Achromobacter Xylosoxidans에 의한 만성눈물주머니염 1예

김체론,김규남,김경현,유지명,서성욱,Che Ron Kim,Gyu Nam Kim,Kyeong Hyeon Kim,Ji Myong Yoo,Seong Wook Seo 대한안과학회 2011 대한안과학회지 Vol.52 No.8

Purpose: To report a case of chronic dacryocystitis caused by Achromobacter xylosoxidans. Case summary: A 73-year-old female was referred to our clinic for management of chronic dacryosyctitis from which she did not to recover despite empirical therapy. A. xylosoxidans was isolated from purulent discharge. Based on the results of susceptibility testing, therapy was changed to fortified ceftazidime eye-drop 6 times a day and intravenous tazocin 4.5 g/20 ml (piperacillin 2 g/tazobactam 0.25 g) 3 times a day. All symptoms were resolved after treatment with sensitive antibiotics and external dacryocystorhinostomy. Conclusions: To our knowledge, this is the first report of A. xylosoxidans dacryocystitis. A. xylosoxidans are rare but potential pathogens which cause dacryocystitis. The cultures and sensitivity test were collected and processed to detect the presence of unusual pathogens in a case with persistent infection despite conventional treatment. J Korean Ophthalmol Soc 2011;52(8):979-983

Drechslera 균종에 의한 진균각막염 1예

김체론,서성욱,박종문,유지명,한용섭,김선주,김성재,Che Ron Kim,MD,Seong Wook Seo,MD,PhD,Jong Moon Park,MD,PhD,Ji Myung Yoo,MD,PhD,Yong Seop Han,MD,Sunjoo Kim,MD,PhD,Seong Jae Kim,MD 대한안과학회 2011 대한안과학회지 Vol.52 No.11

Purpose: To report a case of fungal keratitis caused by Drechslera species. Case summary: A 77-year-old man visited our clinic complaining of left ocular pain and decrease of visual acuity for 1 week On slit-lamp examination, epithelial defect and stromal infiltration on the corneal center with numerous inflammatory cells in the anterior chamber were found. There was no improvement after routine antibiotic treatment. A corneal biopsy and culture were performed on the corneal lesion. The KOH smear study reported hyphae, thus the patient was treated with 0.25% amphotericin B, 0.2% fluconazole and 5% natamycin eye drops. A clinical improvement was observed on the corneal lesion and Drechslera species was identified by the culture study. Conclusions: The authors report an experience of fungal keratitis caused by Drechslera species. J Korean Ophthalmol Soc 2011;52(11):1366-1369

가쪽눈구석에 발생한 저등급 악성 섬유성 조직구종 1예

김체론,김경현,유지명,서성욱,Che Ron Kim,Kyeong Hyun Kim,Ji Myung Yoo,Seong Wook Seo 대한안과학회 2010 대한안과학회지 Vol.51 No.8

Purpose: To report a case of malignant fibrous histiocytoma of the lateral canthal area that was diagnosed clinically as a benign epidermal inclusion cyst. Case summary: A 49 year-old man presented with a cutaneous mass involving the lateral canthal area. A 0.7-cm cystic lesion was freely movable and non-inflamed. After excisional biopsy, the results of immunohistochemical staining led to a final diagnosis of low-grade malignant fibrous histiocytoma. The specimen from excisional biopsy had margins positive for malignancy; the patient underwent a second procedure for complete resection, and that specimen had tumor-free margins. Conclusions: Fibrous histiocytoma is a rare disease but may occur in the eyelid. Therefore, when an eyelid tumor progresses rapidly, malignant fibrous histiocytoma should be considered as a diagnosis. J Korean Ophthalmol Soc 2010;51(8):1129-1132

마이토마이신 C가 흰 쥐의 속눈썹 재성장에 미치는 영향

김체론,유웅선,김경현,서성욱,Che Ron Kim,Woong Sun Yoo,Kyeong Hyun Kim,Seong Wook Seo 대한안과학회 2011 대한안과학회지 Vol.52 No.12

Purpose: The aim of the present study was to determine the effects of mitomycin C (MMC) on eyelash regrowth in rats. Methods: Ten rats were subjected to bilateral eyelid epilation. One drop of 0.04% MMC solution and one drop of normal saline was then administered to the right and left eyelid, respectively. Three months post-epliation, the number of regrown eyelashes was counted, and a section of tissue from each eyelid was examined under light- and electron microscopies. Results: The number of regrown long eyelashes was 1.0 ± 0.81 on the right, and 12.5 ± 1.08 on the left. The rate of regrowth was 7.35 ± 5.55% on the right and 98.45 ± 3.27% on the left. Histological examination revealed no significant differences between the right and left eyelids, except for the absence of any hair shafts in the follicles on the right. However, electron microscopy revealed mitochondrial damage in the follicles of the right eyelid. These changes were not observed in tissue from the left eyelid. Conclusions: The application of 0.04% MMC inhibited the regrowth of normal eyelashes in rats following simple epilation. These results suggest that MMC may be a novel therapy for replacing invasive surgery in trichiasis with no malpositioning. J Korean Ophthalmol Soc 2011;52(12):1501-1506

신경매독과 연관되어 발생한 안매독의 임상 양상

조용운,김체론,한용섭,정인영,박종문,Yong Wun Cho,MD,Che Ron Kim,MD,Yong Seop Han,MD,PhD,In Young Chung,MD,PhD,Jong Moon Park,MD,PhD 대한안과학회 2014 대한안과학회지 Vol.55 No.4

Purpose: To report the manifestation of ocular syphilis combined with neurosyphilis in patients who present with uveitis clinically and are diagnosed initially by an ophthalmologist. Methods: This study is a retrospective, clinical investigation of seven male patients with ocular syphilis from a single tertiary center between 2009 and 2012. Results: The average age of the patients at onset was 44.4 years (range, 33-71 years). Posterior segment involvement was found in all patients. Two patients had papillitis. In serologic testing, all patients had positive responses to Venereal Disease Research Laboratory (VDRL), fluorescent treponemal antibody-absorption test (FTA-ABS) and Treponema pallidum hemagglutination (TPHA). In fluorescein angiography (FAG), retinal vascular and disc leakage was the most common finding. Cerebrospinal fluid (CSF) analysis was performed for six patients and demonstrated positive CSF FTA-ABS and CSF TPHA tests in all patients. CSF VDRL was reactive in 2 patients (33.3%). Conclusions: All patients with ocular syphilis were diagnosed with neurosyphilis based on the analysis of CSF with FTA-ABS and TPHA. Ophthalmologists play an important role in the early diagnosis and treatment of syphilis. J Korean Ophthalmol Soc 2014;55(4):602-607

사시수술 후 빛간섭단층촬영을 이용한 눈물띠의 변화 분석

김지혜(Ji Hye Kim),김체론(Che Ron Kim),김성재(Seong Jae Kim),정인영(In Young Chung),서성욱(Seong Wook Seo),유지명(Ji Myong Yoo) 대한안과학회 2016 대한안과학회지 Vol.57 No.12

목적: 소아에서 사시수술 후 안구표면인자의 변화와 빛간섭단층촬영(optical coherence tomography, OCT)을 이용한 눈물띠의 변화 및 인공눈물 사용유무에 따른 변화를 관찰하고자 하였다. 대상과 방법: 25프리즘디옵터 이상의 외사시로 양안에 외직근 후전술을 시행한 환자 총 30명을 대상으로 하였다. 대상자들은 수술 후 인공눈물을 좌안에만 점안하였다. 눈물막파괴시간검사, Schirmer 검사, 각막염색검사, 결막압흔세포검사, OCT를 이용한 눈물띠 높이, 넓이 검사를 수술 전과 수술 후에 시행하여 비교 분석하였다. 결과: 대상자들의 평균나이는 8.7세였다. 수술 후 8주에 눈물막파괴시간검사, 각막염색검사는 인공눈물 점안을 시행한 경우 12.3 ± 1.5초, 1.3 ± 0.4였으며, 인공눈물을 사용하지 않은 경우 9.5 ± 1.0초, 2.0 ± 0.7로 측정되었다(모두 p<0.000). OCT를 이용한 눈물띠 높이와 넓이 검사에서 수술 후 4주에 인공눈물 점안을 시행한 경우 290.2 ± 42.3 μm, 566.7 ± 48.2 pixels였으며, 인공눈물을 점안하지 않은 경우 246 ± 45.5 μm, 504.0 ± 29.7 pixels로 양안의 유의한 차이를 보였다(p=0.045, p=0.019). 결막압흔세포검사에서 인공눈물을 사용 유무에 따라 수술 후 8주째 유의한 술잔세포 수 차이가 있었다(p=0.033). 결론: 사시 수술 후 발생한 눈물막의 불안정성을 눈물막파괴시간검사, Schirmer 검사, 각막염색검사, 결막압흔세포검사, OCT를 이용하여 확인할 수 있다. 수술 후 인공눈물의 점안은 각결막의 빠른 치유와 눈물막의 안정성을 높여 수술 후 발생하는 안구건조증의 치료에 도움이 된다. Purpose: In this study, the changes in ocular surface parameters and tear meniscus after strabismus surgery when treated with or without artificial tears were evaluated using optical coherence tomography (OCT). Methods: The present study included 30 patients who received bilateral lateral rectus recession surgery for exotropia. The patients instilled artificial tear eye drops only in the left eye. Before and 2, 4, 8, and 12 weeks after surgery, tear film break-up time (BUT), Schirmer’s test, corneal staining test, tear meniscus height and area were measured using OCT and compared in both eyes. Before and 8 weeks after surgery, conjunctival compression cytology test was performed. Results: The mean patient age was 8.7 years. After 8 weeks, BUT and corneal staining scores were 12.3 ± 1.5 seconds and 1.3 ± 0.4 in patients treated with artificial tears and 9.5 ± 1.0 seconds and 2.0 ± 0.7 in patients not treated with artificial tears (both p < 0.000). Four weeks after surgery, tear meniscus height and area using OCT were 290.2 ± 42.3 μm and 566.7 ± 48.2 pixels in patients treated with artificial tears and 246 ± 45.5 μm and 504.0 ± 29.7 pixels in patients not treated with artificial tears (p = 0.045 and p = 0.019, respectively). Goblet cell count was significantly different between the eyes 8 weeks after surgery (p = 0.033). Conclusions: Instability of tear meniscus can be detected after strabismus surgery using BUT, Schirmer’s test, corneal staining test, tear meniscus height and area, and OCT. After surgery, artificial tears help treat dry eye symptoms by corneo-conjunctival wound healing mechanism and increasing tear meniscus stability.

특발성 망막앞막, 황반원공에서 유리체 절제술 후 주입한 가스 종류에 따른 백내장 진행

안자영(Ja young Ahn),김체론(Che Ron Kim),공민귀(Min gui Kong),한용섭(Yong Seop Han),정인영(In Young Chung),박종문(Jong Moon Park) 대한안과학회 2016 대한안과학회지 Vol.57 No.11

목적: 특발성 망막앞막과 황반원공 환자에서 유리체 절제술 후 주입한 가스의 종류에 따른 백내장의 진행 정도를 알아보고자 하였다. 대상과 방법: 유리체 절제술 후 액체/공기 교환술(Group 1), 20% SF6 주입술(Group 2)을 시행 받은 환자를 대상으로 수술 전과 수술 후 1, 2, 4, 6, 12개월째의 Lens Opacities Classification System (LOCS) III 분류를 이용한 핵경화도, 굴절력(구면대응치)을 측정하였다. PentacamⓇ 샤임플러그 이미지를 image J 프로그램을 이용하여 mean nuclear density와 maximal nuclear density를 측정하여 비교 분석하였다. 결과: 총 40명, 40안 중 액체/공기 교환술만 시행한 환자(Group 1)는 21안, 20% SF6 가스를 주입한 환자(Group 2)는 19안이었다. 두 군 모두 수술안이 비수술안에 비해 mean nuclear density와 maximal nuclear density, LOCS III를 이용한 백내장 진행의 분석에서 핵경화의 진행이 빨랐다. 가스의 종류에 따른 비교에서 mean nuclear density는 수술 후 4개월째 두 군의 유의한 차이를 보였으며, maximal nuclear density는 수술 후 2개월과 4개월째 두 군의 유의한 차이를 보였다. LOCS III는 수술 후 2개월과 4개월째, 구면대응치는 수술 후 1개월부터 6개월까지 두 군에서 통계적으로 유의한 차이를 보였다. 결론: 유리체절제술 전과 수술 후의 백내장 진행 정도는 주입한 가스와 관계없이 수술안이 비수술안에 비해 핵경화의 진행이 빨랐다. 20% SF6 주입술(Group 2)을 시행 받은 군에서 핵경화의 진행이 더 빨리 일어난 것을 확인하였으나 수술 후 12개월에는 가스의 종류에 상관없이 핵경화의 변화 정도는 비슷했다. <대한안과학회지 2016;57(11):1745-1751> Purpose: To investigate the outcomes of quantitative lens nuclear opalescence change after pars plana vitrectomy and intravitreal gas injection in patients with idiopathic epiretinal membrane and macular hole. Methods: All patients were divided into two group according to the kinds of injected gases, either Group 1 (fluid/air exchange) or Group 2 (20% SF6 gas injection). Lens nuclear opalescence according to the classification of Lens Opacities Classification System (LOCS) III, mean nuclear density and maximal nuclear density of Pentacam?? scheimpflug image changed by image J, besides refractive errors were evaluated before surgery and 1, 2, 4, 6, and 12 months after surgery. Results: Out of 40 eyes of 40 patients included in the analysis, 21 received only fluid/air exchange (Group 1) and 19 received 20% SF6 gas injection (Group 2). There were significant changes in lens nuclear opalescence between the study and control (unaffected) eyes. In both groups, the study eyes experienced significant progression of cataract compared with the control eyes, in terms of mean nuclear density, maximal nuclear density and LOCS III. In comparison according to the kinds of injected gases, there was a significant difference in mean nuclear density after 4 months, maximal nuclear density after 2 months and 4 months, LOCS after 2 months and 4 months, and refractive error after 1, 2, 4, and 6 months between both groups (p = 0.003). Conclusions: After vitrectomy and intravitreal gas injection, changes in postoperative lens nuclear opalescence of the study eyes progressed more rapidly compared with the control eyes. This study identified that lens nuclear opalescence of Group 2 progressed rapidly, but after 12 months there was no significant difference of lens opacity between the kinds of injected gases. J Korean Ophthalmol Soc 2016;57(11):1745-1751