통합된 두 눈 시야와 한 눈 시야의 Mean Deviation 비교

전연숙,박인기,Yeoun Sook Chun,In Ki Park 대한안과학회 2013 대한안과학회지 Vol.54 No.6

Purpose: To compare the mean deviation (MD) between monocular and integrated binocular visual field (BVF). Methods: Thirty-six patients with glaucoma in at least 1 eye were recruited for the present study. Seventy-two threshold sensitivities of the BVF were obtained without additional visual field test by the Best Location and Binocular Summation methods using the 2 monocular visual fields of central 30o. The MD of the BVF was obtained by comparison to the value distribution in the age-matched population with normal BVF. After defining the better eye with the better MD value from the 2 eyes, comparison of the MDs between individual eyes and the integrated BVF were assessed. In addition, the MDs between the integrated BVF and actual BVF were compared in 11 patients. Results: In patients with a mean age of 58.7 years, the MD of the better eye was -2.3 dB, and the worse eye was -4.9 dB (p < 0.01). There was a significant difference between the 2 MDs derived from Best Location and Binocular Summation (-1.7 and -2.0 dB, respectively p = 0.045). The MDs according to BVF more improved than the better eye (p < 0.01 for both). There was no significant difference in MDs between integrated BVF and actual BVF (-1.9 vs -2.0, -2.3 vs -2.0, respectively p > 0.1). Conclusions: The integrated BVF more improved than the better eye. When providing guidance to glaucoma patients regarding therapeutic decisions considering the MD of IVF may be important.

안내렌즈삽입술 후 안압과 전방각의 변화

전연숙,이종호,이제명,박인기,Yeoun Sook Chun,Jong Ho Lee,Jae Myung Lee,In Ki Park 대한안과학회 2005 대한안과학회지 Vol.46 No.2

Purpose: To evaluate the effects of ICL implantation on angle structures, intraocular pressure (IOP) and pupil diameter. Methods: A Staar implantable contact lens (ICL) was implanted in 81 eyes of 43 patients with spherical equivalent over -6D. Gonioscopy was done 1 day after laser iridotomy and 6 months after ICL implantation and postoperative changes in gonioscopic findings were evaluated. Also IOP and pupil diameter were examined. Results: There were occlusion or narrowing of the LI opening site in 10 eyes (12.3%). Width of angle was wide over 30° in all cases but that was narrowed under 20° in 16 eyes (19.8%) at postoperative 6 months. The mean pigmentation was 2.11 in inferior, 0.47 in nasal, 0.22 in temporal and 0.18 in superior angle at 6 months postoperatively by semiquantitative method (Grade 0~4). There was decrease of pigmentation in nasal and temporal angle but no change in inferior and superior angle after ICL implantation. There was temporary increase of IOP at 1 week and 1 month postoperatively due to steroid eye drops but returned to preoperative level and maintained until the 6 months postoperatively. There was significant decrease of pupil diameter at postoperative 1 and 3 months but returned to the preoperative level at postoperative 6 months. There was no evidence of pigment dispersion syndrome and pigmentary glaucoma. Conclusions: ICL implantation caused the narrowing of width of angle but did not increase trabecular pigmentation. We expect that ICL implantation is safe about pigment dispersion syndrome and pigmentary glaucoma.

엑시머레이저를 이용한 노안 교정 수술의 장기적인 임상 결과

전연숙,이헌일,DieterDausch,김재찬,Yeoun Sook Chun,Hyeon Il Lee,Dieter Dausch,Jae Chan Kim 대한안과학회 2008 대한안과학회지 Vol.49 No.7

Purpose: To evaluate the efficacy, safety, and subjective symptoms of patients who underwent presbyopic corneal surface ablation. Methods: Excimer laser surgery with MEL80 for refractive errors and presbyopia was performed on 128 eyes of 67 patients. Uncorrected and best-corrected visual acuity, distance-corrected near-visual acuity, spectacle near-addition for Jaeger 1, depth of focus, spherical aberration, and subjective symptoms were evaluated before surgery and 1 year after surgery. Results: This study consisted of a myopia group (56 eyes), an emmetropia group (spherical equivalent ≤ ±0.75D, 19 eyes), and a hyperopia group (53 eyes). Presbyopic corneal ablation improved distance and near uncorrected visual acuity, and distance-corrected near visual acuity at postoperative 12 months. There was no significant change in best-corrected visual acuity but there was a significant decrease in the emmetropia only group. Useful near visual acuity (≥20/40) was found in 96 eyes (75%) and spectacle near addition for Jaeger 1 decreased. Our results showed a significant increase of spherical aberration (from -0.19 µm to 0.11 µm) and depth of focus (from 1.45D to 1.69D). A significant positive correlation was found between spherical aberration and uncorrected far and near visual acuity and depth of focus. Loss of two lines of best corrected visual acuity occurred in 11 eyes (8.5%) at far vision and in 7 eyes (5.5%) at near vision. In general, patient satisfaction was good. Conclusions: Presbyopic corneal ablation with MEL80 showed good distant and near visual results and a wide depth of focus induced by increased spherical aberration. J Korean Ophthalmol Soc 49(7):1061-1070, 2008

보툴리눔 독소를 이용한 상윤부각결막염의 치료

전연숙(Yeoun Sook Chun),김재찬(Jae Chan Kim) 대한검안학회 2013 Annals of optometry and contact lens Vol.13 No.2

목적: Riolan 근육에 보툴리눔 독소를 주사한 후 상윤부각결막염의 증상 및 생체염색의 변화를 비교하여 그 치료 효과를 알아보고자 하였다. 대상과 방법: 수년간 안구건조증으로 치료받아왔으나 호전이 없는 환자 중 상윤부각결막염으로 진단된 5명, 10눈을 대상으로 검판 앞 눈둘레근육인 Riolan 근육에 보튤리늄 독소(2.5-5 unit)를 피하 주사하고 증상 변화, 플루오르신과 로즈벵갈 염색의 변화를 치료 전과 치료 후 1주, 2주, 4주, 그 후로 매달 6개월까지 검사하여 효과를 평가하였다. 결과: 평균 46.8세로 여자 4명, 남자 1명이었다. 안구건조증과 가로결막물결주름은 5명 모두에서 발견되었고, 상결막이완증은 3명, 헐거운 눈꺼풀 증후군은 1에서 발견되었다. 보툴리눔 독소 주사 후 증상은 1주 이내, 생체염색은 2주에 거의 소실되었고 그 효과는 평균 4.0개월(2-6개월) 지속되었고 안검하수는 발생하지 않았다. 결론: 눈꺼풀의 긴장을 유지하는 Riolan 근육의 보툴리눔 독소 주사는 상윤부각결막염의 증상과 징후를 매우 빠르고 효과적으로 치료 할 수 있는 방법이다. Purpose: To evaluate the changes of clinical symptoms and vital stainings before and after injection of botulinum toxin A into Riolan’s muscle in the treatment of patients with superior limbic keratoconjunctivitis (SLK). Methods: Ten eyes of 5 patients diagnosed with SLK were injected with botulinum toxin A into the pretarsal orbicularis muscle, or Riolan’s muscle. The changes of clinical symptoms and stainings with fluorescein and rose bengal were evaluated on the day of diagnosis and at 1 week, 2 weeks, 4 weeks, and then monthly 6 months after the injection. Results: The mean age was 46.8 years. Four patients were female and 1 was male. Dry eye syndrome and horizontal conjunctival corrugation were found in all 5 patients, superior conjunctivochalasis in 3 patients, and floppy eye lid syndrome in 1 patient. All five patients showed distinct improvement in clinical symptoms within 1 week after the injection. Improvement of vital stainings was observed at 2 weeks after the injection, and its effect maintained for 4.0 months (2-6 months). There was no ptosis associated with botulinum toxin injection. Conclusions: Injection of botulinum toxin into Riolan’s muscle, which maintains lid tone, resolved symptoms and signs associated with SLK very effectively and rapidly.

Bayonetlike Kinking of Vessel 과 시신경유두의 변화

전연숙(Yeoun Sook Chun),김동명(Dong Myung Kim) 대한안과학회 1999 대한안과학회지 Vol.40 No.5

핀홀 안경이 눈에 미치는 기능적 변화

전연숙(Yeoun Sook Chun),김원수(Won Soo Kim),박홍현(Hong Hyun Park) 대한검안학회 2016 Annals of optometry and contact lens Vol.15 No.4

Multiple-pinhole glasses are currently sold in many countries with unproven and exaggerated advertisements, however, its objective and subjective effects have not been investigated. Therefore, we quantified the visual functional changes caused by multiple pinhole glasses with 125 pinholes in each glasses lens. Multiple pinhole glasses enlarged pupil diameter from 3.6 mm to 6.0 mm and improved uncorrected distance and near visual acuity, depth of focus, and accommodative amplitude. However, contrast sensitivity, stereopsis, and visual field (VF) parameters including mean deviation, pattern standard deviation, and visual field index deteriorated. In conclusions, pinhole glasses had positive effects from the pinhole effect; however, they had negative effects on visual quality. In spite of the increased luminance and preserved peripheral VF with multiple pinholes, particular attention is needed when wearing pinhole glasses while driving, playing, sport, or working with instruments.

점안마취 및 이측투명각막절개술을 이용한 백내장수술이 중심각막내피세포에 미치는 영향

전연숙(Yeoun Sook Chun),이진학(Jin Hak Lee) 대한안과학회 1999 대한안과학회지 Vol.40 No.2

동결-해동-원심분리를 이용한 무세포 돼지각막의 특성 연구

이석현,전연숙,김재찬.Seok Hyun Lee. MD. Yeoun Sook Chun. MD. Jae Chan Kim. MD. PhD 대한안과학회 2011 대한안과학회지 Vol.52 No.1

Purpose: To develop a new decellularization technique of porcine cornea using freezing-thawing-centrifugation (FTC) and to examine the characteristics of acellular porcine cornea (APC) for xenograft material. Methods: Two-hundred micrometer thickness porcine corneas were decellularized with DNase/RNase, followed by 3 freezing-thawing-centrifugations (FTC, group 1), lyophilized FTC-APC (group 2), and chemical enzyme treated APC (CE-APC, group 3). Histologic evaluation to examine cells and collagen matrix, comparison of transparency, and cultivation to determine the viability of stromal cells was performed in fresh porcine cornea and 3 experimental groups. Results: Decellularization occurred successfully in all experimental groups. Decellularization was confirmed by H&E staining and cultivation. Transparency of group 1 was similar to the normal porcine cornea but transparency of group 2 and group 3 was decreased. Collagen fibers of CE-APC (group 3) were not as well arrayed as FTC-APC (group 2). Conclusions: Acellularity of porcine cornea was successfully achieved by the FTC method with preservation of the cornea stroma. Novel decellularized porcine cornea can be considered as xenogeneic material for corneal transplantation. J Korean Ophthalmol Soc 2011;52(1):86-92

양막을 이용한 각막 간질세포의 배양과 중배엽 줄기세포의 분화유도

박수현,전연숙,김재찬.Soo Hyun Park. MS. Yeoun Sook Chun. MD. PhD. Jae Chan Kim. MD. PhD 대한안과학회 2010 대한안과학회지 Vol.51 No.12

Purpose: To investigate the characteristics of cultured rabbit corneal keratocytes in vitro and evaluate the possibility of differentiation of mesenchymal stem cells to keratocytes using the keratocyte conditioned medium (KCM). Methods: Isolated keratocytes were seeded on the stromal side of amniotic membranes (AM) or plastic dishes, and morphologic changes were evaluated. Rabbit mesenchymal stem cells were cultured on AM with α-MEM (minimum essential medium alpha) and KCM. The gene expression patterns of specific keratocyte markers (keratocan, lumican, and aldehyde dehydrogenase family, member A1 (ALDH1A1)) of cultured cells were evaluated by RT-PCR. Results: Keratocytes on AM showed dendritic morphology with slow proliferation in contrast, cells on dishes were stellate in shape with fast proliferation. Cultured keratocytes on AM maintained the expression of keratocan, lumican and ALDH1A1 while keratocytes on plastic dishes steadily lost their keratocyte marker gene expression. Additionally, mesenchymal stem cells cultured with KCM on AM induced expression of keratocan and ALDH1A1. Conclusions: Keratocytes cultured on AM stromal matrix maintained their characteristic morphology and marker gene expression. Morphology changes and marker gene expressions of mesenchymal stem cells suggest an ability to differentiate into keratocytes when grown on AM with KCM. J Korean Ophthalmol Soc 2010;51(12):1652-1658

중증 건성안에서 헤파린과 인지질을 사용한 복합치료의 임상적 효과

주광식,전연숙,김재찬,Kwang Sic Joo,MD,Yeoun Sook Chun,MD,PhD,Jae Chan Kim,MD,PhD 대한안과학회 2010 대한안과학회지 Vol.51 No.8

Purpose: To evaluate the therapeutic effects of topical heparin (Hylo-ParinⓇ, Ursapharm Saarbr cken, Germany) and spray type phospholipids (Tears AgainⓇ, Optima Pharmazeutische GmbH. Freising, Germany) in severe dry eye syndrome resistant to conventional therapy. Methods: Twenty eyes of ten patients with refractory severe dry eye were treated with Hylo-ParinⓇ (two times a day) and Tears AgainⓇ (three times a day) for three months. Before and one and three months after treatment, a symptom questionnaire was administered to the patients. The ocular surface disease index (OSDI), tear film break-up time, Schirmer test, conjunctival fluorescein staining examinations and filamentary keratitis were evaluated. Results: After using Tears AgainⓇ and Hylo-ParinⓇ, the OSDI score improved from 64.13 ± 15.12 to 43.80 ± 15.87 (p<0.01). Tear film break-up time significantly increased from 1.0 ± 0.65 to 2.3 ± 0.73 seconds (p<0.01) and conjunctival staining score (Oxford scale) significantly decreased from 3.85 ± 0.75 to 3.25 ± 0.97 (p<0.01). Filamentary keratitis in the slit-lamp examination showed significant improvement (p<0.01). Conclusions: Tears AgainⓇ and Hylo-ParinⓇ are considered as new treatment modalities for severe dry eye syndrome and filamentary keratitis in patients with chronic ocular surface disease resistant to conventional therapy. These treatments require additional research. J Korean Ophthalmol Soc 2010;51(8):1047-1053