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Tung-Mei Kuang

Publications and source records attributed to Tung-Mei Kuang.

3 recordsLinked to original sources

Methylphenidate (Ritalin)-associated cataract and glaucoma.

Methylphenidate hydrochloride (Ritalin) is the drug of choice for attention deficit hyperactivity disorder (ADHD). However, an association of Ritalin with glaucoma has been reported. We report a case of Ritalin-associated cataract and glaucoma. A 10-year-old boy was diagnosed with ADHD and had received methylphenidate hydrochloride, 60 mg/day for 2 years. He presented with blurred vision. Best-corrected visual acuity was 6/60 in both eyes. Ocular examinations revealed intraocular pressure (IOP) of 30 mmHg under medication, dense posterior subcapsular opacity of lens, pale disc with advanced cupping, and marked constriction of visual field. Despite maximal anti-glaucomatous medication, IOP still could not be controlled. The patient then received combined cataract and glaucoma surgery. Visual acuity improved and IOP was within normal limits in both eyes postoperatively. Large dose of methylphenidate may cause cataract and glaucoma. The mechanism remains unclear. Doctors should be aware of the possible ocular side effects of methylphenidate.

Attention Deficit Disorder with Hyperactivity↗

Body mass index and age-related cataract: the Shihpai Eye Study.

OBJECTIVE: To investigate the association between body mass index (BMI) (calculated as weight in kilograms divided by the square of height in meters) and cataract in a metropolitan Asian elderly population. DESIGN: Population-based cross-sectional study. Age-related cataract was defined as any type of lens opacity (ie, nuclear, cortical, and posterior subcapsular opacity) with a Lens Opacities Classification System III grade of more than 2 in one or both eyes. Weight and height were measured by intensively trained interviewers. RESULTS: A total of 2045 subjects 65 years and older in Shihpai, Taipei, were invited to participate, and 1361 (66.6%) completed the survey. Of the subjects, 806 were diagnosed as having age-related cataracts. With a BMI of less than 21.3 as a reference point (odds ratio [OR], 1.00), a U-shaped relationship between BMI and nuclear opacity was demonstrated. A reverse U-shaped relationship was shown for cortical opacity. In the final multiple logistic regression models, BMI and BMI(2) were significantly related to nuclear opacity (BMI data: OR, 0.73 [95% confidence interval {CI}, 0.54-0.98]; and BMI(2) data: OR, 1.01 [95% CI, 1.00-1.01]) and cortical opacity (BMI data: OR, 1.52 [95% CI, 1.04-2.34]; and BMI(2) data: OR, 0.99 [95% CI, 0.98-0.99]). Neither BMI nor BMI(2) was related to posterior subcapsular opacity. CONCLUSION: Body mass index is an independent risk factor for nuclear and cortical opacities, but in reverse direction to each other.

Aged↗

Clinical experience in the management of neovascular glaucoma.

BACKGROUND: Neovascular glaucoma (NVG) is a devastating ocular disease with poor prognosis. The ideal surgical procedure has yet to be determined. In this study, the clinical course and visual outcome of NVG and their fellow eyes were investigated and the most appropriate management was also evaluated. METHODS: The study was conducted retrospectively consisting of NVG in-patients of Taipei Veterans General Hospital who were under the care of the same glaucoma specialist between January, 1998 and September, 2000. All patients had a minimal follow-up period of 6 months. RESULTS: The total number of patients enrolled was 35 (number of eyes enrolled was 35) with mean age of 66.4 +/- 12.3 years. The underlying cause was diabetes mellitus in 29 patients and central retinal vein occlusion in 6 patients. Twelve (34.3%) eyes had initial intraocular pressure (IOP) of over 60 mmHg. Only 1 (2.9%) eye had initial visual acuity better than 6/60. Four lesion eyes were able to receive panretinal photocoagulation whereas 31 eyes received panretinal cryotherapy. For IOP reducing procedures, 15 eyes received trabeculectomy, and 16 received Diode trans-scleral cyclophotocoagulation (TSCP). At the final visit, 20 eyes (trabeculectomy group: 11 and Diode TSCP group: 9) were able to maintain an IOP < or = 21 mmHg. Of these eyes, 15 (trabeculectomy group: 8 and Diode TSCP group: 7) were able to maintain or improve their vision. Of the remaining 4 eyes, 2 had cyclocryotherapy and 2 had trabeculectomy followed by Diode TSCP. IOP were controlled in these 4 eyes but none were able to maintain stable vision. Among the 34 fellow eyes with stable IOP, 32 were able to maintain stable vision. CONCLUSIONS: Trabeculectomy and Diode TSCP provided no statistically significant difference in IOP control (p = 0.32) and visual outcome (p = 0.59) in our patient group. More randomized, prospective trials are needed to define the most effective treatment for NVG.

Adult↗