ORCID Profile
0000-0001-5972-0270
Current Organisation
Chiang Mai University
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Publisher: Galenos Yayinevi
Date: 04-2022
Publisher: Hindawi Limited
Date: 2015
DOI: 10.1155/2015/529529
Abstract: Purpose . To determine changes in central subfield (CSF) macular thickness and best corrected visual acuity (BCVA) following single session, multispot panretinal photocoagulation (PRP). Methods . Forty eyes of 33 patients with newly diagnosed proliferative diabetic retinopathy were treated with single session, 20-millisecond, multispot PRP. Changes in central macular thickness and BCVA at 4- and 12-week follow-up were compared to baseline measurements. Results . Each eye received a mean (SD) of 2,750 (686.7) laser spots. At 4-week follow-up, there was a statistically significant 24.0 μ m increase in mean CSF thickness ( P = 0 . 001 ), with a 17.4 μ m increase from baseline at 12-week follow-up ( P = 0 . 002 ). Mean logMAR BCVA increased by 0.05 logMAR units ( P = 0 . 03 ) at 4-week follow-up. At 12-week follow-up, BCVA had almost returned to normal with only an increase of 0.02 logMAR units compared to baseline ( P = 0 . 39 ). Macular edema occurred in 2 eyes (5%) at 12-week follow-up. Conclusions . Macular thickening occurs following single session, 20-millisecond, multispot PRP, with a corresponding, mild change in BCVA. However, the incidence of macular edema appears to be low in these patients. Single session, 20-millisecond, multispot PRP appears to be a safe treatment for patients with proliferative diabetic retinopathy.
Publisher: Springer Science and Business Media LLC
Date: 22-12-2013
DOI: 10.1007/S10792-013-9890-8
Abstract: To describe the epidemiology, mechanism of injury, and final visual and anatomical outcomes of pediatric patients with open globe injury. The medical records of patients aged ≤ 16 years diagnosed with open globe injury between January 2006 and December 2010 were retrospectively reviewed. Forty-nine pediatric patients were diagnosed with open globe injury during the study period. Forty-one of the 49 patients (83.7 %) were male. The mean age of the patients was 9.3 ± 4.6 years, with 49 % of the injuries occurring in patients between the ages of 11 and 16 years. Ocular penetration was the most common type of injury (63.3 %), occurring most frequently in the cornea (63.3 %). Wooden objects were the most common cause of injury. Following surgical intervention, 40.8 % of the patients obtained a final visual acuity (VA) of ≥ 6/60. Pars plana vitrectomy was performed in 51 % of cases, with only 36 % of these patients having a final VA of ≥ 6/60. The presence of retinal detachment was the only statistically significant factor (odds ratio 0.05, p < 0.001) that affected VA improvement of more than one line. Corneal penetration was frequently observed in pediatric patients with ocular trauma. Pediatric patients with a retinal detachment were significantly more likely to have a poor final visual outcome than open globe patients whose retina remained attached. Despite prompt surgical intervention, useful vision was preserved in less than half of the patients requiring pars plana vitrectomy.
Publisher: Hindawi Limited
Date: 17-03-2019
DOI: 10.1155/2019/9481902
Abstract: Purpose . To report characteristics and visual results in patients with PDR-associated complications following pars plana vitrectomy (PPV) in a tertiary center over an eight-year period. Methods . Medical records of diabetic retinopathy patients receiving PPV between January 2007 and December 2014 for PDR-related complications were reviewed. Results . A total of 890 consecutive PDR patients were included in the study. PPVs were performed for tractional retinal detachment (36.6%), persistent vitreous hemorrhage (VH) (35.4%), combined tractional and rhegmatogenous retinal detachment (14.5%), and vitreoretinal abnormalities (13.5%), respectively. Preoperative intravitreal bevacizumab injection (IVB) within two weeks prior to PPV and 23G vitrectomy systems was found to decrease the risk for intraoperative retinal break development ( P = 0.045 and P = 0.015 , respectively). The incidence of early dense postoperative VH decreased significantly with the administration of preoperative or intraoperative IVB at the end of PPV. Postoperative visual results significantly correlated with the initial visual acuity level, intraoperative retinal break development, and retained silicone oil t onade at the final visit ( P 0.001 , P = 0.040 , and P = 0.044 , respectively). Administration of adjuvant IVB either before or at the end of PPV had no significant association with the final visual outcomes. Conclusions . This study reported an improvement in visual acuity in nearly half of patients receiving PPV for PDR-associated complications in a limited resource center. The incidence of intraoperative retinal break and early postoperative VH decreased significantly with the application of IVB injections. Poor final visual outcomes were related to the lower initial visual acuity levels, intraoperative retinal breaks, and postoperative retained silicone oil.
Publisher: Elsevier BV
Date: 2022
DOI: 10.1016/J.ORET.2021.03.012
Abstract: To understand timing of complete polypoidal regression on indocyanine green angiography (ICGA) after aflibercept injections for polypoidal choroidal vasculopathy (PCV). Multicenter prospective study. Adults with treatment-naïve PCV. After institutional review board approval, participants were enrolled and followed up for 1 year, from Apr 1, 2016, through Dec 30, 2018, at 2 university-based centers in Thailand. Diagnosis of PCV was based on the Efficacy and Safety of Verteporfin Photodynamic Therapy in Combination with Ranibizumab or Alone versus Ranibizumab Monotherapy in Patients with Symptomatic Macular Polypoidal Choroidal Vasculopathy criteria. Eligible eyes received fixed-dose aflibercept injections (3 monthly then every 8 weeks), or monthly if fluid persisted on OCT. Photodynamic therapy (PDT) was administered when fluid persisted despite 6 consecutive injections. Indocyanine green angiography was performed at baseline and then every 8 weeks. The 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) was administered at baseline, 6 months, and 1 year. Two retina specialists reviewed posttreatment ICGA, categorized into: complete regression (complete disappearance of polypoidal lesions), partial regression (reduced in size or number), or no regression. Disagreements were resolved through open adjudication. Timing of complete regression over 1 year. Final analysis included 40 eyes (39 participants 100% Thai, 59% women mean age±standard deviation, 64 ± 8.3 years). At baseline, 90% had 5 or more polypoidal lesions. Ninety-five percent received aflibercept monotherapy, and 5% received rescue PDT per protocol. Polypoidal statuses at 1 year were 55% complete, 40% partial, and 5% no regression. Cumulative rates of complete regression at 2, 4, 6, and 12 months were 28%, 33%, 43%, and 55%. Of 22 eyes with complete regression at 1 year, complete regression was identified first at 2, 4, 6, 8, 10, 12 months in 50%, 9%, 18%, 5%, 9%, and 9%, respectively. Cumulative rates of complete regression among these eyes at 2, 6, and 12 months were 50%, 77%, and 100%, respectively. Median duration of complete regression was 3 months (interquartile range, 2-6 months). Median visual acuity improved from 20/125 (Snellen equivalent) to 20/50 median NEI VFQ-25 scores improved from 80 to 93 from baseline to 1 year. Complete polypoidal regression could occur as early as 2 months after aflibercept injections. Most PCV eyes with complete polypoidal regression at 1 year already showed complete regression within the first 6 months. These findings support consideration of aflibercept for PCV to achieve both anatomic and visual outcomes.
Publisher: Elsevier BV
Date: 10-2023
Publisher: Informa UK Limited
Date: 2023
DOI: 10.2147/OPTH.S401643
Publisher: Informa UK Limited
Date: 2020
DOI: 10.2147/OPTH.S234035
Publisher: Elsevier BV
Date: 08-2018
DOI: 10.1016/J.AJO.2018.05.005
Abstract: To determine sensitivity and specificity of polypoidal choroidal vasculopathy (PCV) diagnosis using color fundus photography (CFP), optical coherence tomography (OCT), and fundus fluorescein angiography (FFA) without indocyanine green angiography (ICGA). Validity analysis. Treatment-naïve eyes with serous/serosanguinous maculopathy undergoing CFP, OCT, FFA, and ICGA imaging before treatment at a university hospital in Thailand (January 1, 2013 to June 30, 2015) were identified. Images of each subject were categorized into 4 sets (set A: CFP set B: CFP+OCT set C: CFP+FFA set D: CFP+OCT+FFA). Six graders, 3 from Thailand (PCV endemic area) and 3 from the United States (nonendemic area), in idually reviewed each set (without ICGA), and determined if the presumed diagnosis was PCV. In parallel, 2 other graders confirmed if each case had PCV or not using EVEREST criteria (including ICGA). Sensitivity and specificity of a PCV diagnosis with each set (without ICGA) were analyzed compared with diagnoses including ICGA. Of 119 study eyes (113 subjects, 57% male, mean age ± SD 59.9 ± 13.8 years), definite PCV diagnosis was 40.3%. Sensitivity of sets A, B, C, D: 0.63 (95% confidence interval [CI]: 0.47-0.76), 0.83 (95% CI: 0.69-0.92), 0.54 (95% CI: 0.39-0.68), 0.67 (95% CI: 0.51-0.79) specificities: 0.93 (95% CI: 0.84-0.97), 0.83 (95% CI: 0.72-0.91), 0.97 (95% CI: 0.89-0.99), 0.92 (95% CI: 0.82-0.97) accuracies: 0.81 (95% CI: 0.73-0.88), 0.83 (95% CI: 0.76-0.90), 0.79 (95% CI: 0.73-0.87), 0.82 (95% CI: 0.74-0.88). Discrepancies between Thai and US graders existed through sets A, C, and D. These data suggest that without ICGA, fundus photography combined with OCT provides high sensitivity and high specificity to diagnose PCV adding FFA does not improve accuracy.
Publisher: Springer Science and Business Media LLC
Date: 14-08-2018
Publisher: Informa UK Limited
Date: 08-02-2018
Publisher: Springer Science and Business Media LLC
Date: 20-08-2015
DOI: 10.1007/S10792-015-0119-X
Abstract: The aim of this study is to determine the associations between regional macular thickness and gender, age, axial length, and degree of myopia in young and middle-aged healthy myopic eyes. One hundred and seventy-one subjects with -0.5 diopters of myopia or worse underwent prospective macular thickness measurement by Spectralis spectral-domain optical coherence tomography. Subjects' mean age was 32.40 ± 8.25 years (range 18 to 49 years), with 45 % being male. The mean degree of myopia was -4.57 ± 3.52 diopters, with a mean axial length of 25.09 ± 1.67 mm. Multivariate regression analysis demonstrated significantly thicker central (mean 9.13 µm thicker) and inner subfields (mean 8.55 µm thicker) in males (P values were <0.001 and 0.002, respectively). In addition, in both genders, for each millimeter of increased axial length, the central subfield thickness increased by 2.11 µm, the inner subfield decreased by 2.25 µm, and the outer subfield decreased by 3.62 µm (P values were 0.010, <0.001, and <0.001, respectively). Factors including gender and axial length affect baseline regional macular thickness in young and middle-age myopic subjects. The central subfield and inner subfield were affected by both gender and axial length, while the outer subfield was affected only by axial length. The macular thickness of myopic subjects with macular disease should be interpreted in light of these factors.
Publisher: Springer Science and Business Media LLC
Date: 04-10-2012
DOI: 10.1007/S10384-012-0192-X
Abstract: To describe the macular thickness measured by spectral-domain optical coherence tomography (SD-OCT) in healthy eyes of Thai people. Prospective cross-sectional study. Three hundred sixty-eight healthy participants underwent a comprehensive ophthalmic examination, including Spectralis SD-OCT scanning, at Chiang Mai University Hospital. The images were obtained over maculae, using a high-speed volumetric raster scan pattern with lines 240 μm apart. Information was collected from both eyes of each person, with only the right one being used unless it was found to be ineligible (in which case the left eye was studied). A mean retinal thickness was calculated based on nine areas that corresponded to the Early Treatment Diabetic Retinopathy Study by OCT mapping software. The relationships between retinal thickness and sex, age, axial length, and spherical equivalence were analyzed. The mean age of the subjects was 49.17 ± 17.24 years. The mean central retinal thickness was 259.18 ± 19.08 μm, the mean foveal volume was 0.20 ± 0.02, and the mean total macular volume was 8.59 ± 0.37 mm(3). Central subfield (CSF) thickness and foveal volume were significantly greater in men than in women (both P < 0.001). When analyzed for six age groups by ANOVA, the CSF thickness showed no significant difference among the groups, with a P value of 0.280, and foveal volume showed no significant difference among the six groups, with a P value of 0.341. After age adjustment, axial length was correlated positively with the CSF thickness (P < 0.001, Pearson correlation). The normal macular thickness in Thais is thinner than those reported for other populations when measured using the Spectralis SD-OCT. Male gender and axial length were correlated positively with CSF thickness.
Publisher: Asia Pacific Academy of Ophthalmology
Date: 2019
DOI: 10.22608/APO.2017389
Publisher: Elsevier BV
Date: 2014
DOI: 10.1016/J.INJURY.2013.06.003
Abstract: To determine the outcomes and predictive factors of patients with open globe injury requiring pars plana vitrectomy (PPV). The medical records of 114 patients age 10 years or older who had undergone PPV due to ocular trauma, with at least 6 months follow up, were retrospectively reviewed. The mean age of the patients was 42 (SD14) years, with males accounting for 89% of the cases. Penetrating eye injury was the most common injury mechanism (43%) with most injuries occurring secondary to work related incidents (54%). After surgical interventions, 78% of the patients had visual improvement of one or more Snellen lines, while no light perception occurred in 10%. Anatomical attachment was achieved in 87% of eyes at the final follow up. Logistic regression analysis showed that the presence of a relative afferent pupillary defect (RAPD) was a significant predictive factor of visual outcome, while initial retinal detachment was a significant predictor of anatomical outcome. Pupillary reaction is an important presenting ocular sign in estimating the post-vitrectomy poor visual outcome for open globe injury. Vision was restored and improved in more than half of the patients in this study however, long-term sequelae should be monitored.
Publisher: American Medical Association (AMA)
Date: 06-2018
Publisher: Informa UK Limited
Date: 29-01-2020
DOI: 10.1080/09286586.2020.1716381
Abstract: To determine the characteristics and epidemiology of open globe injury (OGI) in a third referral centre over 11 years. The study was a retrospective observational study. The medical records of 978 OGI cases (a total of 998 eyes), admitted to Chiang Mai University Hospital, Thailand from January 2006 to December 2016, were reviewed. The mean age (SD) of patients was 39.1 (17.5) years. Patients were predominantly male (867, 88.7%). The age with the highest incidence of injury ranged from 41 to 60 years, in both genders. Most injuries happened at the workplace (64.8%), with flying objects from electric grass trimmers (23.9%) being the major injury-related mechanism. Penetration injuries were found in 479 eyes (48.0%). In elderly group (aged >60 years), a higher proportion of a globe rupture injuries were observed (13.3%). In general, intraocular foreign body group presented with better initial visual acuity (VA) compared to other injury types (p< 0.001). In all types of injury, final VA was significantly improved after treatment. However, rupture and perforation globe injuries had significantly worse final VA outcomes, compared to penetration and intraocular foreign body injuries (p< 0.001). With multivariable regression analysis, poor initial VA (p< 0.001), type of injury (p= 0.028), positive relative afferent pupillary defect (RAPD) (p< 0.001), and endophthalmitis (p< 0.001) were associated with poor visual outcomes. Work-related eye injury is a major cause of OGI. Poor initial VA, endophthalmitis, presence of RAPD, and rupture were the predictors for poor final visual outcomes.
No related grants have been discovered for Janejit Choovuthayakorn.