유리체강내 트리암시놀론 주입술 후 예방적 안압하강제의 효과

이명원,경성은,장무환.Myung-Won Lee. M.D.. Sung Eun Kyung. M.D.. Moo-Hwan Chang. M.D. 대한안과학회 2008 대한안과학회지 Vol.49 No.5

Purpose: The purpose of this study was to investigate the prophylactic effect of brimonidine 0.15% on intraocular pressure (IOP) elevation and the risk factors for its elevation after intravitreal triamcinolone acetonide injection (IVTA). Methods: A prospective, randomized clinical trial was conducted on 67 eyes of 64 patients undergoing IVTA. Eyes were randomly divided into two groups, those which had used brimonidine 0.15% (40 eyes) and those which had not used it (27 eyes). IOP was measured preoperatively, at one week, and monthly until six months post-injection in each group. Results: The mean post‐injection IOP at one week was 11.93±3.36 mmHg for the group that had used brimonidine and 13.58±3.25 mmHg for the group that had not used it. The difference between the two groups was statistically significant at one week (p=0.049), but others were not statistically significant. An elevation in the IOP of more than 22 mmHg was seen in 8 eyes (20%) in the group using brimonidine and in 7 eyes (25.9%) in the group not using brimonidine. There was no difference in the incidence of IOP elevation between the two groups. Conclusions: Prophylactic use of brimonidine 0.15% will prevent sudden IOP elevation and will, therefore, prevent damage to the retina and optic nerve. However, in the long term, there is no prophylactic effect of brimonidine 0.15% on IOP elevation because there was no difference in the incidence of IOP elevation of more than 22 mmHg between the two groups.

단안 부등시성 약시의 약시 치료 전후 다국소시유발전위 검사결과

전지훈,경성은,Ji Hoon Jeon,MD,Sung Eun Kyung,MD,PhD 대한안과학회 2012 대한안과학회지 Vol.53 No.12

before and after occlusion treatment. Methods: The mfVEP was performed using RETIscanⓇ (Roland,Brandenburg, Germany) for patients with unilateral anisometropic amblyopia before and after occlusion treatment. Amplitude and latency values of mfVEP were analyzed according to the field divided by 6 rings or 4 sectors. Results: The each amplitude of values of all 6 rings were not significantly different before treatment (p = 0.077) in amblyopic eyes. However, the value of ring 1 (p = 0.00) was significantly higher than the value of other rings after treatment. In fellow eyes, the values of ring 1 was consistently significantly higher than the value of other rings before (p = 0.014) and after (p = 0.049) occlusion treatment. Additionally, the amplitudes of ring 1 (p = 0.005) and ring 3 (p = 0.007) were significantly increased in amblyopic eyes after occlusion treatment. In fellow eyes, the values of all rings did not change significantly. The analysis of amplitudes with 4 sectors revealed no significant result. The analysis of latencies with 6 rings and 4 sectors revealed no significant result. Conclusions: The change in amplitude on the central field (ring 1) in amblyopic eyes can be a useful objective monitoring method observing the improvement progress in visual acuity.

가성뇌종양으로 진단된 환자에서 터키안의 정량적 측정

김운형,경성은,Woon Hyung Ghim,Sung Eun Kyung 대한안과학회 2014 대한안과학회지 Vol.55 No.6

Purpose: In this study we evaluated the hypothesis that sella turcica enlarged in size due to increased intracranial hypertension by measuring the sella turcica area using magnetic resonance imaging (MRI) in patients with increased intracranial hypertension and compared to normal controls. Methods: Brain magnetic resonance (MR) midsagittal images of patients diagnosed with pseudotumor cerebri from 2005 to 2012 at Dankook University Hospital and 10 normal controls who had no overt signs or symptoms of neurological disease and had normal gadolinium-enhanced MR examination of brain were compared. The area of the sella turcica was measured by the double- blind method using Dicomworks v 1.3.5b (Philippe Puech and Loic Boussel, Freeware, France). Statistical analysis was conducted using GraphPad Prism (GraphPad Software, Inc., USA) and Mann-Whitney U-test. Results: The sella turcica areas of 2 pseudotumor cerebri patients were 93 mm2 and 123 mm2 and were significantly larger than in the controls (<em>p</em> = 0.03). Conclusions: Empty sella which commonly occurs in pseudotumor cerebri can be caused by pituitary gland atrophy but, conversely, can result from the enlargement of the bony sella in response to an abnormal cerebrospinal fluid pressure gradient. J Korean Ophthalmol Soc 2014;55(6):887-890

스펙트럼영역 빛간섭단층촬영기로 측정한 한국인 정상안의 황반부 용적

강명수,경성은,장무환,Myeong Su Kang,Sung Eun Kyung,Moo Hwan Chang 대한안과학회 2010 대한안과학회지 Vol.51 No.8

Purpose: To evaluate the mean macular volume in normal Korean eyes using spectral-domain optical coherence tomography. Methods: The present study consisted of 132 patients (212 eyes) with no ophthalmic evidence of retinopathy and who had a best corrected visual acuity of 1.0 or better. The total macular volume was measured using spectral-domain optical coherence tomography and was analyzed according to age group, sex, degree of refractive error and presence of systemic disease such as diabetes and hypertension. Results: The mean total macular volume of all subjects was 10.07 ± 0.45 mm3, with means of 10.13 ± 0.40 mm3, 10.05 ± 0.43 mm3 and 9.97 ± 0.58 mm3 measured for the respective A, B, and C age groups. There was a significant difference between male and female patients. In addition, there was a significant difference between diabetic patients in group C and normal subjects. However, there was no significant difference according to degree of refractive error. Conclusions: The measured value of mean macular volume in normal Korean eyes can be expected to provide a standard value for diagnosing retinal disease and the need for careful follow-up. J Korean Ophthalmol Soc 2010;51(8):1077-1083

비문증을 주소로 내원한 환자에서 발견된 지주막낭종 1예

장준규,경성은,장무환.June Kyu Chang. MD. Sung Eun Kyung. MD. Moo Hwan Jang. MD 대한안과학회 2009 대한안과학회지 Vol.50 No.3

Purpose: To report a case of a 9-year-old girl who complained of a floater symptom due to preretinal hemorrhage, subdural hemorrhage and arachnoid cyst. Case summary: A 9-year-old girl presented to our clinic with floater symptom in her right eye and a headache. Her corrected visual acuities were 20/20 in both eyes. Preretinal hemorrhage around the optic disc in both eyes was observed. Brain MRI revealed subdural hemorrhage on the frontal, temporal, and parietal lobes, and the arachnoid cyst in the right fronto-temporal lobe. One year later, the preretinal hemorrhages were absorbed. Conclusions: Arare case of concomitant preretinal and spontaneous subdural hemorrhage with arachnoid cyst was presented. The utilization of brain MRI is recommended to determine underlying causes when fundus examination reaveals retinal hemorrhage without trauma, systemic disease and neurologic symptom.

10세 이후 수술한 간헐외사시 환자의 임상양상 및 결과에 영향을 주는 요인

박진구,경성은.Jin Ku Park. MD. Sung Eun Kyung. MD. PhD 대한안과학회 2010 대한안과학회지 Vol.51 No.7

Purpose: To identify clinical characteristics and preoperative factors that influence the surgical results of an intermittent exotropia patient who underwent lateral rectus recession after the age of 10 years. Methods: A retrospective study was performed based on the medical records of 45 patients who underwent unilateral lateral rectus recession or bilateral lateral rectus recession for intermittent exotropia after the age of 10 years and who had undergone at least three months of postoperative follow-up. The authors investigated the clinical characteristics and factors associated with surgical success according to gender, age at surgery, fusion ability, preoperative angle of deviation, preoperative difference between near and far angles of deviation, vertical deviation, spherical equivalent of refractive error, Randot stereo test and postoperative angle of deviation at one week, one month, and three months. The postoperative deviation change according to the time between groups who underwent surgery before and after 10 years of age for intermittent exotropia was also compared. Results: Surgical success was defined as a final deviation of less than 10 prism diopters. Patients without vertical deviation had a better surgical outcome than did patients with vertical deviation (p=0.022). There was no significant difference in the postoperative deviation changes between groups who underwent surgery for intermittent exotropia before 10 years and after 10 years of age. Conclusions: Among the many preoperative influencing factors, vertical deviation showed a significant difference in postoperative improvement after intermittent exotropia surgery undergone after the age of 10 years. There was no difference in the aspects of surgical success between surgeries for intermittent exotropia before and after the age of 10 years.

안과 장애환자의 임상양상

강명수,경성은,Myeong Su Kang,Sung Eun Kyung 대한안과학회 2010 대한안과학회지 Vol.51 No.1

Purpose: To describe the characteristics of the disabled patients visiting the eye clinic in our institute. Methods: We carried out a retrospective analysis of 35 cases in our clinic from April 2004 to June 2008 using the McBride disability evaluation. We investigated the clinical features and the causes of disorders through visual acuity, visual field and ocular motility. Results: Thirty-three (94.3%) of the 35 patients had disabilities due to trauma; twelve (34.3%) of them were caused by traffic accidents, and 21 (60%) of them were due to blows or lacerations. Other causes of disability were glaucoma and retinal break (5.8%). Nine patients (25.7%) had abnormal findings in the visual field examination, and nine other patients (25.7%) had limitations in ocular motility. Twenty-eight patients (80%) had decreased visual acuity, and nine (25.7%) had multiple symptoms. Conclusions: Considering the contribution of disability estimation of visual field and ocular motility in McBride disability evaluations, we considered the importance of repetitive examinations and evaluations. When patients complained of unexplained decreased visual acuity with no anatomical abnormalities, multifocal ERG and multifocal VEP should be considered in order to distinguish it from malingering or functional visual loss. J Korean Ophthalmol Soc 2010;51(1):95-105

비동맥성 앞허혈시신경병증과 시신경염 감별을 위한 형광안저혈관조영술의 유용성

김시범,경성은,Si Bum Kim,MD,Sung Eun Kyung,MD,PhD 대한안과학회 2012 대한안과학회지 Vol.53 No.8

Purpose: To compare the fluorescein angiographic findings of nonarteritic anterior ischemic optic neuropathy (NA-AION) and optic neuritis. Methods: The present study included 41 patients (41 eyes), who were diagnosed with NA-AION or optic neuritis and underwent fluorescein angiography in our clinic. The clinical profiles of patients, characteristics of optic disc head and hemorrhage, and visual field findings were analyzed retrospectively. The onset and filling time, perfusion time of retinal artery, optic disc, and peripapillary choroid were evaluated quantitatively. Results: Patients with NA-AION showed statistically significant delay in both the onset time, filling time and perfusion time of the optic disc and peripapillary choroid compared with patients with optic neuritis (p < 0.05). There was no significant difference in the dye leakage of the peripapillary areas between the 2 groups (p = 0.324). Conclusions: In the present study, the results of fluorescein filling were significantly different between the NA-AION group and the optic neuritis group. The results may help determine the therapeutic plan and to differentiate between the 2 disease entities, especially in cases of overlapping clinical features. J Korean Ophthalmol Soc 2012;53(8):1143-1149

결막 임파종으로 의심된 환자에서 확진된 엡스타인-바 바이러스 결막종물 1예

신경윤,장무환,경성은,Kyoung Yoon Shin,Moo Hwan Chang,Sung Eun Kyung 대한안과학회 2014 대한안과학회지 Vol.55 No.10

Purpose: To report a case of conjunctival mass with infectious mononucleosis by Epstein-Barr virus (EBV) confirmed with Epstein-Barr encoding region (EBER) in situ hybridization. Case summary: A 8 year-old male without underlying disease was referred with counjunctival mass on the right eye starting 3 days ago. In ophthalmologic evaluation, there was injected, nontender, and “salmon patch” appearance conjunctival lesion on right superior bulbar conjunctiva. The patient was admitted to pediatrics with sore throat and fever. The tonsil were enlarged and white blood cell count was 14960/uL. EBV polymerase chain reaction (PCR) test and Viral capsid antigen Immunoglobulin M (VAC IgM) test were positive, the diagnose of infectious mononucleosis by EBV was made. After 5 days steroid eyedrop therapy, biopsy was performed because the lesion was not improved. There were lymphocyte infiltration, chronic inflammation and positive in EBER in situ hybridization. Conclusions: Elevated and pinkish lesion on conjunctiva, EBV lesion should be considered as differential diagnosis. J Korean Ophthalmol Soc 2014;55(10):1554-1557

577 nm 레이저 섬유주성형술의 단기 임상효과

김종민,조경진,경성은,장무환,Jong Min Kim,MD,Kyong Jin Cho,MD,Sung Eun Kyung,MD,PhD,Moo Hwan Chang,MD,PhD 대한안과학회 2014 대한안과학회지 Vol.55 No.4

Purpose: To evaluate the pressure-lowering effects of single-spot laser trabeculoplasty and patterned laser trabeculoplasty using a 577-nm wavelength laser. Methods: A total 35 eyes of 35 patients with primary open-angle glaucoma were enrolled in this study. Eighteen eyes of 18 patients were treated with 360° single-spot laser trabeculoplasty and 17 eyes of 17 patients were treated with 360° patterned laser trabeculoplasty. All patients were evaluated after laser trabeculoplasty at 1 week, 1 month, 3 months, and 6 months using slit lamp examination and Goldmann applanation tonometry. Results: At 6 months postoperatively, the single-spot laser trabeculoplasty group had a mean IOP of 15.89 ± 3.89 mm Hg with a mean IOP reduction of 37.1%, while the patterned laser trabeculoplasty group had a mean IOP of 17.57 ± 2.64 mm Hg with a mean IOP reduction of 27.1%. Conclusions: Laser trabeculoplasty with a 577-nm optically pumped semiconductor laser was safe and demonstrated an IOP lowering effect. There were no significant differences in the IOP lowering effects between the single-spot laser trabeculoplasty and the patterned laser trabeculoplasty. J Korean Ophthalmol Soc 2014;55(4):563-569