Obstructive sleep apnea (OSA), the most common form of sleep-disordered breathing, is characterized by repetitive episodes of paused breathing during sleep, which in turn induces transient nocturnal hypoxia and hypercapnia. The high prevalence of OSA and its associated health consequences place a heavy burden on the healthcare system. In particular, the consequent episodic oxygenic desaturation/reoxygenation series and arousals from sleep in patients with OSA have the potential to trigger oxidative stress, elevated systemic inflammatory responses, and autonomic dysfunction with sympathetic activation. Given these adverse side-effects, OSA is highly correlated to many eye diseases that are common in everyday ophthalmic practices. Some of these ocular consequences are reversible, but they may permanently threaten a patient’s vision if not treated appropriately. Here, this article seeks to review the ocular consequences and potential pathophysiologic associations in patients with OSA. Understanding these OSA-related eye diseases may help clinicians provide comprehensive care to their patients.

Purpose: To investigate the microbiology and antimicrobial susceptibility of dacryocystitis in adults and identify the changing trends over time in Taiwan. Methods: This is a single-centered, retrospective study. We retrospectively reviewed adult patients with dacryocystitis from January 2012 to December 2021 in a tertiary medical center in Taiwan. The pathogens and in vitro antimicrobial susceptibility of the pus cultures from the lacrimal sac were collected. Results: Thirty-five cultures in acute and 211 cultures in chronic dacryocystitis were collected. Of the 220 isolates, a similar proportion of gram-positive (44%) and gram-negative (43%) aerobes were demonstrated in chronic dacryocystitis and more gram-negative aerobes (50%) than gram-positive aereobes (41%) in acute dacryocystitis. The most common pathogens were methicillin-resistant Staphylococcus aureus (MRSA; 28.1%) and Pseudomonas aeruginosa (28.1%) in acute dacryocystitis, while coagulase-negative Staphylococci was the most common micro-organism in chronic dacryocystitis. The effective antibiotics for gram-positive aerobes were vancomycin (100%), moxifloxacin (88%) and trimethoprim/sulfamethoxazole (78%). Meropenem (95%), amikacin (93%), and levofloxacin (91%) were sensitive to more than 90% of gram-negative aerobes in current study. High resistant species were also isolated in our cohort. Conclusion: More gram-negative pathogens and more resistant species are rising in adult dacryocystitis. Understanding the bacteriology and antimicrobial susceptibility of the region is crucial for the empirical antibiotic selection in clinical practice.

Purpose: To report a case of cytomegalovirus (CMV) retinitis complicated with ganciclovir-related myelosuppression, which was successfully managed with intravenous (IV) ganciclovir and CMV immunoglobulin (CMVIG) therapy. Methods: Observational case report. Results: A 51-year-old male with follicular type non-Hodgkin lymphoma post hematopoietic stem cell transplantation (HSCT) developed vision-threatening retinitis. polymerase chain reaction (PCR) of the aqueous humour showed positive for CMV. Despite myelosuppression occurred during IV ganciclovir therapy, the retinitis resolved and intraocular CMV viral load significantly improved after CMVIG therapy. Conclusion: Combined IV ganciclovir treatment and CMVIG therapy can significantly improve visual outcome and reduce intraocular CMV viral load in vision-threatening CMV retinitis.

Purpose: Persistent diplopia after rectus muscle myectomy is not uncommon but challenging in patients with Graves’ ophthalmopathy. We investigated the role of lateral rectus muscle resection for patients after medial rectus muscle myectomy in Graves’ ophthalmopathy. Methods: We retrospectively reviewed and collected data from patients with persistent diplopia after medial rectus muscle myectomy for Graves’ ophthalmopathy who underwent unilateral or bilateral lateral rectus muscle resection. The eyeball deviations in the primary and reading positions before and after the operation were measured. A successful surgical outcome was defined as having less than five prism diopters (PD) in the primary gaze and functional binocular vision in the central 30° field postoperatively Results: A total of fifteen patients were included (mean post-myectomy deviation: 35.9 PD, range: 14 to −75 PD). The lateral rectus muscle resection after medial rectus muscle myectomy achieved an 80.0% success rate, with one patient over-corrected and two patients under-corrected. Conclusions: The lateral rectus muscle resection is an effective and predictable procedure for managing residual esotropia in Graves’ ophthalmopathy patients who have previously undergone medial rectus muscle myectomy.