Papers by Napaporn Tananuvat
Cornea, 2003
Even though ocular surface squamous neoplasia (OSSN) has been recognized for well over a century,... more Even though ocular surface squamous neoplasia (OSSN) has been recognized for well over a century, the past decade has witnessed advances that have helped rewrite many of the paradigms for the diagnosis and management of these lesions. OSSN occurs predominantly in the elderly for whom they are the third most common oculoorbital tumors after melanoma and lymphoma. In addition to advanced age and male sex, other major risk factors linked to its pathogenesis are ultraviolet light, cigarette smoking, and the human papilloma virus. Although the latter has been linked to OSSN for nearly 4 decades, its identification and role in the pathogenesis of these tumors has been elucidated recently and is addressed in detail in this review. Newer techniques of impression cytology represent a noninvasive and reliable method of diagnosing OSSN and monitoring treated cases. The efficacy of chemotherapeutic agents such as mitomycin C and 5-fluorouracil have been proven in the recent past, making them a clear alternative to the time-tested treatment of surgical excision and cryotherapy. Early reports on the efficacy of topical Iterferon ␣ 2b indicate significant promise in providing another alternative for the treatment of some of these neoplasms. These advances thus represent a minimally invasive and highly successful approach to the diagnosis and treatment of OSSN.
The Open Ophthalmology Journal
Background: Individuals with refractive errors sometimes have other associated ocular and systemi... more Background: Individuals with refractive errors sometimes have other associated ocular and systemic abnormalities. Objectives: To explore ocular and systemic comorbidities in Corneal Refractive Surgery (CRS) candidates and to examine any contraindications for CRS. Methods: This was a cross-sectional study. Medical records of individuals who underwent a refractive surgery screening at Chiang Mai University LASIK Center, Chiang Mai, Thailand, were reviewed. All clinical data of the initial visit were evaluated. Eyes with a history of CRS and phototherapeutic keratectomy were excluded. Results: A total of 1,167 cases (2,334 eyes) were recruited, out of which 643 cases were females (55.09%). Myopia was the most common type of refractive error (2,120 eyes, 90.83%), and 868 (40.94%) eyes had high myopia. Approximately 45% (n=526) of the cases had worn contact lenses. The five most common ocular comorbidities (eyes, proportion) included keratoconus suspect (297, 12.72%), cataract (246, 10.5...
JMIR mHealth and uHealth
Background Dry eye (DE) is a chronic inflammatory disease of the ocular surface of the eye that a... more Background Dry eye (DE) is a chronic inflammatory disease of the ocular surface of the eye that affects millions of people throughout the world. Smartphone use as an effective health care tool has grown exponentially. The “Dry eye or not?” app was created to evaluate the prevalence of symptomatic DE, screen for its occurrence, and provide feedback to users with symptomatic DE throughout Thailand. Objective The purpose of this study was to compare the prevalence of symptomatic dry eye (DE), blink rate, maximum blink interval (MBI), and best spectacle-corrected visual acuity (BSCVA) between people with and without symptomatic DE and to identify risk factors for symptomatic DE in Thailand. Methods This cross-sectional study sourced data from the “Dry eye or not?” smartphone app between November 2019 and July 2020. This app collected demographic data, Ocular Surface Disease Index (OSDI) score, blink rate, MBI, BSCVA, and visual display terminal (VDT) use data. The criterion for symptoma...
Clinical Ophthalmology (Auckland, N.Z.), 2021
Purpose To evaluate the 12-months outcomes of photorefractive keratectomy (PRK) in patients with ... more Purpose To evaluate the 12-months outcomes of photorefractive keratectomy (PRK) in patients with high myopia (≥ 6.0 diopters, D) compared with low-to-moderate myopia (< 6.0 D). Patients and Methods Records of 46 patients (69 eyes) who underwent PRK for myopic and astigmatic correction between October 2015 and December 2018 were reviewed. High myopic eyes (29 eyes) were compared with low-to-moderate myopic eyes (40 eyes). All surgeries were adjunct with 0.02% mitomycin C intraoperatively. Measured outcomes included postoperative uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction spherical equivalent, corneal haze rate, and any complications. Results At 12 months post-PRK, 26 eyes (89.7%) in the high myopia and 39 eyes (97.5%) in the low-to-moderate myopia group had UDVA ≥ 20/20, (p=0.30). Average postoperative logMAR UDVA at 12 months was −0.04 (20/18) and −0.11 (20/15) for the high myopia and low-to-moderate myopia groups, resp...
Additional file 1: Suppl Fig. 1. Scatter plots show the correlation between age and the endotheli... more Additional file 1: Suppl Fig. 1. Scatter plots show the correlation between age and the endothelial cell density (A), coefficient of variation in average cell size (B), cell area (C), and percentage of regular hexagonal cells (D) of the left eyes.
To verify the effectiveness and complications of botulinum toxin A in the treatment of essential ... more To verify the effectiveness and complications of botulinum toxin A in the treatment of essential blepharospasm and hemifacial spasm we studied prospectively 16 patients who had been treated in neuro-ophthalmologic clinic, Department of Ophthalmology, Chiang Mai University during January -August 1997. There were 2 essential blepharospasm and 14 hemifacial spasm. The follow up period was 6-28 weeks We found that after botulinum toxin injection, the treatment was successful in 12 patients (75%) and 4 patients (25%) were unsuccessful. No serious complication was seen except mild and transient localized muscle weakness in 3 patients. The spasm-free interval was 18(16-20) weeks. Botulinum toxin is a safe and effective means of treatment in essential blepharospasm and hemifacial spasm.
BMC Ophthalmology, 2022
Purpose To evaluate clinical characteristics, treatments, and outcomes in patients with ocular su... more Purpose To evaluate clinical characteristics, treatments, and outcomes in patients with ocular surface squamous neoplasia (OSSN) at a tertiary center in Northern Thailand. Methods Patients diagnosed with either corneal-conjunctival intraepithelial neoplasia (CIN) or squamous cell carcinoma (SCC) from May 2000 to December 2015, were recruited. The patients’ demographics, symptoms, clinical characteristics, cytopathology, treatments, and outcomes were reviewed. Results Overall 171 eyes from 168 patients, 92 eyes were CIN and 79 eyes were SCC. Males were affected in 65.5%. The mean age was 58.8 ± 16.8 (29–99) years. In most cases (60.3%), the tumors were located at the limbus. The most common clinical characteristic was papilliform appearance (46.2%). Human immunodeficiency virus (HIV) infection was found in 37 (22.0%) patients with a mean age of 40.5 ± 7.7 years. The treatments and outcomes were evaluated in 136 eyes whose main initial treatment was wide excision with adjunctive cryot...
Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2008
To describe the current practice patterns and prescription preferences in treating microbial kera... more To describe the current practice patterns and prescription preferences in treating microbial keratitis in Thailand. A questionnaire was designed and sent to ophthalmologists to describe their practice in patients with microbial keratitis. The questionnaire also presented two case scenarios with microbial keratitis; the less severe in the first patient and the more severe in the second. The recipients were asked about their diagnostic and therapeutic approaches. The surveys were mailed to 300 ophthalmologists around the country. One hundred and forty-three surveys (48.6%) were used in the analysis. Over half the respondents (56%) would do corneal scraping for some patients with suspected microbial keratitis. Smears and cultures of corneal specimens are the most common diagnostic tools (92%) to identify the causative organisms. Of the respondents, 60% would treat Case 1 as an outpatient, compared with 90% would admit Case 2. About half the respondents (47%) would initiate treatment in...
Drug Design, Development and Therapy, 2021
Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2012
OBJECTIVE To establish the predisposing factors, microbial profiles, demographics of patients and... more OBJECTIVE To establish the predisposing factors, microbial profiles, demographics of patients and clinical outcomes of microbial keratitis at a tertiary eye center in northern Thailand. MATERIAL AND METHOD Patients admitted to Chiang Mai University Hospital with suspected microbial keratitis (non-viral) were studied retrospectively over a 36-month period (April 2003-March 2006, respectively) (n = 305 cases/310 eyes). Predisposing factors, causative organisms, patients' demographic and treatment outcomes were analyzed. RESULTS Ocular trauma was the predisposing factor (43.9%) identified most commonly, followed by undetermined causes (16.1%), ocular surface diseases (13.20%), multiple factors (9.40%), systemic disease (6.80%), ocular surgery (3.9%) and use of contact lens (3.5%). Cultures of corneal scraping were positive in 25.6% of cases. Both bacteria and fungi were common pathogens (49.3% and 46.3%, respectively). Pseudomonas aeruginosa (14.90%) and fusarium spp. (26.90%) was ...
To study the ocular manifestations of dysthyroid orbitopathty,we reviewed 67 patients with dysthy... more To study the ocular manifestations of dysthyroid orbitopathty,we reviewed 67 patients with dysthyroid orbitopathy for four years period from 1992-1996.There is no different between male and female ratio,average age at onset is 43 years old.Two-third of the patients were hyperthyroidism and one-thired were in euthyroid state.The common ocular manifestations were eyelid retraction (80%),limitation of extraocular muscles (70)%,eyelid lag (67%), exophthalmos (61 %) and ptosis (15%). Among the EOM limitation, IR was the most commonly limited muscle. The causes of impaired vision were corneal complication (9%) and optic nerve compression (11 %). Chiang Mai Med Bull 1996; 85 (8): 119124.
We studied the incidence of retinopathy of prematurity (ROP) of 54 oxygen-treated premature babie... more We studied the incidence of retinopathy of prematurity (ROP) of 54 oxygen-treated premature babies in the premature baby unit of the Maharaj Nakorn Chiang Mai Hospital during August 1991-1992. We found that 65.4% had ROP. Those who had more than stage 3 threshold on CRYOROP study group were treated with cryotherapy. The degree of ROP depended on the degree of the immaturity of retinal blood vessel and were the causes of abnormality of retina and blindness. Chiang Mai Med Bull 1995; 34 (1) : 11-4.
Purpose To report the first case of Leber’s hereditary optic neuropathy (LHON) diagnosed in Mahar... more Purpose To report the first case of Leber’s hereditary optic neuropathy (LHON) diagnosed in Maharaj Nakorn Chiang Mai Hospital. Methods Case report. Results A 13-year-old boy was referred for bilateral progressive painless visual loss. Ophthalmic examination revealed temporal disc pallor in the right eye and pseudoedema of the optic disc with peripapillary telangiectasia in the left eye. There was no staining or leakage on a fundus fluorescein angiogram. The visual field had bilateral cecocentral scotoma. On examination of the patient’s mitochondrial DNA from a blood sample, a point mutation 11778 was found. Conclusions LHON is a maternally inherited disorder, characterized by a bilateral painless simultaneous or sequential loss of vision, predominantly in young men. This disorder has been associated with point mutations in the mitochondrial genomes. As there is currently no treatment that improves the final visual outcome, long term management is mainly supportive. In this case, op...
OBJECTIVE To assess the prevalence of visual impairment and ocular abnormalities among schoolchil... more OBJECTIVE To assess the prevalence of visual impairment and ocular abnormalities among schoolchildren in Chiang Mai. DESIGN A community-based survey. SUBJECTS AND METHOD The vision screening project was conducted from June 2000 to March 2002. Students in grade I in the Chiang Mai municipal area were examined for visual acuity (VA), color vision, ocular alignment, anterior segment and fundus. Subjective refraction was done in students with subnormal vision (VA 20/30 or less). Referral to the hospital for further evaluation and treatment was made for students with strabismus, amblyopia and other ocular abnormalities. RESULTS A total of 3,431 and 3,467 students were enrolled in 2000 and 2001, respectively. The prevalence of normal vision (VA 20/20), VA 20/30 or better in at least one eye and 20/40 or less in at least one eye were similar in both years (87%, 5.7%, 7.3% and 85%, 6.4%, 8.7%, respectively). There was no statistically significant difference in visual acuity among boys and g...
Purpose To report a young patient who initially manifested with bilateral anterior nodular scleri... more Purpose To report a young patient who initially manifested with bilateral anterior nodular scleritis and subsequently developed ocular features typical of Vogt-Koyanagi-Harada (VKH) disease. Case description A 9-year-old girl was diagnosed with bilateral anterior nodular scleritis, which improved with topical administration of corticosteroids and systemic nonsteroidal anti-infl ammatory drugs. Four months later, after the treatment was withdrawn, she developed a recurrence of scleritis together with sunset glow fundus and Dalen-Fuchs nodules in both eyes.
This study aimed to develop a Thai version of the Dry Eye–Related Quality-of-Life Score (DEQS-Th)... more This study aimed to develop a Thai version of the Dry Eye–Related Quality-of-Life Score (DEQS-Th) questionnaire and evaluate its validity, reliability, and feasibility among Thai participants. The DEQS-Th, a 15-item self-report measuring dry eye and its impact on quality of life (QOL) was developed based on the DEQS. The questionnaire was divided into two subscales: Bothersome Ocular Symptoms (six questions), and Impact on Daily Life (nine questions). It employed a 5-point Likert scale, addressing on both the frequency and the degree of symptoms. Backward and forward and cultural adaptation process translation methods were employed. Thirty healthy participants were enrolled to evaluate the feasibility of the DEQS-Th in terms of difficulty and convenience. Reliability was assessed using internal consistency determined by Cronbach’s alpha, with values > 0.7 considered acceptable. Convergent validity was determined by the correlation between DEQS-Th and overall health status. Confir...
To study the effects of pterygium on corneal topography and astigmatism and to determine the crit... more To study the effects of pterygium on corneal topography and astigmatism and to determine the critical pterygium size which induces signi fi cant astigmatism. Methods Thirty-three patients with unilateral primary pterygium were evaluated for pterygium morphology (22 women and 11 men with mean age of 56.2±10.9 years). An automated keratometer and an Orbscan II were used to evaluate corneal astigmatism, and the latter was also used to assess corneal topography. Results from the pterygium and contralateral eyes were compared. Results Mean corneal extension and width of the pterygia was 2.7±1.0 and 4.2±1.2 mm, respectively. With-the-rule astigmatism was the most common type (66.7%), followed by oblique (27.3%), and against-the-rule astigmatism (6.0%). The median (IQR) corneal astigmatism between the pterygium and contralateral eyes as measured by auto-keratometry and Orbscan II including auto-K, sim-K, K at the 3-mm and K at 5-mm zones were signi fi cantly different [1.00(0.50-1.94) and ...
International Journal of Ophthalmology
• AIM: To investigate the incidence and the predisposing factors of anterior chamber (AC) gas bub... more • AIM: To investigate the incidence and the predisposing factors of anterior chamber (AC) gas bubbles during femtosecond laser (FS) flap creation for laser in situ keratomileusis (LASIK). • METHODS: All patients who underwent FS-LASIK surgery at CMU LASIK Center between January 2013 and May 2016 were retrospective reviewed. Preoperative and intraoperative data including keratometry, white-towhite (WTW) corneal diameter, flap parameters (diameter, thickness, hinge position, and tunnel length) and pulse energy were reviewed and compared between incident group and control group. To determine the risk factors, univariate and multivariate conditional logistic regression were used; the eye was unit of analysis. • RESULTS: The incidence of AC gas bubbles was 1.6% (22 out of 1378 eyes). The median WTW in the AC bubbles group was 11.5 mm (range 11.1-12.1), which was significantly different from the control group (11.7 mm, range 10.5-12.8, P=0.021). The result of the median WTW minus the flap diameter in the AC bubbles group was 2.5 mm (range 2.1-3.2), which was statistically different to the control group (2.7 mm, range 1.5-3.8, P=0.008). The logistic regression analysis showed that the result of the WTW minus the flap diameter in the AC bubbles group had an adjusted odds ratio of 0.204 (95%CI; 0.056-0.747, P=0.016). • CONCLUSION: Development of AC gas bubbles during FS flap creation is not an uncommon event in Asian eyes which typically have a small WTW. The flap diameter when adjusted relatively to the WTW is a predisposing factor to the possibility of AC gas bubbles occurrence.
Dematiaceous fungal keratitis is an important etiology of visual loss, particularly in an agricul... more Dematiaceous fungal keratitis is an important etiology of visual loss, particularly in an agricultural society. From a retrospective review of medical records from 2012 to 2020, 50 keratitis cases of cultured-positive for dematiaceous fungi were presented at a tertiary care hospital in Northern Thailand. The study aimed to identify the isolated causative dematiaceous species using the PCR technique and to explore their related clinical features, including treatment prognoses. Sequencing of the amplified D1/D2 domains and/or ITS region were applied and sequenced. Of the 50 dematiaceous fungal keratitis cases, 41 patients were males (82%). In most cases, the onset happened during the monsoon season (June to September) (48%). The majority of the patients (72%) had a history of ocular trauma from an organic foreign body. The most common species identified were Lasiodiplodia spp. (19.35%), followed by Cladosporium spp. and Curvularia spp. (12.90% each). About half of the patients (52%) w...
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Papers by Napaporn Tananuvat