Retrocorneal Membrane After Descemet Membrane Endothelial Keratoplasty

Yum, Hae Ri,Kim, Man Soo,Kim, Eun Chul by Lippincott Williams Wilkins. 2013 Cornea Vol.32 No.9

PURPOSE:: To describe a retrocorneal membrane after Descemet membrane endothelial keratoplasty (DMEK). METHODS:: Case report and review of the medical literature. RESULTS:: A 73-year-old woman diagnosed with bilateral pseudophakic bullous keratopathy underwent DMEK in her left eye. Her preoperative best-spectacle-corrected visual acuity OD was 20/500 and OS was 20/500. After DMEK, graft detachment was found on the first and second postoperative days. Graft repositioning with air was performed 2 times. One month after DMEK, a membranous structure was identified behind the cornea by slit-lamp examination. The patient was applying topical levofloxacin 0.5% (Cravit; Santen, Japan) and prednisolone acetate 1% (Pred Forte; Allergan, Irvine, CA) 4 times per day. Two months after DMEK, the retrocorneal membrane disappeared, and the patient’s best-corrected visual acuity OS improved to 20/40. CONCLUSIONS:: We report the first case of retrocorneal membrane formation after DMEK surgery.

Identification of a Fibrillin1 Gene Mutation in a Monozygotic TwinPresenting with Bilateral Juve-nile-onset Ectopia Lentis

( Hae Ri Yum ),( Sung Eun Kim ),( Sun Young Shin ),( Shin Hae Park ) 대한안과학회 2015 Korean Journal of Ophthalmology Vol.29 No.1

Changes in ocular factors according to depth variation and viewer age after watching a three-dimensional display

Yum, Hae Ri,Park, Shin Hae,Kang, Hang-Bong,Shin, Sun Young BMJ Publishing Group Ltd 2014 British journal of ophthalmology Vol.98 No.5

<P><B>Objective</B></P><P>To investigate changes in ocular factors according to the binocular disparity in three-dimensional (3D) images and age after watching 3D display.</P><P><B>Methods</B></P><P>A total of 38 volunteers were enrolled, and they watched a 3D display with a 1° or 3° disparity for 30 min at an interval of 1 week. The near point of accommodation (NPA), near point of convergence (NPC) and tear break-up time (tBUT) of each subject were measured before and after watching the 3D display. In addition, the tear meniscus height and depth were measured using Visante optical coherence tomography and tear osmolarity was measured using TearLab osmometer. A survey of subjective symptoms was also conducted.</P><P><B>Results</B></P><P>NPA and NPC increased after watching the 3D display (p<0.05). NPC and NPA increased more in the 40s–50s group (ie, subjects aged in their 40s and 50s) than in the 20s–30s group (ie, subjects aged in their 20s and 30s) after watching 3D content with a 3° disparity (p<0.05). tBUT and tear meniscus height and depth decreased after watching 3D content (p<0.05). They decreased more in the 40s–50s group than in the 20s–30s group after watching 3D content with a 3° disparity (p<0.05). Recovery times of NPA and NPC were significantly greater after watching 3D content with a 3° disparity and in the 40s–50s group (p<0.05).</P><P><B>Conclusions</B></P><P>Watching a 3D display affects accommodation and convergence abilities and tear dynamics in a transient fashion, especially in the case of 3D images with a large binocular disparity, and in older subjects. These results provide helpful information for establishment of guidelines for 3D equipment manufacturers.</P>

Changes in ocular parameters depending on the motion-in-depth of a three-dimensional display

Yum, Hae Ri,Park, Shin Hae,Kang, Hang-Bong,Shin, Sun Young British Medical Association 2015 British journal of ophthalmology Vol.99 No.12

<P><B>Objective</B></P><P>To compare changes in ocular parameters after watching a display of three-dimensional (3D) images, with reference to motion-in-depth and viewer age.</P><P><B>Methods</B></P><P>A total of 30 healthy subjects were enrolled (of whom 17 were aged 20–30 years and 13, 40–50 years). All subjects watched 3D displays with binocular disparities of 1° or 3° run towards the viewer (who wore polarised glasses) at two defined velocities (slow, 105 mm/s; fast, 257 mm/s) for 15 min at intervals of 1 week. The viewing distance was 1.020 m. The near point of accommodation (NPA) and near point of convergence (NPC), and the tear break-up time (tBUT) of each subject, were measured before and after watching the 3D display. All parameters were repeatedly measured at intervals of 10 min after watching until baseline values became re-established.</P><P><B>Results</B></P><P>NPA and NPC deteriorated more, and tBUT decreased more, after watching a 3D display with fast rather than slow motion-in-depth (all p values <0.05). NPA deteriorated more in those aged 40–50 years as compared in those aged 20–30 years after watching a display of binocular disparity of 3° at fast motion-in-depth (p=0.028). NPC deteriorated more in those aged 40–50 years as compared in those aged 20–30 years after watching a display of binocular disparity of 3° at slow and fast motion-in-depth (p=0.001). The NPA and NPC recovery times were longer after watching at fast motion-in-depth than slow motion-in-depth (p<0.05). The decrease of tBUT was greater after watching at fast rather than slow motion-in-depth but only when the binocular disparity was 1°. All parameters returned to baseline values within 80 min.</P><P><B>Conclusions</B></P><P>Motion-in-depth has an important influence on ocular parameters when a 3D display is watched, and our information would provide some basis in manufacturing 3D equipment.</P>

라식 후 백내장 수술을 받은 근시 환자의 술 후 굴절력의 장기 변화

염혜리,김만수,Hae Ri Yum,Man Soo Kim 대한안과학회 2012 대한안과학회지 Vol.53 No.12

Purpose: To evaluate the long-term change of postoperative refraction after cataract surgery in patients with a history of LASIK. Methods: A retrospective chart review was performed on 40 eyes of 28 patients who had undergone cataract surgery with a history of LASIK, and 40 eyes of 31 patients who had undergone cataract surgery without LASIK. We evaluated preoperative target refraction, and postoperative refraction during the 2-year follow-up period. Results: In the group with a history of LASIK, the target refraction was -1.00 ± 0.98 D, the 2-month postoperative spherical equivalent was -0.53 ± 1.92 D, and the 2-year postoperative spherical equivalent was -1.03 ± 1.84 D. In the group with cataract surgery only, the target refraction was -1.44 ± 1.06 D, the 2-month postoperative spherical equivalent was -1.07 ± 1.27 D, and the 2-year postoperative spherical equivalent was -0.97 ± 1.28 D. The difference in mean spherical equivalent at 2 months postoperatively and at 2 years postoperatively between the 2 groups was statistically significant (p = 0.037). The difference in mean spherical equivalent preoperatively and 2 years postoperatively between the 2 groups was statistically significant (p = 0.002). In the group with cataract surgery only, the postoperative refraction shifted to hyperopic refractive power, and was statistically significant. In the group with a history of LASIK, there were no statistically significant differences between preoperative and postoperative refraction. There were no statistically significant differences according to the cataract type in the group with a history of LASIK. The greater the myopic preoperative spherical equivalent was, the shorter the duration between LASIK and cataract surgery, which was significant in the group with a history of LASIK. Conclusions: The long-term refractive change after cataract surgery was statistically significant between the cataract surgery after LASIK group and the cataract surgery alone group.

소아에서 급성 눈물샘염으로 발현된 비특이성안와염 1예

염혜리,강남여,Hae-ri Yum,Nam-Yeo Kang 대한안과학회 2011 대한안과학회지 Vol.52 No.11

Purpose: To report a case of idiopathic orbital inflammation presenting as unilateral acute dacryoadenitis in a child. Case Summary: A nine-year-old boy presented with painful swelling and redness in the right upper eyelid and temporal conjunctiva without systemic symptoms for five days. Acute orbital cellulitis was suspected but did not respond to systemic antibiotics. An orbital computed tomogram and magnetic resonance imaging revealed a diffusely enlarged and inflamed right lacrimal gland. The patient showed dramatic response to systemic corticosteroids, and acute dacryoadenitis due to idiopathic orbital inflammation was diagnosed. Treatment with oral corticosteroids for two months resolved the inflammation. No relapse was observed during four months of follow-up. Conclusions: Although rare, acute dacryoadenitis as a localized nonspecific orbital inflammation should be considered in the differential diagnosis of acute orbital cellulitis in pediatric patients. J Korean Ophthalmol Soc 2011;52(11):1357-1361

눈꺼풀 바닥편평세포암 1예

염혜리,조원경,백지선,양석우,Hae-Ri Yum,MD,Won-Kyung Cho,MD,Ji-Sun Paik,MD,Suk-Woo Yang,MD 대한안과학회 2011 대한안과학회지 Vol.52 No.12

Purpose: To report a rare case of basosquamous carcinoma of the eyelid, an aggressive tumor with a higher tendency for recurrence and metastasis. Case summary: An 87-year-old woman presented with a painful mass and bloody exudates at the left lateral lower eyelid. Four years previous, the patient was diagnosed with basosquamous carcinoma of the left lower eyelid after biopsy at another hospital. At that time, she was unable to receive operation because she had suffered from a serious heart condition. With time, the left lower eyelid mass continued to grow and symptoms and signs of pain and bloody exudates appeared. The patient underwent surgery for complete tumor resection and repair and the biopsy of a specimen showed tumor-free margins and no metastasis to distal sites. Conclusions: Basosquamous carcinoma is a subtype of basal cell carcinoma with aggressive behavior and a higher tendency for recurrence and metastasis. However, our case showed no recurrence with no metastasis to the nearby lymph nodes, vessels, or nerves. We report a case of basosquamous carcinoma of the eyelid at old age that was cured after operative resection. J Korean Ophthalmol Soc 2011;52(12):1519-1523

범발성 혈관내 응고증 환자에서 발현된 양안 망막중심정맥폐쇄 1예

정경인,염혜리,김인태,Kyoung In Jung,Hae Ri Yum,In Tae Kim 대한안과학회 2011 대한안과학회지 Vol.52 No.8

Purpose: To report a case of bilateral central retinal vein occlusion (CRVO) as one of the initial signs of disseminated intravascular coagulation (DIC). Case summary: A 33-year-old woman with a history of pregnancy-induced thrombotic thrombocytopenic purpura presented to our hospital with bilateral visual loss. On her initial visit, visual acuity was counting fingers at 30 cm in both eyes. Based on the findings of a funduscopic examination, the patient was diagnosed with bilateral CRVO. Laboratory tests confirmed the diagnosis of DIC combined with thrombotic thrombocytopenic purpura (TTP). Plasma exchange and transfusion of cryoprecipitate with fresh frozen plasma was performed. The ocular fundus findings did not improve. Despite medical treatment, the patient’s systemic condition deteriorated and she died of metabolic acidosis two weeks later. Conclusions: Bilateral central retinal vein occlusion occurred as a sign of aggravation of preexisting TTP and progression to DIC in the presented case. In patients with severe bilateral retinal venous changes, there should be a very high level of suspicion for presence or progression of systemic disease, with the possibility of effective early systemic evaluation and therapy. J Korean Ophthalmol Soc 2011;52(8):1005-1008

전체눈근육 마비로 처음 진단된 원발성 뇌하수체 림프종 1예

송석현(Seok Hyeon Song),염혜리(Hae Ri Yum) 대한검안학회 2017 Annals of optometry and contact lens Vol.16 No.4

Purpose: To report a patient with total ophthalmoplegia as the 1st manifestation due to a primary pituitary lymphoma (PPL). Case summary: A 62-year-old woman visited the ophthalmology clinic with 2-week history of right upper eyelid ptosis and binocular diplopia. Ophthalmologic evaluation showed a 7 mm dilated pupil in the right eye, relative afferent pupillary defect (RAPD), exotropia of 70 prism diopters in primary position and eye movement limitation in adduction (-4), elevation (-4), depression (-4), and abduction (-2) of the right eye. The patient suffered from right facial pain and headache, but no definite other systemic symptoms were found. Brain magnetic resonance imaging showed the pituitary macroadenoma. Trans-sphenoidal surgery was performed and the pathology confirmed an infiltration of the pituitary gland by a diffuse large B-cell lymphoma. A bone marrow biopsy, abdomen, pelvis, chest computed tomography, and total body positron emission tomography–computed tomography confirmed the absence of systemic involvement and thus the diagnosis of PPL was posed. The postoperative course was without complications. The patient underwent treatment with systemic chemotherapy. By 2 months postoperatively, the patient had complete resolution of the ptosis, relative afferent pupillary defect, pupil dilatation, diplopia, exotropia and eye movement limitation, and the best corrected visual acuity was approved. Conclusions: Although primary pituitary lymphoma hardly occurs, ophthalmic symptoms like ophthalmoplegia, diplopia, and ptosis can be the first sign of primary pituitary lymphoma. The patient can show recovery from ophthalmic symptoms and nervous symptoms with appropriate diagnosis and treatment.

안구회선에서 맹점지도검사의 진단적 유용성

이재훈(Jae Hoon Lee),염혜리(Hae Ri Yum),이세엽(Se Youp Lee),이영춘(Young Chun Lee) 대한안과학회 2016 대한안과학회지 Vol.57 No.6

목적: 이차하사근기능항진을 보이는 환자에서 수술 전후 안저사진검사와 맹점지도검사로 회선의 변화를 관찰하여, 맹점지도검사의 회선 측정이 진단적 유용성이 있는지 알아보았다. 대상과 방법: 이차하사근기능항진으로 진단된 11명(12안)을 환자군으로, 안운동 이상이 없는 10명(20안)을 대조군으로 하여 안구운동 검사, 안저사진검사와 험프리 자동시야검사를 시행하였다. 안구운동검사로 하사근기능항진 정도를 평가하였으며, 안저사진검사와 험프리 자동시야검사로 회선량을 각각 측정하였다. 환자군에서 수술은 하사근절제술 혹은 후전술을 시행하였고 수평사시가 동반된 경우에는 수평사시수술을 동시에 시행하였으며, 수술 1달 후 하사근기능항진 정도와 회선량을 측정하여 수술 전과 비교하였다. 결과: 환자군에서 하사근기능항진은 수술 전 +2.42 ± 0.63에서 수술 후 +0.50 ± 0.52로 감소되었으며 회선량은 환자군의 안저사진검사에서 수술 전 +14.15 ± 3.60°에서 수술 후 +7.47 ± 1.65° (p<0.001)로, 맹점지도검사에서 수술 전 +12.19 ± 1.62°에서 수술 후 +9.69 ± 1.75°(p=0.061)로 각각 감소되었다. 대조군에서 측정된 회선량은 안저사진검사에서 평균 +7.44 ± 1.62°, 맹점지도검사에 서 +7.24 ± 1.28°로 각각 측정되었다. 결론: 하사근기능항진 정도와 맹점지도검사에서 측정된 안구회선량은 유의한 상관관계를 보이지 않았으며 수술 전후 회선량 또한 유의한 차이를 보이지 않아 임상적 유용성은 적을 것으로 생각된다. <대한안과학회지 2016;57(6):957-962> Purpose: To evaluate diagnostic the usefulness of blind spot mapping in measuring ocular torsion changes and to investigate the correlations of inferior oblique muscle overaction (IOOA) and excyclotorsion measurements using fundus photographs and blind spot mapping in patients with secondary IOOA. Methods: Eleven patients (12 eyes; IOOA group) diagnosed with secondary IOOA were evaluated for ocular movement, fundus photograph and Humphrey standard automated perimetry, and 10 patients (20 eyes; control group) were subjected to the same tests. An ocular movement examination was performed to evaluate IOOA, and fundus photograph and Humphrey standard automated perimetry were used to measure the ocular torsion. Inferior oblique myectomy or recession was performed along with horizontal strabismus surgery, and preoperative and postoperative IOOA and ocular torsion measurements were compared between the groups. Results: In the IOOA group after surgery, the IOOA decreased from +2.42 ± 0.63 to +0.50 ± 0.52, the ocular torsion decreased from +14.15 ± 3.60° to +7.47 ± 1.65° (p < 0.001) on fundus photographs, and from +12.19 ± 1.62° to +9.69 ± 1.75° (p = 0.061) in Humphrey standard automated perimetry. The control group showed a mean ocular torsion of 7.44 ± 1.62° on fundus photographs and +7.24 ± 1.28° on Humphrey standard automated perimetry. Conclusions: The usefulness of blind spot mapping when the ocular torsion was measured in IOOA patients was considered low, due to the weak correlation between IOOA and extorsion; preoperative and postoperative ocular torsion amount values were not significantly different. J Korean Ophthalmol Soc 2016;57(6):957-962