Publications by authors named "Cheng-Kuo Cheng"

Article Synopsis
  • Monkeypox, or Mpox, is a viral illness that has been spreading internationally since mid-2022, including cases in Taiwan.
  • In a reported case, a man developed eye infections and skin symptoms related to Mpox, with tests confirming the presence of the virus in both his throat and skin lesions.
  • Despite initial treatment that included antiviral and antibiotic medications, the patient's eye condition worsened, requiring additional treatments, but eventually the corneal lesion healed, leaving a scar.
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Article Synopsis
  • The study compares conventional phacoemulsification surgery (CPS) and low-energy femtosecond laser-assisted cataract surgery (FLACS) to determine which technique produces better outcomes for cataract patients.
  • Key metrics evaluated include procedure time, visual acuity improvements, and effects on endothelial cells and corneal thickness.
  • The results indicate that while both methods are effective, low-energy FLACS shows advantages in reducing phacoemulsification time and preserving endothelial cell health compared to CPS.
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A recent resurgence in the incidence of syphilis has sparked a new interest in this old disease. Syphilitic uveitis remains a challenging disease, among the variable syphilis infections, due to the diagnostic complexity and the wide clinical manifestations. Here, we provide recommendations regarding clinical manifestations, diagnosis, and treatment for patients with syphilitic uveitis in Taiwan based on an expert meeting and consensus from experienced uveitis specialists.

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Although retinal pigment epithelium (RPE) tears are common in patients with chronic conditions such as exudative age-related macular degeneration or may occur in response to anti-vascular endothelial growth factor or laser treatment, a spontaneous RPE tear can occur in patients with acute and new-onset bullous central serous chorioretinopathy (CSCR). We present a rare case of a healthy young Asian man with unilateral massive subretinal fluid (SRF). An idiopathic acute-onset bullous CSCR with an RPE tear was diagnosed through ancillary examinations.

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Clinical practices on acute post-operative and endogenous endophthalmitis (EnE) are highly variable among clinicians due to a lack of up-to-date, high-quality evidential support. An expert consensus is thus much needed. A panel consisting of ten retinal specialists in Taiwan was organized.

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Rhegmatogenous retinal detachment (RRD) is a significant cause of vision loss and requires appropriate surgical intervention. There are several approaches available, including observation, laser demarcation, pneumatic retinopexy, scleral buckling, and pars plana vitrectomy, which are chosen based on patient condition, surgeon experience, and national health insurance policies. Despite the various options, there is still no consensus on the optimal intervention.

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Purpose: To investigate morphological changes of intraretinal cyst in association with visual acuity following treatment for diabetic macular edema.

Methods: This retrospective study enrolled 105 eyes from 105 treatment naïve patients with diabetic macular edema following anti-vascular endothelial growth factor injections. Best-corrected visual acuity (BCVA) and optical coherence tomography (OCT) data were obtained at baseline, 1, 3, 6, and 12 months.

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Background: The Ranibizumab AMD Clinical Efficacy Study (RACER) conducted in treatment-naive adult Taiwanese patients with neovascular age-related macular degeneration (nAMD) suggested the importance of early and intensive dosing of ranibizumab for optimal treatment outcomes. This subgroup analysis aims to provide clinical information on treatment response that can potentially guide on maintaining the treatment or switching anti-VEGF agents in the real-world setting.

Methods: Visual acuity (VA) and central retinal thickness (CRT) were assessed in the RACER subgroup population.

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Purpose: To compare the visual and anatomical outcomes between strict pro re nata (strict PRN) and treat-and-extend (T&E) anti-vascular endothelial growth factor (anti-VEGF) regimens for neovascular age-related macular degeneration (nAMD).

Methods: A meta-analysis of 1-year and 2-year changes between strict PRN and T&E anti-VEGF regimens were conducted in both randomized controlled trials (RCTs) and real-world studies (RWSs). The best-corrected visual acuity (BCVA), central retinal thickness (CRT), and weighted mean numbers of visits and injections were evaluated.

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Article Synopsis
  • Peripapillary choroidal neovascularization (PPCNV) is a rare condition linked to optic nerve sheath meningioma (ONSM) and other eye diseases.
  • The case described includes features such as age-related macular degeneration, PPCNV, optic disc swelling, and abnormal retinal-choroidal veins.
  • Magnetic resonance imaging identified an ONSM and showed cerebrospinal fluid buildup near the tumor, leading to a hypothesis about how PPCNV may develop in conjunction with ONSMs.
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The purpose of the study was to report an unusual case of recurrent pseudophakic cystoid macular edema (PCME) in an eye with three simultaneous intraocular lenses (IOLs) inside. A 57-year-old female with diabetes mellitus (DM) and a history of complicated cataract surgery was diagnosed with cystoid macular edema (CME). Upon examination, an anterior chamber intraocular lens (ACIOL) with vitreous strand in her right eye was noted.

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Purpose: To report a rare case of cystoid macular edema (CME) as a presentation of acute hydroxychloroquine-related retinal toxicity.

Observations: A 37-year-old female patient visited our ophthalmology department in October 2019 complaining of bilateral blurred vision and metamorphopsia for 3 days. Best-corrected visual acuity (BCVA) was 6/6 in the right eye and 6/7.

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Purpose: To demonstrate the treatment effect of combined intravitreal bevacizumab (IVB) and systemic steroid for systemic inflammatory response syndrome (SIRS)-related Purtscher-like retinopathy (PuR).

Methods: Retrospective case report.

Results: A 19-year-old patient experienced bilateral blurred vision after urinary tract infection-induced SIRS.

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Uveitis is a sight-threatening disease that can be associated with many different etiologies. Successful treatment of uveitis relies on accurate diagnosis and prompt efficient therapy. History taking, physical and ocular examinations, systemic evaluations, and response to treatment provide crucial information to differentiate possible etiologies involved in the pathophysiology of intraocular inflammation.

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The management of neovascular age-related macular degeneration (nAMD) has taken a major stride forward with the advent of anti-VEGF agents. The treat-and-extend (T&E) approach is a refined management strategy, tailoring to the individual patient's disease course and treatment outcome. To provide guidance to implementing anti-VEGF T&E regimens for nAMD in resource-limited health care systems, an advisory board was held to discuss and generate expert consensus, based on local and international guidelines, current evidence, as well as local experience and reimbursement policies.

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Neovascular age-related macular degeneration (nAMD) is a leading cause of irreversible vision loss. The present consensus provides suggestions on diagnosis, evaluation, treatment, and follow-up strategies for nAMD from a panel of 11 practicing ophthalmologists. The experts suggest that the baseline visit for nAMD management should include a comprehensive ophthalmologic examination via a multimodal approach consisting of visual and anatomical evaluation.

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Article Synopsis
  • Optical coherence tomography (OCT) biomarkers, particularly ellipsoid zone (EZ) dynamics, can change over time and may better predict vision improvement in diabetic macular edema after treatment than baseline measurements.
  • A study involving 135 patients treated with anti-VEGF analyzed EZ status and macular perfusion at multiple time points, finding that disruption of the EZ at baseline was associated with poorer outcomes and that macular perfusion status influenced EZ dynamics.
  • The research highlighted that longer durations of EZ disruption were more indicative of visual acuity improvement than the initial status before treatment.
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To compare the visual and anatomical outcomes between intravitreal aflibercept and ranibizumab for diabetic macular edema A total of 194 eyes from 194 patients (aflibercept n = 95, ranibizumab n = 99) were retrospectively enrolled in the study. All eyes fulfilled the key criteria including a baseline best-corrected visual acuity (BCVA) between 20 and 70 ETDRS letters, a central subfield thickness (CST) 300 µm or more. Primary outcomes were BCVA and CST at 1, 3, 6, and 12 months.

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  • * A study reviewed angiography data to redefine PCV subtypes and found distinct features in 56.3% of patients with the branching vascular network (BVN).
  • * Subtype A had the best visual outcomes, potentially due to better baseline acuity, and combination therapy with photodynamic therapy and anti-VEGF showed more promise for visual improvement compared to using anti-VEGF alone.
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Background: The current National Health Insurance scheme in Taiwan reimburses 3 initial plus 4 additional injections of ranibizumab 0.5 mg for eligible patients with neovascular age-related macular degeneration (nAMD). The Ranibizumab AMD Clinical Efficacy in Real-world practice (RACER) study aimed to observe the effectiveness of ranibizumab injections under this reimbursement system.

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  • Acute zonal occult outer retinopathy (AZOOR) is an eye condition that leads to sudden loss of vision and can be confused with optic neuritis.
  • A 17-year-old male experienced fogginess in one eye, but tests showed normal visual acuity; however, further examinations revealed abnormalities suggestive of AZOOR.
  • It's crucial for doctors to distinguish between AZOOR and optic neuritis due to their similar symptoms for accurate diagnosis and timely treatment.
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Diabetic macular edema (DME) is the most common cause of vision loss among patients with diabetes mellitus (DM), rendering it an important growing challenge in ophthalmology. In the past decades, the management strategies for DME had a few paradigm shifts, and the advent of an expanding number of anti-vascular endothelial growth factor (VEGF) agents also calls for an in-depth examination of the currently available evidence. This article was composed with the intention to provide recommendations for practicing clinicians to improve the management and, through it the outcomes of DME.

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Purpose: Using optical coherence tomography angiography to assess and compare changes in pathological vascular tissue, including choroidal neovascularization in neovascular age-related macular degeneration and polypoidal complex in polypoidal choroidal vasculopathy, after treatment with anti-vascular endothelial growth factor.

Methods: This is a retrospective observational case series study. Clinical data were collected, including that on the best-corrected visual acuity and images of spectrum domain optical coherence tomography and optical coherence tomography angiography of consecutive patients with macula-involved lesions, active pathological vascular tissue in neovascular age-related macular degeneration, and polypoidal complex in polypoidal choroidal vasculopathy who were treated with anti-vascular endothelial growth factor injection.

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Purpose: To evaluate associations of body fluid status with optical coherence tomography measurements in patients with diabetic retinopathy (DR).

Methods: This prospective, cross-sectional study enrolled a total of 104 eyes from 104 patients with diabetes mellitus for fundus evaluations of DR and optical coherence tomography examinations. DR severity was graded via fundus photography.

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