소아 안와연조직염 환자의 임상 특징

박강윤,정재호,최희영,Kang Yeun Pak,Jae Ho Jung,Hee Young Choi 대한안과학회 2013 대한안과학회지 Vol.54 No.3

Purpose: The present study reviews the clinical features of orbital cellulitis in childhood for early diagnosis and proper treatment. Methods: The authors performed a retrospective study by computed tomography (CT) on children under 14 years of age diagnosed with orbital cellulitis and admitted to Pusan National University Hospital from 2003 to 2010. Results: In total, 27 patients were identified (range 4 months to 14 years). Periorbital swelling was the most common initiating symptom, followed by fever and conjunctival injection. Paranasal sinus disease was the most common predisposing factor. Preseptal cellulitis was the most common finding, followed by subperiosteal abscess, orbital cellulitis, and orbital abscess. All patients underwent a blood culture; none were positive. Intravenous antibiotics therapy was performed empirically and was effective in all cases. No patients suffered from permanent complications except recurrence. Conclusions: Orbital cellulitis in children presents with periorbital swelling, fever, conjunctival injection in association with sinusitis, and upper respiratory infection (URI). A CT study is a reliable diagnostic option for the early detection and localization in the pediatric orbital cellulitis. Early empirical antibiotic therapy is mandatory for successful treatment.

Yokoyama 술식으로 치료한 근시성 고정사시 1예

박강윤,정재호,최희영,Kang Yeun Pak,MD,Jae Ho Jung,MD,PhD,Hee Young Choi,MD,PhD 대한안과학회 2013 대한안과학회지 Vol.54 No.3

Purpose: To present a surgical result of Yokoyama procedure in myopic strabismus fixus. Case summary: A 51-year-old female patient presented with progressive esotropia and diplopia. According to the Krimsky test, the patient showed 70 prism diopter esotropia and 30 prism diopter hypotropia in her left eye. The axial length was 34.97 mm in the right eye and 33.71 mm in the left eye. The patient was diagnosed with myopic strabismus fixus. The authors performed the Yokoyama procedure on her left eye. Surgical examination revealed each medial rectus muscle was recessed. Half of the muscle bellies of the superior and lateral rectus muscles were sutured together without muscle splitting 15 mm posterior from their insertion. At 1 year postoperatively, the patient showed 30 prism diopter esotropia and 20 prism diopter hypotropia in her right eye by alternative prism cover test. The authors performed the same procedure on her right eye. At 2 months after the second surgery, the patient showed orthotropia in the primary position and gaze limitation was improved. Conclusions: The Yokoyama procedure can be an effective method for improving deviation and ocular motility in esotropia caused by high myopia.

안내후방콘택트렌즈 삽입술에 의해 발생한 색소녹내장 1예

박강윤,김해송,이지웅.Kang Yeun Pak. MD. Hae Song Kim. MD. PhD. Ji Woong Lee. MD. PhD 대한안과학회 2013 대한안과학회지 Vol.54 No.6

Purpose: To report a case of secondary pigmentary glaucoma after implantable contact lens (ICL) implantation successfully treated with trabeculectomy without ICL removal. Case summary: A 29-year-old woman presented with refractory intraocular pressure (IOP) increase in both eyes. IOP was 22 mm Hg in the right eye and 39 mm Hg in the left eye. The patient received posterior chamber phakic intraocular lens implantation in both eyes 22 months prior. Slit lamp examination revealed patent iridotomy sites in both eyes. Gonioscopy revealed open angles with 4-degree pigment deposits on the trabecular meshwork in both eyes. Ultrasound biomicroscopy examination confirmed contact between ICL and the posterior surface of the iris. In spite of well tolerated medical therapy and selective laser trabeculoplasty, IOP was 46 mm Hg in her left eye. Trabeculectomy was performed in her left eye without ICL removal. At 6 months postoperative, IOP measured 6 mm Hg without any anti-glaucoma medication and bleb was maintained in good condition in the left eye. Conclusions: The results from this case study indicate that ICL implantation can lead to secondary pigmentary glaucoma and trabeculectomy without ICL removal may help to decrease the IOP.

수정체안 열공망막박리의 유리체절제술에서 수정체 보존과 백내장 동시수술의 비교

변익수,박강윤,이승민,이지은,엄부섭,Ik Soo Byon,Kang Yeun Pak,Seung Min Lee,Ji Eun Lee,Boo Sup Oum 대한안과학회 2013 대한안과학회지 Vol.54 No.3

Purpose: To compare lens-save and simultaneous phacoemulsification with intraocular lens implantation in primary vitrectomy for phakic rhegmatogenous retinal detachment (RRD). Methods: A retrospective comparative analysis of 54 consecutive eyes from 54 phakic RRD patients who underwent vitrectomy with a minimum of 12 months of follow-up was performed. The patients were divided into the vitrectomy group and the combined group (patients who underwent vitrectomy with concurrent cataract surgery). The main outcome measures were the best corrected visual acuity (BCVA), anatomical success rate, complications and cataract status according to LOCSⅢ grading. Results: Baseline characteristics were similar in both groups, except for age and cataract status. The mean age was 46.9 year in the vitrectomy group (n = 20) and 60.5 years in the combined group (n = 34) (p < 0.001). The postoperative BCVA (log MAR) improved from 1.27 and 1.30 at baseline to 0.45 and 0.28 at 12 months (p < 0.05), respectively, which was not a significant difference between the 2 groups. In the vitrectomy group, cataract status was changed from 1.8 at baseline to 2.5 at 12 months (p = 0.001). Two patients (11.1%) had an additional cataract surgery performed. The primary anatomical success rate was 90.0% in the vitrectomy group and 94.1% in the combined group. Conclusions: The vitrectomy group and combined group had similar results in the repair of phakic RRD. Although postoperative cataract progression was noted, lens should be saved in vitrectomy for young patients, as significant cataract is uncommon.

한국인 신경망막염 환자의 임상양상 및 예후

장수경(Su Gyeong Jang),박강윤(Kang Yeun Pak),권한조(Han Jo Kwon),이승민(Seung Min Lee),박성후(Sung Who Park),변익수(Ik Soo Byon),이지은(Ji Eun Lee) 대한안과학회 2017 대한안과학회지 Vol.58 No.2

목적: 신경망막염 환자의 임상 양상 및 예후에 관해 알아보고자 한다. 대상과 방법: 2012년부터 2015년 사이 진단된 신경망막염 환자 7명의 의무기록을 후향적으로 분석하였다. 결과: 7명 중 2명은 양안에 나타나 총 9안이 포함되었다. 5명의 남성과, 2명의 여성이 포함되었고, 나이는 평균 45.1 ± 13.2세였다. 인플루엔자 유사 증상이 선행했던 경우가 2명이었고, 나머지 5명은 시력저하 외 특이소견이 없었다. 내원 당시 교정시력은 평균 logMAR 0.48 ± 0.55 (0-1.6)였다. 혈청학적 검사에서 40세 이하 4명에서는 특이소견이 관찰되지 않았고, 40세 이상의 3명에서는 개회충증 항체 양성이 확인되었다. 개회충증 항체 양성을 보인 3명 중 2명은 Albendazole을 복용하였고 나머지 한 명은 복용하지 않았다. 개회충증 항체 양성임에도 구충제를 복용하지 않은 1안을 제외한 8안은 모두 20/30 이상으로 시력이 회복되었다. 결론: 국내에서 발생한 신경망막염환자 7명 중 3명에서 개회충증 항체가 검출되었다. 항체 양성이 나온 경우에는 구충제 처방을 고려해야 한다. Purpose: In the present study, the clinical characteristics and outcomes of neuroretinitis in Korea were investigated. Methods: Seven consecutive patients with neuroretinitis from 2012 to 2015 were retrospectively reviewed. Results: The present study included 9 eyes of 7 patients. The subjects consisted of 5 males and 2 females and the mean age was 45.1 ± 13.2 years. Two patients had Influenza-like symptoms and the others had no specific general symptoms. The mean best corrected visual acuity was logMAR 0.48 ± 0.55 (0-1.6) on the initial visit. Four patients 40 years of age or under had no abnormal findings in laboratory work-up. Conversely, 3 patients over 40 years of age were positive for Toxocara based on enzyme-linked immunosorbent assay (ELISA). Two of 3 patients positive for Toxocara were treated with albendazole and 1was not. Eight eyes had good visual recovery over 20/30 except for 1 patient who did not take the albendazole despite being positive for Toxocara detected using ELISA. Conclusions: Three of 7 patients with neuroretinitis in Korea showed positive results forToxocara based on ELISA. In cases with seropositive Toxocara ELISA results, albendazole treatment should be considered.

유리체강 내 애플리버셉트 주사 후 급격히 진행한 망막앞막

권지민(Ji Min Kwon),이명신(Myung Shin Lee),박강윤(Kang Yeun Pak),김현웅(Hyun Woong Kim) 대한안과학회 2018 대한안과학회지 Vol.59 No.10

목적: 삼출성 황반변성에서 유리체강 내 애플리버셉트 주사 후 망막앞막이 급격히 진행한 증례를 경험하였기에 이를 보고하고자 한다. 증례요약: 82세 여자가 1개월 전부터 발생한 좌안 시력저하를 주소로 내원하였다. 초진 시 좌안 시력은 0.2로 측정되었다. 안저검사및 빛간섭단층촬영에서 좌안 황반부의 연성 드루젠과 출혈 및 투명한 망막앞막이 관찰되었다. 형광안저혈관조영술 및 인도시아닌그린혈관조영술 결과 좌안의 망막혈관종성증식 retinal angiomatous proliferation으로 진단하였고, 좌안 유리체강 내 애플리버셉트 주사를 시행하였다. 첫 주사 1개월 후 좌안 오목부위의 망막 내 낭포황반부종은 감소했으나, 안저검사에서 망막앞막의 투명도가 감소하였고 빛간섭단층촬영에서 앞막의 반사도와 두께가 증가하였다. 이후 애플리버셉트 주사를 2회 더 시행하였고, 망막혈관종성증식은 호전 소견을 보였으나 좌안 시력이 0.1로 감소하여 망막앞막에 대한 유리체절제술을 시행하였다. 결론: 망막앞막이 동반된 삼출성 황반변성의 치료로 유리체강 내 애플리버셉트 주사 후 망막앞막의 급격한 진행에 대한 주의 깊은 관찰이 필요하다. Purpose: To report a case of rapid progression of the epiretinal membrane following intravitreal aflibercept injection in a patient with exudative age-related macular degeneration. Case summary: An 82-year-old female presented with a complaint of decreased visual acuity in her left eye for 1 month. The initial best-corrected visual acuity was 0.2 in the left eye. Fundus examination and optical coherence tomography revealed soft drusen with retinal hemorrhage of the macula and a transparent epiretinal membrane in the left eye. Fluorescein angiography and indocyanine green angiography showed retinal angiomatous proliferation (RAP) of the left eye, so intravitreal aflibercept injection was performed. One month after the first injection, intraretinal cystic macular edema decreased, while transparency of the epiretinal membrane decreased and reflectivity and thickness of the membrane increased. After two additional injections of aflibercept, RAP showed improvement, whereas the epiretinal membrane progressed. Visual acuity of the left eye decreased to 0.1 and vitrectomy of the membrane was performed. Conclusions: Careful observation for potentially rapid progression of epiretinal membrane is needed after intravitreal aflibercept injection in the management of exudate age-related macular degeneration accompanied by epiretinal membrane.

나이관련황변변성 환자들의 항산화 영양제 복용에 대한 설문조사

나정호(Jeong Ho Na),임재완(Jae Wan Lim),방종욱(Jong Wook Bang),박강윤(Kang Yeun Pak),김현웅(Hyun Woong Kim) 대한안과학회 2021 대한안과학회지 Vol.62 No.11

목적: 중등도 이상의 황반변성을 진단받고 AREDS2 formula를 복용하고 있는 환자들의 복용 실태에 대해서 조사해 보고자 하였다. 대상과 방법: 2019년 12월부터 2020년 7월까지 황반변성 환자를 대상으로 전향적으로 설문조사를 시행하였다. 설문지는 인구학적 특성, 질병에 대한 인식, 영양제 복용 실태 등에 대해 총 24문항을 조사하였다. 결과: 총 100명의 환자가 포함되었으며, 남자가 56%였고 연령은 60대 이상이 89%였다. 질환에 대한 이해도, 금연의 필요성, 항산화 영양제의 필요성에 대해 안다고 대답한 비율은 66%, 84%, 93%였다. 복용 실태 조사에서 복용 중인 약을 정확히 알고 있는 환자는 58%였고, 이 중 AREDS2 영양제를 제대로 복용하고 있는 환자는 63.8% (전체 환자의 37%)였다. 또한, 영양제 성분에 대해서 알고 있는 환자는 8%, 영양제를 매일 복용한다고 답한 환자는 91%였다. 복용 실태와 인식에 영향을 미치는 인자로 유병 기간이 길어질수록 황반변성 영양제를 복용하는 빈도가 줄어드는 경향이 있었으며(p<0.05), 연령이 높고 저학력일수록 황반변성질환에 대한 인지가 낮았다(p<0.05). 결론: 황반변성 영양제 복용 실태 조사에서 정확한 AREDS2 formula를 복용하지 않는 환자들이 있어 이에 대한 보완책이 필요할 것으로 생각된다. Purpose: To investigate the use of second AREDS2 formula in patients with intermediate or advanced age-related macular degeneration. Methods: A prospective survey was conducted between December 2019 and July 2020. The questionnaire consisted of 24 questions on demographics, disease perception, and formula intake. Results: The survey included 100 patients (males, 56%; age [>60 years], 89%). We found that 66%, 84%, and 93% of patients had a good understanding of their disease, had stopped smoking, and were aware of the need for antioxidant supplements; 58% of patients were aware of the supplement they were prescribed, and 63.8% (37% of total) were using the AREDS2 formula. Only 8% of patients had knowledge regarding the supplement ingredients, and 91% consumed the supplement daily. Patients with long disease duration used supplements less frequently (p < 0.05). Older patients and those with a low education level had a limited perception of the disease (p < 0.05). Conclusions: In this prospective survey, some patients consumed supplements other than the AREDS2 formula. Further studies are required to determine ways to increase the use of the AREDS2 formula.