Browsing by Author "Apichat Tantraworasin"

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    Association of myopia with peripapillary perfused capillary density in patients with glaucoma an optical coherence tomography angiography study
    (2018-05-01) Yanin Suwan; Masoud Aghsaei Fard; Lawrence S. Geyman; Apichat Tantraworasin; Toco Y. Chui; Richard B. Rosen; Robert Ritch; Tehran University of Medical Sciences; Faculty of Medicine, Ramathibodi Hospital, Mahidol University; Icahn School of Medicine at Mount Sinai; New York Eye and Ear Infirmary; Chiang Mai University
    © 2018 American Medical Association. All rights reserved. IMPORTANCE This study used optical coherence tomographic angiography to assess for impaired blood flow in myopic eyes with or without open-angle glaucoma. OBJECTIVE To compare the peripapillary perfused capillary density (PCD) between eyes with and without glaucoma. DESIGN, SETTING, AND PARTICIPANTS In this cross-sectional study at a tertiary glaucoma referral practice, we recruited patients with myopic eyes of spherical equivalent of more than -3.0 diopters with and without open-angle glaucoma, patients with nonmyopic eyes with glaucoma, and patients with no disease from February 2016 to October 2016. We obtained 4.5 × 4.5-mm optical coherence tomographic angiography images of the optic nerve head and calculated PCD as the ratio of pixels associated with capillaries to the number of pixels in the region of interest after large blood vessel removal. Both eyes of each patient were used in the analysis. Continuous variables were assessed by analysis of variance and Tukey tests. A marginal model of generalized estimating equations was performed to adjust for confounding factors and intraclass correlations. MAIN OUTCOMES AND MEASURES Mean PCD. RESULTS We matched 87 patients with myopic eyes with glaucoma (of whom 39 [45%] were women), 17 with myopic eyes without glaucoma (of whom 10 [59%] were women), and 93 with non-myopic eyes with glaucoma (of whom 55 [59%] were women) for visual field defects and included 51 control participants (or whom 38 [75%] were women). Mean (SD) ages were 67.5 (12.0) years for patients with myopia and glaucoma, 48.2 (19.0) years for those with myopia without glaucoma, 67.3 (11.0) years for those with glaucoma without myopia, and 64.7 (8.9) years in control participants. Global PCD demonstrated a progressive decrease from the control group (mean [SD], 41.0 [4.2]) to those with myopia without glaucoma (38.4 [5.8]) to those with glaucoma without myopia (31.9 [7.5]) to those with both (28.2 [6.0]; all P < .001). The mean difference in global PCD between the 3 groups and control group, adjusted for age and axial length, was greatest in those with myopia and glaucoma (-11.1; 95% CI, -14.0 to -8.1; P < .001), followed by those with glaucoma without myopia (-8.6; 95% CI, -10.9 to -6.3; P < .001) and those with myopia without glaucoma (-2.8; 95% CI, -6.9 to 1.2; P = .17). No interaction was found between glaucoma and myopia. CONCLUSIONS AND RELEVANCE These findings demonstrate peripapillary microvascular attenuation to a greater extent in open-angle glaucoma than myopia. The cross-sectional design means we cannot determine if this association is a cause and/or is associated with other confounding factors.
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    Comparison of two tube-modification techniques in baerveldt glaucoma implantation in refractory glaucoma
    (2020-01-01) Purit Petpiroon; Thanyathorn Vijittrakarnrung; Wasu Supakontanasan; Apichat Tantraworasin; Yanin Suwan; Faculty of Medicine, Ramathibodi Hospital, Mahidol University; Chiang Mai University
    © 2020 Petpiroon et al. This work is published and licensed by Dove Medical Press Limited. Importance: To compare treatment outcomes among a stent group, ligature group and combined groupineyeswithrefractoryglaucoma. Background: Various techniques have been used intra-operatively to restrict the aqueous flow in Baerveldt glaucoma implantation. Design: Retrospective chart review. Participants: All glaucoma patients aged over 18-years old who had Baerveldt implantation in Ramathibodi Hospital, Bangkok, Thailand, between October 2011 and February 2018 were included for analysis. Methods: Retrospective interventional research was conducted. All glaucoma patients who underwent drainage device implantations were retrospectively reviewed from medical records and divided into three groups: stent group, ligature group, and combined group. The primary outcome was post-operative intraocular pressure (IOP) changes and BCVA (logMAR) change. The secondary outcome is treatment failure. Repeated measurements with mixed models and multi-level parametric survival model stratified by propensity score and eye side were used to compare the primary and secondary outcomes between stent group and ligature group. Main Outcome Measures: Treatment failure between two groups. Results: A total of 163 patients with a mean age of 57.11 ± 19.04 years, implanted with Baerveldt tube, were eligible. There were no significant differences between stent and ligature groups in terms of post-operative IOP changes [mean difference with 95% confidence interval = 0.53 (−0.49, +1.55) vs −0.02 (−0.84, +0.81); P = 0.411] and post-operative BCVA (logMAR) change (0.02 (−0.13, +0.18) vs –0.05 (−0.18, +0.07); P = 0.465). The hazard ratio and 95% confidence interval of treatment failure in ligature group were 2.57 (0.72–9.19) compared with the stent group. Conclusion: This study suggests a trend toward a better result in the stent group compared with the ligature group. Further research with a larger sample size and randomized control trial is warranted.
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    Effects of Circumpapillary Retinal Nerve Fiber Layer Segmentation Error Correction on Glaucoma Diagnosis in Myopic Eyes
    (2018-11-01) Yanin Suwan; Samantha Rettig; Sung Chul Park; Apichat Tantraworasin; Lawrence S. Geyman; Keith Effert; Luis Silva; Ravivarn Jarukasetphorn; Robert Ritch; Faculty of Medicine, Ramathibodi Hospital, Mahidol University; Icahn School of Medicine at Mount Sinai; Manhattan Eye, Ear and Throat Hospital; Cornell University; New York Eye and Ear Infirmary; Chiang Mai University; Nidek Inc. Fremont; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell
    © Copyright 2018 Wolters Kluwer Health, Inc. All rights reserved. Purpose: In a myopic population, we investigated the occurrence of circumpapillary retinal nerve fiber layer (RNFL) segmentation errors that required manual correction in optical coherence tomography (OCT) and its effect on glaucoma diagnostic capability of OCT. Materials and Methods: Myopic subjects (spherical equivalent refractive error <-3 D) with and without primary open-angle glaucoma were recruited. Three circumpapillary RNFL scans with diameters of 3.45, 4.50, and 6.00 mm were obtained using spectral-domain OCT. RNFL segmentation errors were manually corrected. Receiver operating characteristic curves of retinal nerve fiber layer thickness (RNFLT) were obtained and area under the curves were calculated before and after manual correction. Results: In total, 90 myopic eyes with glaucoma (90 patients; visual field mean deviation, -9.5±7.1 dB) and 58 myopic eyes without glaucoma (58 control subjects) were included. Glaucomatous eyes required manual correction more frequently than control eyes (56% vs. 32% of RNFL OCT scans; P<0.001). After manual correction in the glaucoma group, the global RNFLT decreased significantly from 61.8 to 57.5 μm (P=0.025), 50.8 to 47.2 μm (P=0.019), and 45.5 to 39.6 μm (P=0.006) for the 3.45-, 4.50-, and 6.00-mm scans, respectively. After manual correction of RNFL segmentation errors, the glaucoma diagnostic capability of the global RNFLT improved significantly; the area under the curves increased from 0.827 to 0.886 (P=0.017), 0.829 to 0.880 (P=0.033), and 0.762 to 0.846 (P=0.006) for the 3.45-, 4.50-, and 6.00-mm scans, respectively. Conclusions: A significant proportion of myopic eyes had RNFL segmentation errors in automated spectral-domain OCT analysis, decreasing glaucoma diagnostic capability of OCT RNFLT measurement.
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    Incidence and clinical outcomes of diabetes mellitus in HIV-infected adults in Thailand: A retrospective cohort study
    (2018-08-30) Ninutcha Paengsai; Gonzague Jourdain; Romanee Chaiwarith; Apichat Tantraworasin; Chureeratana Bowonwatanuwong; Sorakij Bhakeecheep; Tim Roy Cressey; Jean Yves Mary; Nicolas Salvadori; Natapong Kosachunhanun; National Health Security Office; Institute of research for development, Thailand; Harvard School of Public Health; University of Liverpool; Mahidol University; Universite Paris 7- Denis Diderot; Chiang Mai University
    © 2018 The Author(s). Background: Since 2005, Thailand has scaled up one of the largest antiretroviral treatment (ART) programs in South East Asia. Although diabetes mellitus (DM) incidence is increasing in low and middle-income countries, its burden and contributing factors in the HIV infected population are not well known. Methods: Using the Thai National AIDS Program data over a period of 8-years, we identified patients diagnosed with DM based on the following records: 1) fasting plasma glucose equal to or greater than 126 mg/dl following the 2013 American Diabetes Association criteria or 2) diagnosis codes E11-E14 of the 2010 WHO International Classification of Diseases, or 3) anti-diabetic drugs. Incidence was the number of new cases divided by that of person-years of follow-up (PYFU). Competing risks survival regression, treating death without DM as a competing event, was used to identify factors associated with DM. The risk of death in patients diagnosed with DM was estimated using Cox regression models. Results: Data of 763,666 PYFU from 199,707 patients (54.2% male; median age 36.2 years at registration with the program) were available and 8383 cases were diagnosed with DM, resulting in an incidence rate of 11.0 per 1000 PYFU. New DM diagnosis was more likely in men (adjusted sub-distribution hazard ratio 1.2), older patients (compared to patients 18 to 34 years old: 1.8 for 35 to 44; 3.0 for 45 to 59; 3.8 for ≥60), and if ART was initiated (1.3). In 2014, 1313 (16.6%) of 7905 diabetic patients had DM complications (11.5% microvascular complications and 6.9% macrovascular complications). Patients diagnosed with DM were at higher risk of death compared to the others. Conclusions: DM incidence was higher in this Thailand cohort of HIV infected adults than in the general population. Risk factors were similar to those in the general population, in addition to starting ART.
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    Peripapillary Perfused Capillary Density in Acute Angle-Closure Glaucoma: An Optical Coherence Tomography Angiography Study
    (2021-01-19) Yanin Suwan; Masoud Aghsaei Fard; Purit Petpiroon; Wasu Supakontanasan; Rotjaporn Pruksacholavit; Apichat Tantraworasin; Chaiwat Teekhasaenee; Robert Ritch; Ramathibodi Hospital; Farabi Eye Hospital; New York Eye and Ear Infirmary; Chiang Mai University
    PURPOSE: To compare peripapillary perfused capillary density (PCD) on optical coherence tomography angiography among resolved acute angle-closure (AAC), primary open-angle glaucoma (POAG), and control eyes. DESIGN: Prospective, cross-sectional, observational study. METHODS: All patients with resolved AAC or POAG of varying severity and controls were enrolled. We obtained 4.5 × 4.5 mm2 optical coherence tomography angiography images of the optic nerve head. PCD was analyzed using customized software with major vessel removal. Continuous variables were assessed using the analysis of variance and Bonferroni correction test. A marginal model of generalized estimating equations was used to adjust for confounding factors and interocular correlation. RESULTS: The study included 44 eyes with resolved AAC (mean duration of elevated intraocular pressure, 8.1 ± 10.9 days), 69 eyes with POAG, and 49 control eyes. PCD showed a similar decrease between AAC and POAG eyes (P > 0.99). After adjusting for age and sex, the mean difference in global PCD between each of the POAG stage groups and the AAC group was the highest in the severe POAG group (-3.43; 95% confidence interval [CI], -11.38 to 2.52; P = 0.211), followed by the mild POAG (0.68; 95% CI, -3.26 to 4.62; P = 0.735) and moderate POAG (0.20; 95% CI, -5.21 to 5.61; P = 0.942) groups. The duration of increased intraocular pressure did not affect PCD (P = 0.258 and 0.168 for global and annular PCDs, respectively). CONCLUSIONS: The degree of microvascular attenuation in AAC eyes was not different from that in POAG eyes.
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    Peripapillary perfused capillary density in exfoliation syndrome and exfoliation glaucoma versus POAG and healthy controls: An OCTA study
    (2018-03-01) Yanin Suwan; Lawrence S. Geyman; Masoud Aghsaei Fard; Apichat Tantraworasin; Toco Y. Chui; Richard B. Rosen; Robert Ritch; Tehran University of Medical Sciences; Faculty of Medicine, Ramathibodi Hospital, Mahidol University; Icahn School of Medicine at Mount Sinai; New York Eye and Ear Infirmary; Chiang Mai University
    Copyright © 2017 Asia-Pacific Academy of Ophthalmology. Unauthorized reproduction of this article is prohibited. Purpose: To compare the peripapillary perfused capillary density (PCD) among eyes with exfoliation syndrome (XFS), exfoliation glaucoma (XFG), primary open-angle glaucoma (POAG), and controls. Design: Observational, cross-sectional study. Methods: Optical coherence tomography angiography (OCTA) images (4.5 × 4.5 mm) of the optic nerve head were obtained using a commercial spectral domain OCTA system (AngioVue Avanti RTVue-XR, OptoVue, Fremont, CA). Two concentric circles with 1.95-mm (inner) and 3.45-mm (outer) diameters were placed manually, producing an annulus of width 0.75 mm centered at the optic disc. PCD was calculated as the ratio of pixels associated with capillaries to the pixels in the annulus after large blood vessel removal. Continuous variables were assessed by analysis of variance and Tukey honest significant difference (HSD) test. Multiple linear regression analysis was performed to adjust for confounding factors. Results: Forty-three XFG eyes, 31 POAG eyes matched for visual field mean deviation, 33 XFS eyes, and 45 control eyes were analyzed. PCD demonstrated a progressive decrease from controls to XFS to POAG to XFG. Pairwise comparisons revealed significant differences in PCD between each pair of groups (all P < 0.01) except for PCD between XFS and POAG (P = 0.08). A multivariable model adjusting for age and stage showed a more significant decrease in PCD in XFG compared with POAG (P = 0.001). Conclusions: PCD was more significantly decreased in XFG compared with POAG eyes and in XFS compared with control eyes. OCTA provides the first quantitative evidence of the microvascular disturbance that accompanies XFS.
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    Recommended First-Line Antiretroviral Therapy Regimens and Risk of Diabetes Mellitus in HIV-Infected Adults in Resource-Limited Settings
    (2019-09-30) Ninutcha Paengsai; Gonzague Jourdain; Nicolas Salvadori; Apichat Tantraworasin; Jean Yves Mary; Tim Roy Cressey; Romanee Chaiwarith; Chureeratana Bowonwatanuwong; Sorakij Bhakeecheep; Natapong Kosachunhanun; University of Phayao; National Health Security Office; Harvard T.H. Chan School of Public Health; IRD Institut de Recherche pour le Developpement; University of Liverpool; Mahidol University; Universite Paris 7- Denis Diderot; Chiang Mai University
    © 2019 The Author(s) 2019. Published by Oxford University Press on behalf of Infectious Diseases Society of America. Objective: The use of some antiretroviral drugs has been associated with a higher risk of diabetes mellitus (DM) in HIV-infected patients, but the risk associated with antiretroviral drug combinations remains unclear. We investigated the association between first-line antiretroviral therapy (ART) regimens, recommended by the World Health Organization (WHO) in 2016, and the risk of DM in adults. Method: We selected all HIV-infected adults within the Thai National AIDS Program who started a first-line ART regimen consisting the following between October 2006 and September 2013: zidovudine+lamivudine+nevirapine; tenofovir disoproxil fumarate (TDF)+lamivudine+nevirapine; zidovudine+lamivudine+efavirenz; TDF+lamivudine/emtricitabine+efavirenz; zidovudine+lamivudine+ritonavir-boosted lopinavir (LPV/r); or TDF+lamivudine+LPV/r. Diagnosis of DM was defined as having at least 2 of the following characteristics: fasting plasma glucose ≥126 mg/dl, 2010 WHO ICD-10 codes E11-E14, or prescription of antidiabetic drugs. To identify ART regimens associated with DM, we used competing risks regression models that considered mortality without DM as a competing event and adjusted for sex, age, pancreas disease, and stratified by groups defined by a score summarizing the propensity to receive a specific first-line ART regimen. Results: Data from 35 710 adults (49.1% male; median age, 35.0 years; median follow-up, 2.0 years) were included. In the multivariable analysis with zidovudine+lamivudine+nevirapine as the reference group, a higher risk of DM was observed with TDF+lamivudine/emtricitabine+efavirenz (adjusted sub-distribution hazard ratio [aSHR], 1.6; 95% confidence interval [CI], 1.3-1.9), zidovudine+lamivudine+efavirenz (aSHR, 2.0; 95% CI, 1.7-2.3), and TDF+lamivudine+LPV/r (aSHR, 2.7; 95% CI, 1.9-3.9). Conclusions: Several of the WHO recommended ART regimens, particularly tenofovir + lamivudine +LPV/r and regimens containing efavirenz, may be associated with an increased risk of DM.