黃奕修教授是現任長庚眼科部部長, 自2007年創立長庚體系葡萄膜炎/虹彩炎門診,設置各種先進且現代化之醫療支援,至今已成為此病重要轉診與研究中心。
虹彩炎/葡萄膜炎是眼內發炎混濁疾病之總稱。美國及歐洲之盛行率約每十萬人40例。台灣並無詳細的統計數字,若依歐美的數字推估,台灣應約有近一萬位眼炎患者。需特別注意的是,虹彩炎/葡萄膜炎患者數雖不多,卻是致盲主因。葡萄膜炎在美國佔每年致盲病因8%左右,在全球可能達14~20%,其乃肇因於許多特殊葡萄膜炎容易誤診且缺乏根治方法,未適當治療之慢性葡萄膜炎將導致視力之破壞。不僅如此,許多葡萄膜炎患者甚至合併有全身性疾病,因此必須以全人照護理念規劃患者之治療方針。
治療葡萄膜炎常用之全身性類固醇與各種免疫抑制劑,潛藏著不少的副作用,使用失當甚至有引起免疫能力低下、腎臟衰竭、藥物性肝炎及致死可能。如何兼顧療效與副作用,各種治療用藥達到”君為主、臣為輔、佐抑制、使為引”之均衡境界,需要醫師長期且大量的臨床經驗。
眼炎症診斷並不是容易的事,因為臨床表現相仿的發炎不僅可能是自體免疫異常,也可能是潛藏的感染。以虹彩炎為例,林口長庚眼炎症團隊近年發現亞裔人口病毒虹彩炎的發生率有上升趨勢,但常被誤診為免疫性虹彩炎,而以類固醇眼藥水治療。給藥初期雖病情可稍見好轉,卻會愈治愈糟,眼壓常直線上升,增加類固醇劑量也不見成效。以降眼壓藥水治療,初期有效,幾個月後又呈現抗藥性,眼壓再也降不下來。持續的炎症與高眼壓將導致青光眼或角膜水腫,只要數星期,視力將永遠無法恢復。
但若能詳加辨識虹彩炎之細微徵兆,區分具特徵性之環形角膜內皮沉積表現、與炎症程度不成比例之高眼壓、受損之角膜內皮細胞與少見之虹彩萎縮等特徵,並檢測病毒DNA,即可精準診斷,及時改用抗病毒藥劑,而得到正確之治療效果。
類似之案例在眼炎病並不少見,因感染與發炎二者之表現雖然類似,但治療方向完全相反。若無法區分其極微小之差異,很容易導致病情惡化。這些臨床的觀察與診斷依據,非常細微,必須關注全人才能做出正確診斷。正確的葡萄膜炎診斷不只需要豐富的經驗與實驗室支援,也需要醫師的全神貫注與豐富經驗。
眼炎症還有地域性的特點,不同地區與人種,疾病種類與表現常有很大差異。近年並領導台灣各醫療機構參與諸多世界多中心之葡萄膜炎研究,各式新一代標靶製劑於林口長庚正積極研發,期盼以新藥造福台灣葡萄膜炎患者,守護國人眼睛的健康。
基因治療是近年眼科學新領域. 與以往只能研究但缺乏治療的情形, 近年已有長足進步. 基因導入/修補的技術已日漸成熟, 有希望解決以往的不治之症.
人工電子眼與基因治療二者皆是用於遺傳性視網膜基因變異疾病的治療模式. 人工電子眼用於已視力退化末期的病患, 而基因治療可用於即將發病或正惡化期的病患. 林口長庚於2017完成人工電子眼亞洲首例植入, 於2018年獲得亞洲人工電子眼中心認證為卓越中心. 此外, 次世代定序技術(next generation sequencing, NGS)包含全基因體定序掃瞄 (whole genome sequencing, WGS)與全外顯子定序掃瞄 (whole exome sequencing, WES)二種. 本院現完成的基因體診斷平台著重此二種技術的臨床應用, 同時開發“長期持續性照護”概念, 結合新電子平台APP, 對病人的臨床診斷需求與快速成長的基因體資料庫作持續的訊息更新, 而不是僅有一次性報告的傳統照護模式.
專長
難治視網膜疾病、虹彩炎、葡萄膜炎疾病治療
治療經驗
每年林口長庚葡萄膜炎新增案例數約400名。持續就診與追蹤數每年約2,000人次。
成功率依不同葡萄膜炎而有不同。難治病毒性葡萄膜炎病毒致炎症抑制率約70%;自體免疫鞏膜炎炎症控制率高於九成。
人工電子眼亞洲首例, 長庚電子眼中心召集人. 完成亞洲電子眼卓越中心認證.
個人網站
http://www.uveitis.tw
http://www.retina.tw
http://www.dreye.net
學歷
長庚大學臨床醫學研究所博士
台北醫學大學醫學系
世界眼科醫學會國際眼科檢定二階段考試通過經
美國Bascom Palmer Eye Institute眼科中心視網膜/葡萄膜炎/電生理研究員
日本國立北海道大學葡萄膜炎研究員
英國Moorfields Eye Hospital葡萄膜炎研究員
國際葡萄膜炎研究組(IUSG) 大會審核通過台灣第一且至今唯一會員
美國葡萄膜炎學會 (AUS)審核通過台灣第一且至今唯一會員
世界葡萄膜炎學會(IOIS)會員
亞太葡萄膜炎學會(APIISG)會員
經歷
長庚體系北院區葡萄膜炎轉診中心醫師/創科醫師
長庚人工電子眼中心/眼科基因體中心 召集人
曾任長庚紀念醫院眼科部副部長 (2020-2021)
長庚紀念醫院眼科部視網膜科主任 (2013-2020)
中華民國黃斑部醫學會常務監事
中華民國視網膜醫學會理事
中華民國視網膜醫學會(Taiwan Retinal Society)副秘書長
長庚產學中心副主任
百大良醫推薦《商業周刊》
現任
長庚紀念醫院眼科部部長
亞洲電子眼卓越中心主持人
中華民國黃斑部醫學會常務監事
中華民國眼科醫學會副秘書長
中華民國眼炎症學會常務理事
獲獎經驗
2020年「醫療防疫 護國先鋒」 COVID-19防疫貢獻 總統表揚 感謝狀
2015年林口長庚醫院醫師類最優教師
亞洲首例人工電子眼手術醫師
醫療貢獻
成立北長庚體系葡萄膜炎學門並成為國內相關疾病轉診中心
成立Second Sight Argus II亞洲電子眼中心 (Center of Excellence, CoE),2017完成亞洲首例人工電子眼植入手術
共發表84篇論文
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- Chu HY, Sun CC, Chuang WY, Liou SW, Ma D HK, Lai CC, Hwang YS* (Corresponding), Hsiao CH*. Cytomegalovirus Associated Corneal Endotheliitis after Penetrating Keratoplasty in a Patient with Fuchs Corneal Endothelial Dystrophy. Br. J. Ophthalmol. 2012 Feb; 96(2):300-1. (SCI;IF =3.036, Ophthalmology 10/56)
- Chuang LH, Wang NK, Chen YP, Hwang YS, Chen KJ, Yeung L, Wu WC, Chen TL, Lai CC*. Comparison of visual outcomes after epiretinal membrane surgery. Taiwan Journal of Ophthalmology. 2012 June; 2(2):56-59.
- Wang NK*, Chuang LH, Lai CC, Chou CL, Chu HY, Yeung L, Chen YP, Chen KJ, Wu WC, Chen TL, Chao AN, Hwang YS. Multimodal fundus imaging in fundus albipunctatus with RDH5 mutation: a newly identified compound heterozygous mutation and review of the literature. Doc Ophthalmol 2012 Aug;125(1):51-62. Epub 2012 Jun 6. (SCI;IF =1.444, Ophthalmology 36/56)
- Wu WC, Lin RI, Shih CP, Wang NK, Chen YP, Chao AN, Chen KJ, Chen TL, Hwang YS, Lai CC, Huang CY, Tsai S. Visual Acuity, Optical Components, and Macular Abnormalities in Patients with a History of Retinopathy of Prematurity. Ophthalmology 2012 Sep;119(9):1907-16. Epub 2012 May 10. (SCI;IF=6.750;Ophthalmology 2/56)
- Wu WC, Liu CH, Chen CC, Wang NK, Chen KJ, Chen, TL, Hwang YS, Li LM, Lai CC. Efficient vitreolysis by combining plasmin and sulfur hexafluoride injection in a preclinical study in rabbit eyesc. Mol Vis. 2012 Sep; 18:2361-2370 (SCI;IF=2.110;Ophthalmology 20/56)
- Chen YH, Lien RI, Lai CC, Chao AN, Chen KJ, Hwang YS, Wang NK, Chen YP, Chen TL, Chang CJ, Wu WC. Retinopathy of prematurity in neonatal patients with birth weight greater than 1500 g in Taiwan. Biomed J. 2013 Mar; 36(2), 84-89.
- Chuang LH, Wang NK, Chen YP, Yeung L, Hwang YS, Chen KJ, Wu WC, Chen TL, Lai CC. Vitrectomy and panretinal photocoagulation reduces the occurrence of neovascular glaucoma in central retinal vein occlusion with vitreous hemorrhage. Retina. 2013 Apr; 33(4):798-802. (SCI;IF=3.039, Ophthalmology 9/56)
- Chen YH, Wu WC, Wang NK, Chen TL, Chao AN, Chen KJ, Hwang YS, Chen YP, Liu L, Kuo J ZC, Chang CJ, Chuang LH, Lai CC. Combined Photodynamic Therapy and Anti-Vascular Endothelial Growth Factor Treatment for Idiopathic Polypoidal Choroidal Vasculopathy: One-Year Follow-up. Acta Soc Ophthalmol Sinicae 2013 Apr; 52(1):21-31.
- Sun YH, Yang YH, Huang YC, Chang CH, Hwang YS*. Reverse Flow in Ophthalmic Artery Helps Protect the Cerebrum from Ischemic Stroke in Total Carotid Artery Occlusion. Taiwan J Ophthalmol. 2013 Jun; 3(2):78-81.
- Hwang YS, Chiang PR, Hong WH, Chiao CC, Chu IM, Hsiue GH, Shen CR. Study in vivo Intraocular Biocompatibility of in situ Gelation Hydrogels: Poly(2-ethyl oxazoline)-block-poly(ε-caprolactone)-block-poly(2-ethyl oxazoline) Copolymer, Matrigel and Pluronic F127. PLoS One 2013 Jul; 8(7): e67495 (SCI;IF=3.057, Multidisciplinary Sciences 11/63)
- Rao X, Wang NK, Chen YP, Hwang YS, Chuang LH, Liu IC, Chen KJ, Wu WC, Lai CC. Outcomes of outpatient fluid-gas exchange for open macular hole after vitrectomy. Am J Ophthalmol. 2013 Aug; 156(2):326-333. (SCI;IF=3.831;Ophthalmology 5/56).
- Lee CM, Hwang YS*. Hemorrhagic Retinal Detachment in Acute Promyelocytic Leukemia. Taiwan J Ophthalmol. 2013 Sep; 3(3):123-125.
- Ho YF, Chen KJ, Chen TL, Hwang YS, Chao AN. Spontaneous Resolution of A Presumed Choroidal Tuberculoma Observed Using Optical Coherence Tomography Features--Case Report. Acta Soc Ophthalmol Sinicae 2013 Oct; 52(2):128-133.
- Wu WC, Shih CP, Wang NK, Lien R, Chen YP, Chao AN, Chen KJ, Chen TL, Hwang YS, Lai CC, Huang CY, Tsai S. Choroidal thickness in patients with a history of retinopathy of prematurity. JAMA Ophthalmol. 2013 Nov, 131(11):1451-1458.
- Chiang PR, Lin TY, Tsai, HC, Chen HL, Liu SY, Chen FR, Hwang YS, Chu IM. Thermosensitive hydrogel from oligopeptide-containing amphiphilic block copolymer: Effect of peptide functional group on self-assembly and gelation behavior. Langmuir 2013 Dec; 29(51): 15981-15991. (SCI;IF=3.993;Materials Science & Multidisciplinary 45/271).
- Reddy AK, Hwang YS, Mandelcorn ED, Davis JL. HLA-DR, DQ Class II DNA Typing in Ped5iatric Panuveitis and Tubulointerstitial Nephritis and Uveitis. Am J Ophthalmol. 2014 Mar; 157(3):678-686. (SCI;IF=3.831;Ophthalmology 5/56).
- Liu CF, Chen LJ, Tsai SH, Lai CC, Chan WC, Wu WC, Wang NK, Chen KJ, Hwang YS, Chen YP, Yeung L. Half-dose verteporfin combined with half-fluence photodynamic therapy for chronic central serous chorioretinopathy. J Ocul Pharmacol Ther. 2014 Jun;30(5):400-405. (SCI;IF=1.754;Ophthalmology 28/56)
- Chuang LH, Chen YP, Wang NK, Yeung L, Chen KJ, Hwang YS, Wu WC, Chen TL, Lai CC. Macular hole repair by vitrectomy and internal limiting membrane peeling in highly myopic eyes. Retina 2014 Oct; 34(10):2021-7. (SCI;IF=3.039, Ophthalmology 9/56)
- Chuang LH, Hwang YS, Wang NK, Chen YP, Liu L, Yeung L, Chen KJ, Chen TL, Wu WC, Lai CC. The chorioretinal damage caused by different half parameters of photodynamic therapy in rabbits. J Ocul Pharmacol Ther. 2014 Oct;30(8):642-649. (SCI;IF=1.754;Ophthalmology 28/56)
- Gong CS A, Lei KF, Hwang YS, Zhang JH, Lei TC. Impedimetric detection of whole blood concentration for early detection of intraocular hemorrhage. Microelectron Eng. 2014 Nov; 129: 70–76. (SCI;IF=1.277;Engineering, Electrical & Electronic 127/255)
- Wu WC, Liu CH, Wang NK, Chen KJ, Chen TL, Hwang YS, Liao PJ, Li LM, Lai CC. Lens subluxation after plasmin and SF6 injections in rabbit eyes. PLoS One. 2014 Nov 14; 9(11):e112957. (SCI;IF=3.057, Multidisciplinary Sciences 11/63)
- Chen YH, Lien RI, Tsai S, Chang CJ, Lai CC, Chao AN, Chen KJ, Hwang YS, Wang NK, Chen YP, Chen TL, Wu WC. Natural history of retinopathy of prematurity: Two-year outcomes of a prospective study. Retina. 2015 Jan;35(1):141-8. (SCI;IF=3.039, Ophthalmology 9/56)
- Wang NK, Liu L, Chen HM, Tsai S, Chang TC, Tsai TH, Yang CM, Chao AN, Chen KJ, Kao LY, Yeung L, Yeh LK, Hwang YS, Wu WC, Lai CC. Clinical presentations of X-linked retinoschisis in Taiwanese patients confirmed with genetic sequencing. Mol Vis. 2015 Apr;21:487-501. (SCI;IF=2.110, Ophthalmology 20/56)
- Shen CR, Juang HH, Chen HS, Yang CJ, Wu CJ, Lee MH, Hwang YS, Kuo ML, Chen YS, Chen JK, Liu CL. The Correlation between Chitin and Acidic Mammalian Chitinase in Animal Models of Allergic Asthma. Int. J Mol Sci. 2015 Nov; 16: 27371–27377. (SCI;IF=3.257, Chemistry, Multidisciplinary 51/163)
- Tseng ST, Yao TC, Huang JL, KW*, Hwang YS*. Clinical manifestations in uveitis patients with and without rheumatic disease in a Chinese population in Taiwan. J Microbiol Immunol Infect. 2015 Dec 16; Article in press. (SCI;IF=2.955, Infectious Diseases 27/83)
- Chen YH, Lien R, Chiang MF, Huang CY, Chang CJ, Wang NK, Chen YP, Chao AN, Chen KJ, Chen TL, Hwang YS, Lai CC, Wu WC. Outer Retinal Structural Alternation and Segmentation Errors in Optical Coherence Tomography Imaging in Patients with a History of Retinopathy of Prematurity. Am J Ophthalmol. 2016 June; 166: 169-180. Epub 2016 Mar. (SCI;IF=3.831;Ophthalmology 5/56).
- Lee YS, Wang NK, Chen YP, Chen KJ, Hwang YS, Lai CC, Wu WC. Plasmin Enzyme-Assisted Vitrectomy in Pediatric Patients with Vitreoretinal Diseases. Ophthalmic Res. 2016 Aug. [Epub ahead of print] (SCI;IF=1.344, Ophthalmology 38/56)
- Gong CA, Syu WJ, Lei KF, Hwang YS. Development of a Flexible Non-Metal Electrode for Cell Stimulation and Recording. Sensors (Basel). 2016 Sep;16(10). pii: E1613. (SCI;IF=2.033, Instruments & Instrumentation 12/56)
- Chuluunbat T, Chan RV, Wang NK, Lien R, Chen YP, Chao AN, Chen KJ, Chen TL, Hwang YS, Lai CC, Wu WC. Nonresponse and recurrence of retinopathy of prematurity after intravitreal ranibizumab treatment. Ophthalmic Surg Lasers Imaging Retina. 2016 Dec;47(12):1095-1105. (SCI;IF=1.212, Ophthalmology 42/56)
- Wu WC, Shih CP, Lien R, Wang NK, Chen YP, Chao AN, Chen KJ, Chen TL, Hwang YS, Lai CC. Serum Vascular Endothelial Growth Factor after Bevacizumab or Ranibizumab Treatment for Retinopathy of Prematurity. Retina. 2017 Apr; 37(4):694-701. (SCI;IF=3.039, Ophthalmology 9/56)
- Gong CS.A, Chang CH, Shiu FL, Chiou HK, Hwang YS. A front-end receiver with a dual cross-coupling technique for MICS applications. Int. J. Circ. Theor. Appl. 2017 Apr; 45(4): 502-514. (SCI;IF=1.179, Engineering, Electrical & Electronic 137/255)
- Liu L, Enkh-Amgalan , Wang NK, Chuang LH, Chen YP, Hwang YS, Chang CJ, Chen KJ, Wu WC, Chen TL, Lai CC. RESULTS OF MACULAR HOLE SURGERY: Evaluation Based on the International Vitreomacular Traction Study Classification. Retina. 2017 Apr. [Epub ahead of print] (SCI;IF=3.039, Ophthalmology 9/56)
- Kang EYC, Hsieh YT, Li CH, Huang YJ, Kuo CF, Kang JH, Chen KJ, Lai CC, Wu WC, Hwang YS*. Deep learning–based detection of early renal function impairment using retinal fundus images: Model development and validation. JMIR Med Inform. 2020 Nov; 8(11):e23472. (SCI;IF=2.955;MEDICAL INFORMATICS 17/30) Cheng YC, Kang EYC, Hwang YS*, Hsiao CH*. Treatment of cytomegalovirus anterior segment infection with intravitreal injection of ganciclovir in adjunction with or without oral valganciclovir: long-term. Sci Rep. 2021 Feb; 11(1):3105. (SCI;IF=4.379;MULTIDISCIPLINARY SCIENCES 17/73)
- Yeh PH, Liu CH*, Sun MH, Chi SC, Hwang YS*. To measure the amount of ocular deviation in strabismus patients with an eye-tracking virtual reality headset. BMC Ophthalmol. 2021 Jun; 21(1):246. (SCI;IF=2.209;OPHTHALMOLOGY 44/62)
- Kang EYC, Kang CY, Wu WC, Sun CC, Chen KJ, Lai CC, Chen TH*, Hwang YS*. Association between Add-On Dipeptidyl Peptidase-4 Inhibitor Therapy and Diabetic Retinopathy Progression. J Clin Med. 2021 Jun;10(13):2871. (SCI;IF=4.241;MEDICINE, GENERAL & INTERNAL 39/169)
- Kang EYC, Garg SJ, Chen HF, Wu WC, Chen LYH, Chou HD, Liu L, Chen KJ, Hwang YS*. Intravitreal Dexamethasone Implants for Refractory Macular Edema in Eyes with Noninfectious Uveitis. J Clin Med. 2021 Aug; 10(17), 3762. (SCI;IF=4.241;MEDICINE, GENERAL & INTERNAL 39/169)
- Hwang YS*, Kang EYC, Shen CR, Hong WH, Wu WC. Noncontact Optical Measurement of Aqueous Humor Glucose Levels and Correlation with Serum Glucose Levels in Rabbit. Biosensors 2021 Oct;11(10): 387. (SCI;IF=5.519;INSTRUMENTS & INSTRUMENTATION 8/64)
- Wu AL, Liu YT, Chou HD, Chuang LH, Chen KJ, Chen YP, Liu L, Yeung L, Wang NK, Hwang YS, Wu WC, Lai CC*. Role of growth factors and internal limiting membrane constituents in müller cell migration. Exp Eye Res. 2021 Jan; 202:108352. (SCI;IF=3.467;OPHTHALMOLOGY 17/62)
- Chou HD, Chong YJ, Teh WM, Chen KJ, Liu L, Chen YP, Yeung L, Hwang YS, Wu WC, Lai CC*. Nasal or Temporal Internal Limiting Membrane Flap Assisted by Sub-Perfluorocarbon Viscoelastic Injection for Macular Hole Repair. Am J Ophthalmol. 2021 Mar;223:296-305. (SCI;IF=5.258;OPHTHALMOLOGY 6/62)
- Chou HD, Yao TC, Huang YS, Huang CY, Yang ML, Sun MH, Chen HC, Liu CH, Chu SM, Hsu JF, Chen KJ, Hwang YS, Lai CC, Wu WC*. Myopia in school-aged children with preterm birth; The roles of time spent outdoors and serum Vitamin D. Br J Ophthalmol. 2021 Apr; 105(4):468-472. (SCI;IF=4.638;OPHTHALMOLOGY 9/62)
- Chen KJ*, Lai CC, Chen HC, Chong YJ, Sun MH, Chen YP, Wang NK, Hwang YS, Chao AN, Wu WC, Yeung L, Sun CC, Liu L, Chen YH, Chou HD. Enterococcus faecalis Endophthalmitis: Clinical Settings, Antibiotic Susceptibility, and Management Outcomes. Microorganisms. 2021 Apr;9(5):918 (SCI;IF=4.128;MICROBIOLOGY 52/137)
- Tsao YT, Wu WC, Chen KJ, Yeh LK, Hwang YS, Hsueh YJ, Chen HC*, Cheng CM. Analysis of aqueous humor total antioxidant capacity and its correlation with corneal endothelial health. Bioeng Transl Med. 2021 May; 6(2): e10199. (SCI;IF=10.711;ENGINEERING, BIOMEDICAL 4/90)
- Kang CY, Kang E YC, Lai CC, Lo WC, Chen KJ, Wu WC, Liu L, Hwang YS, Lo FS, Huang YC*. Nasal Methicillin-Resistant Staphylococcus aureus Colonization in Patients with Type 1 Diabetes in Taiwan. Microorganisms. 2021 June;9(6):1296. (SCI;IF=4.128;MICROBIOLOGY 52/137)
- Hung N, Shih AG, Kin C, Kuo MT, Hwang YS, Wu WC, Kuo CF, Kang EYC*, Hsiao CH*. Using Slit-Lamp Images for Deep Learning–Based Identification of Bacterial and Fungal Keratitis: Model development and Validation with Different Convolutional Neural Networks. Diagnostics. 2021 July;11(7):1246 (SCI;IF=3.706;MEDICINE, GENERAL & INTERNAL 45/169)
- Chou HD, Shih CP, Huang YS, Liu L, Lai CC, Chen KJ, Hwang YS, Wu WC*. Cognitive Outcomes Following Intravitreal Bevacizumab for Retinopathy of Prematurity: 4- to 6-Year Outcomes in a Prospective Cohort. Am J Ophthalmol. 2021 Jul;S0002-9394(21)00363-9. Online ahead of print (SCI;IF=5.258;OPHTHALMOLOGY 6/62)
- Ho MC, Hsiao CH, Sun MH, Hwang YS, Lai CC, Wu WC, Chen KJ*. Antimicrobial susceptibility, minimum inhibitory concentrations, and clinical profiles of stenotrophomonas maltophilia endophthalmitis. Microorganisms 2021 Aug; 9(9):1840. (SCI;IF=4.128;MICROBIOLOGY 52/137)
- Huang YP, Basanta H, Kang EYC, Chen KJ, Hwang YS, Lai CC, Campbell J, Chiang M, Chan R, Kusaka S, Fukushima Y, Wu WC*. Automated Detection of Early-stage ROP Using a Deep Convolutional Neural Network. Br J Ophthalmol. 2021 Aug; 105(8):1099-1103. (SCI;IF=4.638;OPHTHALMOLOGY 9/62)
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