징병신체검사에서 의뢰된 성인 약시 환자의 무늬시유발전위의 양상

유웅선,박연정,유지명,Woong Sun Yoo,MD,Yeon Jung Park,MD,Ji Myong Yoo,MD,PhD 대한안과학회 2010 대한안과학회지 Vol.51 No.10

Purpose: To evaluate the pattern VEP in adult amblyopic patients seen in consultation for ophthalmic evaluation as a past of physical examinations for conscription. Methods: We retrospectively analyzed, 67 men, 20-year-old or older, who had pattern VEP done for the diagnosis of amblyopia from January 2004 to May 2009. P100 latency and P100 amplitude were analyzed. Results: Thirteen patients were non-amblyopic, and 54 patients had amblyopia. Binocular amblyopia and monocular amblyopia were found in 23 and 31 patients, respectively. In the binocular amblyopic patients, four patients were hyperopic, seven patients were myopic, and 12 patients were astigmatic amblyopia. In the monocular amblyopic patients, 15 patients were anisometropic, 12 patients were strabismic, and four patients had organic amblyopia. The value of P100 latency and P100 amplitude were statistically significantly different between non-amblyopic and amblyopic eyes, with check size of 32×32. However, the types of amblyopia among the patients were not different at a statistically significant level. Visual acuity and P100 amplitude were significantly positively correlated. Conclusions: VEP might be a useful tool for diagnosis of adult amblyopia, especially using a 32×32 check size. This tool may impart the ability to decide relationship between amblyopia and visual acuity by analyzing P100 latency and amplitude values. J Korean Ophthalmol Soc 2010;51(10):1392-1397

산소로 유도된 망막증 모델에서 트리암시놀론이 망막 혈관 관련 인자에 미치는 영향

유웅선,서성욱,박종문,유지명,정인영,Woong Sun Yoo,Seong Wook Seo,Jong Moon Park,Ji Myong Yoo,In Young Chung 대한안과학회 2012 대한안과학회지 Vol.53 No.12

Purpose: The present study investigated the effects of triamcinolone acetonide (TA) on retinal vessel-related factors and retinal vascular leakage in the retina of oxygen-induced retinopathy (OIR) rats. Methods: Sprague-Dawley rats used for OIR were exposed to hyperoxia from postnatal day 2 to day 14, then returned to normoxia from day 15 to day 30 and compared with control rats. On postnatal day 16, 2 μl of TA (4 mg/kg) was injected into the vitreous of the right eye in control and OIR rats. The Evans blue method was used for evaluating vascular leakage and RT-PCR was performed for confirmation of mRNA expression. Results: In OIR rats exposed to hyperoxia, retinal vascular permeability increased when returned to normoxia. After intravitreal injection of TA, vascular permeability was decreased in OIR rats, but no changes were found in control rats. In OIR rats, mRNAs of HIF-1α, VEGF, SDF-1 and ICAM-1 were more expressed and down-regulated after intravitreal injection of TA. Occludin mRNA level was decreased in the hypoxic condition and up-regulated after TA treatment. Conclusions: The present study suggests the ability of TA to inhibit retinal vascular leakage in OIR rats and a possibility that TA controls expression of the HIF-1, VEGF, SDF-1, ICAM-1 and Occludin, which may protect retinal vascular destruction from hypoxic conditions; further studies are necessary to confirm changes in protein levels.

경동맥 스텐트 삽입술로 완치된 안허혈증후군 1례

한용섭,유웅선,정인영,박종문,Yong Seop Han,MD,Woong Sun Yoo,MD,In Young Chung,MD,Jong Moon Park,MD,PhD 대한안과학회 2010 대한안과학회지 Vol.51 No.3

Purpose: To report a case of ocular ischemic syndrome successfully treated with delayed carotid angioplasty and stenting (CAS). Case summary: A 52-year-old male was admitted to our hospital because of amaurosis fugax- like symptoms in the right eye for several months. His visual acuity was 0.8 in the right eye and he did not have rubeosis iridis. Neovascularization of the disc, narrowing of the retinal artery and multiple retinal hemorrhages were diagnosed by fundus examination. Fluorescein angiography showed delayed choroidal filling, a delayed arm-to-retina time, prolongation of arteriovenous transit time, neovascularization of the disc, retinal capillary nonperfusion, and staining of the retinal vessels. MR angiography showed severe stenosis in the proximal portion of the right carotid artery. We diagnosed this case as ocular ischemic syndrome. The patient was recommended carotid angioplasty and stenting at the severely narrowed portion of the right carotid artery, but it was postponed about six months after diagnosis because of personal problems. At the final follow-up, 24 months after stenting, the amaurosis fugax symptoms had disappeared, the patient had an improved visual acuity of 1.0, and the new vessels on the disc changed to fibrous tissue. Fluorescein angiography showed resolution of the delayed arm-to-retina time and prolongation of the arteriovenous transit time, disappearances of the leakage around the disc and the retinal capillary nonperfusion. J Korean Ophthalmol Soc 2010;51(3):447-452

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

방사상각막신경염의 임상양상을 보인 세라티아 마르세센스 각막염 1예

김영준,김병선,유웅선,정인영,서성욱,유지명,김성재,Young Jun Kim,Byoung Seon Kim,Woong Sun Yoo,In Young Chung,Seong Wook Seo,Ji Myong Yoo,Seong Jae Kim 대한안과학회 2014 대한안과학회지 Vol.55 No.9

Purpose: To report a case of Serratia marcescens keratitis presenting as radial keratoneuritis. Case summary: A 15-year-old female who wore cosmetic and orthokeratology contact lenses but performed inadequate lens care visited our clinic with severe pain and visual disturbance in her left eye. On slit lamp examination, central corneal epithelial defect and stromal infiltration with radial keratoneuritis were observed. Based on clinical findings and past history, Acanthamoeba keratitis was highly suspected. The patient was treated with topical chlorhexidine 0.02% (Sigma-Aldrich Co., MO, USA) and moxifloxacin 0.5% (Vigamox<sup><font size=`2`>Ⓡ</font>, Alcon, TX, USA) per hour with 200 mg of oral itraconazol (Sporaone<sup><font size=`2`>Ⓡ</font>, LG, Seoul, Korea) once a day. Symptoms and corneal lesions did not improve after three days. After Serratia marsenscens was isolated from her contact lenses and solution, topical chlorhexidine 0.02% was discontinued, and intravenous ceftazidime (Tazime<sup><font size=`2`>Ⓡ</font>, Hanmi, Seoul, Korea) and fortified ceftazidime (50 mg/mL) eye drop was added. The corneal lesion dramatically improved, and after six months of follow-up, best-corrected visual acuity was 20/20 in the affected eye. Conclusions: Radial keratoneuritis can present not only in Acanthamoeba keratitis, but also in Serratia marsenscens keratitis. Confirmation of the isolated organism is useful when treating radial keratoneuritis. J Korean Ophthalmol Soc 2014;55(9):1380-1383

자연적으로 발생한 수정체 관련 포도막염 1예

김지혜(Ji Hye Kim),유웅선(Woong Sun Yoo),공민귀(Min Gui Kong),한용섭(Yong Seop Han),정인영(In Young Chung),서성욱(Seong Wook Seo),유지명(Ji Myong Yoo),김성재(Seong Jae Kim) 대한안과학회 2016 대한안과학회지 Vol.57 No.9

목적: 외상이나 수술의 과거력 없이 자연적으로 발생한 수정체 관련 포도막염을 진단하고 치료하였기에 보고하고자 한다. 증례요약: 77세 여성이 내원 4일 전부터 발생한 우안의 시력 저하 및 안통을 주소로 내원하였다. 환자는 우안에 외상이나 수술 등의 과거력은 없었으며, 내원 당시 교정시력은 우안 안전수동, 좌안 0.22였고 안압은 우안이 27 mmHg, 좌안은 15 mmHg로 측정되었다. 전안부 검사에서 우안에 각막 부종, 전방축농과 심한 염증으로 수정체는 관찰되지 않았으며 안구초음파 검사에서는 수정체 뒤쪽으로 유리체 혼탁이 보였다. 우안 안내염으로 진단하에 전방 천자를 통한 염색 및 배양검사, 전방세척술을 시행하였다. 전방세척술 후 전낭손상 없이 과숙백내장이 관찰되어 수정체낭외적출술을 시행하고 유리체내 항생제 주입술을 함께 시행하였다. 술 후 도말 검사 및 세균배양검사는 모두 음성이었으며, 광학현미경 검사에서 수정체단백을 포식한 대식세포가 관찰되어 과숙백내장으로 인해 발생한 수정체 관련 포도막염으로 진단하였다. 술 후 항생제와 스테로이드 안약을 점안하고 경구 스테로이드를 사용하였으며 염증의 재발없이 치료되었다. 결론: 안내염과 비슷한 양상으로 내원한 환자에서 과숙백내장에 의한 포도막염을 진단하고 치료하였기에 보고하고자 한다. Purpose: To report a case of phacoanaphylactic uveitis presenting as endophthalmitis. Case summary: A 77-year-old woman presented with sudden visual disturbance and painful red right eye. She did not have a history of trauma or surgery in her right eye. Her best corrected visual acuity was hand movement in the right eye and log MAR 0.22 in the left eye; intraocular pressure was 27 mm Hg in the right eye and 15 mm Hg in the left eye. Slit-lamp examination revealed corneal edema and prominent inflammation with hypopyon in the anterior chamber. B-scan showed vitreous opacity behind the lens. Based on the diagnosis of endophthalmitis, anterior chamber paracentesis and irrigation were performed. After irrigation, a hypermature cataract with intact anterior capsule was observed. Therefore, we performed extracapsular cataract extraction and intravitreal antibiotics injection. Gram staining of the aqueous humor revealed numerous macrophages filled with lens protein but no organisms. She was treated with hourly topical corticosteroid and an antibiotic agent. One month later, the anterior chamber is clear, and the cultures remained negative. Conclusions: We report a case of spontaneous phacoanaphylactic uveitis presenting as endophthalmitis in a patient with no history of eye trauma or surgery.

처음 진단된 습성 나이관련황반변성에서 라니비주맙 치료 및 연장 방법의 1년 결과 : 후향적 연구

최영제(Young-Je Choi),유웅선(Woong-Sun Yoo),조용운(Yong-Wun Cho),최유진(Yu-Jin Choi),정인영(In Young Chung) 대한안과학회 2021 대한안과학회지 Vol.62 No.7

목적: 습성 나이관련황반변성에서 라니비주맙 치료 및 연장 방법의 1년 결과와 같은 기간 내 약제를 변경하여 치료한 경우 임상결과를 알아보고자 하였다. 대상과 방법: 습성 나이관련황반변성으로 처음 진단되고 라니비주맙 치료 및 연장 방법으로 1년 이상 치료한 32안과 같은 기간 내에 약제를 변경하여 치료한 24안을 대상으로 주사 횟수, 중심망막두께 변화, 최대교정시력 변화를 후향적으로 분석하였다. 결과: 라니비주맙 치료 및 연장 방법으로 치료한 32안은 초기 최대교정시력은 평균 59.46 ± 15.13글자에서 12개월에 68.00 ± 12.48글자로 향상되었다. 초기 중심망막두께는 평균 409 ± 141 μm였고, 12개월에 273 ± 89 μm로 감소하였다. 1년간 평균 주사 회수는 7.2 ± 0.85회였다. 12개월간 주사와 관련된 합병증은 망막색소상피 찢겨짐이 1건 관찰되었으며, 전신적인 합병증은 관찰되지 않았다. 약제를 변경한 24안 중 애플리버셉트 3회 주사를 시행한 12안에서 초기 시력이 호전되거나 보존할 수 있었던 비율은 83% (10안)였으며, 중심망막두께는 초기 371.58 ± 109.96에서 290.33 ± 58.66으로 호전을 보였다. 결론: 1년간의 관찰에서 습성 나이관련황반변성에서 라니비주맙 치료 및 연장 방법은 효과적이고, 애플리버셉트로 변경한 경우 단기간의 결과 시력을 유지하는 경우가 많고, 해부학적 호전을 보일 수 있음을 알 수 있었다. Purpose: This study investigated the 1-year outcomes of a treat-and-extend regimen of ranibizumab for exudative age-related macular degeneration and examined the clinical results when drug treatment was changed within the same period. Methods: This retrospective analysis included 32 eyes first diagnosed with wet age-related macular degeneration and treated for more than 1 year with a treat-and-extend regimen of ranibizumab, as well as 24 eyes treated by changing from ranibizumab to aflibercept within the same period. The injection number, maximum injection interval, change in central retinal thickness, and best-corrected visual acuity were assessed in all eyes. Results: In 32 eyes that received a treat-and-extend regimen of ranibizumab, the mean best-corrected visual acuity improved from 59.46 ± 15.13 to 68.00 ± 12.48 at 12 months (p < 0.0001). The mean central retinal thickness decreased from 409 ± 141 μm to 273 ± 89 μm at 12 months (p < 0.0001). The average number of injections per year was 7.2 ± 0.85. One complication related to the 12 months of injections was a tear in the retinal pigment epithelium; no systemic complications were observed. Of 24 eyes that underwent a change in medication, the rate of maintenance or improvement in initial visual acuity was 83% (10 eyes). The central retinal thickness was initially 371.58 ± 109.96 μm, but improved to 290.33 ± 58.66 μm in 12 eyes that received three injections of aflibercept. Conclusions: At 1 year, good outcomes were obtained using treat-and-extend ranibizumab for exudative age-related macular degeneration. When the treatment was changed to aflibercept within the same period, vision was often maintained and short-term anatomical improvement was evident.

거대세포바이러스 각막내피염의 임상적 특징과 치료 경과

김영준(Young Jun Kim),유웅선(Woong Sun Yoo),한용섭(Yong Seop Han),정인영(In young Chung),서성욱(Seong Wook Seo),유지명(Ji Myong Yoo),박종문(Jong Moon Park),조민철(Min Chul Cho),김성재(Seong Jae Kim) 대한안과학회 2016 대한안과학회지 Vol.57 No.6

목적: 거대세포바이러스 각막내피염의 임상양상을 보고하고 치료 경과를 알아보고자 하였다. 대상과 방법: 전방수 천자로 획득한 전방수의 중합효소연쇄반응으로 진단하고 ganciclovir를 투여 받은 거대세포바이러스 각막내피염 환자 7명, 8안에 대해 의무기록을 후향적으로 분석하였다. 결과: 거대세포바이러스 각막내피염 환자 7명, 총 8안의 평균 추적관찰 기간은 17.8개월이었으며 1명은 양안의 각막내피염으로 진단 받았다. 모든 안에서 동전모양의 각막후면침착물이 발견되었고 경한(1+~2+) 전방내 염증소견이 관찰되었다. 8안 모두 ganciclovir를 투여하였으며 투여 3주 이후 모든 안에서 전방내의 염증이 사라졌다. 치료 후 마지막 평균 최대교정시력은 0.60 ± 0.40 (logMAR)에서 0.18 ± 0.18 (logMAR)로 의미 있게 증가하였으며 평균 안압은 30 mmHg에서 12 mmHg로 감소하였다. 8안 중 2안에서 재발하였으며, 1안은 전층각막이식술을 시행 받았으며 1안은 유리체강 내 ganciclovir 주입술을 시행하였다 결론: 안압의 상승과 동전 모양의 각막후면침착물이 동반된 경우 거대세포바이러스 각막내피염을 의심해야 하며 전방수 중합효소연쇄반응으로 진단 후 6주 이상의 ganciclovir 치료로 재발을 억제할 수 있다. Purpose: To elucidate the clinical manifestations of cytomegalovirus (CMV) endotheliitis, and evaluate the outcomes of treatment in CMV endotheliitis. Methods: We reviewed the medical records of 7 patients (8 eyes) who were diagnosed with CMV endotheliitis via a polymerase chain reaction (PCR) of aqueous humor and were treated with ganciclovir. Results: Eight eyes of 7 patients were followed for a mean of 17.8 months. One patient had bilateral corneal endotheliitis. All eyes had coin-shaped keratoprecipitates and mild anterior chamber inflammation (1+~2+). All eyes had an absence of anterior segment inflammation 3 weeks after ganciclovir treatment. Following treatment, the mean visual acuity improved significantly from 0.60 ± 0.40 (log MAR) at baseline to 0.18 ± 0.18 (log MAR) at last follow-up. The mean intraocular pressure (IOP) decreased significantly from 30 mm Hg at baseline to 12 mm Hg at last visit. Two eyes had a recurrence of corneal endotheliitis, where one underwent penetrating keratoplasty and the other was treated with intravitreal ganciclovir injection. Conclusions: Patients with increased IOP and coin-shaped keratoprecipitates are suspected to have CMV endotheliitis, and PCR of aqueous humor is needed to diagnose CMV endotheliitis. More than 6 weeks of ganciclovir treatment might be effective for CMV endotheliitis and may help prevent recurrence. J Korean Ophthalmol Soc 2016;57(6):863-875

Antiphospholipid Syndrome of Bilateral Nonarteritic Anterior Ischemic Optic Neuropathy Patient Deteriorating Over Time

조용운(Yong Wun Cho),김병선(Byoung Seon Kim),유웅선(Woong-Sun Yoo),서성욱(Seong-Wook Seo),정인영(In Young Chung) 대한안과학회 2021 Korean Journal of Ophthalmology Vol.35 No.2

망막분지정맥폐쇄에 동반된 황반부종에서 베바시주맙치료 결과

최유진(Yu-Jin Choi),최영제(Young Je Choi),조용운(Yong Wun Cho),유웅선(Woong-Sun Yoo),정인영(In Young Chung) 대한안과학회 2021 대한안과학회지 Vol.62 No.9

목적: 망막분지정맥폐쇄에 동반된 황반부종에서 유리체내 베바시주맙주입술 방법에 따른 치료 결과를 알아보고자 한다. 대상과 방법: 망막분지정맥폐쇄에서 첫 치료로 유리체내 베바시주맙을 주입한 62명 62안에 관하여 후향적으로 분석하였다. 초기 한 달 간격으로 3회 로딩 치료에 성공한 21안과 그렇지 않은 그룹 41안을 대상으로 주사 전과 주사 후 시기별 최대교정시력 및 빛간섭단층촬영의 소견 변화와 예후 관련인자를 분석하였다. 결과: 최대교정시력은 초기 3회 주입군에서 3회 로딩으로 치료하지 않은 군보다 3개월, 6개월, 12개월째 더 큰 호전을 보였다(p=0.025, p=0.019, p=0.008). 중심황반두께는 6개월째 초기 3회 주입군에서 3회 로딩으로 치료하지 않은 군보다 더 큰 호전을 보였다(p=0.034). 다변량 회귀분석 결과 증상 발현 기간, 3회 로딩, 최대교정시력, 망막내층손상, 맥락막두께가 시력호전 정도와 관련된 예측인자였으며(p=0.044, p=0.047, p=0.004, p=0.045, p=0.034), 연령, 3회 로딩, 최대교정시력, 망막내층손상이 최종 시력과 관련된 예측인자로 나타났다(p=0.045, p=0.046, p=0.002, p=0.034). 증상 발현 기간, 중심황반두께, 맥락막두께가 중심황반두께 호전에 관련된 예측인자로 나타났다(p=0.042, p=0.009, p=0.015). 결론: 망막분지정맥폐쇄의 황반부종에서 유리체내 베바시주맙 초기 3회 주입은 3회 로딩으로 치료하지 않은 방법에 비하여 단기적인 기능적 및 해부학적 호전과 장기적인 기능적 호전에 치료 우위적 효과를 보였다. Purpose: To evaluate the results of treatment according to the method of intravitreal injection of bevacizumab for macular edema due to branch retinal vein occlusion (BRVO). Methods: The clinical records of macular edema patients were analyzed retrospectively for a total of 62 eyes of 62 patients who were injected with bevacizumab into the vitreous as the first treatment for BRVO. Best-corrected visual acuity (BCVA), the findings of spectral-domain optical coherence tomography before and after injection, and prognosis-related factors were evaluated for 21 eyes that received the initial three monthly loading treatments and the 41 eyes that did not. Results: Significant improvement in BCVA was observed in the group having received the initial three injections compared with the group who did not receive the injections at 3, 6, and 12 months (p = 0.025, p = 0.019, and p = 0.008, respectively). The central macular thickness (CMT) showed greater improvement in the initial three injections group than the group without at 6 months (p = 0.034). Multivariate regression showed that the duration from the onset, the three loadings, BCVA, disorganization of the retinal inner layer (DRIL), and choroidal thickness were predictors related to visual gain (p = 0.044, p = 0.047, p = 0.004, p = 0.045, and p = 0.034, respectively). Age, three loadings, BCVA, and DRIL were predictors related to final visual acuity (p = 0.045, p = 0.046, p = 0.002, and p = 0.034, respectively). Duration from the onset, CMT, and choroidal thickness were predictors related to CMT improvement (p = 0.042, p = 0.009, and p = 0.015, respectively). Conclusions: In macular edema of BRVO, the initial three monthly intravitreal injections of bevacizumab provided superior treatment outcomes regarding short-term functional and anatomical improvements and long-term functional improvement, compared with methods that did not treat with the initial three monthly injections.