed.ResultsLOXHD1 accounted for 33.3% of all genetically diagnosed cases of down-sloping SNHL (n=18) and 12.8% of cases in the whole down-sloping SNHL cohort (n=47) of young adults. We identified a potential common founder allele, as well as an interesting genotype–phenotype correlation. We also showed that transcript 6 is necessary and probably sufficient for normal hearing.ConclusionsLOXHD1 exceeds other genes in its contribution to down-sloping SNHL in young adults, rising as a signature causative gene, and shows a potential but interesting genotype–phenotype correlation.

Purpose: To compare the efficacy and safety of HU00701 (0.01% cyclosporin A + 3% trehalose), HU007 (0.02% cyclosporin A + 3% trehalose) (all w/v), and placebo in patients with moderate to severe dr...

To compare the proportions of patients satisfying Korean dry eye guidelines and Asia Dry Eye Society (ADES) diagnostic criteria and to describe the clinical characteristics and practice patterns of dry eye patients in Korea. Prospective observational study. This study enrolled 160 patients, with 158 patients analyzed. ADES guidelines were applied to dry eye patients satisfying the Korean dry eye guidelines. Risk factors for dry eye (e.g. visual display terminal [VDT] use) were evaluated. Dry eye subtypes were categorized as aqueous-deficient or evaporative. Objective signs (e.g. corneal and keratoconjunctival staining scores, tear break-up time [TBUT], and Schirmer test) and symptoms (Dry Eye-Related Quality of Life Score [DEQS] and Ocular Surface Disease Index [OSDI] questionnaire) were evaluated. Treatment patterns were also recorded. Patients (mean age 43.1 years) were mainly women (85.4%), with a high proportion (77.2%) of VDT users. Concordance between Korean and ADES guidelines was high (94.3%), with most patients (94.3%) having tear film instability (TBUT ≤ 5 s). Evaporative dry eye occurred in 60.1% and aqueous-deficient in 39.9% of cases. Objective signs were significantly better in evaporative than in aqueous-deficient dry eye. The DEQS bothersome ocular symptoms’ score was significantly higher in VDT users than in non-users. OSDI symptom severity and DEQS were significantly correlated (p

Purpose To investigate the characteristics of eyes with dry eye disease (DED) whose lipid layer thickness (LLT) measured 100 nm on a LipiView II interferometer and compare the DED parameters of them to those with LLT below 100 nm. Methods A total of 201 eyes of 102 enrolled DED patients (mean age 56.4 ± 11.8 years) were classified into 3 groups according to their average LLT; < 60 nm as thin-LLT (n = 49), 60–99 nm as normal-LLT (n = 77), and 100 nm as thick-LLT (n = 75). LLT, meiboscore, Schirmer I test, tear film break-up time (TBUT), ocular surface staining (OSS), and ocular surface disease index (OSDI) were assessed. Results The OSS and TBUT were significantly worse in the thick-LLT group than in the normal-LLT group (p = 0.020, and p = 0.028, respectively). The OSDI was significantly higher in the thick-LLT group than in the thin-LLT group (p = 0.006). However, the meiboscore was not different among the three groups (p = 0.33). Age, OSS, and OSDI showed a positive correlation with LLT (r = 0.16, p = 0.023; r = 0.213, p = 0.003; and r = 0.338, p = 0.001, respectively). In sensitivity analyses, eyes with corneal erosions had a significantly higher average LLT (p = 0.015), higher OSDI (p = 0.009), shorter TBUT (p < 0.001), and shorter Schirmer I value (p = 0.024) than those with clear corneas. Conclusion The average LLT of eyes with corneal erosions was thicker than those without erosions, suggesting that the LLT of 100 nm in the eyes with corneal erosions should not be regarded as a stable physiologic condition. Cautious interpretation of LLT along with other dry eye parameters is required.

To report the efficacy and safety of large diameter scleral lenses and determine their suitability in Asian subjects with intractable ocular surface diseases. This prospective study enrolled intractable ocular surface diseases subjects with uncorrected visual acuity > counting finger but ≥ 0.3 logMAR and best-corrected visual acuity (BCVA) ≥ 0.3 logMAR, to fit large diameter scleral lenses for 12 weeks. 21 eyes (13 subjects) consisting ten eyes (47.6%) with persistent epithelial defects, 6 (28.6%) with graft-versus-host disease, 4 (19.0%) with Stevens–Johnson syndrome and one (4.8%) with severe dry eye were ultimately enrolled. Primary outcome measures were the visual acuity, corneal and conjunctival fluorescein staining, Ocular Surface Disease Index (OSDI), and National Eye Institute 25-Item Visual Function Questionnaire (NEI-VFQ-25). At week 12 with large diameter scleral lenses, BCVA improved from 0.77 logMAR to 0.27 logMAR (P P = 0.0036 and 0.0063, respectively). OSDI and NEI-VFQ-25 improved from 67.89 to 34.69 and 51.40 to 64.48, respectively (P Trial registration Korean Health Technology R&D Project, Ministry of Health & Welfare, Republic of Korea (Project No. HI12C0015 (A120018)). Clinical Trials.gov, NCT04535388. Registered 18 August 2020—Retrospectively registered, http://clinicaltrials.gov/ct2/show/NCT04535388.

To determine the efficacy of subconjunctival bevacizumab injection after pterygium excision with limbal conjunctival autograft and limbal fixation suture. This retrospective study included a total of 150 eyes of 150 patients with primary pterygium who received three different procedures after pterygium excision, i.e., 49 eyes with limbal conjunctival graft (group A), 48 eyes with limbal conjunctival autograft with limbal fixation suture (group B), and 53 eyes with limbal conjunctival autograft with limbal fixation suture followed by bevacizumab injection (group C). Image analysis was performed using preoperative anterior segment photographs to measure parameters including relative length, relative width, relative area, and vascularity index of pterygium. Recurrence of pterygium was determined at 1 year after surgery, and outcomes were compared between the 3 groups. Risk factors related to recurrence were evaluated using univariate and multivariate analyses. Recurrence rates after 1 year were 18.4% (9/49), 8.3% (4/48), and 1.9% (1/53) in groups A, B, and C, respectively (P = 0.004). Multivariate analysis showed that patients in group C had significantly reduced risk of recurrence compared with those in group A (P = 0.009), whereas the risk of recurrence was not significantly different between groups A and B (P = 0.227) and groups B and C (P = 0.068), respectively. Among various parameters, higher vascularity index had significant correlation with increased risk of recurrence (P = 0.008). Bevacizumab injection after limbal conjunctival autograft and limbal fixation suture may effectively reduce recurrence after pterygium excision. The vascularity of pterygium was associated with a higher risk of recurrence.

Purpose To evaluate the agreement in ocular biometry outcomes measured by three different devices, the IOL Master 500, IOL Master 700, and Lenstar LS900, and compare the refractive outcomes after cataract surgery obtained using those three devices. Methods Medical records of 178 eyes of 89 patients who underwent ocular biometry with the three devices were retrospectively reviewed, and 124 eyes met the inclusion criteria. Paired comparisons were performed for axial length (AL), mean keratometry (Km), and anterior chamber depth and quantified their agreement using Bland-Altman plots. Subgroup analyses were done according to the AL and the Km. Refractive outcomes were compared with respect to absolute prediction errors after cataract surgery in 54 eyes. Results Among 124 eyes, 12, 3, and 5 eyes failed to be measured of AL by IOL Master 500, IOL Master 700 and Lenstar LS900, respectively. The AL measured by Lenstar LS900 was longer than that measured by IOL Master 500 and IOL Master 700 (p < 0.001, p = 0.002, respectively). Subgroup analysis revealed that these results were statistically significant only in long eyes (AL >25.5 mm). Km measured using the IOL Master 500 was steeper than that measured with the IOL Master 700 or Lenstar LS900 (p = 0.001, p < 0.001, respectively). anterior chamber depth measured by IOL Master 500 was shallower than that measured by IOL Master 700 or Lenstar LS900 (p < 0.001, p < 0.001, respectively). Ocular biometry measurements by the three devices showed high agreement with narrow 95% limits of agreement. Absolute prediction errors from the 3 devices showed no statistically significant differences after cataract surgery. Conclusions The IOL Master 700 and Lenstar LS900 demonstrated superior acquisition rates of biometric measurements compared with the IOL Master 500. Ocular biometry using the 3 different devices showed high agreement, although statistically significant differences were observed; however, since there was no difference in predicting the refractive outcomes, those differences are clinically negligible.

The purpose of this study was to determine the clinical characteristics, disease course, therapeutic outcomes, and prognostic factors for pediatric patients with blepharokeratoconjunctivitis (BKC).A retrospective medical chart review was performed for patients aged 15 years or younger who had been diagnosed with BKC between 2004 and 2020 at 2 tertiary hospitals in Korea. The following data were collected: demographics, medical history, ocular findings, geometric profiling of corneal lesion, medical management, and outcomes.A total of 137 patients (90 female and 47 male) were included. The patients' mean age was 8.3 ± 3.8 years at disease onset. Both eyes were involved in 57.7% of cases. The most common corneal lesion was corneal neovascularization (77.4%), followed by clinically visible corneal infiltration (51.8%) and stromal scarring (43.1%). Most of the corneal lesions involved a single quadrant, most commonly the inferior quadrant. After treatment, disease remission was achieved in 95% of patients, and visual acuities improved from 0.2 ± 0.3 logarithm of minimal angle of resolution at disease presentation to 0.1 ± 0.3 logarithm of minimal angle of resolution at final follow-up (P = 0.001). Recurrence occurred in 52.6% of patients. Cylinder power was significantly higher in patients with recurrence than in those without. The number of cases of recurrence was positively associated with final cylinder power.Although the treatment induced disease remission in 95% of children with BKC, recurrence occurred in 52.6% of those cases. Because recurrence resulted in significant astigmatism, careful observation for recurrence and prompt management are warranted for preservation of vision in pediatric patients with BKC.

ObjectiveSjögren’s syndrome (SS) is a systemic autoimmune disease that targets the exocrine glands, resulting in impaired saliva and tear secretion. To date, type I interferons (I-IFNs) are increasingly recognized as pivotal mediators in SS, but their endogenous drivers have not been elucidated. This study investigates the role of mitochondrial double-stranded RNAs (mt-dsRNAs) in regulating I-IFN response in SS.MethodsSaliva and tear from SS patients and controls (n=73 for saliva and n=16 for tear), the salivary glands of the SS-prone-non-obese-diabetic mouse, and primary human salivary glandular cells were screened for mt-dsRNAs by RT-qPCR. The human salivary cell line (NS-SV-AC) grown as three-dimensional spheroids were subject to dsRNA stress to measure mt-dsRNA induction and recapitulation of SS glandular inflammatory features. Acetylcholine, SS-IgG, upadacitinib (JAK1 inhibitor), or 2-C′-methyladenosine (mitochondrial transcription inhibitor) were applied to characterize the roles of mt-dsRNAs. To identify endogenous dsRNA-sensor and confirm the mitochondrial origin of cytoplasmic dsRNAs, the immunoprecipitation of dsRNAs was performed.Resultsmt-dsRNAs were elevated in the SS specimens with salivary ND5 and tear CYTB1 being statistically associated with secretory dysfunction/inflammation and corneal/conjunctival damage, respectively. Stimulation of the spheroids with dsRNA stress of poly I:C induced mt-dsRNAs, p-PKR, and I-IFNS via the JAK1/STAT pathway whereas the inhibition of mt-RNA synthesis or JAK1 attenuated the glandular signature. The inhibitory effect of acetylcholine on mt-dsRNAs and I-IFNS induction was reversed by SS-IgG.Conclusionmt-dsRNAs amplify the impact of dsRNA stress on SS glandular signaturesin vitro, potentially propagating a pseudo-viral signal in the SS target tissue.SummaryMitochondrial double-stranded RNA levels were elevated in the tear and saliva of SS patients, which was associated with secretory dysfunction and tissue inflammation. These RNAs amplified type I interferon signature as well as glandular phenotypes reported in SS. Inhibitors of mitochondrial RNA transcription or JAK1 in salivary gland acinar cell spheroids attenuated the mitochondrial RNA-mediated changes.

PurposeThis study aimed to evaluate the efficacy of a new automated method for the evaluation of histopathological images of pterygium using artificial intelligence.MethodsAn in-house software for automated grading of histopathological images was developed. Histopathological images of pterygium (400 images from 40 patients) were analysed using our newly developed software. Manual grading (I–IV), labelled based on an established scoring system, served as the ground truth for training the four-grade classification models. Region of interest segmentation was performed before the classification of grades, which was achieved by the combination of expectation-maximisation andk-nearest neighbours. Fifty-five radiomic features extracted from each image were analysed with feature selection methods to examine the significant features. Five classifiers were evaluated for their ability to predict quantitative grading.ResultsAmong the classifier models applied for automated grading in this study, the bagging tree showed the best performance, with a 75.9% true positive rate (TPR) and 75.8% positive predictive value (PPV) in internal validation. In external validation, the method also demonstrated reproducibility, with an 81.3% TPR and 82.0% PPV for the average of four classification grades.ConclusionsOur newly developed automated method for quantitative grading of histopathological images of pterygium may be a reliable method for quantitative analysis of histopathological evaluation of pterygium.

To determine the incidence of spontaneous regression of congenital corneal opacity (CCO) and identify clinical factors associated with the regression. Medical records and anterior segment photographs were reviewed of 57 eyes in 35 patients with CCO that were not related to congenital glaucoma, tumors, infection, trauma, or metabolic disorders and were followed up without corneal transplantation for longer than one year at Seoul National University Hospital. Spontaneous regression of corneal opacity was defined as a decrease in corneal opacity significant enough for visual axis clearance. Data on demographics, systemic, and ocular characteristics were collected and compared between patients who had spontaneous regression of CCO and those who did not. Spontaneous regression of corneal opacity developed in 32 eyes (22 patients, 56.1%) out of 57 CCO eyes (35 patients) at the mean 8.2 ± 5.4 months of age (the median 6.7 months). Absence of combined ocular anomalies such as iris anomaly, lens opacity, and peripheral corneal vascularization was significantly associated with the regression of opacity. Corneal opacity can spontaneously regress in 56.1% of eyes with CCO during the first year of life. Careful follow-up with amblyopia management can be one of treatment options for CCO.

Background/aims This study aimed to investigate the inf luence of poor sleep quality on clinical features of primary Sjogren's syndrome (pSS). Methods Sleep quality was cross-sectionally assessed using the Pittsburgh Sleep Quality Index (PSQI), and demographic, clinical, and laboratory data were collected from 115 Korean patients with pSS. The patients completed questionnaires on the European League Against Rheumatism (EULAR) SS Patient Reported Index (ESSPRI), quality of life (EuroQOL five dimensions questionnaire [EQ-5D]), fatigue (fatigue severity score [FSS]), and depression (Beck Depression Inventory [BDI] II]). Symptoms and patient global assessment (PGA) were evaluated with a 100-mm visual analogue scale (VAS). The EULAR sicca score (ESS), ESSPRI, and EULAR SS Disease Activity Index (ESSDAI) were calculated at study enrollment. Results Fifty-three patients (46.1%) had poor sleep quality and 32.4% of 71 patients without depression were poor sleepers. Poor sleepers had a significantly lower EQ-5D or ESSDAI and a significantly higher FSS, BDI-II, PGA, ESS, ESSPRI, or VAS scores for extra-glandular symptoms than good sleepers. Neutrophil and lymphocyte counts were significantly higher and immunoglobulin G levels tended to decrease in poor sleepers. Additionally, PSQI was negatively correlated with EQ-5D and ESSDAI and positively with ESS, FSS, BDI-II, PGA, VAS scores for their symptoms, and ESSPRI. Multivariate analysis revealed that poor sleep quality remained the independent determinants of the unsatisfactory symptom state (ESSPRI ≥ 5). Conclusion Our results showed that poor sleep quality could significantly affect the patient-oriented outcomes and physician-reported activity index of pSS patients through the various effects of sleep quality on the psychological or somatic symptoms and the immune system.

This study was performed to evaluate the prevalence and risk factors of dry eye disease (DED) among paramedical workers at a university hospital in Korea. This cross-sectional study included 566 paramedical workers at a university hospital in Korea. Dry eye symptoms were assessed using a 9-item questionnaire, and DED was defined as having 1 or more dry eye symptoms often or all the time. A survey including demographic data and potential risk factors of DED was also performed. Psychological stress was measured using stress VAS and perceived stress scale 4 (PSS-4) questionnaires. Of the 566 paramedical workers, 232 (35 male and 197 female) completed the survey. Prevalence of DED was 42.7% (99/232). Univariate analysis revealed that female sex (P P = 0.003) and higher stress VAS (P P = 0.009) scores had significant association with DED. In multivariate analysis, DED had significant association with female sex (P = 0.003) and stress VAS (P = 0.013) after adjustment for sex, duration of computer use and stress VAS, and had significant association with female sex (P = 0.003) and durations of computer use (P = 0.029) after adjustment for sex, duration of computer use and PSS-4 score. In conclusion, DED was prevalent among paramedical workers in Korea. Its risk increased among females and workers with increased psychological stress. Prolonged use of computer was possibly associated with DED.

Background Conjunctival myeloid sarcoma (MS) as an isolated presentation of acute myeloid leukemia (AML) relapse is rare. Here, we report a case of unilateral conjunctival MS revealed as a sign of AML relapse. Case presentation A 50-year-old man with a history of AML in remission visited our clinic presenting with a left conjunctival injection persisting for 1 month. Diffuse subconjunctival thickening with conjunctival vascular engorgement was observed. Ultrasound biomicroscopy revealed a hyper-reflective, thickened conjunctiva in his left eye. During the incisional biopsy, the lesion was strongly attached to the underlying sclera; histopathologic examination revealed infiltration of leukemic blasts. The relapse of AML was confirmed by a successive bone marrow biopsy. The ocular lesion disappeared after allogeneic peripheral blood stem cell transplantation (PBSCT) and concomitant salvage radiotherapy on the left eye. The patient has remained in remission for 3 years after allogeneic PBSCT. Conclusions Incidental conjunctival lesions can indicate AML relapse in patients treated earlier for AML. An ophthalmologist may have a role in the early detection of AML when a patient presents with an atypical conjunctival lesion.

This multi-center cohort study included 3401 myopic laser in situ keratomileusis (LASIK) procedures conducted in 1756 myopia patients between 2002 and 2005. Pre- and postoperative uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), and manifest refraction spherical equivalent (SE) were recorded. Factors predicting low postoperative efficacy (defined as a postoperative UCVA &lt, 0.5) were identified using univariate and multivariate logistic regression analysis. Compared with 1 month postoperatively, logMAR UCVA at 3 months postoperatively was significantly decreased (p = 0.002) and that at 2 and 3 years was significantly increased (p &lt, 0.001). LogMAR BCVA at 2 years postoperatively was significantly decreased compared with 1 month postoperatively (p = 0.008). Over the 3-year postoperative period, overall refractive predictability within ±1.00 D and ±0.50 D ranged from 69.0% to 86.2% and from 43.3% to 67.8%, respectively. This also decreased from 1 month to 6 months postoperatively (p &lt, 0.005). Multivariate logistic regression analysis using generalized estimating equations, revealed that higher preoperative SE (odds ratio [OR], 2.58 and 7.23, p &lt, 0.001) and lower preoperative BCVA (OR, 2.44, p = 0.003) were predictive of a low postoperative efficacy. In summary, myopic LASIK can be effective and safe with a high refractive predictability in a Korean population, but myopic regression occurs over time. Higher preoperative SE and lower preoperative BCVA are predictive of a low postoperative efficacy.

Dry eye disease (DED) is a common disease, and have an adverse effect the physical, functional, and psychological quality of life. It is a multifactorial disorder characterized by the loss of tear film homeostasis, in which self-perpetuating vicious cycle leads to deterioration of function and inflammation of the lacrimal functional unit. Hence, treatment strategies should be aimed at the interruption of the vicious inflammatory cycle and alleviation of ocular surface inflammation. Anti-inflammatory therapies have been shown to improve the signs and symptoms of the disease. Evidence indicates that polyunsaturated fatty acids (PUFAs) may contribute to reinforcement of innate anti-inflammatory mechanisms, and systemic and topical administration of PUFAs may help modulate ocular surface inflammation. In the present review, the authors will introduce the results of clinical and experimental studies to elucidate the mechanism, efficacy, and safety of systemic and topical supplementation with PUFAs as an alternative therapeutic strategy for DED. This review will also include discussion regarding current perspectives, including evidence-based recommendations and possible side effects of PUFAs supplementation. The review of the literature suggests that PUFAs supplementation can be a viable option for the treatment of DED, although further studies are needed for establishment of treatment guidelines.

Purpose This study aimed to evaluate the correlation between tear film lipid layer thickness and transepidermal water loss (TEWL) from the ocular area in patients with short tear break-up time (TBUT)-type dry eye and healthy controls. Methods This prospective study included 25 eyes of patients with short TBUT-type dry eye disease and 25 eyes of healthy controls. Results Tear film lipid layer thickness was measured using an interferometer, and TEWL from the ocular area was measured using a Tewameter TM300 with custom-made goggles. The correlation between tear film lipid layer thickness and TEWL was evaluated. Additionally, other parameters such as TBUT, Schirmer I score, ocular surface staining, the presence and type of meibomian gland dysfunction (MGD), ocular surface disease index (OSDI), and visual analog scale (VAS) scores were evaluated. Tear film lipid layer thickness did not show a significant correlation with TEWL from the ocular area measured using a Tewameter TM300. However, tear film lipid layer thickness was significantly correlated with tear break-up time (p = 0.004) and ocular surface staining by NEI (National Eye Institute) scheme (p = 0.03). TEWL showed positive correlation with the Schirmer I score (p = 0.004). Conclusions The tear film lipid layer affected the stability of the tear film more than the amount of TEWL in patients with short TBUT dry eye and healthy controls.

Sjogren’s syndrome is an autoimmune inflammatory disease that targets exocrine glands. Dry eye along with dry mouth is the major symptoms in patients, adversely affecting patients’ quality of life. Proper ocular evaluation is mandatory for the diagnosis of Sjogren’s syndrome and for the exclusion of other ocular conditions. Although management of dry eye in Sjogren’s syndrome is not quite different from non-Sjogren’s syndrome dry eye, severe aqueous deficiency and decreased corneal sensitivity in Sjogren’s syndrome often hinder effective treatment. Traditional diagnostic methodologies, such as Schirmer’s test, tear breakup time, and fluorescein staining are still commonly applied for the evaluation of dry eye in clinical practice. However, recent advances of noninvasive methods, imaging, and assessing the quality and functional aspects of tear film have provided better understanding of the disease and guided patients for optimal treatment. Treatment is aimed at resolving aqueous deficiency, controlling chronic ocular surface inflammation, and promoting epithelial healing with a treatment goal of restoring the homeostasis of ocular surface. Overview of diagnostic modalities for the assessment of tear production, tear film stability, ocular surface damage, and symptomatology is presented herein. The treatment strategies also are reviewed in terms of the efficacy to Sjogren’s syndrome-related dry eye patients.

Down-sloping sensorineural hearing loss (SNHL) in people in their teens and 20s hampers efficient learning and communication and in-depth social interactions. Nonetheless, its aetiology remains largely unclear, with the exception of some potential causative genes, none of which stands out especially in people in their teens and 20s. Here, we examined the role and genotype-phenotype correlation of lipoxygenase homology domain 1 (Based on the Seoul National University Bundang Hospital (SNUBH) genetic deafness cohort, in which the patients show varying degrees of deafness and different onset ages (n=1055), we have established the 'SNUBH Teenager-Young Adult Down-sloping SNHL' cohort (10-35 years old) (n=47), all of whom underwent exome sequencing. Three-dimensional molecular modelling, minigene splicing assay and short tandem repeat marker genotyping were performed, and medical records were reviewed.

Background To investigate the 3-month postoperative performance and safety after implantation of a trifocal intraocular lens (IOL) in a Korean population. Methods This was a clinical, prospective, multicenter, single-arm study. Forty-four subjects (88 eyes) with bilateral cataract with expected postoperative corneal astigmatism of Results Binocular defocus curve at 3 months after bilateral implantation showed VA of 0.1 logMAR or better from + 0.5 D through − 2.5 D. Binocular BCDVA mean ± SD at 4 m was − 0.05 ± 0.07 logMAR. Binocular and monocular UCVA was 0.03 ± 0.1 and 0.08 ± 0.12 logMAR (4 m), − 0.00 ± 0.11 and 0.05 ± 0.13 logMAR (60 cm), and 0.03 ± 0.12 and 0.09 ± 0.13 logMAR (40 cm), respectively. Contrast sensitivity with glare was 1.67 ± 0.13, 1.91 ± 0.17, 1.54 ± 0.21, and 1.14 ± 0.20 log units at 3, 6, 12, and 18 cycles/degree, respectively. At near and intermediate distances, 84 and 77% of subjects reported good/excellent satisfaction, and 84 and 91% of subjects reported spectacle independence, respectively. Conclusions In a Korean population, visual performance of the trifocal TFNT00 IOL 3 months postoperatively was Trial registration www.ClinicalTrials.gov (NCT03268746). Registered August 31, 2017.