Surgical Results of Ahmed Valve Implantation With Intraoperative Bevacizumab Injection in Patients With Neovascular Glaucoma

Ma, Kyoung Tak,Yang, Jong Yun,Kim, Ji Hyun,Kim, Na Rae,Hong, Samin,Lee, Eun Suk,Seong, Gong Je,Kim, Chan Yun Lippincott Williams Wilkins, Inc. 2012 Journal of glaucoma Vol.21 No.5

PURPOSE: To investigate the surgical results of Ahmed valve implantation with intraoperative bevacizumab injection in patients with neovascular glaucoma (NVG). METHODS: A retrospective comparative case series review was conducted on 52 eyes with NVG who underwent Ahmed glaucoma valve implantation with or without intraoperative bevacizumab intravitreal injection. In the intraoperative intravitreous bevacizumab injection group (IVB group, 20 eyes), 1.25 mg of bevacizumab was injected into the vitreous cavity during Ahmed valve implantation. In the control group (32 eyes), only Ahmed valve implantation was performed. Surgical failure was defined when (1) the postoperative intraocular pressure was over 21 mm Hg at consecutive clinic visits, (2) the visual acuity became light perception negative, (3) additional antiglaucomatic surgery was required, or (4) devastating operative or postoperative complications were noted. RESULTS: Although the success rate in the IVB group (70.0%) was higher than that in the control group (62.5%) 1 year after operation, the differences were not statistically significant (P=0.828 by log-rank test). Mean intraocular pressures in the IVB group were significantly lower than those of the control group at 12 and 15 months (P<0.05 by the Mann-Whitney U test). Postoperative complications were similar between the 2 groups. Preoperative history of trabeculectomy was a significant risk factor for surgical failure of Ahmed valve implantation in NVG (relative risk=4.618; P=0.018 by Cox regression model). CONCLUSIONS: Intraoperative IVB injection does not seem to be helpful for better surgical outcomes of Ahmed valve implantation in NVG. A history of trabeculectomy is a risk factor for failure after Ahmed valve implantation in patients with NVG.

Relationship between the Retinal Thickness Analyzer and the GDx VCC Scanning Laser Polarimeter, Stratus OCT Optical Coherence Tomograph, and Heidelberg Retina Tomograph 2 Confocal Scanning Laser Ophthalmoscopy

( Kyoung Tak Ma ),( Sang Hyup Lee ),( Sa Min Hong ),( Kyoung Soo Park ),( Chan Yun Kim ),( Gong Je Seong ),( Young Jae Hong ) 대한안과학회 2008 Korean Journal of Ophthalmology Vol.22 No.1

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. Korean Journal of Ophthalmology 22(1):10-17, 2008

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

Kyoung Tak Ma,Sang Hyup Lee,Samin Hong,Kyoung Soo Park,Chan Yun Kim,Gong Je Seong,Young Jae Hong 대한안과학회 2008 Korean Journal of Ophthalmology Vol.22 No.1

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. Korean Journal of Ophthalmology 22(1):10-17, 2008

시운동 안진 반응과 시력과 상관 관계

마경탁,한승한,장지호,Kyoung-Tak Ma,M,D,Sueng-Han Han,M,D,Ji-Ho Chang,M,D 대한안과학회 2005 대한안과학회지 Vol.46 No.3

Purpose: The purpose of this paper was to determine the correlation between optokinetic nytagmus and grating and Snellen visual acuity charts and the validity of this correlation as an index. Methods: Diffusion blur was used to cause visual decrease in 24 patients with normal eyes. Vision was measured using 3 different methods. To compare the central and peripheral vision, visiual acuity was measured using a macula occluder. Results: Twenty four patients had an average uncorrected vision of 1.0 and showed regular visual acuity decrease using diffusion blur. Grating visual acuity showed correlation with the Snellen visual acuity but OKN visual acuity showed low correlation (p<0.05, ANOVA with repeated measure trend). OKN visual acuity showed low correlation with grating acuity when central visual acuity was occluded and only peripheral acuity was taken into consideration. Conclusions: Visual acuity measured using Snellen or grating acuity had little correlation with OKN visual acuity, and visual acuity measured using OKN was unable to indicate visual acuity in a quantitative manner.

A Case of Decreased Visual Field after Uneventful Cataract Surgery: Nonarteritic Anterior Ischemic Optic Neuropathy

Hun Lee,Chan Yun Kim,Gong Je Seong,Kyoung Tak Ma 대한안과학회 2010 Korean Journal of Ophthalmology Vol.24 No.1

The purpose of this article is to report a case of nonarteritic anterior ischemic optic neuropathy (NAION) after uneventful cataract surgery. A 53-year-old Filipina underwent cataract surgery. She had a small optic disc with cup-to-disc ratio of 0.2 in the left eye and 0.3 in the right eye. On the first postoperative day, the uncorrected visual acuity (UCVA) was 20/20, with an intraocular pressure (IOP) of 20 mmHg in the left eye. At one week after operation, the UCVA was 20/20 and the IOP was 15 mmHg. Three weeks later, she underwent cataract surgery in the right eye. On the first postoperative day, her UCVA was 20/20 in both eyes, but she complained of a visual field decrease in the left eye. A relative afferent pupillary defect (RAPD) was noted and the optic disc was pallid and swollen diffusely. A red-free photo showed defect surrounding the optic disc. A visual field test showed tunnel vision sparing the central vision. In this report, the authors hypothesize an association between cataract extraction and delayed NAION. Since the risk of NAION in the fellow eye is 30-50%, visual acuity, visual field, fundus exam and RAPD should be routinely checked.

Anterior Chamber Measurements by Pentacam and AS-OCT in Eyes With Normal Open Angles

( Jeong Ho Yi ),( Hun Lee ),( Samin Hong ),( Gong Je Seong ),( Sung Yong Kang ),( Kyoung Tak Ma ),( Chan Yun Kim ) 대한안과학회 2008 Korean Journal of Ophthalmology Vol.22 No.4

Purpose: To assess the reproducibility and agreement of anterior chamber measurements between the Pentacam (PTC) and the Anterior segment optical coherence tomography (AOCT) in normal healthy eyes with open angle. Methods: Prospective cross-sectional comparative case series. A total of 162 eyes of 81 healthy volunteers with normal open angle were included in this study. Anterior chamber angle (ACA) and anterior chamber depth (ACD) were measured with PTC and AOCT. Intra-observer variability and inter-methods agreement of both instruments for ACA and ACD were evaluated. Results: Values of temporal and nasal ACA measured by two instruments were similar, and the results of ACD were also not significantly different between modalities (p>0.01). ACA and ACD measurements by PTC and AOCT showed good intra-observer and inter-method agreements (all >0.9). Conclusions: PTC and AOCT are presumed to be very useful for the anterior chamber angle examination. They may provide good images and quantitative data about the angle structures including ACA and ACD. Korean J Ophthalmol 2008;22:242-245

Anterior Chamber Measurements by Pentacam and AS-OCT in Eyes With Normal Open Angles

Jeong-Ho Yi,Hun Lee,Samin Hong,Gong Je Seong,Sung Yong Kang,Kyoung Tak Ma,Chan Yun Kim 대한안과학회 2009 Korean Journal of Ophthalmology Vol.23 No.1

Purpose: To assess the reproducibility and agreement of anterior chamber measurements between the Pentacam (PTC) and the Anterior segment optical coherence tomography (AOCT) in normal healthy eyes with open angle. Methods: Prospective cross-sectional comparative case series. A total of 162 eyes of 81 healthy volunteers with normal open angle were included in this study. Anterior chamber angle (ACA) and anterior chamber depth (ACD) were measured with PTC and AOCT. Intra-observer variability and inter-methods agreement of both instruments for ACA and ACD were evaluated. Results: Values of temporal and nasal ACA measured by two instruments were similar, and the results of ACD were also not significantly different between modalities (p>0.01). ACA and ACD measurements by PTC and AOCT showed good intra-observer and inter-method agreements (all >0.9). Conclusions: PTC and AOCT are presumed to be very useful for the anterior chamber angle examination. They may provide good images and quantitative data about the angle structures including ACA and ACD.

Comparison of OCT and HRT Findings Among Normal, Normal Tension Glaucoma, and High Tension Glaucoma

In Ha Shin,Sung Yong Kang,Samin Hong,Seung Kab Kim,Gong Je Seong,MD,Kyoung Tak Ma,Chan Yun Kim 대한안과학회 2009 Korean Journal of Ophthalmology Vol.23 No.1

Purpose: To evaluate the relationship between optic disc and retinal nerve fiber layer (RNFL) measurements obtained with the optical coherence tomography (OCT) and the Heidelberg retina topography (HRT) in normal, normal tension glaucoma (NTG), and high tension glaucoma (HTG). Methods: Normal, NTG and HTG subjects who met inclusion and exclusion criteria were evaluated retrospectively. One hundred seventy eyes of 170 patients (30 normal, 40 NTG, and 100 HTG) were enrolled. Complete ophthalmologic examination, HRT, OCT, and automated perimetry were evaluated. Results: Disc area, cup area and cup/disc area ratio measured with HRT were significantly different between NTG and HTG (all p<0.05). Mean RNFL thickness measured by OCT with ascanning diameter of 3.4 mm was larger in NTG than HTG (84.97±24.20 μm vs. 73.53±27.17 μm, p=0.037). Four quadrant RNFL thickness measurements were not significantly different between NTG and HTG (all p>0.05). Mean deviation and corrected pattern standard deviation measured by automated perimetry was significantly correlated with mean and inferior RNFL thickness in both NTG and HTG (Pearson’s r, p<0.05). Mean RNFL thickness/disc area ratio was significantly larger in HTG than NTG (35.21±18.92 vs. 31.30±10.91, p=0.004). Conclusions: These findings suggest that optic disc and RNFL damage pattern in NTG may be different from those of HTG.