우성시신경위축

전보영(Bo Young Chun) 대한검안학회 2020 Annals of optometry and contact lens Vol.19 No.2

Dominant optic atrophy (DOA) is the most commonly diagnosed inherited optic atrophy, causing progressive bilateral visual loss that begins early in life. This review provides a summary of recent advances in the understanding of the clinical manifestations, genetic, and pathophysiological basis of this disease. Loss of optic atrophy 1 (OPA1) protein function by OPA1 gene mutations causes mitochondrial dysfunction, which in turn leads to increased reactive oxygen species levels in mitochondria and possibly insufficient adenosine triphosphate production. The histopathological hallmark of DOA is the primary degeneration of retinal ganglion cells, preferentially in the papillomacular bundle, which results temporal optic disc pallor and cecocentral scotomas in patients with DOA. There are no effective treatments for DOA, although clinical investigations are underway.

경덕왕과 승려의 교류양상과 그 의미

전보영(Chun, Bo-Young) 한국사학회 2013 史學硏究 Vol.- No.112

이글에서는 景德王대 활동한 승려들, 그중에서도 경덕왕과 직?간접적으로 교류했던 승려들의 사례를 통해 당시 사회의 변화와 그에 따른 사상사적 변화의 의미를 살펴보고자 한다. 경덕왕이 승려들과 교류한 시기와 목적, 그리고 형태를 살펴보고 그 변화의 양상과 의미를 찾아보는 것이 이글의 목적이다. 경덕왕은 재위기간 동안 중대 다른 왕들보다 많은 승려와 교류했고, 횟수와 목적, 그리고 형태가 다양했다. 승려들과의 교류 사례는 경덕왕 13년(754) 이후로 눈에 띄게 증가하는데 이와 함께 재해와 관직교체가 빈번해지고 佛事도 늘어나고 있다는 점이 주목된다. 특히 재위 후반기로 갈수록 교류의 형태와 문제해결의 방법이 변화하고 있다는 점은 경덕왕대 사회변화와 궤를 함께 하고 있어서 흥미롭다. 경덕왕과 승려의 교류양상이 당시 사회의 정치와 사상경향의 상관관계를 보여주고 있다는 점에서 주목되기 때문이다. 재위 전반기에 만난 승려인 眞表와 大賢, 그리고 法海의 경우 기존의 중대 사회에서 고승을 등용했던 모습과는 차이점을 보였다. 변화하는 사회에 참여하고 그에 따른 영향력을 펴고자 하는 방향에서 이루어졌기 때문이다. 그러나 그 과정에서는 齋나 講說등 공식적이고 의례적인 왕실 불교신앙의 형태는 여전히 유지되고 있었다. 반면 재위 13년 이후 만난 승려들과의 관계 속에서는 전혀 다른 형태가 나타난다. 새로운 승려를 찾고, 기존과는 다른 방법으로 문제를 해결하고자 했다. 表訓에게는 신이한 능력을 요구하여 후사문제를 해결했고, 중국의 도교 성지에서 천관보살신앙을 받아온 元表에게 法施하기도 했다. 또한 月明과 忠談을 만나 향가를 짓게 하여 사회문제를 해결하고자 했다. 이러한 경향은 경덕왕 재위 후반기로 갈수록 어려워지는 정치?사회적 상황과 불교의 대중화와 더불어 일어난 현상으로 보인다. 즉 점차 변화하는 사회에서 기존의 방법으로 문제를 해결하는 것에 한계를 느낀 경덕왕은 문제해결과 사회 안정을 위해 불교신앙 뿐만 아니라 대중을 교화할 수 있는 여러 가지 방법과 그에 알맞은 승려를 이용해 사회의 안정과 통치에 힘을 얻고자 한 것이다.

굴절조절내사시에 대한 5년간의 경과관찰결과

김동주,전보영,권정윤,Dong Ju Kim,M,D,Bo Young Chun,M,D,Jung Yoon Kwon,M,D 대한안과학회 2007 대한안과학회지 Vol.48 No.2

Purpose: To evaluate the clinical characteristics of refractive accommodative esotropia followed up for 5 years. Methods: Forty-three subjects with refractive accommodative esotropia, who had been followed up for at least 5 years were included in this study. Age and sex distribution, age at onset and the interval between onset of esotropia and initial visit were evaluated. Changes of the angle of deviation and the amount of hyperopia during follow-up period were analyzed. Results: The initial amount of hyperopia of 4.42±3.27D was decreased to 3.84±3.46D by the last exam. The average rate of hyperopia decrease per year was 0.12 diopters. The average angles of deviation at the initial and final exam were 31.74±13.72PD and 30.11±14.27PD, respectively. Among the 43 subjects who participated in this study, decompensation occurred in 2 patients in the third year and 1 patient in the fourth year. Conclusions: There is a tendency for the amount of hyperopia to decrease over time. Further, deviation may deteriorate over time as well. Thus, long term follow-up management is necessary to control deviation in patients with refractive accommodative esotropia.

사체적출안구에서 트리판 블루를 사용하여 계측한 상사근과 상직근 간의 해부학적 위치관계

신용태,전보영,Yong Tae Shin,Bo Young Chun 대한안과학회 2012 대한안과학회지 Vol.53 No.10

Purpose: To recognize the anatomical positions of the superior oblique muscle in enucleated eyes using trypan blue. Methods: Twenty-two surgically-enucleated eyes of 11 bodies were studied. The shortest distance from the nasal insertion of superior rectus to the anterior end of the superior oblique tendon, the distance from the temporal insertion of superior rectus to the anterior end of the superior oblique insertion, and the greatest width of superior oblique tendon insertion were measured by caliper 3 consecutive times. The average values in each of the above 3 points were calculated, and values prior to and after trypan blue staining were compared. Results: Prior to staining with trypan blue, the average distance from the nasal insertion of superior rectus to the anterior end of the superior oblique tendon was 4.97 mm and the average distance from the temporal insertion of superior rectus to the anterior end of the superior oblique insertion was 7.57 mm; after staining with trypan blue, the average values were 5.09 mm and 7.65 mm, respectively. There was no statistically meaningful difference in values prior to and after staining (p > 0.05). Prior to staining, the average value of the greatest width of the superior oblique tendon was 10.32 mm, and after staining with trypan blue, the average value increased to 10.76 mm. There was a statistically meaningful difference between the values (p = 0.02). Conclusions: Trypan blue staining helped to recognize the location and the width of the superior oblique tendon more precisely. J Korean Ophthalmol Soc 2012;53(10):1488-1492

한 눈 혹은 두 눈의 시야장애가 입체시에 미치는 영향

장주현,전보영,신재필.Joo Hyun Chang. MD. Bo Young Chun. MD. PhD. Jae Pil Shin. MD. PhD 대한안과학회 2014 대한안과학회지 Vol.55 No.5

Purpose: To evaluate the stereoscopic acuity in patients with unilateral or bilateral visual field defects. Methods: Stereoscopic acuity was measured using the Titmus stereo test for 36 subjects with visual field defects (VFD). VFD was assessed by sum of MD (mean deviation, MDsum) and PSD (pattern standard deviation, PSDsum) of both eyes in Humphrey visual field test and presence of central VFD (within 30° isopter) in Goldman visual field test. 25 glaucoma subjects and 11 optic neuritis subjects were included. Patients with strabismus or ocular motility disorders which could affect stereoscopic acuity were excluded. Results: The mean of MDsum was -20.10 ± 12.31 dB (-45.13~-10.64 dB) and PSDsum was 13.10 ± 8.76 dB (9.62-25.47 dB). The mean stereoscopic acuity was 710 ± 922 arc sec (40-3000 arc sec) with Titmus stereo test. The associations between stereoscopic acuity and PSDsum (r = 0.400, <em>p</em> = 0.016), presence of central VFD within 30 degrees (r = 0.428,<em> p</em> = 0.03) were statistically significant. There was positive trend between stereoscopic acuity and duration of VFD, but with no statistical significance. Conclusions: Decreased stereoscopic acuity was associated with PSDsum and VFD in the central 30 degrees. We should consider this decrease of stereoscopic acuity as well when evaluating visual function of the patients with VFD. J Korean Ophthalmol Soc 2014;55(5):734-739

고용량 스테로이드 치료에 추가 트리암시놀론 구후주사가 구후시신경염의 시력회복에 미치는 영향

박준호,신재필,전보영,Joon Ho Park,Jae Pil Shin,Bo Young Chun 대한안과학회 2013 대한안과학회지 Vol.54 No.1

Purpose: To evaluate the effect of additional retrobulbar triamcinolone acetonide (TA) injection on early recovery of visual acuity in retrobulbar optic neuritis patients. Methods: A prospective, randomized clinical study including 30 patients with retrobulbar optic neuritis was conducted between March 2003 and June 2007. Patients were divided into 2 groups: Group 1 (n = 9) with retrobulbar triamcinolone (TA, 40 mg/1 ml) injection on the first day of ONTT protocol, and group 2 (n = 21) with conventional ONTT protocol. The following parameters were measured and analyzed: patient’s sex, age, pupillary reactions, color vision, visual field, and best-corrected visual acuity before treatment, and after 1 day, 1 week, 2 weeks, 1 month, and 3 months of follow-up. Results: Mean visual acuity before treatment was 1.00 ± 0.89 log MAR units in group 1 and 0.98 ± 0.75 log MAR units in group 2. One day after injection, visual acuity was better in group 1 (0.50 ± 0.42 log MAR units) than in group 2 (0.73 ± 0.61 log MAR units), however, there was no statistically significant difference between the 2 groups (p = 0.07). There was no significant difference in visual acuity, recovery of RAPD, color vision, or visual field at 3 months of follow-up. No serious side effect related to retrobulbar TA injection was observed. Conclusions: Additional retrobulbar TA injection may help optic neuritis patients who have a need for prompt visual recovery. However, further studies are required to ascertain whether this procedure can help early recovery of visual acuity in retrobulbar optic neuritis patients.

안과적 이상을 동반한 DiGeorge 증후군 1예

김경민,이지웅,전보영,신재필,김시열,Kyoung Min Kim,Ji Woong Lee,Bo Young Chun,Jae Pil Shin,Si Yeol Kim 대한안과학회 2009 대한안과학회지 Vol.50 No.12

Purpose: DiGeorge syndrome (chromosome 22q11.2 deletion syndrome) is a syndrome of multiple congenital anomalies characterized by hypoplasia or aplasia of the thymus and parathyroid, cardiovascular malformation, immune deficiency, cleft palate, characteristic facial features, and hypocalcemia. Ocular findings of DiGeorge syndrome are posterior embryotoxon, retinal vascular tortuosity, strabismus, ptosis, amblyopia and tilted optic disc. The authors present a case of DiGeorge syndrome with ocular manifestation not reported previously in Korea. Case summary: A six-year old female diagnosed with DiGeorge syndrome was referred to the authors’ department within the hospital. The chief complaint was blurring vision in both eyes. Best corrected visual acuity of the right eye was 0.5 and of the left eye was 0.63. Cycloplegic refraction revealed high hyperopia and astigmatism in both eyes (OD: +7.25 Dsph; -2.5 Dcyl axis 180°, OS: +6.25 Dsph; -3.75 Dcyl axis 180°). In addition, hypertelorism, ptosis and tortuous retinal vessels during fundus examination were noted. Conclusions: Upon the initial diagnosis of DiGeorge syndrome in children, a comprehensive ocular examination is necessary because other ocular conditions may exist which can affect the visual development of the patient. J Korean Ophthalmol Soc 2009;50(12):1909-1912

소아사시수술 후 무보존제 플루오로메토론 0.1% 점안액의 결막충혈과 각막독성에 대한 영향

김수연(Su Yeon Kim),전보영(Bo Young Chun) 대한안과학회 2017 대한안과학회지 Vol.58 No.7

목적: 사시수술 후 점안한 플루오로메토론 0.1%의 보존제 유무에 따라 술 후 결막충혈 및 각막독성의 정도를 비교하고자 하였다. 대상과 방법: 간헐외사시 수술을 시행한 환자를 대상으로 전향적 임상연구를 시행하였다. 대상자를 무작위 배정하여 항생제와 함께 보존제(1군) 또는 무보존제(2군) 플루오로메토론 0.1%를 하루 3번 점안하도록 하였다. 술 후 1주와 3주 결막충혈과 각막독성 정도를 Image J program으로 측정한 평균 픽셀 값과 Oxford stain score (OSS)를 평가하여 두 군 간의 결과를 비교하였다. 결과: 총 61명의 환자 중 1군(보존제군) 17명(34안), 2군(무보존제군) 20명(40안)이 최종적으로 포함되었다. 술 후 1주일 결막충혈 정도를 측정한 평균 픽셀 값은 1군이 31,732 ± 9,946, 2군이 38,347 ± 12,189였고, 술 후 3주에는 각각 10,150 ± 4,493, 11,836 ± 4,290 이었다. 3주 동안 감소한 결막충혈의 평균 픽셀 값은 각각 21,582 ± 8,716, 26,510 ± 11,153으로 2군의 충혈 감소량이 통계적으로 유의하게 많았다(p=0.040). 술 후 3주에 측정한 OSS는 두 군 간 유의한 차이는 보이지 않았으나 설문지로 조사한 술 후 불편감의 정도는 2군에서 통계적으로 유의하게 낮았다(p=0.001). 결론: 사시수술 후 무보존제 플루오로메토론 0.1% 점안액을 사용하였을 때 결막충혈 감소량이 유의하게 더 많았으며 술 후 불편감 또한 통계적으로 유의하게 낮았다. 따라서 사시수술 후 무보존제 스테로이드 점안액 사용이 술 후 충혈을 감소시키고 불편감을 줄이는데 보다 효과적일 것으로 생각된다. <대한안과학회지 2017;58(7):846-851> Purpose: To compare the degrees of conjunctival injection and corneal toxicity between preservative and preservative-free topical 0.1% fluorometholone after strabismus surgery. Methods: A randomized, prospective clinical study was performed to compare the degrees of conjunctival injection and corneal toxicity between preservative and preservative-free topical 0.1% fluorometholone after strabismus surgery. Sixty-one patients with intermittent exotropia were included in this study. They were told to apply antibiotic eye drops (ED) and either preservative or preservative-free topical 0.1% fluorometholone (F1) three times a day. Measurements of the degrees of conjunctival injection and corneal toxicity were performed at postoperative 1 week and 3 weeks each. Results: Seventeen patients (34 eyes) were included in group 1 (preservative F1) and twenty patients (40 eyes) were included in group 2 (preservative-free F1). The average pixel value (measured via the Image J software) representing the degree of conjunctival injection was 31,732 ± 9,946 in group 1 and 38,347 ± 12,189 in group 2 at postoperative 1 week, while the average pixel value was 10,150 ± 4,493 in group 1 and 11,836 ± 4,290 in group 2 at postoperative 3 weeks. There was a significant difference between the decrease in pixel value for the two groups (p = 0.040). There was no significant difference in the mean value of the Oxford stain score between the two groups at postoperative 3 weeks, however the mean questionnaire scores in group 2 were significantly lower than in group 1 (p = 0.001). Conclusions: Preservative-free 0.1% fluorometholone ED demonstrated a larger decrease in the degree of conjunctival injection than for preservative ED after strabismus surgery. Therefore, the use of preservative-free steroid ED may be beneficial for decreasing both conjunctival injection and postoperative discomfort following strabismus surgery. J Korean Ophthalmol Soc 2017;58(7):846-851

사체적출안구에서 트리판 블루를 사용하여 계측한 상사근과 상직근 간의 해부학적 위치관계

신용태 ( Yong Tae Shin ),전보영 ( Bo Young Chun ) 한국안전학회(구 한국산업안전학회) 2003 International Journal of Safety Vol.2 No.1

목적: 트리판 블루(Trypan blue)의 사용이 상사근건의 위치와 범위를 보다 정확히 파악하는 데 도움이 되는지 여부를 알아보고자 하였다.대상과 방법: 본교에서 해부실습용으로 사용된 사체 11구 22안을 대상으로 안구적출술을 시행한 후, 상직근 비측 부착부에서 상사근건전연까지의 최단거리와 상직근 이측 부착부에서 상사근 부착부 전연까지의 거리, 그리고 상사근 부착부의 최대폭을 계측하였다. 이후상사근건에 트리판 블루를 도포한 후, 위의 동일한 세 지점에서 계측하여 트리판 블루 사용 전후의 계측치를 비교하였다.결과: 상직근 비측 부착부에서 상사근건 전연까지의 평균거리, 상직근 이측 부착부에서 상사근 부착부 전연까지의 평균거리는 염색전후 계측값 간의 통계적으로 유의한 차이가 없었다(p>0.05). 상사근 부착부 최대폭의 평균값은 10.32 mm였고, 염색 후 측정한 평균 값은 10.76 mm로 염색 후 통계적으로 유의한 차이가 있었다(p=0.02). 결론: 트리판 블루 염색으로 상사근건의 위치 및 범위를 보다 명확하게 파악할 수 있었다. Purpose: To recognize the anatomical positions of the superior oblique muscle in enucleated eyes using trypan blue. Methods: Twenty-two surgically-enucleated eyes of 11 bodies were studied. The shortest distance from the nasal insertion of superior rectus to the anterior end of the superior oblique tendon, the distance from the temporal insertion of superior rectus to the anterior end of the superior oblique insertion, and the greatest width of superior oblique tendon insertion were measured by caliper 3 consecutive times. The average values in each of the above 3 points were calculated, and values prior to and after trypan blue staining were compared. Results: Prior to staining with trypan blue, the average distance from the nasal insertion of superior rectus to the anterior end of the superior oblique tendon was 4.97 mm and the average distance from the temporal insertion of superior rectus to the anterior end of the superior oblique insertion was 7.57 mm; after staining with trypan blue, the average values were 5.09 mm and 7.65 mm, respectively. There was no statistically meaningful difference in values prior to and after staining (p> 0.05). Prior to staining, the average value of the greatest width of the superior oblique tendon was 10.32 mm, and after staining with trypan blue, the average value increased to 10.76 mm. There was a statistically meaningful difference between the values (p = 0.02). Conclusions: Trypan blue staining helped to recognize the location and the width of the superior oblique tendon more precisely. J Korean Ophthalmol Soc 2012;53(10):1488-1492

내사시가 동반된 루빈스타인-테이비 증후군

강용구(Yong Koo Kang),전보영(Bo Young Chun) 대한검안학회 2017 Annals of optometry and contact lens Vol.16 No.1

Purpose: To report a patient with Rubinstein-Taybi syndrome who had undergone bilateral medial rectus recession to correct his esotropia. Case summary: A 7-year-old male patient with long-standing esodeviation was brought to our clinic. Previously, he was diagnosed with refractive accommodative esotropia and was wearing glasses. On ophthalmologic examination, esotropia of 40 prism diopters with no limitation of ocular movement was observed by alternate prism cover test. His esodeviation did not change after full correction of hyperopia obtained with cycloplegic refraction, and was diagnosed with decompensated accommodative esotropia. The patient demonstrated mental retardation, post-natal growth deficiency, broad thumbs and halluces, and characteristic facial features such as downward slanted palpebral fissures and large deformed ears. He was diagnosed with Rubinstein-Taybi syndrome on the basis of clinical findings and confirmed by genetic testing. Decompensated accommodative esotropia of the patient was corrected to orthotropia following bilateral medial rectus muscle recession. Conclusions: Esotropia may be accompanied with a genetic disease such as Rubinstein-Taybi syndrome. In this case, refractive accommodative esotropia turned into decompensated accommodative esotropia, which was corrected with strabismus surgery.