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김훈동,박상혁,온영훈 대한안과학회 2010 대한안과학회지 Vol.51 No.4
Purpose: To introduce the clinical utility of multifocal visual evoked potential (mfVEP) and to assess the waveform from normal Korean subjects. Methods: mfVEP with 4 channel recording was performed using the RETIscanⓇ system (Roland Consult, Wiesbaden, Germany) for 25 eyes of 25 normal subjects. Amplitudes and implicit times were obtained from ring-shaped 6 areas and 4 sectors. To investigate the false-positive ratio of the examination, stimuli were given with one-half of the CRT monitor completely covered and the results were compared. Results: Amplitudes of P1, N2 were larger in the central 10°area than other areas (p<0.001). Amplitudes were reduced and implicit times were prolonged on peripheral areas. P1 amplitudes were larger in the inferior field. Waves with large amplitudes by noise were recorded in 13.7% of covered areas. Conclusions: mfVEP is useful tool to detect local optic nerve damage and rule out the non-organic cause of visual field defect. However, mfVEP results are difficult to interpret due to noise and poor patient cooperation. Standardization of mfVEP is necessary for its application. J Korean Ophthalmol Soc 2010;51(4):532-541
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비전형적인 임상양상을 보인 칸디다 파라프실로시스 각막염 1예
김훈동,김소영,정문선,Hoon Dong Kim,So Young Kim,Moon Sun Jung 대한안과학회 2010 대한안과학회지 Vol.51 No.1
Purpose: To report a case of Candida parapsilosis keratitis with atypical presentation demonstrated by subepithelial white dot deposits without peripheral inflammatory reaction. Case summary: A 45-year-old woman with Stevens-Johnson syndrome had used topical corticosteroid and bandage contact lens due to recurrent epithelial defect and keratitis. Multiple subepithelial white dot deposits were revealed on the central corneal area without surrounding inflammation. The corneal lesion was improved after epithelial debridement with topical antibiotics and steroid eyedrops. A few months later, however, the corneal lesion recurred. Smear cytology was performed, and yeast-formed fungi and pseudohyphae were found. C. parapsilosis was identified in the culture study. Therefore, the topical steroid was withdrawn and 0.15% topical Amphotericin was applied. The corneal lesion improved and corneal opacity did not progress. Conclusions: The case reported in this study is C. parapsilosis keratitis with multiple subepithelial white dot deposits without typical presentations of fungal kertitis. Although no typical infectious indication was evident, infection should be suspected in patients who show abnormal corneal lesion under immunosuppressive treatment. J Korean Ophthalmol Soc 2010;51(1):136-140
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김훈동,박상혁,온영훈,박수은 대한안과학회 2009 대한안과학회지 Vol.50 No.10
Purpose: To evaluate the nature of photopic negative response (PhNR) in normal subjects. Methods: The electroretinogram (ERG) waves were recorded in 52 eyes of 26 normal subjects with UTAS E-3000Ⓡ (LKC Technologies Inc., Gaithersberg, MD, USA). Photopic cone response was obtained for analysis from a white flash with white background illumination (group 1) and a red flash with blue background illumination (group 2), after stimulations ranging from 0.007674 cd.s/m² (-25dB) to 7.736 cd.s/m² (5dB) with a 5dB interval. Results: PhNRs were observed in all 52 eyes in group 1 stimulated with the white flash at 0.9933 cd.s/m² (-4dB). PhNRs were also observed in all 52 eyes in group 2 at 2.4297 cd.s/m² (0dB) after stimulation with the red flash. There was correlation between the amplitudes of PhNR and intensity of stimuli (p <0.001). Implicit times of PhNR were correlated with age in both groups, but amplitudes decreased with age in group 1. Conclusions: The amplitudes of PhNR were correlated with intensity of stimuli and age had an influence on PhNR. Standardization of examination conditions is necessary when recording PhNR. 목적: 정상안에서 나타나는 명음성반응(photopic negative response, PhNR)의 특징에 대하여 알아보고자 하였다. 대상과 방법: 정상인 26명, 52안을 대상으로 UTAS E-3000Ⓡ (LKC Technologies)을 이용하여 망막전위도를 시행하였다. 각 대상에 대해 백색 배경하 백색자극(1군)을 주고, 청색 배경하 적색자극(2군)을 0.007674 cd.s/m²(-25dB)부터 7.736 cd.s/m² (5dB)까지 5dB 간격으로 가한 후 명음성반응의 측정값을 분석하였다. 결과: 1군은 0.9933 cd.s/m² (-4dB)에서, 2군은 2.4297 cd.s/m² (0dB)의 자극에서 모든 대상자에서 명음성반응이 나타났고, 자극 세기와 명음성반응의 진폭은 유의한 상관관계를 보였다(p<0.001). 두 군 모두에서 연령이 증가하면서 반응도달시간이 길어졌고, 1군에서는 연령이 증가함에 따라 진폭도 감소하는 것으로 나타났다. 결론: 명음성반응은 자극의 종류와 자극의 세기, 피검자의 연령에 따라 진폭과 반응도달시간에 차이가 있었다. 따라서 정확한 검사를 위하여 명음성반응의 측정에 있어 검사 조건의 표준화가 필요하다.
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Goldmann Applanation, Dynamic Contour, Non-contact Tonometer를 이용한 백내장 수술 전후 각막의 변화에 따른 안압 측정 비교
김훈동,하승주 순천향의학연구소 2008 Journal of Soonchunhyang Medical Science Vol.14 No.2
Background : To evaluate the intraocular pressure using Dynamic contour tonometer (DCT), Goldmann applanation tonometer (GAT), Non-contact tonometer (NCT) according to the changes of corneal biomechanical characteristics for patients with cataract extraction Methods : From Jan 2007 to Dec 2007, intraocular pressure was evaluated using DCT, GAT and NCT for 48 patients (55 eyes) who underwent phacoemulsification with posterior chamber IOL implantation in this period. And central corneal thickness (CCT) and corneal curvature were examined with ultrasonic pachymetry and autokeratometry. Results : Intraocular pressures using DCT, NCT and GAT were decreased at postop 1 day, and get back to preop value at postop 7 day. Corneal curvature and CCT were decreased at postop 1 day and restored at postop 7 day. DCT has no correlation with CCT and cornel curvature. Conclusions : Changes in bi1)omechanical characteristics like corneal thickness, curvature, hysteresis are able to make an error in intraocular pressure evaluation. But DCT can check the intraocular pressure without influence of central corneal thickness and corneal curvature resulted from cataract extraction. DCT is a reliable and useful method to reduce the error during IOP measurement for patients with cataract extraction.
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당뇨황반부종에서 유리체내 베바시주맙 및 후테논낭하 스테로이드 주입술 병합요법의 효과
김훈동,최경식,이성진 대한안과학회 2009 대한안과학회지 Vol.50 No.11
목적: 당뇨황반부종에서 유리체내 베바시주맙과 후테논낭하 트리암시놀론 주입술의 병합요법을 각각의 단독요법과 비교하였다. 대상과 방법: 당뇨황반부종이 있는 83명, 90안을 대상으로 각 30안씩 무작위로 유리체내 베바시주맙 주입술 (IVB 군), 후테논낭하 트리 암시놀론 주입술(STTA 군) 및 병합요법(combined 군)을 시행하였고, 술 전 및 술 후 1, 3, 6개월의 시력, 중심황반두께 및 안압의 변화를 비교하였다. 결과: 세 군 모두 중심황반두께의 감소가 술 후 3개월까지 유지되다가 6개월째에 다시 증가하였고, 시력 호전은 술 후 3개월까지 유지되 다가 6개월 후에 다시 감소하는 양상을 보였다. 술 후 초기 1개월간 중심황반두께의 감소량 및 시력 호전량은 병합요법에서 가장 크게 나타 났다(p=0.003, p=0.021). 관찰 기간 중 안내염, 망막박리 등의 심각한 합병증은 관찰되지 않았고, 총 3안에서 안압 상승이 관찰되었다. 결론: 당뇨황반부종에서 유리체강내 베바시주맙과 테논낭하 트리암시놀론 주입술의 병합요법은 각각의 단독요법에 비하여 시력 호전과 중심황반두께 감소에 있어 초기 1개월에 높은 치료 효과를 보였으며, 3개월 이후에는 비슷하였다. Purpose: To investigate the outcomes of the combined therapy of intravitreal bevacizumab (IVB) and posterior sutbtenon triamconolone acetonide (STTA) injections as compared to single injections of each in patients with diabetic macular edema (DME). Methods: IVB injection (IVB group), STTA injection (STTA group) and combined therapy injection (combined group) were performed randomly for 90 eyes (83 patients) diagnosed with DME. Changes in central macular thickness (CMT), best corrected visual acuity (BCVA) and intraocular pressure (IOP) were compared among groups prospectively at pre-injection and one, three and six months after injection. Results: Reduction of CMT and improvement of BCVA were maintained for three months after treatment in all groups, but CMT and BCVA deteriorated at six months after treatment. The combined therapy group revealed significant reductions in CMT and improvement of BCVA (p=0.003, p=0.021, respectively) for the first month compared to the single treatment group. Elevated IOPs were found in three cases and there was no endophthalmitis or retinal detachment. Conclusions: The combined therapy injection showed significant early improvements in CMT and BCVA for one month. Additionally, the combined therapy revealed similar outcomes as compared with each single treatment after three months.
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