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.

The Effect of Swimming Goggles on Intraocular Pressure and Blood Flow within the Optic Nerve Head

마경탁,정우석,서경률,성공제,김찬윤 연세대학교의과대학 2007 Yonsei medical journal Vol.48 No.5

Purpose: Goggles are frequently worn in the sport of swimming and are designed to form a seal around the periorbital tissue orbit. The resultant pressure on the eye may have the potential to affect intraocular pressure and blood flow of the optic nerve head. This study evaluates the influence of wearing swimming goggles on intraocular pressure (IOP) and blood flow of the ocular nerve head (ONH) in normal subjects. Materials and Methods: Thirty healthy participants took part in this study. The IOP of each participant was measured using a Goldmann tonometer. Measurements were taken immediately before putting on swimming goggles, at 5, 10, 30, and 60 minutes after putting on swimming goggles, and then immediately after taking off the goggles. Blood flow of the ONH was measured using the Heidelberg retinal flowmeter. Results: The average IOP before, during and after wearing the swimming goggles were 11.88±2.82mmHg, 14.20±2.81 mmHg and 11.78±2.89mmHg, respectively. The IOP increased immediately after putting on the goggles (p<0.05) and then returned to normal values immediately after removal (p>0.05). Blood flow of the ONH was 336.60±89.07 Arbitrary Units (AU) before and 319.18±96.02 AU after the goggles were worn (p<0.05). Conclusion: A small but significant IOP elevation was observed immediately after the swimming goggles were put on. This elevated IOP was maintained while the goggles were kept on, and then returned to normal levels as soon as they were taken off. Blood flow of the ONH did not change significantly throughout the experiment. These facts should be considered for safety concerns, especially in advanced glaucoma patients.

Anterior Transposition of Inferior Oblique Muscle for Treatment of Unilateral Superior Oblique Muscle Palsy with Inferior Oblique Muscle Overaction

장윤희,마경탁,이종복,한승한 연세대학교의과대학 2004 Yonsei medical journal Vol.45 No.4

Although many weakening procedures for the inferior oblique muscle have been advocated, there is some controversy as to the most beneficial procedure for weakening overacting inferior oblique muscles. This study was undertaken to determine if unilateral anterior transposition of the inferior oblique muscle alone could be a safe and effective procedure for treating unilateral superior oblique palsy from the perspective of hypertropia, inferior oblique overaction, and abnormal head posture. The records of 33 patients, who underwent anterior transposition of the inferior oblique muscle for unilateral superior oblique palsy at our institution between Jan 1995 and Dec 2002, were retrospectively reviewed. The average preoperative inferior oblique overaction was 2.3±0.64, and the hypertropia in the primary position was 12.3±7.69 prism diopter (PD). Twenty-six patients showed head tilt to the opposite direction preoperatively. After the anterior transposition of the inferior oblique, inferior oblique overaction was diminished in 32 patients (97%). Twenty-six out of 33 patients (79%) had no hypertropia in the primary position at last postoperative assessment. Of the 26 patients with head tilt before surgery, 21 patients (81%) achieved full correction after surgery. Satisfactory results were obtained in most of the patients in our study with the exception of three patients who required additional surgery. No patient demonstrated postoperative hypotropia in the primary position. None of the patients noticed elevation deficiency or lower lid elevation. The anterior transposition of the inferior oblique was found to be safe and effective for treating superior oblique palsy with secondary overaction of the inferior oblique muscle.

백내장 수술에서 후낭 파열로 인한 섬모체고랑 삽입 후 일체형 인공수정체 도수 결정 및 전방 변화

양종윤,마경탁,김지현 대한안과학회 2012 대한안과학회지 Vol.53 No.6

Purpose: To evaluate the appropriate correction of predicted intraocular lens (IOL) power when sulcus implantation due to posterior capsular rupture was performed and to compare the anterior chamber angle of sulcus-implanted eyes with in-the-bag implanted eyes using anterior segment optical coherence tomography (Visante OCT). Methods: Fifty-two eyes of 52 patients who had IOL implantation in the sulcus due to posterior capsular rupture during cataract surgery were retrospectively reviewed. A 0.5 lower diopter IOL than predicted IOL power using SRK-T formula was chosen. The difference between the predicted refractive error and the spherical equivalence at the 3-month time-point after sulcus implantation were evaluated. Among 52 patients, 16 patients whose fellow eye had an in-the-bag IOL implantation underwent Visante OCT and the anterior angle of affected eyes and normal fellow eyes were compared. Results: The difference between the predicted refractive error using SRK-T formula and the spherical equivalence after sulcus implantation was a myopic shift of 0.597 ± 0.879 diopter. The mean iridocorneal angles, angle opening distance (AOD), trabecular iris surface area (TISA) at 500 um and 750 um for both nasal and temporal sides in sulcus implantation were all significantly lower than in-the-bag implantation. Conclusions: A choice of a 0.5 lower diopter power IOL than the power for in-the-bag implantation may be considered because of greater myopic shift than predicted refractive error when sulcus implantation due to posterior rupture is performed. Anterior chamber angle in sulcus IOL implantation was shallower than in-the-bag IOL implantation. J Korean Ophthalmol Soc 2012;53(6):775-780

Surgical Results of Trabeculectomy and Ahmed Valve Implantation Following a Previous Failed Trabeculectomy in Primary Congenital Glaucoma Patients

이나은,마경탁,배형원,홍사민,성공제,홍영재,김찬윤 대한안과학회 2015 Korean Journal of Ophthalmology Vol.29 No.2

Purpose: To compare the surgical results of trabeculectomy and Ahmed glaucoma valve implantation after a previous failed trabeculectomy. Methods: A retrospective comparative case series review was performed on 31 eye surgeries in 20 patients with primary congenital glaucoma who underwent trabeculectomy or Ahmed glaucoma valve implantation after a previous failed trabeculectomy with mitomycin C. Results: The preoperative mean intraocular pressure was 25.5 mmHg in the trabeculectomy group and 26.9 mmHg in the Ahmed glaucoma valve implantation group (p = 0.73). The 48-month postoperative mean intraocular pressure was 19.6 mmHg in the trabeculectomy group and 20.2 mmHg in the Ahmed glaucoma valve implantation group (p = 0.95). The 12-month trabeculectomy success rate was 69%, compared with 64% for Ahmed glaucoma valve implantation, and the 48-month success rates were 42% and 36% for trabeculectomy and valve implantation, respectively. The success rates following the entire follow-up period were not significantly different between the two groups (p > 0.05 by log rank test). Postoperative complications occurred in 25% of the trabeculectomy-operated eyes and 9% of the Ahmed-implanted eyes (p = 0.38). Conclusions: There was no significant difference in surgical outcome between the trabeculectomy and Ahmed glaucoma valve implantation groups, neither of which had favorable results. However, the trabeculectomy group demonstrated a higher prevalence of adverse complications such as post-operative endophthalmitis.

난치성 녹내장에서 아메드 방수유출장치 삽입술의 효과

이상협,마경탁,홍영재,Sang Hyup Lee,M,D,Kyung Tak Ma,M,D,Young Jae Hong,M,D 대한안과학회 2007 대한안과학회지 Vol.48 No.1

Purpose: To evaluate the outcome of Ahmed valve implantation as a primary or secondary glaucoma surgery to treat refractory glaucoma patients. Methods: A total of 101 eyes of 101 patients with refractory glaucoma, who received Ahmed valve implantation between March 1995 to September 2004 were included. We divided cases into primary surgery group, who had no trabeculectomy, and secondary surgery group, who had trabeculectomy before Ahmed valve implantation. Successful operation was defined as having the following outcomes: (1) postoperative intraocular pressure (IOP) sustained between 5 and 21mmHg and reduced 30% from the baseline IOP with or without medication, (2) no visual decline due to IOP or complications, and (3) no additional filtering surgery. Clinical records were reviewed, and IOP, antiglaucoma medications, and complications were recorded. Kaplan-Meier survival analysis was used to calculate the overall probability of success. Results: In primary surgery group, overall success rate was 57.6%, 46.7%, 39.7%, and 39.7% at 1, 3, 5, and 7 years, respectively. In secondary surgery group, overall success rate was 67.8%, 58.1%, 52.4%, and 43.5% at the same time points. There was, however, no statistical difference in success rates between two groups. The incidence of complications were as follows: 4.2% of endophthalmitis, 4.2% of valve exposure, 4.2% of hypotony was found in the primary surgery, and 3.8% of endophthalmitis, 1.9% of valve exposure, 9.4% of hypotony were found in the secondary surgery. There were no statistical differences in the incidences of complications between the two groups. Conclusions: Ahmed valve implantation was effective for IOP control in refractory glaucoma patients. Success rate did not show significant difference between primary and secondary Ahmed valve implantation group.

Kearns-Sayre Syndrome -3 Cases Reports and Review of Clnical Feature-

박성배,마경탁,국경훈,이상렬 연세대학교의과대학 2004 Yonsei medical journal Vol.45 No.4

Kearns-Sayre syndrome, first described by Kearns and Sayre in 1958, is a rare disorder consisting of ptosis, limited movement of both eyes and atypical retinal pigmentary change (salt-pepper like appearance). Most cases have shown an increase in the concentration of mitochondria and ragged-red fiber under Gomori-trichrome staining on muscle biopsy. Occasionally, it is combined with other neurologic and endocrinologic symptoms such as ataxia, dementia, diabetes, and hyperaldosteronism. We recently experienced three cases of male teenaged patients who expressed the clinical features of Kearns-Sayre syndrome.

샤임플러그 사진기와 초음파 생체현미경을 이용한 전방 계측 비교

박용식,안현석,김나래,마경탁,홍사민,성공제,김찬윤 대한안과학회 2009 대한안과학회지 Vol.50 No.12

Purpose: To evaluate the clinical reliability of PentacamⓇ by comparing anterior chamber parameters measured by Oculus Pentacam system (Oculus Inc., Germany) and Hi-scan ultrasound biomicroscopy (OPTIKON 2000, Rome, Italy) in primary angle closure (PAC) and normal patients. Methods: A prospective study was performed from June 2006 to January 2007. Fifty-one eyes in 26 primary angle-closure patients and 39 eyes in 20 normal control patients, for a total of 90 eyes of 46 patients were recruited from glaucoma out-patient clinics. The correlation and agreement of both measurements of anterior chamber depth and anterior chamber angle measured by UBM and PentacamⓇ were calculated. Sensitivity and specificity of each tool were also compared and the diagnostic value of angle closure was examined. Results: Anterior chamber depth measured by UBM and PentacamⓇ showed strong correlation in the normal control group (r=0.821) and PAC group (r=0.957). Anterior chamber angle showed moderate correlation in the normal control group (r=0.523) and PAC group (r=0.456) while good agreement was also observed. In diagnosing angle closure, anterior chamber measurements appear similar in UBM and PentacamⓇ using the ROC curve (AUC of UBM, 0.942; AUC of PentacamⓇ, 0.931). Conclusions: PentacamⓇ shows high to moderate correlation of anterior chamber measurements and good agreement compared with UBM. PentacamⓇ shows similar ability in diagnosing angle closure compared with UBM and thus is expected to be a good tool in diagnosing angle closure. 목적: 원발폐쇄각 및 정상군에서 Oculus Pentacam system (Oculus Inc., Germany)과 Hi-scan ultrasound biomicroscopy (OPTIKON 2000, Rome, Italy)의 전방계측치를 비교함으로써 PentacamⓇ의 신뢰도를 평가하고자 했다. 대상과 방법: 2006년 6월부터 2007년 1월까지 내원한 원발폐쇄각군 26명(51안)과 정상군 20명(39안), 총 46명(90안)에 대해 전향적 연구 를 하였다. UBM과 PentacamⓇ의 전방계측치와 폐쇄각 진단능력을 비교하였다. 결과: 전방깊이는 정상군(r=0.821)과 환자군(r=0.957)에서 두 기계간의 강한 상관관계를, 전방각은 정상군(r=0.523)과 환자군(r=0.456)에서 중등도 상관관계와 양호한 일치도를 보였다. ROC curve로써 평가한 전방각 측정값의 폐쇄각 진단능력(AUC of UBM, 0.942; AUC of PentacamⓇ, 0.931)은 비슷하였다. 결론: 두 도구의 전방계측치는 고도 또는 중등도의 상관관계, 양호한 일치도 그리고 비슷한 폐쇄각 진단능력을 보이므로 폐쇄각의 진단 에 PentacamⓇ의 역할이 기대된다.