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Biomedical subjects

Wen-Ming Hsu

Publications and source records attributed to Wen-Ming Hsu.

At least 73 records · Page 4Linked to original sources
PubMed2003

Transforming growth factor-beta2 inhibition of corneal endothelial proliferation mediated by prostaglandin.

PURPOSE: To determine the influence of Prostaglandin (PG) E2 on transforming growth factor (TGF)-beta2-mediated inhibitory effects on the proliferation of corneal endothelial cells (CE). METHODS: The PGE2 and cell proliferation assays were performed using cultured rabbit corneal endothelium. A PGE2-specific enzyme immunoassay was used to check PGE2 synthesis in supernatants of cells cultured with and without added TGF-beta2 and/or indomethacin. To evaluate the inhibitory effects of PGE2 and TGF-beta2 on CE proliferation, the number of cells grown with exogenous PGE2, or TGF-beta2 with or without indomethacin pretreatment was determined. RESULTS: TGF-beta2, 0.5 to 50 ng/ml, increased the PGE2 secretion of CE dose-dependently in a time-dependent manner. Indomethacin (> or =0.1 microg/ml) inhibited this PGE2 secretion to a low level (around 5-10 ng/ml) in the presence or absence of exogenous TGF-beta2. Both exogenous TGF-beta2 and PGE2 inhibited CE proliferation dose-dependently over a wide range of concentrations. Indomethacin reversed the inhibitory effects of TGF-beta2 but not those of exogenous PGE2. In the medium supplemented with indomethacin, even in the presence of 50 ng/ml of TGF-beta2, CE growth did not differ from control cultures. CONCLUSIONS: TGF-beta2 stimulates PGE2 synthesis in CE and inhibits CE proliferation in a dose-dependent manner. Indomethacin extinguishes the inhibitory effects of TGF-beta2 on CE proliferation but not the effect of exogenous PGE2. These data suggest that the antiproliferative effects of TGF-beta2 on CE may be possibly due to TGF-beta2-induced synthesis of PG, most likely PGE2. SUMMARY: Inhibition of endogenous prostaglandins synthesis by indomethacin extinguished the inhibitory effects of Transforming Growth Factor-beta2 on corneal endothelium proliferation but not exogenous prostaglandin E2. It suggesting that TGF-beta2-induced autocrine synthesis of PGs, most likely PGE2, may be responsible for the anti-proliferative effects of TGF-beta2 on corneal endothelium.

Animals↗
PubMed2003

Pseudomonas corneal ulcer related to overnight orthokeratology.

PURPOSE: To report two cases of Pseudomonas aeruginosa corneal ulcers as a complication of overnight orthokeratology lens wear. METHODS: Case report. RESULTS: Two 11-year-old girls with acute central corneal ulcers were referred to our hospital. In both cases, the ulcers were about 2 mm in diameter, located centrally, contained dense cellular infiltration, and discharged purulent material. Intensive topical ceftazidime was applied to treat the ulcers. Cultures of the scraped corneal tissues and the contact lens storage solutions in both cases grew P. aeruginosa, which was sensitive to the antibiotic. The presenting best-corrected visual acuity was hand motion at 20 cm in one patient and 6/20 in the other. Both patients had received several months of overnight orthokeratology treatment with rigid gas permeable contact lenses to correct myopia (-4.25 D and -4.75 D in the two affected eyes). The final best-corrected visual acuity was 6/60 in one patient and 6/7.5 in the other. CONCLUSIONS: Overnight orthokeratology contact lens wear carries a potential risk of corneal ulcer and may cause significant visual impairment in children.

Anti-Bacterial Agents↗
PubMed2003

Refractive errors in an elderly Chinese population in Taiwan: the Shihpai Eye Study.

PURPOSE: Few epidemiologic data are available on refractive status in elderly Asians. The purpose of the study was to determine prevalence and risk factors associated with refractive errors in a metropolitan elderly Chinese population in Taiwan. METHODS: A population-based survey was conducted in the Shihpai district of Taipei, Taiwan. A total of 2045 residents aged 65 years or more were randomly selected and invited to complete a comprehensive questionnaire and undertake a detailed ocular examination, including best corrected visual acuity and measurements of refractive error, using autorefraction. Of the subjects, 1361 (66.6%) participated in the ocular examination. Spherical equivalent (SE) was calculated in diopters (D), and data from right eyes were reported. RESULTS: The age- and sex-adjusted prevalence rates were determined for myopia (SE<-0.5 D, 19.4%; SE<-1.0 D, 14.5%), high myopia (SE<-6.0 D, 2.4%), hyperopia (SE>+0.5 D, 59.0%; SE>+1.0 D, 44.2%), astigmatism (cylinder<-0.5 D, 74.0%; cylinder<-1.0 D, 45.3%), and anisometropia (SE difference between right and left eyes>0.5 D, 45.2%; SE difference>1.0 D, 21.8%). The prevalence of myopia, astigmatism, and anisometropia significantly increased with age (all P<0.01). The prevalence of hyperopia tended to decrease with age. There was no gender difference in prevalence rates in any type of refractive error, except that women had a higher rate of hyperopia (SE>+1.0 D) than men (P=0.004). Multivariate regression analysis showed that myopia was weakly associated with higher educational level. The severity of lens nuclear opacity was positively associated with the rates of myopia and negatively associated with the rates of hyperopia. CONCLUSIONS: The prevalence of myopia in this elderly Chinese population is not much higher than in similarly aged elderly white populations, compared with a much greater difference in prevalence among younger Chinese versus white people. This suggests that changing environmental factors may account for the increased prevalence of myopia in younger cohorts of Chinese.

Age Distribution↗
PubMed2003

Association between visual impairment and depression in the elderly.

BACKGROUND AND PURPOSE: Visual disturbances greatly influence daily activities and social activities of the elderly. The purpose of this study was to investigate the association between impaired vision and depression among the elderly in a metropolitan community. METHODS: A population-based survey of eye diseases among subjects 65 years of age and older was conducted in Taipei between July 1, 1999, and December 31, 2000. A total of 2045 subjects were invited to participate, and 1361 (66.6%) participated in the survey. A structured questionnaire was used for door-to-door data collection. Interviewers also collected information on subjects' demographic characteristics, medical history, and from the Geriatric Depression Scale-Short Form (GDS-S). Those subjects who had been interviewed were invited to the hospital for detailed eye examinations, including best-corrected visual acuity measurement. RESULTS: Among the participants, the prevalence of impaired vision (visual acuity less than 6/12 in the better eye) was 7.2% and the percentage with depression (GDS-S scores of > or = 5) was 8.8%. Impaired vision [p < 0.05, odds ratio (OR) = 2.11], female gender (p < 0.05, OR = 2.03), cardiovascular disease (p < 0.05, OR = 1.72), and stroke (p < 0.05, OR = 2.85) were significantly associated with depression in multivariate analyses. Multiple logistic regression models were used to evaluate the impact of impaired vision on each depressive item of the GDS-S. After controlling for all other covariates, impaired vision was a positive predictor for the following 4 items of the GDS-S: elderly with impaired vision feel unhappy most of the time [OR = 1.73; 95% confidence interval (CI) = 1.01 to 2.88]; they do not think it is wonderful to be alive now (OR = 2.13; 95% CI = 1.21 to 3.64); they feel worthless the way they are now (OR = 2.23; 95% CI = 1.24 to 3.90); and they feel that their situation is hopeless (OR = 1.95; 95% CI = 1.03 to 3.52). CONCLUSIONS: Visual impairment was associated with feelings of worthlessness and hopelessness in this community population of older adults. However, elderly people often ignore disturbances or impact associated with worsening vision. There is an ongoing need for public education regarding the need for elderly people to pay active attention to visual care in their later life.

Age Factors↗
PubMed2003

The efficacy and safety of brimonidine 0.2% compared with timolol 0.5% in glaucoma: a randomized clinical trial on Taiwanese patients.

BACKGROUND: Brimonidine is a highly selective alpha-2 adrenergic receptor agonist with intraocular pressure (IOP) reducing effect. We conducted this study in Taiwan to compare the safety and efficacy ofbrimonidine 0.2% with timolol 0.5% for the treatment of glaucoma. METHODS: A prospective, randomized, single-masked, 1-month clinical efficacy and safety trial was conducted from March to September 2000. Forty glaucoma patients were enrolled--29 in the brimonidine group and 11 in the timolol group. Patients instilled their study medications twice daily for 4 weeks, and were followed at baseline visit, weeks 2 and 4. Demographic data, reduction of IOP, safety and adverse events were obtained and analyzed. RESULTS: Both drugs showed sustained ocular hypotensive efficacy in the study period. At baseline, the mean IOP was 24.48 +/- 2.29 mmHg in the brimonidine group and 23.32 +/- 0.82 mmHg in the timolol group. The IOP readings after treatment were significantly lower than their baseline levels in both groups at all visits (p < 0.001). At peak, the mean decreases from the baseline IOP ranged from 5.22 +/- 0.30 mmHg to 6.96 +/- 0.33 mmHg for brimonidine and from 4.55 +/- 0.49 mmHg to 6.64 +/- 0.53 mmHg for timolol. At trough, the mean decreases from baseline ranged from 3.72 +/- 0.32 mmHg to 4.55 +/- 0.32 mmHg for brimonidine and 3.82 +/- 0.52 mmHg to 4.27 +/- 0.51 mmHg for timolol. No significant between-group differences were seen at peak or trough at all visits. The clinical success rate was 86.2% in the brimonidine group and 81.8% in the timolol group, making no statistically significant difference between them (p = 0.817). 17.2% of patients in brimonidine group and 9.0% patients in timolol group reported mild adverse events. Ocular allergy occurred in 10.3% of patients in brimonidine group. No significant changes in visual acuity, biomicroscopy or ophthalmoscopy were observed in both groups. Mean systolic and diastolic blood pressure remained relatively stable in both groups except in week 2 (p = 0.016) when brimonidine had lower systolic blood pressure. However, brimonidine showed no significant difference in week 4 from baseline. The mean heart rate in the brimonidine group was relatively unchanged over the study period. Patients receiving timolol experienced statistically significant mean heart rate decreases from baseline (p = 0.020) in week 4. CONCLUSIONS: Topically applied twice daily for one month, brimonidine tartrate 0.2% has clinical effectiveness equivalent to timolol 0.5% in Taiwanese patients with glaucoma. It has a safe systemic profile with minimum effect on the heart.

Adrenergic alpha-Agonists↗
PubMed2003

Frosted branch angiitis in two Chinese young girls.

We examined 2 relatively healthy young girls who presented with acute red eyes and blurred vision. Each patient developed thick, inflammatory infiltrates surrounding the retinal vessels creating the appearance of frosted tree branches in both eyes. Marked inflammatory reactions with cells and flare were noted in anterior chambers. One patient even had hypopyon in both eyes. Initial visual acuity ranged from 6/6.7 to 6/60. Both patients showed rapid improvement with systemic and/or topical corticosteroid therapy, and all of the affected eyes regained a visual acuity of 6/6. The clinical appearances and courses of these two patients matched the condition previously described in Japan and labeled frosted branch angiitis. Before this article, there was only one case reported in Taiwan.

Adrenal Cortex Hormones↗
PubMed2002

Change of gene expression profiles in the retina following optic nerve injury.

The purpose of the present study was to search for changes in gene expression patterns in the retina following optic nerve injury. We conducted a subtractive hybridization for comparison of the mRNAs in those retinas receiving optic nerve crush injury and those receiving sham operation. Both forward and reverse subtractions were carried out for 8-h and 24-h time points postoperatively. Resultant subtractive cDNA for each group was re-amplified and cloned to a plasmid. After DNA sequencing, the identity of subtractive cDNA was analyzed by blasting sequences to the Nonredundant gene database, Unigene database, and dbest database at NCBI. Thirty-four known genes and 32 EST were found in the forward subtractions. Forty-two known genes and 46 EST were found in reverse subtractions. Identities of the rest could not been found in the databases. To verify the subtractive results, RT-PCR was performed to test expression patterns of eight known genes found in the above analysis. Among these eight genes, seven demonstrated a statistically significant difference between the crushed eyes and the control eyes by quantitative image analysis. Together, our data show that expression of fatso, ephrin B2, NonO, Zfx, vitronectin, and XLRS increased after optic nerve injury, and expression of stathmin exhibited reduction after injury.

Animals↗
PubMed2002

Efficacy of probing the nasolacrimal duct with adjunctive Mitomycin-C for epiphora in adults.

PURPOSE: To investigate the efficacy and safety of adjunctive low-dose mitomycin-C during lacrimal probing for adults with blocked nasolacrimal ducts. DESIGN: Prospective, noncomparative, interventional case series. PARTICIPANTS: From January 1998 to December 2000, a total of 32 adult patients (36 eyes) seen with epiphora caused by primary nasolacrimal duct obstruction was treated and evaluated. INTERVENTION: Lacrimal probing with adjunctive mitomycin-C (0.2 mg/ml). MAIN OUTCOME MEASURES: Objective evaluation of patency with irrigation, as well as patients' subjective assessment of improvement. RESULTS: For 32 of the treated eyes (89%), the nasolacrimal duct remained open 9 months after treatment. Repeat procedure was successful for two of the remaining four eyes with recurrent obstruction during follow-up, yielding an overall patency rate of 94%. Patient satisfaction was assessed after 9 months and indicated that the epiphora was at least mildly improved for 30 (83%) of the treated eyes. Watering was completely absent for nine eyes (25%), rated as moderately improved for 17 (47%), and mildly improved for 4 (11%). No complications were encountered over the 9-month follow-up period. CONCLUSIONS: Our experience suggests good long-term results for probing with adjunctive, topical Mitomycin-C for cases of adult epiphora caused by obstruction of the nasolacrimal duct followed by repeat procedure if necessary. It can be recommended as a simple, effective, and minimally invasive technique, with no significant complications resulting from low-dose use in our study.

Aged↗
PubMed2002

Changes in intraocular pressure and ocular perfusion pressure after latanoprost 0.005% or brimonidine tartrate 0.2% in normal-tension glaucoma patients.

OBJECTIVE: To evaluate and compare the effects of latanoprost 0.005% once daily and brimonidine tartrate 0.2% twice daily in patients with normal-tension glaucoma (NTG). DESIGN: A randomized, open-label, crossover study. PARTICIPANTS: Twenty-eight NTG patients with progressive visual field defects/optic disc excavation, new disc hemorrhage, or field defects that threatened fixation. INTERVENTION: Patients were randomly allocated to one of two groups. Patients in group 1 were treated with latanoprost, lubricant, and brimonidine for 4 weeks each, whereas patients in group 2 were treated with brimonidine, lubricant, and latanoprost for 4 weeks each. MAIN OUTCOME MEASURES: Intraocular pressure (IOP), pulse rate, and blood pressure were measured at 8 am, 12 noon, and 4 pm after each 4-week treatment. Ocular perfusion pressure (OPP) was calculated. RESULTS: Latanoprost and brimonidine reduced the average IOP by 3.6 +/- 1.9 mmHg (P < 0.001) and 2.5 +/- 1.3 mmHg (P < 0.001), respectively, with a significant difference between the two regimens (P = 0.009). Both drugs significantly reduced IOP at each time point. Latanoprost decreased IOP significantly more than did brimonidine at 8 am (11.7 +/- 2.2 mmHg vs. 13.7 +/- 2.1 mmHg, P = 0.004) and 4 pm (11.4 +/- 2.1 mmHg vs. 13.2 +/- 2.9 mmHg, P = 0.004), but IOP was equal between the two agents at 12 noon (11.5 +/- 2.6 mmHg vs. 11.5 +/- 2.3 mmHg, P = 0.967). IOP was maintained at 12 mmHg or lower in 18 (66.7%) of 27 patients after treatment with latanoprost and in 9 (33.3%) of 27 patients after treatment with brimonidine. Latanoprost monotherapy reduced IOP by 30% in 8 patients (29.6%), but brimonidine monotherapy did not reduce IOP by that much in any of the patients. OPP increased after latanoprost treatment (P < 0.001) but did not increase after brimonidine treatment (P = 0.355). There was no significant change in pulse rate or blood pressure. CONCLUSIONS: Both latanoprost and brimonidine reduce IOP in NTG patients. Brimonidine has a peak IOP-lowering effect equal to that of latanoprost but produces a higher mean diurnal IOP than does latanoprost because of its shorter effect. Latanoprost might favorably alter optic disc blood perfusion by increasing OPP.

Adrenergic alpha-Agonists↗
PubMed2002

Nitric oxide levels in the aqueous humor in cataract patients.

PURPOSE: To determine the role of nitric oxide (NO) in the clinical manifestations of cataract in different age and etiological groups. SETTING: Multicenter study, Taipei, Taiwan, Republic of China. METHODS: Aqueous humor samples were obtained from 114 cataract patients in different etiological and age groups (eg, juvenile, traumatic, and age-related cataract). Using chemiluminescence assay, NO was detected through the light generated by ozone and NO interaction. The amount of NO production was calculated and compared among groups. The results were correlated with patient age. RESULTS: The NO levels in aqueous humor were highest in the 12 patients with traumatic cataract and lowest in the 15 patients with juvenile cataract (47.59 micromol/L +/- 12.81 [SD] and 7.66 +/- 2.62 micromol/L, respectively; P <.001). Aqueous humor NO levels were correlated with age and were highest in patients older than 80 years (mean 38.78 +/- 6.29 micromol/L) and in those with mature cataract (mean 40.15 +/- 6.15 micromol/L) (P <.05). CONCLUSIONS: The NO levels in the aqueous humor increased with age and traumatic events. The results suggest that NO could be a risk factor in cataract formation.

Adolescent↗
PubMed2002

Corneal ulcer of the side port after phacoemulsification induced by Acinetobacter baumannii.

A 75-year-old man had clear corneal phacoemulsification using a temporal approach in the left eye. Two months after surgery, a focal corneal epithelial defect developed with infiltration near the lower limbus on the site of the side-port incision. The culture of corneal scrapping grew Acinetobacter baumannii, which is resistant to most ordinary antibiotics in sensitivity tests. After appropriate antibiotic treatment, the ulcer healed gradually with vessel ingrowth. Acinetobacter baumannii is usually found in nosocomial infection of immune-compromised patients in the intensive care unit. It is a rare pathogen of infectious keratitis. Our case, with its unusual infection site, may point to potential risk factors for this pathogen.

Acinetobacter↗
PubMed2002

Use of latanoprost to reduce acute intraocular pressure rise following neodymium: Yag laser iridotomy.

PURPOSE: To evaluate the efficacy of latanoprost in reducing acute intraocular pressure (IOP) elevation after neodymium:Yag laser iridotomy (LI). METHODS: Primary angle-closure glaucoma (PACG) eyes were randomized to receive premedication with latanoprost and pilocarpine or with pilocarpine only before LI. Postoperative IOP changes were compared with Wilcoxon signed-ranks test using the fellow eyes of 47 patients who had one eye in each group. RESULTS: Postoperative pressure spikes were significantly lower (p = 0.010) in the latanoprost group (4.1 +/- 5.0 mmHg) than in the control group (6.7 +/- 7.0 mmHg). Mean elevation of IOP was less in the latanoprost group than in the control group at 1 hour (2.5 +/- 4.8 versus 4.1 +/- 4.7 mmHg, p = 0.013) and 2 hours (0.8 +/- 5.6 versus 4.4 +/- 8.1 mmHg, p = 0.003) postoperatively. Eleven eyes in the latanoprost group (23.4%) and 20 eyes in the control group (42.6%) developed a rise in IOP > or = 6 mmHg (p = 0.048). CONCLUSION: Latanoprost may reduce the pressure rise following LI in PACG eyes, but its application is limited by a late onset of effect.

Acute Disease↗
PubMed2002

Laparoscopic Ladd's procedure for intestinal malrotation: report of three cases.

Ladd's procedure for laparoscopic repair of malrotation has many advantages over conventional surgical techniques, such as earlier feeding and discharge. However, this procedure is still not commonly used in Taiwan. This report describes the results of treatment of intestinal malrotation in three patients using laparoscopic Ladd's procedure. The patients, aged 8 days, 17 days, and 3 years, underwent laparoscopic Ladd's procedure between July 1999 and September 2000. All three patients had symptoms of intermittent vomiting and were shown to have intestinal malrotation by upper gastrointestinal series study. The procedure was performed using three trocars of 5 mm diameter placed at the infraumbilical ring and the right and left lower quadrants. All procedures were completed laparoscopically. The operative times were 4.8, 3.6, and 3.5 hours, respectively. Feeding was started on postoperative Day 2 to 5, and the hospital stay was 6 to 11 days. Our results suggest that laparoscopic Ladd's procedure can be performed safely in pediatric patients. In addition, patients are expected to benefit from the smaller incision, earlier feeding, shorter hospital stay, and fewer complications compared with traditional Ladd's procedure.

Child, Preschool↗
PubMed2002

Pneumosinus dilatans associated with orbital neurilemmoma.

BACKGROUND: [corrected] Pneumosinus dilatans (PSD) is a rare condition. It has been reported in association with spheno-orbital meningioma, optic nerve sheath meningioma, orbital fibro-osseous diseases and intracranial meningioma, but never with orbital neurilemmoma. We report 4 cases of orbital neurilemmomas in association with PSD, and stress the importance of PSD in cases of orbital neurilemmomas. METHODS: We reviewed the hospital chart, and found 324 orbital tumors were found from 1974 to 1996. Eight consecutive cases of pathology-proven primary orbital neurilemmoma were studied. Clinical features, es pecially computed tomography (CT) scan, were completely reviewed to find the co-existence of orbital neurilemmoma and pneumosinus dilatans. RESULTS: Four cases (50%) among 8 cases of pathology-proven orbital neurilemmomas were found to have pneumosinus dilatans in their CT scan. All these four cases were extraconal tumors. Representative CT scan showed enlarged, aerated sinus with thinning of the affected sinus walls. Ethmoidal, frontal and maxillary sinuses were the most frequently affected. CONCLUSIONS: Pneumosinus dilatans is commonly associated with primary orbital neurilemmoma.

Adult↗
PubMed2002

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↗
PubMed2002

Phthiriasis palpebrarum: an unusual blepharoconjunctivitis.

Phthiriasis palpebrarum is an unusual cause of blepharoconjunctivitis and may easily be overlooked because of the failure of physicians to recognize Phthirus pubis. We report a case of a 30-year-old woman with persistent itching in the left eyelid which was unsuccessfully treated under the diagnosis of allergic blepharoconjunctivitis. Careful ophthalmic examination revealed seven bugs with multiple red pinpoint excretions and numerous small translucent oval eggs (nits) coating the eyelashes. The patient was successfully treated with mechanical removal of all the lice and nits from the eyelashes. The specimen proved histopathologically to be the Phthirus pubis infestation. The Phthirus pubis infestation is usually associated with poor hygiene in overcrowded or undeveloped country. However, it may become a notable problem because of frequent traveling and commercial activities across the different countries.

Adult↗
PubMedDate not supplied

Low conversion rate to multiple sclerosis in idiopathic optic neuritis patients in Taiwan.

PURPOSE: To investigate the clinical characteristics of patients with idiopathic optic neuritis (ON) in Taiwan and to assess the conversion rate to multiple sclerosis (MS) in these patients. METHODS: We studied the medical records of a total of 109 patients with a clinical diagnosis of idiopathic ON treated in the Taipei Veterans General Hospital during the period from January 1986 to May 2003. Clinical characteristics, management, and disease courses were retrospectively reviewed. Our main focus was on the development of multiple sclerosis after an ON attack. Univariate and multivariate analyses were used to evaluate the risk indicators for MS conversion. RESULTS: The patients (58 women, 51 men) had a mean age of 41.2 years at onset. ON was retrobulbar in 46.8% of the patients. Management with or without pulse therapy did not affect the final visual outcome. Female sex, retrobulbar type ON, recurrent cases, elevated cerebrospinal fluid (CSF) IgG index, and central nervous system (CNS) imaging abnormalities were identified as risk indicators for the development of MS (P < 0.05). The 2-year cumulative probability of developing MS was 5.92%, and the 5-year cumulative probability was 14.28%. The conversion rate to MS did not differ among treatment groups. CONCLUSIONS: Idiopathic ON patients in Taiwan have an older age at onset and a higher percentage of optic disc edema than reported in previous literature. The characteristic features of ON patients associated with a high risk of developing MS are female sex, retrobulbar type ON, CNS imaging abnormalities, elevated CSF IgG index, and recurrence. Idiopathic ON patients in Taiwan display a significantly lower conversion rate to MS.

Adolescent↗