Cataract extraction has become a much safer procedure with the development of phacoemulsification... more Cataract extraction has become a much safer procedure with the development of phacoemulsification, extending its application in ocular conditions such as glaucoma for better disease control. This review aims at summarizing the effect of lens extraction with or without combined glaucoma surgeries in different types of glaucoma and describing the intraoperative techniques and changes of glaucoma care postoperatively. A comprehensive literature search was performed through Medline and PubMed, and 67 studies were selected for this review. In primary angle closure (PAC) diseases, studies have revealed significant intraocular pressure (IOP) and medication requirement reduction after lens extraction. Fewer studies described its application in primary open angle glaucoma (POAG) and ocular hypertension (OHT), but literature available suggests that it can also lead to better disease control. Likewise, lower postoperative IOP and pressure fluctuations have been shown in normal tension glaucoma...
Purpose To compare clinical features, complications, and outcomes of CMV retinitis in non-HIV imm... more Purpose To compare clinical features, complications, and outcomes of CMV retinitis in non-HIV immunocompromised patients with HIV infected patients. Methods A retrospective study of patients diagnosed with CMV retinitis with or without HIV infection was performed. Results: Thirty-five eyes from 27 patients (median follow up 26 months) were included. Six patients had HIV infection, the others were immunocompromised from a range of causes. The baseline visual acuity (VA) was similar in the two groups. Prevalence of different types of retinitis (fulminant/indolent) was similar in the two groups. Presence of vitreous haze ≥1+ (p = .041), presence of arteritis, (p = .016) and widespread vascular occlusion (p = .003) were more common in the non-HIV group. Conclusion CMV retinitis can present with different features depending on the cause of immunocompromise. Evidence of intraocular inflammation such as vitritis, retinal arteritis, and vascular occlusions was more common in HIV-negative su...
To report the clinical presentations of ocular tuberculosis infection (OTB) and the treatment reg... more To report the clinical presentations of ocular tuberculosis infection (OTB) and the treatment regimen and outcome in an endemic area. This is a retrospective case series of patients with presumed OTB treated in a tertiary teaching hospital in Hong Kong in 2014–2019. Among the nineteen patients recruited, the most common clinical presentation of OTB was retinal vasculitis (42.1%), followed by scleritis, intermediate uveitis, and choroidal tuberculoma (15.8% respectively). 94.7% and 94.4% of the subjects were treated with ATT and steroid, respectively, and 31.6% were put on systemic immunosuppressant prior to the initiation of ATT. Apart from those suffering from intermediate uveitis, most demonstrated good clinical response within 8 weeks of ATT initiation. Ocular involvement of TB has been increasingly recognized, especially in endemic regions like Hong Kong. High index of suspicion is recommended for OTB in typical clinical phenotypes or recurrent/resistant ocular inflammation unresponsive to conventional therapy. TB retinal vasculitis was the most common presentation of OTB in this study and OTB generally requires treatment with either regional or systemic steroid together with ATT.
Purpose: To investigate the patterns and predictors of intraocular pressure (IOP) changes after i... more Purpose: To investigate the patterns and predictors of intraocular pressure (IOP) changes after intravitreal injection (IVI) of anti-vascular endothelial growth factors (anti-VEGFs).Methods: This study enrolled 32 men and 16 women (mean age, 65.3±12.3 years) who underwent IVI of anti-VEGFs between January and March 2020 in our department. IOPs were measured using Goldmann applanation tonometry. Potential predictors included age, sex, lens status, axial length, history of glaucoma, number of previous IVIs, diagnosis, and post-injection vitreous reflux.Results: The respective mean IOP was 16.2 mmHg, 32.7 mmHg, 21.7 mmHg, and 18.3 mmHg at baseline and at 5, 15, and 30 minutes after IVI. IOP elevation of ≥15 mmHg was observed in 48% of eyes at 5 minutes after IVI; all spikes resolved and the IOP reduced to <21 mmHg within 60 minutes. Previous IVI number (r=0.346, p=0.016) and baseline IOP (r=0.304, p=0.04) were associated with IOP at 5 minutes after IVI. Baseline IOP was associated w...
Cataract extraction has become a much safer procedure with the development of phacoemulsification... more Cataract extraction has become a much safer procedure with the development of phacoemulsification, extending its application in ocular conditions such as glaucoma for better disease control. This review aims at summarizing the effect of lens extraction with or without combined glaucoma surgeries in different types of glaucoma and describing the intraoperative techniques and changes of glaucoma care postoperatively. A comprehensive literature search was performed through Medline and PubMed, and 67 studies were selected for this review. In primary angle closure (PAC) diseases, studies have revealed significant intraocular pressure (IOP) and medication requirement reduction after lens extraction. Fewer studies described its application in primary open angle glaucoma (POAG) and ocular hypertension (OHT), but literature available suggests that it can also lead to better disease control. Likewise, lower postoperative IOP and pressure fluctuations have been shown in normal tension glaucoma...
Purpose To compare clinical features, complications, and outcomes of CMV retinitis in non-HIV imm... more Purpose To compare clinical features, complications, and outcomes of CMV retinitis in non-HIV immunocompromised patients with HIV infected patients. Methods A retrospective study of patients diagnosed with CMV retinitis with or without HIV infection was performed. Results: Thirty-five eyes from 27 patients (median follow up 26 months) were included. Six patients had HIV infection, the others were immunocompromised from a range of causes. The baseline visual acuity (VA) was similar in the two groups. Prevalence of different types of retinitis (fulminant/indolent) was similar in the two groups. Presence of vitreous haze ≥1+ (p = .041), presence of arteritis, (p = .016) and widespread vascular occlusion (p = .003) were more common in the non-HIV group. Conclusion CMV retinitis can present with different features depending on the cause of immunocompromise. Evidence of intraocular inflammation such as vitritis, retinal arteritis, and vascular occlusions was more common in HIV-negative su...
To report the clinical presentations of ocular tuberculosis infection (OTB) and the treatment reg... more To report the clinical presentations of ocular tuberculosis infection (OTB) and the treatment regimen and outcome in an endemic area. This is a retrospective case series of patients with presumed OTB treated in a tertiary teaching hospital in Hong Kong in 2014–2019. Among the nineteen patients recruited, the most common clinical presentation of OTB was retinal vasculitis (42.1%), followed by scleritis, intermediate uveitis, and choroidal tuberculoma (15.8% respectively). 94.7% and 94.4% of the subjects were treated with ATT and steroid, respectively, and 31.6% were put on systemic immunosuppressant prior to the initiation of ATT. Apart from those suffering from intermediate uveitis, most demonstrated good clinical response within 8 weeks of ATT initiation. Ocular involvement of TB has been increasingly recognized, especially in endemic regions like Hong Kong. High index of suspicion is recommended for OTB in typical clinical phenotypes or recurrent/resistant ocular inflammation unresponsive to conventional therapy. TB retinal vasculitis was the most common presentation of OTB in this study and OTB generally requires treatment with either regional or systemic steroid together with ATT.
Purpose: To investigate the patterns and predictors of intraocular pressure (IOP) changes after i... more Purpose: To investigate the patterns and predictors of intraocular pressure (IOP) changes after intravitreal injection (IVI) of anti-vascular endothelial growth factors (anti-VEGFs).Methods: This study enrolled 32 men and 16 women (mean age, 65.3±12.3 years) who underwent IVI of anti-VEGFs between January and March 2020 in our department. IOPs were measured using Goldmann applanation tonometry. Potential predictors included age, sex, lens status, axial length, history of glaucoma, number of previous IVIs, diagnosis, and post-injection vitreous reflux.Results: The respective mean IOP was 16.2 mmHg, 32.7 mmHg, 21.7 mmHg, and 18.3 mmHg at baseline and at 5, 15, and 30 minutes after IVI. IOP elevation of ≥15 mmHg was observed in 48% of eyes at 5 minutes after IVI; all spikes resolved and the IOP reduced to <21 mmHg within 60 minutes. Previous IVI number (r=0.346, p=0.016) and baseline IOP (r=0.304, p=0.04) were associated with IOP at 5 minutes after IVI. Baseline IOP was associated w...
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Papers by Jolly Tsui