About

Catherine Y. Liu, MD, PhD, is the Director of Medical Student Education at UCSD's Shiley Eye Institute. Her role involves ensuring that all UCSD medical students gain exposure to ophthalmology and learn core skills in the eye exam. She is dedicated to inspiring and mentoring medical students interested in pursuing ophthalmology as a career. Dr. Liu is part of a faculty comprising world-class leaders in ophthalmology who are committed to medical student education. Her work emphasizes providing comprehensive ophthalmology training and fostering interest in the field among future physicians.

Research topics

• Internal medicine
• Surgery
• Medicine
• Pathology
• Dermatology
• Immunology

Selected publications

• Systemic Effects of Teprotumumab Treatment on Thyroid Function in Patients With Thyroid Eye Disease: A Retrospective Study

  Ophthalmic Plastic and Reconstructive Surgery · 2026-02-13

  articleSenior author

  BACKGROUND: Teprotumumab, a monoclonal antibody targeting the insulin-like growth factor-1 receptor, has demonstrated significant efficacy in treating thyroid eye disease. While its ophthalmic benefits are well established, limited data exist regarding its effects on thyroid hormone regulation. OBJECTIVE: To characterize changes in thyroid function associated with teprotumumab therapy in thyroid eye disease patients. METHODS: We performed a retrospective comparative study of 46 thyroid eye disease patients treated with teprotumumab and 46 thyroid eye disease patients treated with orbital decompression at a tertiary care facility between January 2020 and December 2023. Thyroid function tests (thyroid-stimulating hormone and free thyroxine) were analyzed at pretreatment and posttreatment. Subgroup analysis was conducted based on prior thyroidectomy or radioactive iodine therapy. Clinical outcomes, including proptosis and Clinical Activity Score, were also evaluated. RESULTS: The teprotumumab cohort had a mean age of 55.9 years, with 80.5% female and 65.2% hyperthyroid at presentation. The orbital decompression cohort mean age was 49.8 years, with 89.1% female and 80.4% hyperthyroid. Both groups showed significant improvements in Clinical Activity Score and proptosis. In the teprotumumab group, free thyroxine levels significantly declined posttreatment (1.7 ± 1.2 to 1.3 ± 0.4, p = 0.049), particularly in patients without prior thyroidectomy/radioactive iodine (1.8 ± 1.4 to 1.2 ± 0.3, p = 0.041). The orbital decompression group showed no significant change in free thyroxine levels (p = 0.63). Over half (52.2%) of teprotumumab patients required medication adjustments during therapy, compared with 12.5% in the orbital decompression group (p < 0.001). CONCLUSIONS: Teprotumumab may impact thyroid hormone homeostasis, especially in patients with functioning thyroid tissue, suggesting a need for endocrine monitoring with treatment.

  PublisherDOI

• Team-Based Endoscopic Management of a Giant Sinonasal-Orbital Osteoma with Vascularized Flap Reconstruction

  Journal of Neurological Surgery Part B Skull Base · 2026-02-27

  article
  PublisherDOI

• Severe Congenital Ptosis Repair

  Ophthalmology · 2026-04-01

  article
  PublisherDOI

• The Role of Corticosteroids in the Management of Orbital Cellulitis

  Ophthalmology · 2026-04-01

  article
  PublisherDOI

• Use of Electronic Health Records to Examine Margin-to-Reflex Distance in Normal Patients

  Research Square · 2026-02-27

  preprintOpen access
  PublisherOA PDFDOI

• External Dacryocystorhinostomy

  2025-01-01

  book-chapterSenior author
  PublisherDOI

• Impact of unilateral Mueller’s muscle conjunctival resection on contralateral upper eyelid position in patients without preoperative Hering’s effect

  Indian Journal of Ophthalmology · 2025-07-18

  articleOpen access

  PURPOSE: To evaluate the effect of unilateral Mueller's muscle conjunctival resection (MMCR) on the contralateral upper eyelid position in patients without preoperative Hering's effect. METHODS: This retrospective study analyzed 33 patients who underwent unilateral MMCR for mild to moderate ptosis at Shiley Eye Institute, University of California, San Diego. Patients with additional procedures or preoperative Hering's effect were excluded. Margin Reflex Distance (MRD1) was measured using Image J software from standardized digital images. Five masked researchers independently measured MRD1, with the average of the middle three values used for analysis. RESULTS: The mean preoperative and postoperative MRD1 of the operated eye were 1.20 mm (SD 0.92) and 3.35 mm (SD 0.83), respectively. For the nonoperated eye, preoperative MRD1 was 3.15 mm (SD 0.85) and postoperative MRD1 was 3.28 mm (SD 0.8). There was a statistically significant improvement in the operated eyelid MRD1 ( P < 0.001) but no statistically significant change in the nonoperated eyelid position ( P = 0.704). One patient (3%) experienced an MRD1 drop >1 mm in the fellow eye. Thirty-two patients (97%) had ≤1 mm difference between operated and nonoperated eyelids postoperatively. Interestingly, 18 patients (54.5%) showed a paradoxical increase in contralateral MRD1 (mean 0.66 mm, range 0.02-2.39 mm). All patients achieved acceptable symmetry without requiring additional procedures. CONCLUSION: MMCR effectively corrects mild to moderate unilateral upper eyelid ptosis with minimal impact on the contralateral eyelid in patients without preoperative Hering's effect. While the procedure resulted in no significant changes to the contralateral eyelid in 97% of cases, the unexpected finding of paradoxical contralateral lid elevation in over half the patients warrants further investigation.

  PublisherDOI

• Bilateral Retrobulbar Hemorrhage After Asphyxiation

  Ophthalmic Plastic and Reconstructive Surgery · 2025-11-27

  articleCorresponding

  A 48-year-old woman presented to the emergency department with acute bilateral eye pain, diplopia, and blurry vision. Her examination was notable for reduced supraduction OD, with a diffuse facial petechial rash, significant periorbital ecchymosis, upper eyelid ptosis, and subconjunctival hemorrhage (Fig. 1). The patient’s visual acuity was 20/20 OU without afferent pupillary defect, with normal intraocular pressures and dilated fundus examination. She denied a medical history of coagulopathies, anticoagulant use, or recent periorbital procedures. Further history revealed that the patient had undergone consensual erotic manual strangulation with her partner and suffered immediate loss of consciousness with presenting symptoms after a short period of strangulation. CT scan (Fig. 2A–C) showed bilateral retrobulbar stranding concerning for hemorrhage and right orbital superior extraconal hematoma (black arrow) with mild mass effect on the superior rectus and levator palpebrae superioris, as well as right-sided proptosis with mild straightening of the optic nerve (asterisk). There was no clinical evidence of orbital compartment syndrome, and the decision was made to monitor the patient. On follow-up 4 months after initial injury, the patient reported complete resolution of her pain and double vision, with no persistent cosmetic defects. Retrobulbar hemorrhage is a rare but potentially vision-threatening finding in orbital trauma. Few reports have been published describing retrobulbar hemorrhage after asphyxiation. To our knowledge, this case is the first report of this finding in this setting. Physicians should be aware of this phenomenon to guide workup and management. Patients should also be aware of possible health consequences, including vision-threatening sequelae.FIG 1.FIG 2.

  PublisherDOI

• Controversies, consensuses, and guidelines for acute primary angle closure attack (APACA) by the Asia-Pacific Glaucoma Society (APGS) and the Academy of Asia-Pacific Professors of Ophthalmology (AAPPO)

  Asia-Pacific Journal of Ophthalmology · 2025-07-02 · 6 citations

  articleOpen access

  The Asia-Pacific Glaucoma Society (APGS), in collaboration with the Academy of Asia-Pacific Professors of Ophthalmology (AAPPO), convened a panel of 18 international experts from 10 countries/territories to identify areas of controversy and establish consensus on diagnosing and managing Acute Primary Angle Closure Attack (APACA). APACA is a relatively common and potentially vision-threatening ocular emergency, particularly in Chinese and Asian populations. With timely and appropriate intervention, favorable outcomes could be achieved. However, with the current treatment protocol, two areas need to be improved: 1) more rapid and consistent reduction of intraocular pressure (IOP), and 2) reducing the proportion of patients who develop chronic IOP elevation after resolution of an acute attack and successful laser peripheral iridotomy. The international panel of experts systematically revisited and debated alternative treatments to address the above issues. Consensus was evaluated using a five-point Likert scale (strongly agree, agree, neutral, disagree, and strongly disagree), in which each expert considered and voted anonymously and independently on each consensus statement. A statement consensus is established when the summation of votes for "agree" and "strongly agree" reaches a 75 % threshold. Argon laser peripheral iridoplasty, anterior chamber paracentesis, and laser pupilloplasty are considered appropriate and suitable options for rapid IOP reduction. Earlier phacoemulsification is effective in preventing further retinal ganglion cell loss and disease progression after APACA and is worth considering, provided adequate facilities and expertise are available. Further studies are warranted to evaluate the safety and efficacy of corneal indentation as a rapid and immediate treatment to lower IOP.

  PublisherDOI

• Periostin: a promising biomarker in nonspecific orbital inflammation and orbit-involving IgG4 disease

  Orbit · 2025-06-11

  articleSenior authorCorresponding

  PURPOSE: To demonstrate crisp, specific immunohistochemistry (IHC) for periostin and document its utility as a biomarker for nonspecific orbital inflammation (NSOI) and immunoglobulin G4-related orbital disease (IgG4-RD). METHODS: A multi-institutional retrospective study of both NSOI and IgG4-RD patients. Demographics, clinical disease location, and severity were recorded. Routine histologic sections of affected NSOI and IgG4-RD tissue and fibrocollagenous control tissue were interrogated with an anti-periostin antibody. RESULTS: Ten NSOI patients had orbital manifestations of variable severity involving the lacrimal gland, extraocular muscle, and diffuse or focal orbital tissue. 12 IgG4-RD disease patients had involvement of the lacrimal gland, multifocal orbital disease, or extra-orbital extension. Periostin IHC showed strong, diffuse positivity restricted to pathological fibrotic zones, sparing inflammatory and epithelial elements. This was observed in both the NSOI and IgG4 cases. CONCLUSION: Periostin is highly expressed in zones of pathologic fibrosis, indicating its potential role in NSOI and IgG4 disease pathogenesis and as a disease biomarker.

  PublisherDOI

Frequent coauthors

• Don O. Kikkawa

  University of California, San Diego

  126 shared

• Bobby S. Korn

  Fleet Science Center

  117 shared

• Michelle Ting

  Fleet Science Center

  55 shared

• Nicole J. Topilow

  Fleet Science Center

  37 shared

• Daniel J. Ozzello

  University of California, San Diego

  32 shared

• Eman Al-Sharif

  Smith-Kettlewell Eye Research Institute

  28 shared

• Jin Sook Yoon

  Severance Hospital

  27 shared

• Lilangi S. Ediriwickrema

  University of California, Irvine

  25 shared

Labs

• Shiley Eye InstitutePI

Awards & honors

• American Society of Ophthalmic Plastic and Reconstructive Su…