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김진철,함돈일,Jin Chul Kim,Don Il Ham 대한안과학회 2009 대한안과학회지 Vol.50 No.1
Purpose: To investigate the clinical characteristics and treatment of intermediate uveitis under new diagnostic standards. Methods: Medical records of patients diagnosed with pars planitis or intermediate uveitis were followed for more than 6 months, and retrospectively reviewed. Results: A total of 90 patients and 117 eyes were enrolled in the study. The mean age was 40.1 years, and the mean follow-up period was 43.0 months. Thirty percent of cases were bilateral. The most common initial symptom was decreased visual acuity. Snowbank was detected in 39.3%, snowballs in 15.4%, vitritis in 96.6%, and vasculitis in 56.4%. Common complications includedcystoid macular edema (57.3%), cataracts (43.6%), and epiretinal membrane (36.8%). Therapies included topical steroids (82.9% of cases), posterior sub-Tenon steroid injection (45.3% of cases), systemic steroid administration (67.8% of cases), and immunosuppressants (28.7% of cases). Vitrectomy was performed in 11.1% of patients due to complications such as epiretinal membrane and traction retinal detachment. The mean initial and final visual acuities were 0.67 and 0.74, respectively. Conclusions: The patients in this study experienced various courses of symptoms that required different treatment plans. Future investigations may corroborate these results.
정송이,함돈일,Song Ee Chung,Don Il Ham 대한안과학회 2006 대한안과학회지 Vol.47 No.8
Purpose: To evaluate the factors contributing to the visual outcome of patients with culture-proven bacterial endophthalmitis. Methods: We reviewed medical records of all eyes with infectious endophthalmitis between January 1996 and June 2005. The causative bacteria were identified in 18 of 90 eyes, for which we evaluated their clinical features and factors influencing their visual prognosis. Results: Bacterial endophthalmitis occurred after cataract surgery in 6 of 18 eyes, after trabeculectomy or glaucoma implant surgery in 4 eyes, after trauma in 3 eyes, after intravitreal triamcinolone injection in 1 eye, and after endogenous endophthalmitis in 4 eyes. The culture results were similar between gram positive and gram negative organisms. Final vision was 0.1 or better in 6 of the 18 eyes. Final visual acuities showed statistically significant correlation with causative organisms (p=0.018). Conclusions: For effective management of bacterial endophthalmitis and prediction of prognosis, we recommend thorough bacterial culture. Also, further investigation with a large population is needed.
초극소저출생체중아와 극소저출생체중아의 미숙아망막병증 발생 빈도와 위험 인자에 관한 연구
최성호,함돈일.Sung Ho Choi. M.D.. Don Il Ham. M.D. 대한안과학회 2006 대한안과학회지 Vol.47 No.6
Purpose: To evaluate the risk factors and prevalence of retinopathy of prematurity (ROP) in extremely low birth weight (ELBW) infants and very low birth weight (VLBW) infants. Methods: All babies were screened for ROP at a postconceptional age of 31 weeks or at 4 weeks of chronological age. We divided the infants into two groups according to birth weight < 1000 g (ELBW) and 1000~1500 g (VLBW), to compare the incidence of ROP and photocoagulation, and to retrospectively evaluate the risk factors. Results: Three hundred eight consecutive infants were included in the data analysis. The incidences of ROP were 70.5% (79/112) in ELBW infants and 36.7% (72/196) in VLBW infants (p<0.0001). 31 of 79 ELBW infants (39.2%) and 17 of 72 VLBW infants (23.6%) had undergone photocoagulation (p<0.0001). Among the various risk factors, mechanical ventilat6ion (p=0.039) and surfactant (p<0.000) were the independent risk factors associated with ROP in all infant groups by logistic regression analysis. In the ELBW group, however, surfactant injection was the only factor independently associated with ROP (p=0.008). The use of surfactant, the only risk factor in ELBW infants, was attributed with the initiation of ROP. However, it did not act as an aggravating factor. Conclusions: ELBW was associated with a higher incidence of ROP and laser photocoagulation. The results of this study emphasize that more special attention is needed for immature infants when ventilators and surfactants are used.