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Objectives: To analyse the ophthalmic manifestations and treatment outcomes of Korean patients with granulomatosis with polyangiitis (GPA)., Methods: One hundred twenty patients diagnosed with GPA by rheumatologists from January 1984 to March 2019 at three referral centres were retrospectively reviewed. Patients with ophthalmic symptoms were examined by ophthalmologists and underwent orbital imaging. Ophthalmic manifestations were divided into ocular involvement and ocular adnexal involvement. Multivariable logistic regression was used to examine the factors related to ocular, ocular adnexal, and optic nerve involvement. Visual improvement was defined as a best-corrected visual acuity gain of ≥2 Snellen lines, accompanied by improvements in optic nerve function., Results: Ophthalmic manifestations were observed in 50 patients (41.7%) during the median follow-up period of 6.7 years. Proteinase 3-anti-neutrophil cytoplasmic antibody (PR3-ANCA) positivity (odds ratio 3.19, 95% confidence interval 1.18-8.60) was an independent risk factor for ocular involvement, while sinonasal involvement (21.94, 2.54-189.69) and brain involvement (5.38, 1.50-19.31) were independent risk factors for ocular adnexal involvement. Antinuclear antibody (ANA) positivity was associated with optic nerve involvement (12.8, 1.80-90.5). Visual improvement occurred in 5 of 14 patients with optic nerve involvement, all of whom received intravenous (IV) immunosuppressive treatments beyond oral steroids within 2 months of visual impairment., Conclusions: Ophthalmic involvement is common in Korean GPA patients and should be considered in the presence of PR3-ANCA, sinonasal or brain involvement. Patients with positive ANA have an increased risk of optic nerve involvement, and early IV immunosuppressive treatments beyond oral steroids are necessary to improve the visual outcome., (© 2022. The Author(s), under exclusive licence to The Royal College of Ophthalmologists.)

Background/aim: To analyse the clinical risk factors for extraophthalmic involvement and treatment outcomes in patients with IgG4-related ophthalmic disease (IgG4-ROD) in Korea., Methods: We retrospectively reviewed medical records of 42 patients diagnosed with IgG4-ROD confirmed by a surgical biopsy during the 7-year period, between January 2009 and March 2015, at three tertiary referral centres in Korea. Data regarding patients' demographics, clinical characteristics and radiological findings were obtained. The relapse rate was compared between systemic steroids only and combined immunosuppressant therapy., Results: The mean patient age was 55.2 years (male:female ratio, 1:1). Based on the primary orbital structure affected, the IgG4-RODs were classified as dacryoadenitis (52.4%), orbital soft tissue inflammation (21.4%), trigeminal nerve involvement (11.9%) and myositis (9.5%). Extraophthalmic involvement (n=21) was associated with bilateral involvement (p=0.004), longer symptom duration (p=0.033) and a higher serum IgG4 level (p=0.034). Initial treatment regimens included attentive observation (n=7), prednisolone alone (n=22) and prednisolone plus immunosuppressive agent (n=13). During follow-up (mean, 24 months), 13 patients (37.1%) experienced relapse. In the extraophthalmic involvement group, steroid therapy alone resulted in a significantly higher relapse rate than combined immunosuppressant treatment (p=0.028)., Conclusion: Bilateral involvement, longer symptom duration and higher IgG4 levels were significant risk factors for extraophthalmic involvement in Korean patients with IgG4-ROD. In patients with an extraophthalmic involvement, prednisolone combined with an immunosuppressive agent was more effective for preventing recurrence than prednisolone alone., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

Purpose: To investigate longitudinal changes in risk factors for amblyopia in children treated with congenital nasolacrimal duct obstruction (CNLDO). Methods: Retrospective observational case control study. A total of 446 children under 4 years of age who underwent probing and/or intubation for CNLDO between January 2004 and January 2018, and 446 age-matched controls were included. Cycloplegic refraction and ocular alignment were investigated at the time of treatment and after at least one year of symptom improvement. Children were classified as having amblyopia risk factors on the basis of the American Association for Pediatric Ophthalmology and Strabismus guideline in 2013. Main outcome measures: The prevalence of amblyogenic refractive errors, and determinants associated with the presence of amblyogenic refractive errors in CNLDO patients. Results: The prevalence of amblyogenic refractive errors in CNLDO patients (5.4%) was similar to that of the control group (6.5%) (P = 0.571). After one year of symptom improvement in CNLDO patients, the prevalence of amblyogenic refractive errors was 4.7%. There was no difference in the prevalence of amblyogenic refractive errors between unilateral and bilateral CNLDO patients. Multivariate analysis revealed that manifest strabismus was the only risk factor related with the presence of amblyogenic refractive errors (odds ratio = 6.383, confidence interval = 1.205–33.826, P = 0.029). Conclusions: This study found no evidence to suggest that the prevalence of amblyopia risk factors is higher in CNLDO patients compared with normal controls. Manifest strabismus was the only determinant associated with the presence of amblyogenic refractive errors. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 57-year-old woman referred for conjunctival injection and eyeball pain with history of hearing difficulty and left facial nerve palsy. Topics discussed include her history of chemotherapy for acute promyelocytic leukaemia, observations of severe eyelid swelling, conjunctival injection and chemosis; and her diagnosis with relapsing polychondritis along with neurolabyrinthitis in the right ear.

Purpose: To investigate the prevalence and clinical features of acquired lower eyelid epiblepharon in Korean patients with thyroid-associated ophthalmopathy (TAO) and compare the pathogenic features of acquired and congenital epiblepharon. Design: Retrospective, nonrandomized, comparative case series, cross-sectional study. Participants: A total of 494 Korean patients with TAO and 845 Korean patients with congenital lower eyelid epiblepharon. Methods: The medical records were reviewed, and the presence, location, and extent of epiblepharon were identified. Clinical features of TAO (lower eyelid retraction, exophthalmos, and elevation limitation) were compared between patients with TAO with and without epiblepharon. Acquired epiblepharon was classified into 3 types according to the location and extent. The prevalence of epiblepharon types was determined and evaluated for associations with TAO clinical features. Comparisons were made between the prevalence of epiblepharon types in acquired and congenital epiblepharon. Main Outcome Measures: Prevalence, location, and extent of epiblepharon; association with clinical features of TAO; and difference from congenital epiblepharon. Results: An acquired lower eyelid epiblepharon was found in 42 (8.5%) of 494 patients with TAO. The mean age of patients with TAO with epiblepharon (34.2±13.5 years) was significantly lower than that of patients with TAO without epiblepharon (46.5±14.1 years) (P = 0.000). Lower eyelid retraction (0.78±1.11 mm) was more severe in patients with TAO with epiblepharon than in patients without epiblepharon (0.30±0.73 mm) (P = 0.000). Lower eyelid retraction was more severe in diffuse-type acquired epiblepharon than in central-type epiblepharon (P = 0.012). Elevation limitation was more severe in central-type acquired epiblepharon than in medial-type epiblepharon (P = 0.001). The occurrence of central-type epiblepharon was higher in TAO-associated acquired epiblepharon (20 eyelids, 30.8%) than in congenital epiblepharon (27 eyelids, 1.9%, P = 0.000). Conclusions: Acquired lower eyelid epiblepharon is one of the clinical features of patients with TAO. The association between lower eyelid retraction and acquired epiblepharon may lead to a better understanding of the cause of acquired epiblepharon in patients with TAO. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article. [ABSTRACT FROM AUTHOR]