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Kuo YK, Chuang LH, Lai CC, Wu PC, Chen SY, Chen HC, Yeung L, Wang NK, Hwang YS, Liu CF. Exploring the Location of Corneal Pigmented Arc and Myopia Control Efficacy in Orthokeratology-Treated Children Using Pentacam Measurements. Eye Contact Lens 2024; 50:84-90. [PMID: 38193846 DOI: 10.1097/icl.0000000000001048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2023] [Indexed: 01/10/2024]
Abstract
OBJECTIVES To determine the location and intensity of the corneal pigmented arc in orthokeratology (ortho-k)-treated children and its relationship with annual axial length (AL) change using Pentacam. METHODS This retrospective cohort study enrolled children aged 9 to 15 years who had been followed up for at least one year after ortho-k treatment for myopia control. A Pentacam was used to determine the location and intensity of pigmented arc after lens wear. Annual AL changes were further used as the outcome measurement to determine their relationships with the location and intensity of pigmented arc using generalized estimating equations (GEE). RESULTS In total, 62 eyes from 33 patients (mean age 10.9 years) were included in our final analysis. The mean follow-up time was 30.6 months. The mean annual AL changes were 0.10 mm. Age statistically correlated with annual AL change (GEE, P= 0.033). In addition, the annual AL change was negatively associated with the relative vertical distance of the lowest density of pigmented arc point based on the visual center, pupil center, and corneal thinnest point after adjustment with age ( P =0.005, P =0.004, and P< 0.001, respectively). CONCLUSIONS Pentacam could be a useful tool for evaluating the location and intensity of the corneal pigmented arc. In addition, there was a negative correlation between the vertical distance of the pigmented arc and annual AL change. These findings may provide important information regarding myopia control, next-generation ortho-k design, and prescription.
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Affiliation(s)
- Yu-Kai Kuo
- Department of Ophthalmology (Y.-K.K., L.-H.C., C.-C.L., S.-Y.C., L.Y., C.-F.L.), Chang Gung Memorial Hospital, Keelung, Taiwan; College of Medicine (Y.-K.K., L.-H.C., C.-C.L., P.-C.W., S.-Y.C., H.-C.C., L.Y., Y.-S.H., C.-F.L.), Chang Gung University, Taoyuan, Taiwan; Taiwan Myopia Disease Society (L.-H.C., C.-C.L., P.-C.W., C.-F.L.), Kaohsiung, Taiwan; Department of Ophthalmology (P.-C.W.), Chang Gung Memorial Hospital, Kaohsiung, Taiwan; Department of Ophthalmology (H.-C.C., Y.-S.H.), Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan; Department of Ophthalmology (N.-K.W.), Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, Columbia University, New York, NY; Department of Ophthalmology (Y.-S.H.), Chang Gung Memorial Hospital, Xiamen Branch, Xiamen, China; Department of Ophthalmology (Y.-S.H.), Jen-Ai Hospital Dali Branch, Taichung, Taiwan; and Institute of Biochemistry and Molecular Biology (C.-F.L.), National Yang-Ming University, Taipei, Taiwan
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Chen ZR, Chen SC, Wan TY, Chuang LH, Chen HC, Yeh LK, Kuo YK, Wu PC, Chen YW, Lai IC, Hwang YS, Liu CF. Treatment of Myopia with Atropine 0.125% Once Every Night Compared with Atropine 0.125% Every Other Night: A Pilot Study. J Clin Med 2023; 12:5220. [PMID: 37629261 PMCID: PMC10456055 DOI: 10.3390/jcm12165220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 07/04/2023] [Accepted: 07/20/2023] [Indexed: 08/27/2023] Open
Abstract
(1) Purpose: To investigate the efficacy of myopia treatment in children using atropine 0.125% once every two nights (QON) compared with atropine 0.125% once every night (HS). (2) Methods: This retrospective cohort study reviewed the medical records of two groups of children with myopia. Group 1 comprised children treated with atropine 0.125% QON, while group 2 included children treated with atropine 0.125% HS. The first 6 months of data of outcome measurements were subtracted as washout periods in those children undergoing both atropine QON and HS treatment. The independent t-test and Pearson's chi-square test were used to compare the baseline clinical characteristics between the two groups. A generalized estimating equations (GEE) model was used to determine the factors that influence treatment effects. (3) Results: The average baseline ages of group 1 (38 eyes from 19 patients) and group 2 (130 eyes from 65 patients) were 10.6 and 10.2 years, respectively. There were no significant differences in axial length (AL) or cycloplegic spherical equivalent (SEq) at baseline or changes of them after 16.9 months of follow-up. GEE showed that the frequency of atropine 0.125% use has no association with annual AL (QON vs. HS: 0.16 ± 0.10 vs. 0.18 ± 0.12) and SEq (QON vs. HS: -0.29 ± 0.44 vs. -0.34 ± 0.36) changes in all children with myopia. It also showed that older baseline age (B = -0.020, p < 0.001) was associated with lesser AL elongation. (4) Conclusion: The treatment effects of atropine 0.125% HS and QON were similar in this pilot study. The use of atropine 0.125% QON may be an alternative strategy for children who cannot tolerate the side effects of atropine 0.125% HS. This observation should be confirmed with further large-scale studies.
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Affiliation(s)
- Zi-Rong Chen
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Z.-R.C.); (T.-Y.W.); (L.-H.C.); (H.-C.C.); (L.-K.Y.); (Y.-K.K.); (P.-C.W.); (Y.-W.C.); (I.-C.L.); (Y.-S.H.)
| | - Shin-Chieh Chen
- Department of Environmental and Occupational Medicine, National Taiwan University Hospital, Taipei 100, Taiwan;
- Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei 100, Taiwan
| | - Tsung-Yao Wan
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Z.-R.C.); (T.-Y.W.); (L.-H.C.); (H.-C.C.); (L.-K.Y.); (Y.-K.K.); (P.-C.W.); (Y.-W.C.); (I.-C.L.); (Y.-S.H.)
| | - Lan-Hsin Chuang
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Z.-R.C.); (T.-Y.W.); (L.-H.C.); (H.-C.C.); (L.-K.Y.); (Y.-K.K.); (P.-C.W.); (Y.-W.C.); (I.-C.L.); (Y.-S.H.)
- Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung 204, Taiwan
| | - Hung-Chi Chen
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Z.-R.C.); (T.-Y.W.); (L.-H.C.); (H.-C.C.); (L.-K.Y.); (Y.-K.K.); (P.-C.W.); (Y.-W.C.); (I.-C.L.); (Y.-S.H.)
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taoyuan 333, Taiwan
- Center for Tissue Engineering, Chang Memorial Hospital, Linkou, Taoyuan 333, Taiwan
| | - Lung-Kun Yeh
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Z.-R.C.); (T.-Y.W.); (L.-H.C.); (H.-C.C.); (L.-K.Y.); (Y.-K.K.); (P.-C.W.); (Y.-W.C.); (I.-C.L.); (Y.-S.H.)
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taoyuan 333, Taiwan
| | - Yu-Kai Kuo
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Z.-R.C.); (T.-Y.W.); (L.-H.C.); (H.-C.C.); (L.-K.Y.); (Y.-K.K.); (P.-C.W.); (Y.-W.C.); (I.-C.L.); (Y.-S.H.)
- Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung 204, Taiwan
| | - Pei-Chang Wu
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Z.-R.C.); (T.-Y.W.); (L.-H.C.); (H.-C.C.); (L.-K.Y.); (Y.-K.K.); (P.-C.W.); (Y.-W.C.); (I.-C.L.); (Y.-S.H.)
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan
| | - Yun-Wen Chen
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Z.-R.C.); (T.-Y.W.); (L.-H.C.); (H.-C.C.); (L.-K.Y.); (Y.-K.K.); (P.-C.W.); (Y.-W.C.); (I.-C.L.); (Y.-S.H.)
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan
| | - Ing-Chou Lai
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Z.-R.C.); (T.-Y.W.); (L.-H.C.); (H.-C.C.); (L.-K.Y.); (Y.-K.K.); (P.-C.W.); (Y.-W.C.); (I.-C.L.); (Y.-S.H.)
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan
- Department of Ophthalmology, Chang Gung Memorial Hospital, Chiayi City 613, Taiwan
| | - Yih-Shiou Hwang
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Z.-R.C.); (T.-Y.W.); (L.-H.C.); (H.-C.C.); (L.-K.Y.); (Y.-K.K.); (P.-C.W.); (Y.-W.C.); (I.-C.L.); (Y.-S.H.)
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taoyuan 333, Taiwan
- Department of Ophthalmology, Chang Gung Memorial Hospital, Chiayi City 613, Taiwan
- Department of Ophthalmology, Chang Gung Memorial Hospital, Xiamen Branch, Xiamen 361000, China
| | - Chun-Fu Liu
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Z.-R.C.); (T.-Y.W.); (L.-H.C.); (H.-C.C.); (L.-K.Y.); (Y.-K.K.); (P.-C.W.); (Y.-W.C.); (I.-C.L.); (Y.-S.H.)
- Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung 204, Taiwan
- Program in Molecular Medicine, National Yang Ming University, Taipei 112, Taiwan
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Sankaridurg P, Berntsen DA, Bullimore MA, Cho P, Flitcroft I, Gawne TJ, Gifford KL, Jong M, Kang P, Ostrin LA, Santodomingo-Rubido J, Wildsoet C, Wolffsohn JS. IMI 2023 Digest. Invest Ophthalmol Vis Sci 2023; 64:7. [PMID: 37126356 PMCID: PMC10155872 DOI: 10.1167/iovs.64.6.7] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023] Open
Abstract
Myopia is a dynamic and rapidly moving field, with ongoing research providing a better understanding of the etiology leading to novel myopia control strategies. In 2019, the International Myopia Institute (IMI) assembled and published a series of white papers across relevant topics and updated the evidence with a digest in 2021. Here, we summarize findings across key topics from the previous 2 years. Studies in animal models have continued to explore how wavelength and intensity of light influence eye growth and have examined new pharmacologic agents and scleral cross-linking as potential strategies for slowing myopia. In children, the term premyopia is gaining interest with increased attention to early implementation of myopia control. Most studies use the IMI definitions of ≤-0.5 diopters (D) for myopia and ≤-6.0 D for high myopia, although categorization and definitions for structural consequences of high myopia remain an issue. Clinical trials have demonstrated that newer spectacle lens designs incorporating multiple segments, lenslets, or diffusion optics exhibit good efficacy. Clinical considerations and factors influencing efficacy for soft multifocal contact lenses and orthokeratology are discussed. Topical atropine remains the only widely accessible pharmacologic treatment. Rebound observed with higher concentration of atropine is not evident with lower concentrations or optical interventions. Overall, myopia control treatments show little adverse effect on visual function and appear generally safe, with longer wear times and combination therapies maximizing outcomes. An emerging category of light-based therapies for children requires comprehensive safety data to enable risk versus benefit analysis. Given the success of myopia control strategies, the ethics of including a control arm in clinical trials is heavily debated. IMI recommendations for clinical trial protocols are discussed.
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Affiliation(s)
- Padmaja Sankaridurg
- Brien Holden Vision Institute, Sydney, Australia
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - David A Berntsen
- University of Houston, College of Optometry, Houston, Texas, United States
| | - Mark A Bullimore
- University of Houston, College of Optometry, Houston, Texas, United States
| | - Pauline Cho
- West China Hospital, Sichuan University, Sichuan, China
- Eye & ENT Hospital of Fudan University, Shanghai, China
- Affiliated Eye Hospital of Wenzhou Medical University, Wenzhou, China
| | - Ian Flitcroft
- Centre for Eye Research Ireland, School of Physics and Clinical and Optometric Sciences, Technological University Dublin, Dublin, Ireland
- Department of Ophthalmology, Children's Health Ireland at Temple Street Hospital, Dublin, Ireland
| | - Timothy J Gawne
- Department of Optometry and Vision Science, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Kate L Gifford
- Queensland University of Technology, Brisbane, Australia
| | - Monica Jong
- Johnson & Johnson Vision, Jacksonville, Florida, United States
| | - Pauline Kang
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Lisa A Ostrin
- University of Houston, College of Optometry, Houston, Texas, United States
| | | | - Christine Wildsoet
- UC Berkeley Wertheim School Optometry & Vision Science, Berkeley, California, United States
| | - James S Wolffsohn
- College of Health & Life Sciences, Aston University, Birmingham, United Kingdom
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Liang X, Wei S, Li SM, An W, Du J, Sun Y, Gan J, Bai W, Cai Z, Song Q, Yin L, Wang N. Effect of Atropine 0.01% Eye Drops on the Difference in Refraction and Axial Length between Right and Left Eyes. Ophthalmic Res 2023; 66:496-505. [PMID: 36603556 DOI: 10.1159/000528878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 12/19/2022] [Indexed: 01/06/2023]
Abstract
INTRODUCTION This study sought to determine whether the application of 0.01% atropine eye drops could impact the disparity in refraction and axial length (AL) between the right and left eyes in Chinese children. METHODS The study was designed as a double-blind, placebo-controlled randomized trial. A total of 220 children aged 6-12 years were recruited from the Beijing Tongren Hospital in Beijing, China. Participants were randomized in a 1:1 ratio and were prescribed 0.01% atropine or placebo eye drops to be administered once a night to both eyes for the duration of 1 year. The cycloplegic refraction and AL were recorded including baseline, 6 months, and again at the 12 months. RESULTS After 1-year follow-up period, 76 (69%) and 83 (75%) subjects of the initial 220 participants were identified as the 0.01% atropine and placebo groups, respectively. The inter-ocular difference in spherical equivalent refraction (SER) and AL demonstrated stable values in the 0.01% atropine treatment group (SER: p = 0.590; AL: p = 0.322) analyzed after 1 year, but found a significant increase (SER: p < 0.001; AL: p = 0.001) in the placebo group. Furthermore, over 1 year, eyes with greater myopia in the atropine group exhibited slower myopia progression (0.45 ± 0.44 D) than the lesser myopic eye (0.56 ± 0.44 D) (p = 0.003). CONCLUSION This study demonstrated that 0.01% atropine could maintain the inter-ocular SER and AL difference. And 0.01% atropine appeared to be more effective in delaying the progression of myopia in eyes with more myopia than in the less myopic eyes.
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Affiliation(s)
- Xintong Liang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Shifei Wei
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Shi-Ming Li
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Wenzai An
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Jialing Du
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Yunyun Sun
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Jiahe Gan
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
- Department of Ophthalmology, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Weiling Bai
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Zhining Cai
- Department of Clinical Medicine, Capital Medical University, Beijing, China
| | - Qianqian Song
- Department of Clinical Medicine, Capital Medical University, Beijing, China
| | - Lei Yin
- Department of Ophthalmology, Zhengzhou First People's Hospital, Zhengzhou, China
| | - Ningli Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
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Cho H, Seo Y, Han SH, Han J. Factors Related to Axial Length Elongation in Myopic Children Who Received 0.05% Atropine Treatment. J Ocul Pharmacol Ther 2022; 38:703-708. [PMID: 36269657 DOI: 10.1089/jop.2022.0036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Purpose: To evaluate the longitudinal changes of axial length (AL) and factors associated with AL growth in myopic children receiving 0.05% atropine. Methods: This single-center retrospective study included children aged 4-13 years with myopia of at least -0.5 diopters (D) treated with 0.05% atropine eye drops from November 2016 to May 2021. Predictive factors for AL change were evaluated using linear mixed models. Results: Among 109 patients (218 eyes), 58 (53.2%) were male and the mean age at treatment was 8.5 ± 2.0 years. At baseline measurement, the mean spherical equivalent was -4.05 ± 2.34 diopters (D), and AL was 25.00 ± 0.97 mm. The mean follow-up duration was 25.4 (12-58) months, and the mean AL elongation was 0.23 ± 0.17 mm/year during the follow-up periods. AL shortening of ≥0.05 mm at subsequent visit occurred in 18 patients (26 eyes). The mean AL change in the group without initial AL shortening was statistically larger than that in the group with initial AL shortening (0.26 ± 0.16 mm/year vs. 0.02 ± 0.17 mm/year, P < 0.001). In linear mixed model, the age at atropine treatment and initial AL shortening were significantly associated with respect to AL growth (beta coefficient: -0.032 and -0.122, respectively, P < 0.001 for both). Conclusions: Our study found that older age and initial AL shortening are predictors of favorable response after 0.05% atropine treatment. Children with AL shortening at initial subsequent visit may be associated with good long-term response, and younger children may require higher concentration of atropine for optimal response.
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Affiliation(s)
- Hyuna Cho
- Institute of Vision Research, Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Yuri Seo
- Institute of Vision Research, Department of Ophthalmology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, South Korea
| | - Sueng-Han Han
- Institute of Vision Research, Department of Ophthalmology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Jinu Han
- Institute of Vision Research, Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
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Kuo YK, Chen YT, Chen HM, Wu PC, Sun CC, Yeung L, Lin KK, Chen HC, Chuang LH, Lai CC, Chen YH, Liu CF. Efficacy of Myopia Control and Distribution of Corneal Epithelial Thickness in Children Treated with Orthokeratology Assessed Using Optical Coherence Tomography. J Pers Med 2022; 12:jpm12020278. [PMID: 35207766 PMCID: PMC8875657 DOI: 10.3390/jpm12020278] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 01/07/2022] [Accepted: 01/25/2022] [Indexed: 12/16/2022] Open
Abstract
The association between myopia control efficacy in children treated with orthokeratology and corneal epithelial thickness is still unknown. The aim of this study was to explore the corneal epithelial thickness and its association with axial length changes in children treated with orthokeratology. This retrospective cohort study enrolled children aged from 9 to 15 years who had received orthokeratology for myopia control and had been followed up for at least 1 year. Anterior segment optical coherence tomography was performed to generate wide epithelial thickness maps of the patients. Annual axial length changes were calculated from the axial length at 6 months after the initiation of orthokeratology lens wear and at final measurements. Corneal epithelial thickness data were obtained from 24 sectors and a central 2 mm zone of the wide epithelial thickness map. Associations between annual axial length changes and corneal epithelial thickness for each sector/zone of the wide epithelial thickness map, and orthokeratology treatment data were determined by generalized estimating equations. Finally, a total of 83 eyes of 43 patients (mean age 11.2 years) were included in the analysis. The mean annual axial length change was 0.169 mm; when regressing demographic and ortho-k parameters to mean annual axial length changes, age and target power were both negatively associated with them (β = −14.43, p = 0.008; β = −0.26, p = 0.008, respectively). After adjusting for age and target power, the annual axial length changes were positively associated with the corneal epithelium thickness of IT1, I1, SN2, and S2 sectors of the wide epithelial thickness map, and negatively with that of the I3 sector. In conclusion, we identified associations between annual axial length changes and the corneal epithelium thickness of certain sectors in children treated with orthokeratology. This may facilitate the design of orthokeratology lenses with enhanced efficacy for myopia control.
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Affiliation(s)
- Yu-Kai Kuo
- Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung 20401, Taiwan; (Y.-K.K.); (H.-M.C.); (C.-C.S.); (L.Y.); (L.-H.C.); (C.-C.L.)
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (Y.-T.C.); (P.-C.W.); (K.-K.L.); (H.-C.C.)
| | - Yen-Ting Chen
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (Y.-T.C.); (P.-C.W.); (K.-K.L.); (H.-C.C.)
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou 33305, Taiwan
| | - Ho-Min Chen
- Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung 20401, Taiwan; (Y.-K.K.); (H.-M.C.); (C.-C.S.); (L.Y.); (L.-H.C.); (C.-C.L.)
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (Y.-T.C.); (P.-C.W.); (K.-K.L.); (H.-C.C.)
| | - Pei-Chang Wu
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (Y.-T.C.); (P.-C.W.); (K.-K.L.); (H.-C.C.)
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan
| | - Chi-Chin Sun
- Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung 20401, Taiwan; (Y.-K.K.); (H.-M.C.); (C.-C.S.); (L.Y.); (L.-H.C.); (C.-C.L.)
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (Y.-T.C.); (P.-C.W.); (K.-K.L.); (H.-C.C.)
| | - Ling Yeung
- Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung 20401, Taiwan; (Y.-K.K.); (H.-M.C.); (C.-C.S.); (L.Y.); (L.-H.C.); (C.-C.L.)
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (Y.-T.C.); (P.-C.W.); (K.-K.L.); (H.-C.C.)
| | - Ken-Kuo Lin
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (Y.-T.C.); (P.-C.W.); (K.-K.L.); (H.-C.C.)
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou 33305, Taiwan
| | - Hung-Chi Chen
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (Y.-T.C.); (P.-C.W.); (K.-K.L.); (H.-C.C.)
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou 33305, Taiwan
- Center for Tissue Engineering, Chang Gung Memorial Hospital, Linkou 33305, Taiwan
| | - Lan-Hsin Chuang
- Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung 20401, Taiwan; (Y.-K.K.); (H.-M.C.); (C.-C.S.); (L.Y.); (L.-H.C.); (C.-C.L.)
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (Y.-T.C.); (P.-C.W.); (K.-K.L.); (H.-C.C.)
| | - Chi-Chun Lai
- Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung 20401, Taiwan; (Y.-K.K.); (H.-M.C.); (C.-C.S.); (L.Y.); (L.-H.C.); (C.-C.L.)
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (Y.-T.C.); (P.-C.W.); (K.-K.L.); (H.-C.C.)
| | - Yau-Hung Chen
- Department of Chemistry, Tamkang University, Tamsui 251301, Taiwan;
| | - Chun-Fu Liu
- Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung 20401, Taiwan; (Y.-K.K.); (H.-M.C.); (C.-C.S.); (L.Y.); (L.-H.C.); (C.-C.L.)
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (Y.-T.C.); (P.-C.W.); (K.-K.L.); (H.-C.C.)
- Program in Molecular Medicine, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan
- Correspondence: ; Tel.: +886-2-2431-3131
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