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Biomedical subjects

Shih-Jen Chen

Publications and source records attributed to Shih-Jen Chen.

At least 19 recordsLinked to original sources

The immediate early 2 protein of human cytomegalovirus (HCMV) mediates the apoptotic control in HCMV retinitis through up-regulation of the cellular FLICE-inhibitory protein expression.

Human CMV (HCMV) is a widespread human pathogen that causes blindness by inducing retinitis in AIDS patients. Previously, we showed that viral immediate early 2 (IE2) protein may allow HCMV to evade the immune control by killing the Fas receptor-positive T lymphocytes attracted to the infected retina with increased secretion of Fas ligand (FasL). In this study, we further demonstrate that the secreted FasL also kills uninfected Fas-rich bystander retinal cells and that IE2 simultaneously protects the infected cells from undergoing apoptotic death, in part, by activating the expression of cellular FLIP (c-FLIP), an antiapoptotic molecule that blocks the direct downstream executer caspase 8 of the FasL/Fas pathway. c-FLIP induction requires the N-terminal 98 residues of IE2 and the c-FLIP promoter region spanning nucleotides -978 to -696. In vivo association of IE2 to this region, IE2-specific c-FLIP activation, and decrease of FasL-up-regulated activities of caspases 8 and 3 were all demonstrated in HCMV-infected human retinal cells. Moreover, c-FLIP up-regulation by IE2 appeared to involve PI3K and might also render cells resistant to TRAIL-mediated death. Finally, enhanced c-FLIP signals were immunohistochemically detected in IE-positive cells in the HCMV-infected lesions of the human retina. Taken together, these data demonstrate specific activation of c-FLIP by HCMV IE2 and indicate a novel role for c-FLIP in the pathogenesis of HCMV retinitis.

Apoptosis↗

Effects of hyperbaric oxygen therapy on circulating interleukin-8, nitric oxide, and insulin-like growth factors in patients with type 2 diabetes mellitus.

BACKGROUND: The potential benefits of hyperbaric oxygen therapy (HBOT) have been reported in diabetic patients with foot ulcers. However, the roles of HBOT on wound healing-associated growth factors and inflammatory mediators are not completely understood in diabetes mellitus (DM). OBJECTIVES: The aim of this study was to investigate the effects of HBOT on circulating cytokines, NO, and insulin-like growth factors (IGF) in patients with type 2 DM. DESIGN AND METHODS: Serum samples were collected from patients with type 2 DM (n=31) and healthy subjects (n=29) before (baseline) and after the first and third exposure. RESULTS: Before HBOT, body mass index (BMI) and serum HbA1c were significantly greater, whereas serum IGF-I was significantly lower in diabetic patients compared to healthy subjects (one-way ANOVA, p<0.05). After adjusting for age, gender, and BMI, serum insulin, growth hormone (GH), IGF-II, IGF-binding protein (IGFBP)-1, IGFBP-3, leptin, interleukin (IL)-8, and NO were not significantly altered by HBOT in diabetic patients and healthy subjects (repeated-measures ANOVA). Change in serum insulin (baseline to the third exposure) was a positive predictor of changes in leptin and NO in healthy subjects and diabetic patients, respectively. CONCLUSIONS: Our results suggest that short-term HBOT may not alter the circulating insulin, IGF, leptin, IL-8, and NO levels. In addition, healthy subjects and diabetic patients showed differential responses to HBOT in the relationships of leptin, insulin, and NO. Further studies are needed to clarify the mechanism of HBOT-improved wound healing in diabetic patients with foot ulcers.

Adult↗

Fluoxetine up-regulates expression of cellular FLICE-inhibitory protein and inhibits LPS-induced apoptosis in hippocampus-derived neural stem cell.

Fluoxetine is a widely used antidepressant compound which inhibits the reuptake of serotonin in the central nervous system. Recent studies have shown that fluoxetine can promote neurogenesis and improve the survival rate of neurons. However, whether fluoxetine modulates the proliferation or neuroprotection effects of neural stem cells (NSCs) needs to be elucidated. In this study, we demonstrated that 20 microM fluoxetine can increase the cell proliferation of NSCs derived from the hippocampus of adult rats by MTT test. The up-regulated expression of Bcl-2, Bcl-xL and the cellular FLICE-inhibitory protein (c-FLIP) in fluoxetine-treated NSCs was detected by real-time RT-PCR. Our results further showed that fluoxetine protects the lipopolysaccharide-induced apoptosis in NSCs, in part, by activating the expression of c-FLIP. Moreover, c-FLIP induction by fluoxetine requires the activation of the c-FLIP promoter region spanning nucleotides -414 to -133, including CREB and SP1 sites. This effect appeared to involve the phosphatidylinositol-3-kinase-dependent pathway. Furthermore, fluoxetine treatment significantly inhibited the induction of proinflammatory factor IL-1beta, IL-6, and TNF-alpha in the culture medium of LPS-treated NSCs (p<0.01). The results of high performance liquid chromatography coupled to electrochemical detection further confirmed that fluoxentine increased the functional production of serotonin in NSCs. Together, these data demonstrate the specific activation of c-FLIP by fluoxetine and indicate the novel role of fluoxetine for neuroprotection in the treatment of depression.

Animals↗

Necrotizing retinitis induced by Angiostrongylus cantonensis.

PURPOSE: To describe a case of bilateral necrotizing retinitis induced by Angiostrongylus cantonensis. DESIGN: Interventional case report. METHODS: A 52-year-old Asian woman developed eosinophilic meningitis after eating several undercooked snails. One week later, sudden onset of vision loss was noted in both eyes. Widespread yellow retinal exudates were accompanied by bullous retinal detachment in both eyes. RESULTS: Angiostrongylus cantonensis infection was confirmed by positive enzyme-linked immunosorbent assay of the serum and cerebrospinal fluid, and a positive Western blot test of the subretinal fluid. After treatment with mebendazole, levamisole, and corticosteroid, these necrotizing patches regressed gradually. However, the final visual acuity was no light perception. CONCLUSIONS: Angiostrongylus cantonensis infection should be considered as one of the causes of necrotizing retinitis.

Angiostrongylus cantonensis↗

Assessing the natural course of diabetic retinopathy: a population-based study in Kinmen, Taiwan.

PURPOSE: To explore the natural course of diabetic retinopathy among type 2 diabetics using the indirect ophthalmoscope and single-field fundus photographs in Kinmen, Taiwan. METHODS: A screening program for diabetic retinopathy was carried out by a panel of ophthalmologists, who employed the ophthalmoscope and 45-degree retinal color photographs to examine the fundus after pupil dilation. Screening, which was conducted between 1999 and 2002, involved 971 patients diagnosed with type 2 diabetes. A multi-state Markov model was used to assess the natural course of diabetic retinopathy among type 2 diabetics. RESULTS: Among the 725 diabetes patients who attended at least two ophthalmological fundus check-ups and were screened, the overall response rate was about 75%. The mean duration of the disease states mild nonproliferative diabetic retinopathy, moderate nonproliferative diabetic retinopathy, severe nonproliferative diabetic retinopathy, and proliferative diabetic retinopathy were 4.05 [95% confidence interval (CI): 3.28-5.32], 4.18 (95% CI: 3.18-6.06), 2.52 (95% CI: 1.78-4.27), and 4.22 (95% CI: 2.88-7.81) years, respectively. Compared to controls, the incidence of blindness reduction for annual, biennial, 3-year, 4-year, and 5-year screenings of diabetic retinopathy were approximately 94.4% (95% CI: 91.6%-96.3%), 83.9% (95% CI: 83.6%-84.2%), 70.2% (95% CI: 69.8%-70.7%), 57.2% (95% CI: 56.7%-57.7%), and 45.6% (95% CI: 45.0%-46.1%), respectively. CONCLUSIONS: In conclusion, the average time for the development of diabetic retinopathy from nonexistence to blindness was approximately 26.5 years. The present recommendation for annual screening in type 2 diabetics with nonproliferative diabetic retinopathy should be retained only for the mild form, not for the moderate or severe forms.

Aged↗

Siderosis oculi: visual dysfunctions even after iron removal: a role of OCT.

Four males with sidersosis oculi were reviewed. Vitreous/anterior chamber angle irons (cases 1 and 3) were misdiagnosed initially and discovered later. In case 2, the retina-incarcerated iron was long ignored. Exceptionally in case 4, the iron was encapsulated by using optical coherence tomography (OCT). Preoperatively, in cases 1 and 4, the injured eye's vision, electro-oculogram, and electroretinogram were reduced compared with the other eye. In three cases, field defects were relevant to their iron locations. Postremoval, iron-impaired retinal functions didn't obviously improve. Early iron removal seems vital. OCT identified iron encapsulation, ameliorating iron toxicity. Consistently, field defect in case 4 was nonprogressive.

Adolescent↗

Electrical stimulation in isolated rabbit retina.

Experiments were conducted to assess the effect of stimulating electrode parameters (size, position, and waveform shape) on electrically elicited ganglion cell action potentials from isolated rabbit retina. Thirty-eight isolated rabbit retinas were stimulated with bipolar stimulating electrodes (either 125 or 25 microm in diameter) positioned on either the ganglion or the photoreceptor side. Recording electrodes were placed between the optic disc and the stimulating electrodes. Cathodic-first, biphasic, current waveforms of varying pulse durations (0.1, 0.5, 1 ms) were used. For the four conditions tested (125-electrode and 25-microm electrode, ganglion cell, and photoreceptor positions) threshold currents ranged from 6.7 to 23.6 microA, depending on location and pulse duration. With 1-ms pulse duration, no statistically significant difference was seen between threshold currents when either size electrode was used to stimulate either the ganglion cell side or the photoreceptor side. For all groups, the threshold currents using the 1-ms pulse were lower than those using 0.1 ms, but the 0.1-ms pulses used less charge. These experiments provide a number of valuable insights into the relative effects of several stimulation parameters critical to the development of an implanted electronic retinal prosthesis.

Action Potentials↗

Different plasma levels of vascular endothelial growth factor and nitric oxide between patients with choroidal and retinal neovascularization.

Because the blood flow is much more intense in the choroid than in the retina, it is interesting to explore whether choroidal neovascularization (CNV) is more influenced by plasma angiogenic factors than retinal neovascularization. The aim of this study was to investigate plasma profiles of vascular endothelial growth factor (VEGF) and nitric oxide (NO) in patients with CNV due to age-related macular degeneration (AMD) and in those with retinal neovascularization due to proliferative diabetic retinopathy (PDR). Seventy-seven subjects with AMD, 22 with PDR, and 42 nondiabetic, non-AMD controls were enrolled in this comparative case series. AMD subjects were classified into three groups: dry type (dry AMD, n = 17), wet type with active CNV (CNV/AMD, n = 42), and disciform scar due to advanced wet AMD (scar/AMD, n = 18). Plasma VEGF and NO levels of each subject were measured with enzyme-linked immunosorbent assay and chemiluminescence, respectively. Plasma VEGF level in CNV/AMD (median 256.0 pg/ml, interquartile range 146.4-375.3 pg/ml) was significantly higher than in PDR (124.8 pg/ml, 75.7-215.3 pg/ml; p = 0.004) and controls (120.3 pg/ml, 82.8-168.2 pg/ml, p =0.001). CNV/AMD also had the highest VEGF level among the AMD subgroups. Plasma NO level was significantly elevated in PDR (137.4 microM, 63.7-240.1 microM) when compared with CNV/AMD (71.8 microM, 42.4-113.3 microM; p = 0.004) and controls (62.6 microM, 39.0-114.9 microM; p = 0.002). There was no significant difference in NO levels among the AMD subgroups. No significant correlation between VEGF and NO levels was noted. These findings indicate that both circulating VEGF and NO may play different roles in the pathogenesis of retinal neovascularization and CNV.

Aged↗

A community-based epidemiologic study of gender differences in the relationship between insulin resistance/beta-cell dysfunction and diabetic retinopathy among type 2 diabetic patients in Kinmen, Taiwan.

PURPOSE: The purpose of this study was to explore whether there were gender differences in the relation of insulin resistance and beta-cell dysfunction to diabetic retinopathy among type 2 diabetic patients. METHODS: From 1999 to 2002, a screening regimen for diabetic retinopathy was performed by a panel of ophthalmologists using ophthalmoscopy and 45-degree color fundus photography to examine the fundus in a total of 971 type 2 diabetic patients examined between 1991 and 1993 in Kinmen, Taiwan. Seven hundred and twenty-five type 2 diabetic patients (301 males and 424 females) attended ophthalmological fundus checkup. RESULTS: The response rate in males and females was 71.3 and 77.2%. The proportion of diabetic retinopathy at the first eye screening was 16.3% in males and 20.1% in females. From the multiple logistic regression, the type of diabetes (known cases vs. new cases) was a significant factor of diabetic retinopathy in both males (OR = 3.65, 95% CI: 1.59-8.37) and females (OR = 3.66, 95% CI: 2.01-6.70). Diabetic retinopathy was also strongly affected by the homeostasis model assessment of insulin resistance (HOMA IR) and homeostasis model assessment of beta-cell dysfunction (HOMA beta-cell) (p < 0.0001 for trend test). In males, those who were in the 2nd quartile, 3rd quartile, and 4th quartile of HOMA IR had 4.87 times (95% CI: 1.18-20.11), 6.83 times (95% CI: 1.91-24.46), and 10.15 times (95% CI: 2.42-42.56) the risk for diabetic retinopathy as compared to those in the 1st quartile. There was a reduced risk for diabetic retinopathy in relation to HOMA beta-cell for the 2nd quartile, 3rd quartile, and 4th quartile of 86% (95% CI: 37-97%), 95% (95% CI: 77-99%), and 96% (95% CI: 78-99%) as compared to that in the 1st quartile. Only the 4th quartile had a significant risk (OR = 2.62, 95% CI: 1.17-5.86) for diabetic retinopathy as compared to that in the 1st quartile in females. The reduced risk for diabetic retinopathy found in relation to HOMA beta-cell for the 3rd and 4th quartiles were 66% (95% CI: 6-88%) and 66% (95% CI: 10-87%) as compared to that in the 1st quartile. CONCLUSIONS: Gender differences in the relationship between insulin resistance/beta-cell dysfunction and diabetic retinopathy were demonstrated in type 2 diabetic patients.

Adult↗

Association of the Y402H polymorphism in complement factor H gene and neovascular age-related macular degeneration in Chinese patients.

PURPOSE: Age-related macular degeneration (AMD), with its complex traits and multiple risk factors, is the leading cause of blindness in the elderly. A strong association between a coding variant, Y402H, in the complement factor H gene (CFH) and AMD has been recently identified in white patients. This study was conducted to investigate the association between the Y402H polymorphism in CFH and neovascular AMD in Chinese patients. METHODS: One hundred sixty-three Chinese patients with neovascular AMD and 232 age-matched healthy controls were enrolled in the study. Genomic DNA from white blood cells was extracted. The Y402H polymorphism in CFH, with the substitution of T to C at nucleotide position 1277 in exon 9, was determined by polymerase chain reaction-restriction fragment length polymorphism analysis. The association between the genetic polymorphism and the disease was examined by chi(2) test and logistic regression. RESULTS: The frequency of the risk allele, 1277C, was 11.3% in AMD patients compared with 2.8% in controls (P < 0.00001). Genotype frequency differed significantly between the two groups (1277TT 81.0%, 1277TC 15.3%, and 1277CC 3.7% in the AMD group; 1277TT 94.4%, 1277TC 5.6%, and 1277CC 0% in the control group; P < 0.0001). The 1277C allele significantly increased the risk for neovascular AMD and had an odds ratio of 4.4 (95% confidence interval [95% CI], 2.3-8.5; P < 0.00001). CONCLUSIONS: The allele frequency of Y402H polymorphism in CFH has an ethnic variation, with much lower 1277C frequency in Chinese than in white patients. Despite this, the polymorphism is significantly associated with neovascular AMD in the Chinese population.

Aged↗

A novel in vitro retinal differentiation model by co-culturing adult human bone marrow stem cells with retinal pigmented epithelium cells.

Human retinal pigment epithelium (HRPE) cells are important in maintaining the normal physiology within the neurosensory retina and photoreceptors. Recently, transplantation of HRPE has become a possible therapeutic approach for retinal degeneration. By negative immunoselection (CD45 and glycophorin A), in this study, we have isolated and cultivated adult human bone marrow stem cells (BMSCs) with multilineage differentiation potential. After a 2- to 4-week culture under chondrogenic, osteogenic, adipogenic, and hepatogenic induction medium, these BMSCs were found to differentiate into cartilage, bone, adipocyte, and hepatocyte-like cells, respectively. We also showed that these BMSCs could differentiate into neural precursor cells (nestin-positive) and mature neurons (MAP-2 and Tuj1-positive) following treatment of neural selection and induction medium for 1 month. Furthermore, the plasticity of BMSCs was confirmed by initiating their differentiation into retinal cells and photoreceptor lineages by co-culturing with HRPE cells. The latter system provides an ex vivo expansion model of culturing photoreceptors for the treatment of retinal degeneration diseases.

Bone Marrow Cells↗

A community-based follow-up study on diabetic retinopathy among type 2 diabetics in Kinmen.

The purpose of this follow-up study was conducted to assess the incidence and risk factors of diabetic retinopathy (DR) among type 2 diabetics in Kinmen, Taiwan. A penal of eye screening regimes were performed yearly for 971 type 2 diabetics by two senior ophthalmologists using indirect ophthalmoscopy and 45-degree color fundus photography to examine fundus after dilating pupils from 1999 to 2002. 74.7% (725/971) of diabetics had been screened at least two times during this period. Among the 548 type 2 diabetics who had no DR at first screening, 93 subjects developed any type of DR. The 3-year 18.2% cumulative incidence was (95% CI: 14.8-21.5%) and incidence density was 6.62% per year (95% CI: 5.36-8.06% per year). Using Cox regression model, HbAlc revealed the significantly dose response relationship to the development of DR (chi2-test for trend = 9.41, p < 0.05) after controlling for confounding factors. Other independent predictors related to the development of DR included duration of diabetes (RR: 1.09, 95% CI: 1.05-1.13), higher systolic blood pressure (>140 vs. < 140 mm Hg, RR: 1.96, 95% CI: 1.23-3.12), and higher triglyceride (> 200 vs. < 200 mg/dl, RR: 1.60, 95% CI: 1.01-2.54). In conclusion, in addition to poor glycemic control of which is the most significant risk factor for the development of DR, longer duration of diabetes, higher systolic blood pressure, and elevated serum triglyceride levels were also associated with the development of DR among type 2 diabetics in Kinmen.

Adult↗

Community-based study of cataracts among type 2 diabetics in Kinmen.

The purpose of this study was to assess the prevalence and risk factors of each type of cataract among type 2 diabetics in Kinmen, Taiwan. There were 971 type 2 diabetics ascertained from a community-based mass screening between 1991 and 1993. In 1999, a total of 578 (59.5%) patients with type 2 diabetes were examined with an eye screening performed by two senior ophthalmologists using a 45-degree thin slit-lamp biomicroscopy and ophthalmoscopy to examine the lens after dilating the pupils. The overall prevalence, including subjects with or without surgery, was 31.0% (179/578, 95% CI: 27.3-34.7%), and had a statistically significant difference for gender (chi2 = 8.78, p = 0.003) and age (chi2-trend = 11.89, p < 0.0001). Based on multiple logistic regression, the significant risk factors of all types of cataracts were age (OR = 1.16, 95% CI: 1.12-1.20), lower diastolic blood pressure (DBP) at baseline (OR = 0.47, 95% CI: 0.25-0.88), and higher triglyceride at baseline (OR = 2.19, 95% CI: 1.07-4.45). In conclusion, our results found that in addition to age, lower DBP and higher triglyceride at baseline may increase the risk of prevalent cataracts in type 2 diabetics.

Age Factors↗

Electrophysiological changes in lipaemia retinalis.

PURPOSE: To report the electrophysiologic findings in a patient with lipaemia retinalis. DESIGN: Observational case report. METHODS: An 11-year-old girl with diabetes had hyperlipidemia and presented for ophthalmologic consultation. Fundus examinations revealed milky discoloration of retinal vessels in both eyes. Laboratory testing disclosed hyperglycemia and markedly elevated level of triglycerides and cholesterol. Although the visual acuity was not affected, the electroretinograms showed decrease amplitudes of a- and b-wave in both cone and rod responses. RESULTS: After correction of blood sugar and lipids with insulin and diet control, the lipaemia retinalis resolved, and the impaired ERG response reversed within 1 week. CONCLUSIONS: Lipaemia retinalis usually resolves rapidly without visual impairment after correction of hyperlipidemia. The reversible deficits of electroretinogram response in lipaemia retinalis are reported for the first time. High level of triglycerides or cholesterol or both may impair retinal function. The mechanism of an impaired electroretinogram remained speculative.

Blood Glucose↗

A community-based study for the utility values associated with diabetic retinopathy among type 2 diabetics in Kinmen, Taiwan.

A community-based cross-sectional study was conducted to assess the utility values associated with varying degrees of diabetic retinopathy (DR) among type 2 diabetics in Kinmen, Taiwan. A total of 725 eligible type 2 diabetics received DR screening during 1999-2002 and then evaluated utility values in 2003. The diagnosis of DR was performed by a panel of ophthalmologists using ophthalmoscopy and a 45-degree color retinal photographs to examine fundus after dilating pupils. The utility values were measured by using time trade-off method. There were 406 type 2 diabetics participating the utility survey with 56% response rate. The overall mean utility value was 0.92+/-0.12 (95% confidence intervals (CI): 0.91-0.93) suggesting that type 2 diabetics were willing to trade about 8% (95%CI: 7-9%) of their remaining life in return for being free of type 2 diabetes perpetually. The significant associated factors of utility values based on the multiple linear regression analysis were older age and different degrees of DR among type 2 diabetics. In conclusion, our results found that in addition to older age, different degrees of DR do decrease utility values in type 2 diabetics from the patient's preference-based viewpoint.

Adult↗

Photodynamic therapy for subfoveal choroidal neovascularization secondary to age-related macular degeneration.

BACKGROUND: To evaluate the safety and efficacy of verteporfin photodynamic therapy (PDT) in patients with subfoveal choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD). METHODS: We retrospectively reviewed the chart records and fluorescein angiography of patients with subfoveal CNV who were treated with verteporfin PDT between September 2001 and March 2003 and who completed at least 1 year of follow-up. The primary efficacy outcomes were the proportions of patients whose Snellen visual acuities had more than 1 line increase, no change or more than 1 line decrease 1 year after study entry compared with their baseline examinations. The secondary efficacy outcome was the changes in the logarithm of the minimum angle of resolution visual acuities at 1-year follow-up. Complications were monitored and tabulated. RESULTS: Forty-eight eyes of 48 patients with subfoveal CNV secondary to AMD were enrolled in this study. The mean follow-up was 12.56 +/- 1.37 months. At their last visit, 10.4% of eyes had more than 1 line improvement in Snellen visual acuity, 72.9% of eyes had no change, and 16.7% experienced more than 1 line of visual acuity loss (7 eyes lost < 3 lines of Snellen visual acuity, 1 eye lost between 3 and 6 lines). None experienced more than 6 lines of visual loss. There was no statistically significant difference between baseline and final visual acuity for eyes with predominantly classic CNV, minimally classic CNV and occult without classic CNV (Wilcoxon Signed Rank test, p = 0.59 ). There was a positive correlation between baseline visual acuity and final visual outcome (Kruskal-Wallis test, p = 0.002). No severe systemic and ocular adverse events were encountered. CONCLUSION: Of our patients with subfoveal CNV secondary to AMD, 83.3% could maintain or improve their visual acuity 1 year after verteporfin PDT. The risk of deterioration in visual acuity due to subfoveal CNV could be reduced by verteporfin PDT. Baseline visual acuity is significantly correlated with the final proportion of visual outcome.

Aged↗

Optical measurement of human retinal macular pigment and its spatial distribution with age.

The existence of macular pigment (MP) in human eyes has been found to be of importance in the prevention of age-related macular degeneration (ARMD). A noninvasive technique of two-wavelength imaging fundus reflectometry was developed to measure the density distribution of this yellow pigment in retina in vivo. A total of 55 healthy human subjects were recruited and divided into three groups with average ages and sample sizes of 25.2+/-2.1 (N = 25), 40.2+/-8.3 (N = 13), and 67.5+/-7.1 years (N = 17), respectively. Only the MP distributions in the horizontal meridian of retinas are presented in this report. The results show that the average peak optical density of MP are 0.23+/-0.07, 0.21+/-0.05, and 0.25+/-0.06 from young to old groups, respectively. No significant difference is shown in the statistical t-test between the groups of the peak MP density. The half width of MP spatial distribution (HWMPD) are 4.8 degrees+/-1.5 degrees, 5.1 degrees+/-2.1 degrees and 7.7 degrees+/-2.0 degrees (1 degree = approximately 0.3 mm) from young to old groups, respectively. Mean HWMPD = approximately 5.6 degrees +/- 2.1 degrees. It shows that the area of MP is increased approximately by a rate of 0.06 degrees/yr according to the application of linear regression. However, the cause of the MP extension in the retina with age is unknown.

Adult↗

Postpartum endogenous Candida endophthalmitis.

Candida albicans is the most common pathogen causing intraocular fungal infection. Postpartum endogenous Candida endophthalmitis, however, is extremely rare. We report the case of a 33-year-old postpartum woman who presented with a 5-day history of decreased vision and had a positive blood culture for C. albicans. Fundus examination showed vitreous haze and multiple pre-retinal whitish lesions with indistinct borders. Systemic investigations revealed acute renal failure and cardiomegaly. After treatment with intravenous antifungal therapy, vitrectomy, and intravitreal injection of antimycotics, systemic and intraocular infections were eradicated successfully.

Adult↗