Mansing Ratanasukon

Prince of Songkla University, Songkhla, Changwat Songkhla, Thailand

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Publications (16)5.8 Total impact

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    ABSTRACT: Purpose: To identify the characteristics (demographics, anatomical classification, diagnoses, and treatment) of all uveitis patients who were seen at our newly started Uveitis and Ocular Inflammatory Disease Clinic over a two-year period. Methods: The computerized uveitis database files and medical records for all new consecutive patients seen at our Uveitis and Ocular Inflammatory Disease Clinic from January 2010 through December 2011 were included. Results: A total of 254 patients were seen during the study period. Anterior uveitis and panuveitis were most frequently found, each accounting for around 35% of cases. Specific diagnoses were established in 70.9% of patients and the top five most common specific diagnoses were VKH (11%), HLA-B27-associated anterior uveitis (7.9%), Behçet disease (7.1%), toxoplasmosis (7.1%), and herpetic anterior uveitis (4.7%). Conclusion: In this setting, the authors found VKH to be the most common diagnosis in the noninfectious uveitis group. Regarding infectious uveitis, toxoplasmosis ranked the most common diagnosis.
    Ocular immunology and inflammation 02/2013; 21(1):38-45. · 0.72 Impact Factor
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    ABSTRACT: To evaluate photoreceptor disruption in patients with central serous chorioretinopathy (CSC) treated by half-dose photodynamic therapy (PDT). A total of 29 patients with symptomatic CSC were recruited and underwent half-dose verteporfin PDT covering the leakage sites as observed via fundus fluorescein angiography. The primary outcome was the percentage of patients with the presence of photoreceptor disruption, and the secondary outcome was the correlation between photoreceptor disruption and visual results at the 1-year follow-up. Photoreceptor disruption was identified in 13 eyes (44.8%) 12 months after treatment. Twenty-seven patients experienced best-corrected visual acuity (BCVA) improvement after PDT, while two patients showed stable BCVA. The mean BCVA in patients with photoreceptor disruption at the baseline and every follow-up visit was significantly lower than that of patients without photoreceptor disruption. However, there was no correlation between the presence or absence of photoreceptor disruption and the improvement of visual acuity because the BCVA gain at the last follow-up visit between the two groups was not significant (P = 0.69). No potential ocular complication was encountered in the study. Photoreceptor disruption was found in about 45% of CSC patients treated by PDT, which ultimately resulted in poor visual outcomes. However, a half-dose PDT might not affect or modify the photoreceptor function because it gave the same pattern of visual recovery in patients with and without photoreceptor cell loss.
    Clinical ophthalmology (Auckland, N.Z.) 01/2013; 7:87-92.
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    ABSTRACT: To determine the efficacy of high-dose antioxidants in the acute stage of central serous chorioretinopathy (CSC). This was a randomized placebo-controlled study. The patients with acute CSC (onset within 6 weeks) were randomized to receive either high-dose antioxidant tablets (study group A) or placebo tablets (control group B) for 3 months or until the complete resolution of subretinal fluid. After 3 months, additional treatment with laser or photodynamic therapy (PDT) was considered if any fluorescein leakage persisted. The outcomes measured were the changes in visual acuity (VA) and central macular thickness (CMT), the number of patients with subretinal fluid at each follow-up time, the number of patients with fluorescein leakage at the end of the 3rd month and patients who received additional treatments. Fifty-one of 58 patients (88%) completed the follow-up criteria. The baseline demographic data were comparable in both groups. At the end of the 3rd month, the VA and CMT showed no statistical difference between the groups but the patients in group A has less fluorescein leakage and additional treatments than in group B (p = 0.027 and 0.03). The high-dose antioxidants for acute CSC did not show any benefits in VA and CMT. However, the drugs might decrease the chance for fluorescein leakage and additional treatments at the end of the 3rd month.
    BMC Ophthalmology 07/2012; 12:20. · 1.44 Impact Factor
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    ABSTRACT: To evaluate the one-year results of half-dose photodynamic therapy with verteporfin in chronic or recurrent central serous chorioretinopathy (CSC). A Retrospective, consecutive case series. Twenty-seven eyes of 27 patients with chronic symptomatic CSC or recurrent CSC underwent photodynamic therapy (PDT) with half-dose (3 mg/m2) verteporfin. The demographic data such as age, side, gender spot sizes of laser photodynamic therapy (PDT) were recorded. The primary outcomes were the best correct visual acuity (BCVA), central foveal thickness using the optical coherence tomography (OCT) and complication were recorded as secondary outcome at baseline, month 1,3,6 and 12 post PDT RESULTS: At 12 months after half-dose PDT the mean logMAR BCVA improved from 0.32 to 0.18 (p = 0.001), the mean central foveal thickness decreased from 375.52 microm to 186.52 mirom (p < 0.001). The results also showed significant improvement of logMAR BCVA and decreased central foveal thickness after 1 month (0.32 to 0.22, p = 0.003 and 375.52 microm to 175.41 microm, p < 0.001) and maintained the results until one-year follow-up. Twenty-five eyes (92.59%) showed complete resolution of subretinal fluid at 1 month, 27 patients (100%) showed complete resolution at 3 month and all sustained the complete resolution until the last visit. No serious complications were recorded during and after the treatment. The half-dose PDT in area of fluorescein leakage is one of the effective treatment options for chronic or recurrent CSC, especially in patients who cannot be performed by focal laser photocoagulation. The treatment sustained the good visual results and has no serious complications up to one-year.
    Journal of the Medical Association of Thailand = Chotmaihet thangphaet 04/2012; 95 Suppl 4:S56-60.
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    ABSTRACT: To evaluate the role and validity of the Watzke-Allen test in following up patients after surgeries for an idiopathic full-thickness macular hole (FTMH). A prospective interventional analytical study Patients with idiopathic FTMH were consecutively recruited. A comparative analysis between preoperative and post operative visual acuity, macular hole status and Watzke-Allen slit beam test results was performed using a Chi-square test and a random intercept mixed model. Twenty-one patients with an average age of 65.90 +/- 6.05 years were included in the present study. Three months after surgery, macular holes were surgically closed in 13 eyes (61.9%) and still open in eight eyes (38.1%). An improvement in metamorphopsia, according to Watzke-Allen test results, was found in 61.53% of patients with closed holes and 87.5% of those with open holes. There was no statistically significant correlation between the Watzke-Allen test and the restorative status of a macular hole post surgery The Watzke-Allen test is a useful subjective assessment of visual function for diagnosis in patients with idiopathic FTMH. However the test is not beneficial in the post operative follow-up of patients.
    Journal of the Medical Association of Thailand = Chotmaihet thangphaet 04/2012; 95 Suppl 4:S87-91.
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    ABSTRACT: To determine the pattern of electroretinographic change after an intravitreal ranibizumab (Lucentis(®)) injection for the treatment of choroidal neovascular membrane (CNVM). A prospective interventional case series of patients treated by intravitreal ranibizumab injection. Best corrected visual acuity, optical coherence tomography (OCT), and multifocal electroretinography (mfERG) were assessed prior to treatment, and 2 weeks, 1 and 3 months after treatment. Primary outcome was the functional change in amplitude and implicit time by mfERG and secondary outcome was the structural change in macular thickness by optical coherence tomography (OCT). Twenty-six eyes from 25 consecutive patients were enrolled. At 3 months after treatment, the mean visual acuity (VA) improved from 1.06 to 0.84 logMAR (P = 0.034) and the mean macular thickness decreased from 389.7 to 264.4 microns (P = 0.003). The mean implicit time of the central zone showed an improvement at 3 months after treatment when compared with the response at baseline (P = 0.024) and at 1 month (P = 0.013) but the mean amplitude showed no significant change. In subgroup analysis, the eyes with initial visual acuity (VA) ≥ 20/200 had a significant improvement in mean implicit time of the peripheral zone at 2 weeks after treatment (P = 0.028). The OCT revealed a significant decrease (P < 0.003) in macular thickness at 1 and 3 months postoperatively. The mean implicit time of the central zone improved significantly at 3 months after treatment, whereas the mean amplitude showed no significant change. The macular thickness decreased significantly after the treatment, while VA improved to a lesser extent.
    Clinical Ophthalmology 01/2011; 5:567-72.
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    ABSTRACT: Giant cell arteritis (GCA) is a chronic granulomatous vasculitis of large and medium size vessels in the elderly. A new-onset headache is the most frequent symptom. An anterior ischemic optic neuropathy (AION) is one of the most common causes of permanent visual loss. There are four cases with unusual presentation of giant cell arteritis, scalp abscess, prolonged transient monocular visual loss (TMVL), bilateral central retinal artery occlusion (CRAO), and chronic ear pain. All patients had pathologically proven giant cell arteritis, and three of them progressed to blindness in the end. Scalp abscess is a rare sign in GCA. Delay in diagnosis because confusion of the abscess after scalp ischemia with other cutaneous lesions may result in death. TMVL is the forewarning symptom of AION or CRAO in GCA. Early recognition of TMVL is important to make early diagnosis of GCA to prevent blindness. Spontaneous ear pain is extremely rare, and reports have documented delay in diagnosis of GCA resulting in irreversible blindness.
    Journal of the Medical Association of Thailand = Chotmaihet thangphaet 05/2010; 93(5):629-32.
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    ABSTRACT: To determine the long-term effect of photodynamic therapy (PDT) with verteporfin for age-related macular degeneration (AMD) and non-AMD in Thailand and to compare with the Treatment of Age-Related Macular Degeneration with Photodynamic Therapy (TAP) and Verteporfin in Photodynamic Therapy (VIP) study. The data of patients who received PDT between July 2003 and December 2004 and had completed two-year follow-up were prospectively reviewed. Treated eyes were classified into two main groups, the AMD (group 1) and non-AMD (group 2) groups. The AMD group was further divided into three subgroups, group 1A, AMD with subfoveal choroidal neovascularization (CNV) and TAP/VIP compatible if they followed the recommendation guidelines characteristics, group 1B, AMD with subfoveal CNV and TAP/VIP incompatible, and group 1C, AMD with non-subfoveal CNV. The main outcomes were visual acuity change, number of treatments and the comparison with the first year results. Of 56 eyes, 46 eyes (82.14%) had completed 24-month follow-up. Thirty-four eyes had CNV-related AMD and 12 eyes were non-AMD. At the 24-month follow-up, mean visual acuity change in group 1A, 1B, 1C were increased 0.25 (p = 0.13), 0.05 (p = 0.52), and 0.28 (p = 0.003), respectively. The total number of treatments in the first and second year was 1.8 and 0.1 in group 1A, 2.3 and 0.1 in group 1B, 1.5 and 0.25 in group 1C. PDT was effective in Thai patients for the two-year follow-up even if they were not compatible with TAP/VIP criteria. The treatment demonstrated stabilization or less visual loss in long-term results.
    Journal of the Medical Association of Thailand = Chotmaihet thangphaet 04/2009; 92(3):367-72.
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    ABSTRACT: To determine the pattern of functional and anatomical responses after intravitreal triamcinolone (IVTA) for macular edema in diabetic retinopathy, retinal vein occlusion, uveitis, and macular telangiectasia. A Retrospective interventional study was carried out between January 2004 and July 2006. Thirty-eight eyes from 36 patients who had undergone an IVTA injection for macular edema from etiologies other than age-related macular degeneration (non-AMD macular edema) were included in the present study. Visual improvement and retinal thickness were the main outcomes. Potential complications, including increased intraocular pressure (IOP), intraocular bleeding, and postoperative endophthalmitis were also recorded. The mean pre-operative logarithm of Minimum Angle of Resolution (logMAR) visual acuity (VA) was 1.0 with an average macular thickness of 463.2 +/- 141.4 microns and mean IOP of 12.9 +/- 2.7 mmHg. The macular thickness rapidly decreased in the first week after an injection with a trough at two months (p < 0.001) and began to rise thereafter. The overall VA started to improve significantly at one month and lasted for two months. The IOP significantly increased from the mean baseline during the first two months in 31.6%, which could be controlled only by the medication. No other serious complications were observed. IVTA has the potential to improve both functional and anatomical outcomes in non-AMD macular edema. The decrease in macular thickness occurs from one week after an injection but the visual function improves more slowly and has a short-time effect.
    Journal of the Medical Association of Thailand = Chotmaihet thangphaet 01/2009; 92(1):58-63.
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    ABSTRACT: To evaluate the effect of photodynamic therapy (PDT) with verteporfin for age-related macular degeneration (AMD) and non-AMD in Thais, and compare with the Treatment of Age-Related Macular Degeneration with Photodynamic Therapy (TAP) and Verteporfin in Photodynamic Therapy (VIP) study. The authors prospectively evaluated all data of 51 eyes of 51 patients who had undergone PDT and accomplished a 1-year follow up. The assessments were divided into two categories: group 1 included three subsets of AMD, and group 2 was non-AMD. The first group classified into three subgroups: group 1A: AMD with subfoveal choroidal neovascularization (CNV) and TAP/VIP compatible with recommendation guidelines characteristics, group 1B: AMD with subfoveal CNV and TAP/VIP incompatible, and group 1C: AMD with non-subfoveal CNV. The measurement outcomes comprised of the baseline characteristics, change in visual acuity, and number of treatments. Thirty-eight eyes had CNV-related AMD and 13 eyes were non-AMD. At the 12-month examination, the mean visual acuity change in group 1A, 1B, 1C had increased 0.19 (p = 0.077), 0.14 (p = 0.076), and 0.24 (p = 0.003), respectively. The number of treatments was 1.8 in group 1A, 2.3 in group 1B, and 1.5 in group 1C. PDT is beneficial to Thai patients with AMD at first year even if they were not compatible with TAP/VIP criteria.
    Journal of the Medical Association of Thailand = Chotmaihet thangphaet 11/2007; 90(10):2090-6.
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    ABSTRACT: To evaluate the efficacy and results of pars plana vitrectomy with endotamponade for retinal detachments caused by necrotizing retinitis in HIV patients. The data of patients with HIV-related retinal detachment who underwent pars plana vitrectomy with silicone oil or gas endotamponade between January 2003 and June 2005 were retrospectively reviewed The outcome measures were demographic data, anatomical, and visual results. Of all 24 eyes from 20 patients, 19 eyes underwent pars plana vitrectomy with silicone oil tamponade and 5 eyes with long-acting gas tamponade. Mean follow up time was 13 months (range 2-33 months). The overall anatomical success was 83% (84% and 80% with silicone oil and gas tamponade, respectively). Final best corrected visual acuity was equal or better than 5/200 in 12 eyes (50%). Forty-six percent had stabled or improved vision at the end of follow-up. Pars plana vitrectomy with silicone oil or gas tamponade gives the high anatomical success rate in the repair of retinal detachments caused by necrotizing retinitis in HIV patients. There were the same reattachment rate and visual results between the two tamponade groups. However, the use of gas tamponade may be effective in patients with highly active antiretroviral therapy (HAART).
    Journal of the Medical Association of Thailand = Chotmaihet thangphaet 07/2007; 90(6):1161-6.
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    ABSTRACT: To evaluate the anatomical and visual results of a primary scleral buckling procedure for the treatment of stage 4A and 4B retinopathy of prematurity (ROP) in Thai patients. The data of premature infants treated with a primary scleral buckling procedure for stage 4 ROP from December 2000 to May 2004 were retrospectively reviewed The outcomes measures were anatomical success, visual outcomes, and refractive error at the end of follow-up. Sixteen eyes of ten patients underwent a scleral buckling procedure and had the mean follow-up period of 17.3 months (range 3-44 months). The anatomical success was 100% (8 of 8 eyes) in stag 4A and 50% (4 of 8 eyes) in stage 4B. At the end of the follow-up, the buckle was removed in 92% (11 of 12 eyes) of retina-attached eyes and showed a mean myopic refraction of-8.68 diopters (range -4. 75 to 13.50). Favorable visual outcome was 50% (4 of 8 eyes) in stage 4A and 12.5% (1 of 8 eyes) in stage 4B. Scleral buckling appears to play a role in reducing the progression from stage 4 to stage 5 ROP The anatomical success rate was excellent but the visual results remain challenging for these cases.
    Journal of the Medical Association of Thailand = Chotmaihet thangphaet 11/2006; 89(10):1659-64.
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    M Ratanasukon, N Wongchaikunakorn
    Eye 05/2006; 20(4):499-502. · 1.82 Impact Factor
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    M Ratanasukon, A Kittantong
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    ABSTRACT: To study the results of intravitreal tissue plasminogen activator (tPA) and expansile gas injection for submacular haemorrhage in Thai patients. The medical records of Thai patients who presented with submacular haemorrhage between January 1998 and December 2002 were reviewed. The inclusion criteria were acute onset of bleeding (<1 month), treatment with intravitreal injection of tPA solution (50-100 mug in 0.1 ml) and expansile gas (0.3-0.4 ml of 100% perfluoropropane or sulphur hexafluoride), and at least 6 months of follow-up. Our main outcome measures were best final postoperative visual acuity and surgical complications. A total of 19 eyes of 19 patients completed the inclusion criteria with a mean duration of 13.1 days. The causes of haemorrhage were age-related macular degeneration in 15 eyes (78.9%), idiopathic choroidal neovascularization in two eyes (10.5%), and traumatic, and valsalva retinopathy in one eye each (5.2%). After a mean follow-up of 13 months (range 6-39 months), postoperative visual acuity improved two lines or greater in 12 eyes (63.2%), stabilized in six eyes (31.6%) and worsened in one (5.2%). The final visual acuity measured 20/63 or better in 10 eyes (52.6%). The surgical complications were breakthrough vitreous haemorrhage (three eyes) and cataracts (three eyes), and two had retinal detachments. The treatment of submacular haemorrhage with intravitreal injection of tPA and expansile gas improved visual acuity in more than half of the patients. In all, 10 in 19 eyes demonstrated final visual acuity at a functional level.
    Eye 12/2005; 19(12):1328-32. · 1.82 Impact Factor
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    ABSTRACT: We describe two Thai families with Norrie disease (ND) in three generations, including 10 affected males and one manifesting female. All affected males in each family had severely defective eye development with complete loss of vision. In addition, three male patients (one from family 1 and two from family 2) suffered from epilepsy, and one female carrier from one family manifested blindness with phthisis bulbi in her right eye. Mutation analysis of the ND gene (NDP) revealed two different novel missense mutations (L16P and S75P) that co-segregated with ND in each family, suggesting that the newly appearing proline at codon 16 or codon 75 alters the conformation of the ND protein and contributes to the severe phenotype of ND in each family. Other studies suggest that epileptic seizures or growth retardation that is associated with ND is the consequence of loss of contiguous genes, because most such patients had deletions extending beyond the Norrie locus. Our finding that the three affected males in the two families with the missense mutations had epilepsy does not support a contiguous gene effect, but favors the pleiotropism of NDP, at least as far as the epileptic manifestation is concerned. The unilateral blindness in the female carrier may have been due to non-random X-inactivation.
    American Journal of Medical Genetics 05/2001; 100(1):52-5.
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    ABSTRACT: We describe two Thai families with Norrie disease (ND) in three generations, including 10 affected males and one manifesting female. All affected males in each family had severely defective eye development with complete loss of vision. In addition, three male patients (one from family 1 and two from family 2) suffered from epilepsy, and one female carrier from one family manifested blindness with phthisis bulbi in her right eye. Mutation analysis of the ND gene (NDP) revealed two different novel missense mutations (L16P and S75P) that co-segregated with ND in each family, suggesting that the newly appearing proline at codon 16 or codon 75 alters the conformation of the ND protein and contributes to the severe phenotype of ND in each family. Other studies suggest that epileptic seizures or growth retardation that is associated with ND is the consequence of loss of contiguous genes, because most such patients had deletions extending beyond the Norrie locus. Our finding that the three affected males in the two families with the missense mutations had epilepsy does not support a contiguous gene effect, but favors the pleiotropism of NDP, at least as far as the epileptic manifestation is concerned. The unilateral blindness in the female carrier may have been due to non-random X-inactivation. © 2001 Wiley-Liss, Inc.
    American Journal of Medical Genetics 04/2001; 100(1):52 - 55.