1: Korean J Ophthalmol. 2008 Mar;22(1):70-1. 

Retinal artery occlusion in a healthy pregnant patient.

Chung YR, Kim JB, Lee K, Lew HM.

Department of Ophthalmology, Ajou University School of Medicine, Suwon, Korea.

PURPOSE: We report a case of branch retinal artery occlusion (BRAO) in a healthy
pregnant woman. METHODS: A 29-year-old pregnant woman presented with decreased
vision in her left eye. She had a pale retina with macular edema consistent with
BRAO. An extensive workup was performed to determine an etiologic factor. All
test results were within normal limits except for her factor VIII activity. Her
visual acuity improved from finger counting to 20/30 over 2 months without any
treatment. RESULTS: This case suggests that BRAO can occur in healthy patients
without any systemic or ocular disorders. CONCLUSIONS: BRAO can occur in healthy
patients without any systemic or ocular disorders, despite an extensile
evaluation.

PMID: 18323711 [PubMed - in process]

2: Korean J Ophthalmol. 2008 Mar;22(1):66-9. 

Bilateral ophthalmic artery occlusion in rhino-orbito-cerebral mucormycosis.

Song YM, Shin SY.

Department of Ophthalmology, Hanyang University College of Medicine, Seoul,
Korea.

PURPOSE: To report a case of bilateral ophthalmic artery occlusion in
rhino-orbito-cerebral mucormycosis. METHODS: Reviewed clinical charts,
photographs, and fluorescein angiography RESULTS: An 89-year-old man with poorly
controlled diabetes developed sudden bilateral ptosis, complete ophthalmoplegia
of the right eye, and superior rectus palsy of the left eye. Brain and orbit
magnetic resonance imaging showed midbrain infarction and mild diffuse
sinusitis. On the 2nd day of hospitalization, sudden visual loss and light
reflex loss developed. There were retinal whitening, absence of retinal arterial
filling, and a total lack of choroidal perfusion on fluorescein angiography of
the right eye. The left eye showed a cherry red spot in the retina and the
absence of retinal arterial filling and partial choroidal perfusion on
fluorescein angiography. On rhinologic examination, mucormyosis was noticed.
Despite treatment, visual acuity and light reflex did not recover and he died 4
days after admission. CONCLUSIONS: Bilateral ophthalmic artery occlusion can
occur in rhino-orbital-cerebral mucormycosis.

PMID: 18323710 [PubMed - in process]

3: Korean J Ophthalmol. 2008 Mar;22(1):63-5. 

A case of postoperative Sphingomonas paucimobilis endophthalmitis after cataract
extraction.

Seo SW, Chung IY, Kim E, Park JM.

Department of Ophthalmology, Gyeongsang National University, College of
Medicine, Jinju, Korea.

PURPOSE: To report a case of an acute onset of delayed postoperative
endophthalmitis that was caused by Sphingomonas paucimobilis. METHODS: This case
demonstrates an acute onset of delayed postoperative endophthalmitis at 3 months
after uneventful cataract extraction and posterior chamber intraocular lens
implantation. We performed vitrectomy, intraocular lens and capsular bag
removal, and intravitreal antibiotics injection. On the smear stains from the
aspirated vitreous humor, gram-negative bacilli were detected and S.
paucimobilis was found in culture. RESULTS: At three months after vitrectomy,
the best corrected visual acuity was 20/300. Fundus examination showed mild pale
color of optic disc and macular degeneration. CONCLUSIONS: Vitrectomy with
intravitreal ceftazidime injection had contributed to the favorable result in
case of an acute onset of delayed postoperatire endophthalmitis caused by S.
paucimobilis.

PMID: 18323709 [PubMed - in process]

4: Korean J Ophthalmol. 2008 Mar;22(1):58-62. 

A case of cataract surgery without pupillary device in the eye with
iridoschisis.

Lee EJ, Lee JH, Hyon JY, Kim MK, Wee WR.

Department of Ophthalmology, Seoul National University College of Medicine,
Seoul, Korea.

PURPOSE: To introduce a case of iridoschisis patient who underwent cataract
surgery successfully without pupil device. METHODS: A 64-year-old female who
showed iridoschisis of her both eyes underwent cataract operation at her right
eye without a pupillary device. The preoperative and postoperative
ophthalmologic examinations including visual acuity, intraocular pressure,
reaction of anterior chamber, and degree of damage on iris was evaluated
respectively. RESULTS: Cataract surgery was performed under topical anesthesia
through a clear corneal incision. Iris fibrils were held in place by ophthalmic
viscosurgical device (OVD, sodium hyaluronate 3%-sodium chondroitin sulfate 4%,
Viscoat) that was injected into the anterior chamber. A small capsulorrhexis was
made and the nucleus was delivered with low-power phacoemulsification, most of
which was performed under the anterior capsule. The iris came into contact with
the OVDs only and received no mechanical trauma. There were no intraoperative
complications such as tear of the iris, hyphema, loss of mydriasis, or rupture
of the posterior lens capsule. The edema of corneal stroma and inflammation of
anterior chamber was shown at immediate-postoperative period, but completely
subsided 2 weeks later. The visual acuity showed improvement from 20/400 to
20/30. CONCLUSIONS: In iridoschisis patients, there is a risk of aspiration of
iris fibers during cataract surgery. With adequate use of OVD and careful
modulation of surgical devices, cataract surgery was successfully performed
without using extra pupil-supporting device.

PMID: 18323708 [PubMed - in process]

5: Korean J Ophthalmol. 2008 Mar;22(1):53-7. 

A case report on the change of the refractive power after a blunt trauma.

Kim SI, Cha YJ, Park SE.

Department of Ophthalmology, Eulji University School of Medicine, Eulji Medical
Center, Seoul, Korea.

PURPOSE: To determine the pathogenesis of transient myopia after blunt eye
trauma. METHODS: In one patient, the refraction of both eyes (the left eye was
injured, but the right eye was not) was measured with an autorefractometer. The
cycloplegic refraction was measured at the early stage of trauma and again 3
months after the blunt eye injury. The angle and depth of the anterior chamber,
the ciliary body, and the choroids were examined by ultrasound biomicroscopy
(UBM) over 3 months. The depth of the anterior chamber, the thickness of the
lens, and the axial length were measured by A-scan ultrasonography in both eyes.
During the 3 months after the injury, we made comparisons between the menifest
and the cycloplegic refractions, the depths of anterior chambers, the thickness
of the lenses, the axial lengths, and the UBM-determined appearances of the
angles and depths of the anterior chambers, the ciliary bodies, and the choroids
in both eyes. RESULTS: We suspect that the depth reduction in the anterior
chamber, the increase in anterior to posterior lens diameter, and the edema in
the ciliary body are all related to the change in the refractive power following
the blunt trauma. CONCLUSIONS: Ultrasound biomicroscopy (UBM) and
ultrasonography of the anterior segment in the eye may be helpful to diagnose
and confirm changes in the refractive power that occur after trauma.

PMID: 18323707 [PubMed - in process]

6: Korean J Ophthalmol. 2008 Mar;22(1):49-52. 

Experience of Comamonas acidovorans keratitis with delayed onset and treatment
response in immunocompromised cornea.

Lee SM, Kim MK, Lee JL, Wee WR, Lee JH.

Department of Ophthalmology, Seoul National University College of Medicine,
Seoul, Korea.

PURPOSE: To report 2 cases of Comamonas acidovorans keratitis in
immunocompromised cornea. METHODS: A complete review of the medical records of
the two cases of Comamonas acidovorans keratitis. RESULTS: We found some
similarities in clinical courses of two cases. Both of them showed development
of keratitis during the management with corticosteroids, delayed onset, slow
response to antibiotics, and relatively less affected corneal epithelium.
CONCLUSIONS: Comamonas acidovorans is known as a less virulent organism. However
it can cause an indolent infection that responds slowly even to adequate
antibiotics therapy in immunocompromised corneas.

PMID: 18323706 [PubMed - in process]

7: Korean J Ophthalmol. 2008 Mar;22(1):43-8. 

Case report: femtosecond laser-assisted small incision deep lamellar endothelial
keratoplasty.

Lee DH, Chung TY, Chung ES, Azar DT.

Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University,
School of Medicine, Seoul, Korea.

PURPOSE: To report two cases of femtosecond laser-assisted small incision deep
lamellar endothelial keratoplasty (DLEK) for patients with corneal endothelial
decompensation by Fuchs dystrophy and glaucoma METHODS: Femtosecond laser
(IntraLase; IntraLase Corp., Irvine, CA) with 15 kHz of repetition rate, was
used for a 9.5 mm diameter by 400 micrometer thickness donor corneal lamellar
dissection. RESULTS: In Case 1, the graft was clear and compact without
interface haze, Orbscan showed smooth and regular corneal surface, specular
microscopy was unremarkable without sign of corneal endothelial damage, and
Optical coherence tomography showed uniform graft well attached to recipient
stroma with minimal interface reflection at 2 months postoperation. In Case 2,
the graft was clear and compact with minimal interface haze at 1 month
postoperation. Femtosecond laser-assisted small incision DLEK was safe and
technically feasible in our cases; however, further evaluation is required to
determine long-term effects.

PMID: 18323705 [PubMed - in process]

8: Korean J Ophthalmol. 2008 Mar;22(1):37-42. 

Differences in the histopathology and matrix metalloproteinase expression in
Tenon\'s tissue of primary open-angle glaucoma and primary angle-closure
glaucoma.

Seo JH, Park KH, Kim YJ, Yoo YC, Kang SH, Kim DM.

Department of Ophthalmology, Seoul National University College of Medicine,
Seoul, Korea.

PURPOSE: To investigate the differences in the histopathology and matrix
metalloproteinase (MMP) expression in the Tenon\'s tissue of primary open-angle
glaucoma (POAG) patients, primary angle-closure glaucoma (PACG) patients, and
non-glaucomatous patients. METHODS: POAG and PACG patients, who underwent a
trabeculectomy and had no history of ocular disease except glaucoma, were
enrolled. The number and instillation period of topical eye drops were reviewed.
For the controls, which were patients without glaucoma or a history of ocular
surgery, the Tenon\'s tissue was obtained in the course of retinal detachment
surgery. For glaucoma patients, the Tenon\'s tissue was obtained during the
trabeculectomy. H&E and Masson\'s trichrome staining and immunohistochemistry for
MMP-1, MMP-2, and MMP-9 were performed. A total of six eyes of POAG, six eyes of
PACG, and four control eyes were evaluated. RESULTS: The duration of topical
anti-glaucoma medication and the mean number of anti-glaucoma medications were
similar in the POAG and PACG groups. The levels of MMP-1 and 2 were elevated in
the POAG and PACG groups compared to the control group (p=0.03, 0.01,
respectively). Compared with the control group, the MMP-2 level was higher in
the POAG patients (p=0.01), whereas the MMP-1 was higher in the PACG patients
(p=0.04). The levels of MMP-9 in the POAG and PACG patients were not
significantly different from that of the control patients (p=0.48, 0.26). The
levels of MMP-2 were significantly lower in the PACG patients than in the POAG
patients (p=0.02). CONCLUSIONS: The MMP expression was altered in the Tenon\'s
tissue of glaucoma patients compared to the control group. The levels of MMP-2
were lower in the PACG patients than in the POAG patients. These results suggest
that there may be histopathological differences in the Tenon\'s tissue of POAG
and PACG patients.

Publication Types:
    Research Support, Non-U.S. Gov\'t

PMID: 18323704 [PubMed - in process]

9: Korean J Ophthalmol. 2008 Mar;22(1):32-6. 

Results of re-operation on the deviated eye in patients with sensory
heterotropia.

Kim MJ, Khwarg SI, Kim SJ, Chang BL.

Department of Ophthalmology, Seoul National University College of Medicine,
Seoul Korea.

PURPOSE: To evaluate the result of re-operation on the deviated eye of recurred,
consecutive or undercorrected sensory strabismus after surgery. METHODS: The
medical records of 11 patients who had received second strabismus operation on
the deviated eye due to recurred, consecutive or undercorrected sensory
strabismus were studied retrospectively. RESULTS: Among the 11 patients, five
patients were operated for recurred exotropia after surgery of sensory exotropia
(group 1), two for consecutive exotropia after surgery of sensory esotropia
(group 2), and four for undercorrected esotropia after surgery of sensory
esotropia (group 3). Re-operation was performed 19.2+/-12.6 years after the
first operation and the mean preoperative deviation before re-operation was
30.0+/-8.66 prism diopters (PD), 32.5+/-10.6PD, and 32.5+/-8.66PD, respectively.
In all cases, a small amount of recession or resection compared with the usual
surgical dosage was applied in re-operation on the deviated eye. The mean
follow-up period after re-operation was 12.3+/-14.2 (1-48 months). Among the 11
patients, postoperative deviations less than 10PD were achieved postoperatively
in 8 (72.7%) at 1 month and of the 8 patients with follow-up data beyond 6
months, 5 (62.5%) showed orthotropia within 10PD at 6 months or later.
CONCLUSIONS: The surgical result of re-operation on the deviated eye of
recurred, consecutive or undercorrected sensory strabismus after the first
surgery was satisfactory in spite of the reduced amount of surgical correction
compared with the surgical dosage recommended for the non-operated eye.

PMID: 18323703 [PubMed - in process]

10: Korean J Ophthalmol. 2008 Mar;22(1):26-31. 

Outcomes of 6 hour part-time occlusion treatment combined with near activities
for unilateral amblyopia.

Park KS, Chang YH, Na KD, Hong S, Han SH.

The Institute of Vision Research, Department of Ophthalmology, Yonsei University
College of Medicine, Seoul, Korea.

PURPOSE: To evaluate the outcome of the part-time occlusion therapy with near
activities in monocular amblyopic patients according to gender, age, severity of
amblyopia, and the cause of amblyopia. METHODS: Fifty eight patients who were
prescribed part-time occlusion therapy with near activity from July 1998 to
October 2004, were included in this retrospective study. All patients were
divided into groups by gender, age, severity of amblyopia, and the cause of
amblyopia. Main outcome measures were best corrected visual acuity, line
improvement, and success rate. RESULTS: At the end of patch therapy, visual
acuity improved from baseline by an average of 3.2+/-2.5 lines (0.33+/-0.26 log
MAR), and follow-up period was 19.71+/-14.61 months (1.62+/-1.20 years). At the
last follow-up, visual acuity improved from baseline by an average of 3.7+/-2.4
lines (0.38+/-0.26 log MAR), and follow-up period was 37.41+/-25.83 months
(3.08+/-2.12 years). The success rate was 86% (50 patients) at the end of patch
therapy. In 44 patients out of 50 patients (88%), the visual acuity was
maintained. While 43 patients out of 47 patients who were less than 7 years old
(91%) achieved success, 7 patients out of 11 patients 7 years or older (64%)
achieved success (p=0.035). CONCLUSIONS: Six-hour part-time occlusion treatment
combined with near activities appears to be favorable in treating 58 children
during follow-up of mean 3.08 years. The significant factor was the age at
initial treatment.

PMID: 18323702 [PubMed - in process]

11: Korean J Ophthalmol. 2008 Mar;22(1):18-25. 

Relationship between scanning laser polarimetry with enhanced corneal
compensation and with variable corneal compensation.

Kim KH, Choi J, Lee CH, Cho BJ, Kook MS.

Department of Ophthalmology, University of Ulsan, College of Medicine, Asan
Medical Center, Seoul, Korea.

PURPOSE: To evaluate the structure-function relationships between retinal
sensitivity measured by Humphrey visual field analyzer (HVFA) and the retinal
nerve fiber layer (RNFL) thickness measured by scanning laser polarimetry (SLP)
with variable corneal compensation (VCC) and enhanced corneal compensation (ECC)
in glaucomatous and healthy eyes. METHODS: Fifty-three eyes with an atypical
birefringence pattern (ABP) based on SLP-VCC (28 glaucomatous eyes and 25 normal
healthy eyes) were enrolled in this cross-sectional study. RNFL thickness was
measured by both VCC and ECC techniques, and the visual field was examined by
HVFA with 24-2 full-threshold program. The relationships between RNFL
measurements in superior and inferior sectors and corresponding retinal mean
sensitivity were sought globally and regionally with linear regression analysis
in each group. Coefficients of the determination were calculated and compared
between VCC and ECC techniques. RESULTS: In eyes with ABP, R2 values for the
association between SLP parameters and retinal sensitivity were 0.06-0.16 with
VCC, whereas they were 0.21-0.48 with ECC. The association of RNFL thickness
with retinal sensitivity was significantly better with ECC than with VCC in 5
out of 8 regression models between SLP parameters and HVF parameters (P<0.05).
CONCLUSIONS: The strength of the structure-function association was higher with
ECC than with VCC in eyes with ABP, which suggests that the ECC algorithm is a
better approach for evaluating the structure-function relationship in eyes with
ABP.

PMID: 18323701 [PubMed - in process]

12: Korean J Ophthalmol. 2008 Mar;22(1):10-7. 

Relationship between the retinal thickness analyzer and the GDx VCC scanning
laser polarimeter, Stratus OCT optical coherence tomograph, and Heidelberg
retina tomograph II confocal scanning laser ophthalmoscopy.

Ma KT, Lee SH, Hong S, Park KS, Kim CY, Seong GJ, Hong YJ.

Siloam Eye Hospital, Seoul, Korea.

PURPOSE: To assess the relationship between the retinal thickness analyzer (RTA)
parameters, and those of the GDx VCC scanning laser polarimeter (GDx VCC),
Stratus OCT optical coherence tomography (Stratus OCT), and Heidelberg retinal
tomograph II confocal scanning laser ophthalmoscopy (HRT II). METHODS:
Twenty-nine primary open-angle glaucoma patients were retrospectively included
in this study. Measurements were obtained using the RTA, GDx VCC, Stratus OCT,
and HRT II. We calculated the correlation coefficients between the parameters of
RTA and those of the other studies. RESULTS: Among the optic disc parameters of
RTA, the cup volume was best correlated with Stratus OCT (R=0.780, p<0.001) and
HRT II (R=0.896, p<0.001). Among the posterior pole retinal thickness
parameters, the posterior pole abnormally thin area (PPAT) of the RTA and the
inferior average of the GDx VCC were best correlated (R=-0.596, p=0.001). The
PPAT of the RTA and the inferior maximum of the Stratus OCT were best correlated
(R=-0.489, p=0.006). The perifoveal minimum thickness (PFMT) of the RTA and the
cup shape measurement of the HRT II were best correlated (R=-0.565, p=0.004).
CONCLUSIONS: Many RTA optic disc parameters were significantly correlated with
those of the Stratus OCT and HRT II. The RTA posterior pole retinal thickness
parameters were significantly correlated with those of the GDx VCC, Stratus OCT
and HRT II. The RTA optic disc and posterior pole retinal thickness parameters
may be valuable in the diagnosis of glaucoma.

PMID: 18323700 [PubMed - in process]

13: Korean J Ophthalmol. 2008 Mar;22(1):6-9. 

Pulsatile ocular blood flow in healthy Koreans.

Kim SK, Cho BJ, Hong S, Kang SY, Kim JS, Kim CY, Seong GJ.

Institute of Vision Research, Department of Ophthalmology, Yonsei University
College of Medicine, Seoul, Korea.

PURPOSE: To determine the normal reference range of pulsatile ocular blood flow
(POBF) values in healthy Korean subjects and to find out the factors that may
affect them. METHODS: A total of 280 eyes of 280 normal subjects were included
in this study. Best corrected visual acuity (BCVA), intraocular pressure (IOP),
axial length, POBF, systemic blood pressure, and pulse rate were measured. The
mean, standard deviation, range, and the 5th and 95th percentiles of POBF were
calculated, and the influences of various parameters to POBF were determined by
multiple regression analyses. RESULTS: The mean POBF value was 766.0+/-221.6
microl/min in men and 1021.1+/-249.5 microl/min in women. The 5th and 95th
percentiles for POBF values were 486.0 microl/min and 1140.0 microl/min in men
and 672.0 microl/min and 1458.0 microl/min in women. The POBF values were
significantly influenced by gender, mean blood pressure, pulse rate, and axial
length. CONCLUSIONS: Even though the POBF values were influenced by gender, BP,
and axial length, we could define the normal reference range of POBF in healthy
Koreans.

PMID: 18323699 [PubMed - in process]

14: Korean J Ophthalmol. 2008 Mar;22(1):1-5. 

Long-term visual outcome of arteriovenous adventitial sheathotomy on branch
retinal vein occlusion induced macular edema.

Oh IK, Kim S, Oh J, Huh K.

Department of Ophthalmology, College of Medicine, Korea University, Seoul,
Korea.

PURPOSE: To evaluate long-term visual outcome of arteriovenous adventitial
sheathotomy in BRVO-induced macular edema. METHODS: The visual outcomes of 8
patients following vitrectomy with arteriovenous adventitial sheathotomy for
BVO-induced macular edema (surgery group) were retrospectively evaluated. The
three-year post-operative visual acuity of the surgery group was compared with
that of the conservatively managed controls. RESULTS: All patients were followed
for a minimum of 36 months. Mean BCVA (logMAR) in the surgery group changed from
1.10+/-0.34 to 1.19+/-0.70 and to 0.80+/-0.36 at 12 and 36 months, respectively
(p=0.959 at 12 months, p=0.018 at 36 months). In the control group, visual
acuity improved from 1.15+/-0.43 to 0.43+/-0.44 and to 0.43+/-0.39 at 12 and 36
months, respectively (p=0.015 at 12 months, at p=0.003 at 36 months). A strong
trend toward better visual acuity at 12 months and final examination was
observed for controls. (surgery vs. control group, p=0.052 at 12 months, p=0.066
at 36 months). CONCLUSIONS: Considering the favorable natural course of BVO and
the unproven effect of reperfusion on macular edema, surgical efficacy of
arteriovenous adventitial sheathotomy requires further evaluation.

PMID: 18323698 [PubMed - in process]