한국인 녹내장 환자에서 중심각막두께와 공막두께의 상관성

하석규,김용연,Suk Gyu Ha,Yong Yeon Kim 대한안과학회 2010 대한안과학회지 Vol.51 No.11

Purpose: To evaluate the correlation between central corneal thickness (CCT) and scleral thickness (ST) in glaucoma patients. Methods: Seventy-eight eyes of 78 patients with no previous history of intraocular surgery and 23 control eyes were enrolled in the present study. For all eyes, CCT, ST, axial length, anterior chamber depth and refractive error were measured by a single examiner. The correlations among the measurements were analyzed. Results: The mean patient age was 57.32 ± 9.44 years, and the mean CCT was 532.80 ± 43.75 μm. The mean CCT of ocular hypertension (576.00 ± 26.59 μm) was thicker than that of the normal control group (530.30 ± 35.34 μm, p = 0.028), although the mean STs of the groups were not significantly different. No significant correlation was found between CCT and ST (r = -0.073, p = 0.466). Conclusions: In the present study, no correlation between CCT and ST was observed. In addition, the STs of the groups were not significantly different. J Korean Ophthalmol Soc 2010;51(11):1485-1490

난독증과 얼렌증후군

하석규(Suk-Gyu Ha),김승현(Seung-Hyun Kim) 대한검안학회 2015 Annals of optometry and contact lens Vol.14 No.4

Meares-Irlen syndrome (MIS) is characterized by symptoms of eye strain, headache and visual perceptual distortions during viewing text. The symptoms of MIS and visual stress are non-specific and the condition needs to be differentially diagnosed from other ocular conditions, such as refractive error, binocular abnormality and accommodative problems. Deficit of magnocellular system and cortical excitation have been suggested as causes of MIS. MIS and primary dyslexia are separate entities and are treated in different ways. The symptoms are alleviated with individually prescribed colored tinted lens, such as MISViS filters. However, there is a controversy of presence of MIS, further long-term studies are needed to investigate pathophysiology of MIS and prove effectiveness of tinted lens on MIS.

성인에서 단안조절연축을 동반한 외사시 1예

권일주(Il Joo Kwon),하석규(Suk Gyu Ha),김승현(Seung Hyun Kim) 대한검안학회 2016 Annals of optometry and contact lens Vol.15 No.3

Purpose: To report one case of unilateral accommodative spasm, associated with exotropia. Case summary: A 52-year-old male patient visited our clinic with visual loss in a left eye. Alternate cover test revealed 12 prism diopter (PD) of exodeviation at distant and 14 PD of exodeviation at near. As pseudomyopia of a left eye was identified by both manifested refraction test and cycloplegic refraction test, exotropia with unilateral accommodative spasm was diagnosed. Left lateral rectus recession was done for correcting exotropia, and the surgery was effective. After the surgery, the patient was treated with cycloplegic mediations for accommodative spasm. However, the symptom of pseudomyopia has not been alleviated yet. Conclusion: We confirmed a case of unilateral accommodative spasm, associated with exotropia.

간헐외사시 환자에서 수술 후 근거리 작업이 지연발현 속발내사시 발생에 미치는 영향

강형주(Edward Kang),하석규(Suk-Gyu Ha),김승현(Seung-Hyun Kim) 대한안과학회 2021 대한안과학회지 Vol.62 No.6

목적: 간헐외사시수술 후 근거리 작업이 지연발현 속발내사시 발생에 미치는 영향을 알아보고자 한다. 대상과 방법: 2019년 1월부터 2020년 1월까지 외래 내원한 환자 중 간헐외사시로 양안 외직근후전술을 시행 받고 정위를 회복한 후 다시 내편위가 발생한 지연발현 속발내사시 환자들(1군)과 정위 회복 후 3년간 내사시가 발생한 적이 없는 환자들(2군)을 대상으로 술 후 하루 근거리 작업 시간 등을 설문 조사하였다. 결과: 총 42명의 환자가 포함되었다. 수술 전 원거리 사시각은 1군 28.5 ± 4.4 prism diopters (PD) 대조군은 30.5 ± 5.2 PD, 근거리 사시각은 1군 29.3 ± 4.8 PD, 2군 31.6 ± 6.0 PD로 유의한 차이를 보이지 않았다. 하루 두 가지 이상의 초근거리 작업을 하고 있는 경우 통계적으로 유의하게 1군에서 많았다(1군 47.8%, 2군 15.8%, p=0.02). 2군에서는 TV 시청이 12명(63.2%)으로 1군과 비교하여 통계적으로 유의하게 많았다(1군 6명 26.1%, p=0.02). 초근거리 작업 시간의 경우 하루에 1군 2.7 ± 2.1시간, 2군은 1.5 ± 1.2시간으로 유의한 차이가 있었다(p=0.037). 결론: 양안 외직근후전술 후 지연발현 속발내사시가 발생한 환자들의 가림치료 종료 후 초근거리 작업의 빈도 및 시간은 술 후 내사시가 발생한 적이 없는 환자들에 비해 유의하게 높았다. 술 후 환자 및 보호자에게 초근거리 작업의 주의가 고려되어야 하겠다. Purpose: To identify the correlation between near work and the occurrence of delayed-onset consecutive esotropia after surgery for intermittent exotropia. Methods: A survey and retrospective review were conducted on patients in two groups. The study included patients who visited from January 2019 to January 2020. Patients who re-developed esodeviation after recovering orthophoria after the initial postoperative overcorrection for the surgical correction of intermittent exotropia were included in the delayed-onset esotropia group (Group 1), and patients with persistent orthotropia for at least 3 years after bilateral lateral rectus recession for intermittent exotropia were included in Group 2. We evaluated the daily frequency and hours of distance/near work in both groups. Results: A total of 42 patients were evaluated. Preoperative exodeviation at a distance was 28.5 ± 4.4 prism diopters (PD) in group 1 and 30.5 ± 5.2 PD in group 2, with no significant difference between the two groups. The percentages of patients who chose two or more extremely near-work activities a day were 47.8% and 15.8% for groups 1 and 2, respectively; these values were statistically significant (p = 0.02). Twelve patients in Group 2 answered “watching TV” (63.2%) as the most common activity, which was statistically significant compared to Group 1 (26.1% in Group 1, p = 0.02). The total numbers of hours of extremely near-work a day were 2.7 ± 2.1 and 1.5 ± 1.2 hours for groups 1 and 2, respectively, which was also statistically significant (p = 0.037). Conclusions: We found a significant correlation with occurrence of delayed-onset consecutive esotropia with the frequency and hours of extremely near-work after bilateral lateral rectus recession for intermittent exotropia. More attention to extremely near-work should be considered carefully after bilateral lateral rectus recession for intermittent exotropia.

비면역기능저하 환자에서 발생한 비안와 뮤코르진균에 의한 단안 압박성 시신경병증

조성원(Sung-Won Cho),하석규(Suk Gyu Ha),김승현(Seung-Hyun Kim) 대한검안학회 2019 Annals of optometry and contact lens Vol.18 No.1

Purpose: To report a case of unilateral compressive optic neuropathy caused by rhino-orbital mucormycosis in an immunocompetent patient. Case summary: A 62-year-old male visited the ophthalmology department with discomfort and decreased visual acuity in his right eye. There were no signs of eyelid edema, limited ocular movement, or proptosis. The patient had no history of diabetes and hypertension. On ophthalmologic examination, relative afferent pupillary defect, decreased color vision, optic disc swelling, and inferior visual field defect were observed in the right eye. There were no abnormal results of laboratory investigation. Brain and orbit magnetic resonance image revealed right ethmoidal sinus mass-like lesion with extension into the orbital cavity, and ethmoidal biopsy confirmed it as mucormycosis. Conclusions: We reported a case of unilateral compressive optic neuropathy caused by rhino-orbital mucormycosis in the non-immunocompromised patient without other systemic diseases.

소아에서 빛간섭단층촬영으로 진단된 독립된 중심와형성저하 1예

김민정(Min Jung Kim),하석규(Suk-Gyu Ha)김승현(Seung Hyun Kim) 대한검안학회 2018 Annals of optometry and contact lens Vol.17 No.1

Purpose: To report a case of isolated foveal hypoplasia diagnosed with optical coherence tomography (OCT) in a pediatric patient. Case summary: A 4-year-old male patient came to clinic with complaints of defective vision detected by preschool vision screening. At that initial visit, best-corrected visual acuity (BCVA) was 0.4 in the right eye and 0.6 in the left eye with bilateral hyperopia of +1.25 diopters (D) and +1.75 D in right and left eye. Fundus photograph seemed to have no abnormal findings. After prescribing glasses, he revisited the clinic 3 months later. The BCVA was still 0.3 in the right eye and 0.4 in the left eye and there was no improvement in visual acuity. To identify the cause of amblyopia, the patient underwent OCT examination. The OCT scans showed the absence of the foveal depression and persistent nerve fiber layer and inner retinal layers within the fovea in both eyes. Rechecked fundus examination revealed absent foveal reflexes and macular pigmentation in both eyes. Conclusions: This case shows that the clinical diagnosis in children could be missed because of the subtle fundus change and OCT is useful in diagnosing isolated foveal hypoplasia.

재발로 인해 3회 이상 수술을 시행한 간헐외사시 환자군의 임상분석

김민재(Min Jae Kim),하석규(Suk Gyu Ha),김승현(Seung Hyun Kim) 대한안과학회 2017 대한안과학회지 Vol.58 No.11

목적: 3회 이상 재수술을 시행한 간헐외사시 환자들의 임상양상을 분석하여 3회 이상 재수술에 이르게 하는 요인에 대하여 알아보고자 한다. 대상과 방법: 간헐외사시로 2차 수술 후 재발되어 3차 이상의 수술을 시행 받은 13명과 2차 수술 후 1년 이상 경과 관찰을 통하여 수술의 성공을 판단할 수 있었던 29명을 대상으로 후향적으로 분석하였다. 다중 로지스틱 회귀분석을 사용하여 증상 발생 시 나이, 1차, 2차, 3차, 4차 수술 시 나이, 각 수술 전후의 입체시, 각 수술 전후의 원거리 및 근거리 사시각, 각 수술 시 항상성 유무 등이 2차 수술 후의 수술 결과에 미치는 영향을 분석하였다. 결과: 3회 이상의 수술군에서는 2회 수술군에 비하여 1세 이전에 증상이 발생한 경우가 많았고(p=0.011), 1차 수술 전 사시각이 30PD 이상으로 크며(p=0.003), 항상성인 경우가 많았다(p=0.023). 또한 3회 이상 수술군에서는 1차 수술 후 1일째 내편위를 보인 경우가 적었으며(p=0.003), 2차 수술 후 성공적인 입체시 회복을 보인 경우가 유의하게 적었다(p=0.043). 이들 요인 중 다중 로지스틱 회귀 분석을 통하여 2차 수술 후 재수술과 성공에 영향을 주는 가장 중요한 요인은 술 후 성공적인 입체시의 회복 여부였다(odds ratio [OR]=50.00, 95% confidence interval [CI]=4.392-569.224, p=0.002). 결론: 본 연구에서는 사시가 1세 이전에 발생한 경우, 첫 수술 시 큰 각의 항상성 외사시인 경우, 술 후 초기 과교정이 안 된 경우에 재발로 인해 3회 이상의 수술이 필요할 수 있었고, 술 후 입체시 회복 여부가 2차 수술 후 결과의 가장 중요한 예측 인자였다. Purpose: To evaluate the clinical analysis of intermittent exotropia patients who required more than three reoperations and to investigate the factors leading to situations that require more than three reoperations. Methods: We retrospectively analyzed the results of 13 patients who underwent more than three reoperations for recurrence after the second operation, as well as for 29 patients who had successful results for operation at least 1 year after the second operation. We investigated the factors associated with surgical outcomes of the second operation using multiple logistic regression analysis, which included; onset of symptom, primary, secondary, tertiary, and fourth ages of surgery, stereopsis before and after surgery, distance and near deviation before and after surgery, and constancy of exotropia. Results: There were more cases in which symptoms occurred before 1 year of age (p = 0.011) and which had constant exotropia (p = 0.023), with a large deviation at first operation (p = 0.003) after more than three operations compared to patients who only had two operations. There were less cases that achieved initial overcorrection after first operation (p = 0.003) and successful postoperative stereopsis after second operation (p = 0.043) in the three operations group than in the two operations group. Among these factors, the most important factor affecting reoperation and success after second operation was related to successful recovery of stereopsis using multiple regression analysis (odds ratio [OR] = 50.00, 95% confidence interval [CI] = 4.392-569.224, p = 0.002). Conclusions: In cases of intermittent exotropia occurring before 1 year of age, constant exotropia with a large deviation at first operation, and insufficient initial overcorrection after operation, it may be necessary for patients to receive more than three operations because of recurrence. Further, recovery of postoperative stereopsis after the second operation was the most important predictor for postoperative results. J Korean Ophthalmol Soc 2017;58(11):1269-1275

성인에서 진단된 양안 Ⅲ형 듀안안구후퇴증후군 1예

허정아(Jungah Huh),하석규(Suk Gyu Ha),김승현(Seung-Hyun Kim) 대한검안학회 2018 Annals of optometry and contact lens Vol.17 No.4

Purpose: To report a case of bilateral Duane retraction syndrome type Ⅲ in adult. Case summary: A 18-year-old female visited for the evaluation of strabismus. Under ophthalmologic evaluations, bilateral limitation of adduction and abduction. In adduction, bilateral fissure narrows are observed. Eight prism diopters of exophoria are primary gaze was observed without noticeable abnormal head position. Downshoot of left eye was observed in adduction and more prominent in down gaze. There was no extraocular muscle abnormality in orbital computed tomography. Conclusions: We report rare case of bilateral Duane retraction syndrome type Ⅲ in adult.

역설머리기울임을 보인 선천상사근마비 환자의 수술 결과

김중훈(Joong-Hun Kim),하석규(Suk-Gyu Ha),김승현(Seung-Hyun Kim) 대한검안학회 2018 Annals of optometry and contact lens Vol.17 No.4

Purpose: We report the surgery outcome of three cases with congenital superior oblique palsy (SOP) with paradoxical head tilt after conducting ipsilateral inferior oblique (IO) recession. Case summary: Case 1 was a 4-year-old boy with right head tilt noted since about 3-4 months of age. He demonstrated right hypertropia of 6 prism diopters (PD). Case 2 was a 4-year-old girl who demonstrated left hypertropia of 6 PD and exotropia of 18 PD. She had shown intermittent left head tilt since about 3 months of age. Case 3 was a 8-year-old boy with right head tilt noted since about 1 year of age. He demonstrated right hypertropia of 10 PD. Case 1 underwent left IO recession and left lateral rectus recession. Case 2 and 3 underwent right IO recession. Conclusions: Ipsilateral IO weakening was also the effective surgery in congenital SOP with paradoxical head tilt as well as in the one manifesting usual head tilt.

단안 시력저하를 주소로 내원한 소아 비기능성 뇌하수체 거대선종

허정아(Jungah Huh),하석규(Suk-Gyu Ha) 대한검안학회 2017 Annals of optometry and contact lens Vol.16 No.2

Purpose: To report a case of unilateral visual symptom in nonfunctioning pediatric pituitary macroadenoma. Case summary: A 11-year-old girl came to clinic complaining of right uncorrected visual loss with field defect. There was no abnormal finding including pupil, extraocular movement and fundus examination. Visual field test revealed bilateral temporal hemianopsia. The patient was referred to department of pediatric neurology for further evaluation and brain magnetic resonance revealed pituitary tumor. However level of secretary hormone test was normal. She underwent surgery with endoscopic transsphenoidal adenomectomy. The diagnosis was confirmed histological pituitary adenoma. She completely recovered her visual acuity and field after surgery at final visit. Conclusion: The further examination, including systemic and neurologic evaluation should be considered when pediatric patient complained with nonspecific visual loss.