돌연변이 마이오실린 발현에 의한 섬유주세포 사멸 및 그 기전

임동희,손성수,김태은,기창원,Dong Hui Lim,Seongsoo Sohn,Tae Eun Kim,Changwon Kee 대한안과학회 2011 대한안과학회지 Vol.52 No.12

Purpose: To determine whether the expression of mutant myocilin can lead to death of human trabecular meshwork (HTM) cells and to determine whether the mechanism by which this occurs is apoptosis. Methods: HTM cells were transduced with a recombinant adenovirus expressing human mutant (Q368X) myocilin. The apoptotic death of HTM cells caused by expression of mutant myocilin was examined using a cell proliferation assay, flow cytometry, Western blot analysis, and immunocytochemistry. Results: It appeared that the expression of mutant myocilin itself was not sufficient to cause HTM cell death. Furthermore, the expression of mutant myocilin did not lead to apoptosis of HTM cells although it did elicit a protein unfolding response. Conclusions: Our data suggest that the mechanism of myocilin glaucoma is not apoptotic death of HTM cells caused by mutant myocilin expression, and that the actual mechanism remains unknown. J Korean Ophthalmol Soc 2011;52(12):1507-1513

ZCB00 인공수정체의 부분결합간섭계와 초음파 방식의 술 후 굴절 예측치 차이

신동훈,임동희,유자영,정의상,정태영,Dong Hoon Shin,Dong Hui Lim,Ja Young You,Eui Sang Chung,Tae Young Chung 대한안과학회 2014 대한안과학회지 Vol.55 No.4

Purpose: To evaluation the accuracy of the IOL power calculation formulae measured by IOL Master<sup>® and applanation ultrasonography for the Tecnis ZCB00 IOL Methods: We performed a retrospective study of 170 eyes in 121 patients who underwent cataract surgery in our hospital with AMO Tecnis ZCB00 IOL.s. The SRK/T formula was used to predict the patient's implanted IOL power. Differences in the predicted refractive errors between IOL Master<sup>® and ultrasonography were analyzed and factors attributed to the differences were also analyzed. Three months after cataract surgery, mean numeric error and mean absolute error were analyzed. Results: SRK/II and SRK/T formulas calculated using ultrasonography showed differences compared to the same formulas calculated using IOL Master<sup>®, in which hyperopic shift was also demonstrated. No definite factor was attributed to the differences between the 2 methods. Although the 3 formulas of IOL Master<sup>® showed no significant difference in refractive errors, the SRK/T formula calculated using IOL Master<sup>® showed the least mean absolute and numeric errors. Conclusions: IOL Master<sup>® is considered more suitable when determining proper AMO Tecnis ZCB00 IOL power in cataract surgery. The hyperopic shift should be considered when calculating the IOL power using only ultrasonography. J Korean Ophthalmol Soc 2014;55(4):527-533

정상안압녹내장의 시야 진행과 시신경유두주위위축의 관련성

한종철,서울,임동희,기창원.Jong Chul Han. MD. Wool Suh. MD. Dong Hui Lim. MD. Changwon Kee. MD. PhD 대한안과학회 2012 대한안과학회지 Vol.53 No.6

Purpose: To evaluate the relations between progression of glaucoma in visual field and peripapillary area change in normal tension glaucoma (NTG). Methods: We respectively evaluated 66 patients (66 eyes) with normal tension glaucoma; these patients were classified as progressive glaucoma group and non-progressive glaucoma group by visual field test. Interobserver and intraobserver agreement was evaluated for qualitative assessment. Zone β change was measured by Image J (National Institute of Health, Bethesda, USA) by two methods. One method used paired t-test and the other method used CV (correlation of variation) to define significant progression of zone β. Results: 46 patients (46 eyes) were classified as progressive glaucoma and 20 patients (20 eyes) were classified as non-progressive glaucoma. There was no statistically significant different change of zone β between two groups and there were no changes of zone β over coefficient of variation (CV). Conclusions: The measurement of change of zone β seems to be of no use in recognition of progression in normal tension glaucoma. J Korean Ophthalmol Soc 2012;53(6):807-812

겔솔린형 격자 각막 이영양증 1예

김태협,배지현,임동희,정의상,정태영,Tae Hyup Kim,MD,Ji Hyun Bae,MD,Dong Hui Lim,MD,Eui Sang Chung,MD,PhD,Tae Young Chung,MD,PhD 대한안과학회 2013 대한안과학회지 Vol.54 No.4

Purpose: To report the first case of lattice corneal dystrophy, gelsolin type in Korea. Case summary: A 61-year-old man visited our clinic with severe dry eye symptom in both eyes. Clinical examination revealed in both eyes a visual acuity of 0.7 without correction and intraocular pressure of 18 mm Hg. On slit-lamp examination, both corneas had scattered lattice lines at various depths within the stroma with punctate epithelial erosions. The patient had characteristic features of Meretoja syndrome, including cranial neuropathy characterized by dermatochalasis and facial weakness, and was positive for the gelsolin mutation according to DNA analysis. This is the first description of a patient with lattice corneal dystrophy, gelsolin type in Korea. Conclusions: This is the first description of a patient with lattice corneal dystrophy, gelsolin type in Korea and demonstrates the importance of recognizing the systemic and ophthalmic features for appropriate management of the condition.

각막굴절교정학용 렌즈가 소아의 근시 진행에 미치는 영향

김재령,정태영,임동희,배지현,Jae Ryung Kim,MD,Tae Young Chung,MD,PhD,Dong Hui Lim,MD,Ji Hyun Bae,MD 대한안과학회 2013 대한안과학회지 Vol.54 No.3

Purpose: The present study assessed the influence of overnight orthokeratology (ortho-k) on the myopic progression in Korean children and analyzed factors affecting myopic progression. Methods: The ortho-k group was comprised of 31 patients satisfying the inclusion criteria for ortho-k. In the ortho-k group, spherical equivalent refractive error (SER) was measured at baseline, and after 2 weeks, 6 and 12 months. The control group was comprised of 31 patients who were matched according to age, gender, and baseline SER of the ortho-k subjects. Results: In the ortho-k group, the mean ± SD changes in SER from 2 weeks to 6 months, 6 to 12 months, and 2 weeks to 12 months were -0.17 ± 0.50 D, -0.04 ± 0.76 D, and -0.21 ± 0.78 D, respectively. In the control group, the changes in SER from baseline to 6 months, 6 to 12 months, and baseline to 12 months were -0.38 ± 0.42 D, -0.44 ± 0.38 D, and -0.82 ± 0.68 D, respectively. Significant differences were found between changes in SER from 6 to 12 months and from baseline to 12 months (p < 0.05). In the ortho-k group, relationships between the changes of SER for 1 year and the numeric values of baseline measurements were analyzed. When comparing the results between the group of SER change ≥ -0.5 D with the group of SER change < -0.5 D, numeric values of white-to-white diameters of the 2 groups were different, and a significant correlation was found between the range of SER change and the white-to-white diameter (Pearson’s r = -0.471, p = 0.008). Conclusions: Ortho-k is effective for slowing myopic progression. The smaller the white-to-white diameter, the slower the myopic progression could be.

백내장 수술에서 수정체낭원형절개와 인공수정체의 중심이탈 및 경사가 임상 결과에 미치는 영향

어두리(Doo Ri Eo),임동희(Dong Hui Lim),현주(Joo Hyun),이주연(Ju Yeon Lee),임한웅(Han Woong Lim),오재응(Jae Eung Oh),정의상(Eui Sang Chung),정태영(Tae Young Chung) 대한안과학회 2016 대한안과학회지 Vol.57 No.4

목적: 백내장 수술 후 수정체낭원형절개와 인공수정체의 중심이탈 및 경사도가 술 후 임상 결과에 미치는 영향을 알아보고자 한다. 대상과 방법: 백내장 수술을 받은 환자 52명 62안을 대상으로 술 전과 술 후 3개월의 나안 및 교정시력, 현성굴절검사를 시행하였다. 술 후 3개월에 전안부 사진을 촬영하여 인공수정체의 중심이탈 정도를 분석하고, 전안부단층촬영을 하여 인공수정체의 경사도를 분석하여, 술 후 나안시력, 교정시력 및 고위수차와의 관련성을 분석하였다. 또한 술 중 수정체낭원형절개의 크기 및 중심이탈을 측정하여 술 후 인공수정체의 위치 변화와의 연관성을 알아보았다. 결과: 술 중 평균 수정체낭원형절개의 크기는 5.40 ± 0.51 mm (4.12-6.24 mm), 중심이탈은 0.30 ± 0.19 mm (0.09-1.21 mm)였으며, 술 후 평균 인공수정체의 중심이탈은 0.23 ± 0.15 mm (0.00-0.71 mm), 경사도는 1.43 ± 0.73° (0.00-4.22°)로 측정되었다. 술 중 수정체낭원형절개의 크기 및 중심이탈 정도는 술 후 인공수정체의 중심이탈과는 유의한 관련성을 보였으나(p=0.01, p<0.001), 술 후 인공수정체의 경사도와는 관련이 없었다(p=0.69, p=0.52). 술 후 인공수정체의 중심이탈 및 경사도는 술 후 시력, 난시 및 고위수차와는 유의한 관련성을 보이지 않았다(p>0.05). 결론: 술 중 수정체낭원형절개의 크기 및 중심이탈은 술 후 인공수정체의 중심이탈에 영향을 미치지만, 인공수정체의 중심이탈과 경사도는 술 후 임상 결과에 큰 영향을 주지 않는 것으로 생각한다. Purpose: To evaluate the effects of continuous curvilinear capsulorhexis, intraocular lens (IOL) decentration and tilt on postoperative clinical outcomes after cataract surgery. Methods: We reviewed 62 eyes of 52 patients who underwent cataract surgery and measured the uncorrected visual acuity, best corrected visual acuity and manifest refraction preoperatively and 3 months postoperatively. IOL decentration on anterior segment photography and IOL tilt on anterior optical coherent tomography were analyzed and correlations of postoperative uncorrected visual acuity, best corrected visual acuity, and higher order aberrations were evaluated. In addition, we inspected the relationship of size and decentration of continuous curvilinear capsulorhexis (CCC) intraoperatively with the change in IOL position postoperatively. Results: The average size of CCC was 5.40 ± 0.51 mm (4.12-6.24 mm) and the average decentration of CCC was 0.30 ± 0.19 mm (0.09-1.21 mm) intraoperatively. The average decentration of IOL was 0.23 ± 0.15 mm (0.00-0.71 mm) and the average IOL tilt was 1.43 ± 0.73° (0.00-4.22°) postoperatively. Intraoperative CCC size and decentration were associated with postoperative IOL decentration (p = 0.01, p < 0.001), but not with IOL tilt (p = 0.69, p = 0.52). There were no significant correlations between IOL decentration and tilt with postoperative visual outcomes and higher order aberrations. Conclusions: The CCC size and decentration can affect the IOL decentration, but IOL decentration and tilt do not have a significant impact on clinical outcomes after cataract surgery.

Double-pass 영상기법을 이용한 객관적인 백내장 정도 평가

이은정(Eun Jung Lee),임동희(Dong Hui Lim),현주(Joo Hyun),정태영(Tae-Young Chung) 대한검안학회 2016 Annals of optometry and contact lens Vol.15 No.1

Purpose: To evaluate objective cataract grading with double-pass image technique. Methods: Cataract grading was performed with lens opacities classification system III and HD analyzer, and quality of vision questionnaire was conducted. Patients were divided by preoperative best-corrected visual acuity into two groups; those with visual acuity less than 20/30 to group A, and those with visual acuity better than 20/30 to group B. The correlation of HD Analyzer parameters including objective scatter index (OSI) and preoperative visual acuity was investigated. Results: Among a total of 50 eyes of 37 patients, group B consisted of 20 eyes (40%) of 10 patients. OSI score was 5.8 ± 2.8 (1.9-10.6), and cases with score over 5 consisted 68%, and 52% among group B. OSI showed significant positive relationship to preoperative best-corrected visual acuity (p=0.012), but cases with good visual acuity and relatively high OSI score resulted in weaker relationship between OSI and visual acuity. OSI score was related to focus item in questionnaire. Conclusions: Cataract surgery decision based on best-corrected visual acuity can overlook the discomfort of patients with good visual acuity and subjectively decreased quality of vision. OSI measurement via HD Analyzer could be expected to act as an objective method to evaluate cataract grade and help in deciding early surgery, especially in patients with good visual acuity and subjective discomfort.

백내장 수술 시 첫 번째 안의 실제굴절오차의 반영률에 따른 두 번째 안의 실제굴절오차

어두리(Doo Ri Eo),임동희(Dong Hui Lim),현주(Joo Hyun),최재환(Jae Hwan Choi),이민규(Min Gyu Lee),정의상(Eui Sang Chung),정태영(Tae Young Chung) 대한안과학회 2016 대한안과학회지 Vol.57 No.3

목적: 양안 초음파 수정체유화술 및 후방 인공수정체 삽입술을 시행 받은 환자에서 실제굴절오차를 분석하여 첫 번째 수술 후의 실제 굴절오차를 두 번째 수술 시에 어느 정도 반영하여야 실제굴절오차를 최소화할 수 있는지를 분석하고자 한다. 대상과 방법: 양안 백내장 수술을 시행 받은 환자 248명을 대상으로 후향적 연구를 시행하였으며, 수술 전에 산출된 예상굴절력의 구면렌즈 대응치와 술 후의 실제굴절력의 구면렌즈 대응치를 비교하였고, 첫 번째 수술 시의 실제굴절오차의 반영률을 계산하여 반영률에 따른 두 번째 수술 시의 실제굴절오차의 범위를 분석하였다. 결과: 첫 번째 수술 시의 IOL Master?潁? 이용하여 Sanders-Retzlaff-Kraff (SRK)-T, SRK II 공식으로 계산된 예상굴절력과 실제굴절력의 차이가 0.5D보다 큰 경우에 그 차이의 50-60%, 40-50%를 반영하는 것이 두 번째 수술 시의 실제굴절오차를 0.5D 이내로 줄일 수 있는 확률이 제일 높았다(75%, 100%). 결론: 양안 백내장 수술 시, 첫 번째 수술 시의 실제굴절오차를 40-60% 반영하는 것이 두 번째 수술 시의 실제굴절오차를 더 줄일 수 있다. Purpose: To evaluate the reflection rate of the first eye in order to minimize the real refractive error in the second eye in bilateral consecutive cataract surgeries. Methods: A retrospective analysis was performed with 248 patients who underwent bilateral sequential uncomplicated phacoemulsification and posterior chamber intraocular lens implantation. Predicted spherical equivalent was compared with postoperative spherical equivalent, and the range of real refractive error was analyzed by calculating the reflection rate of the first eye. Results: When the difference between predicted spherical equivalent and postoperative spherical equivalent was greater than 0.5 D as calculated with the formula of Sanders-Retzlaff-Kraff Theoretical (SRK)-T and SRK II, application of 50-60%, 40-50% of the difference of the first eye was high probability to reduce the second-eye real refractive error (75%, 100%). Conclusions: Application of 40-60% of the real refractive error in the first-eye can minimize the real refractive error in the second-eye in bilateral sequential cataract surgeries.

마이봄샘 기능 이상 환자에서 자동 온열 압박 치료기기의 임상적 효과 및 예후 분석

남승완(Seung Wan Nam),임동희(Dong Hui Lim),현주(Joo Hyun),정태영(Tae Young Chung) 대한안과학회 2016 대한안과학회지 Vol.57 No.5

목적: 마이봄샘 기능 이상 환자에서 자동 온열 압박 치료기기(KCL 1100??, Korea KCL, Bucheon, Korea)의 효과 및 안전성 평가를 시행하고, 자동 온열 압박 치료 효과에 영향을 주는 요인을 알아보고자 하였다. 대상과 방법: 마이봄샘 기능 이상으로 진단된 환자 24명 48안을 대상으로 1달간 전향적 연구를 시행하였다. 대상 환자는 매일 하루 2회, 15분씩 자동 온열 압박 치료기기(KCL 1100??)를 사용하였고, 치료 전, 치료 2주 후 및 1달 후 내원하여 나안시력, 안압, Standard Patient Evaluation for Eye Dryness (SPEED), Ocular Surface Disease Index (OSDI), Lipid Layer Thickness (LLT), Meibomian Gland Secretion score (MGS), Meibomian Gland Expressibility (MGE), 눈물막 파괴 시간(tear break-up time, BUT), 플루오레신 각막 염색 점수(Oxford scale)를 측정하였다. 자동 온열 압박 치료의 효과 및 안전성 분석 시 내원 시마다 측정한 각각의 지표를 짝지은 t 검정을 시행하였다. 자동 온열 압박 치료 효과에 영향을 주는 초기 요인을 확인하기 위해 이 지표들의 치료 전과 치료 1달간 변화량에 대해 단일 회귀 분석을 시행하였다. 자동 온열 압박 치료에 따른 마이봄샘 기능 변화와 증상 호전 및 안구표면 변화의 관계를 확인하기 위해 치료 1달간 마이봄샘 기능의 변화량과 치료 1달간 건조증 증상 및 안구 표면 지표들의 변화량에 대해 단일 회귀분석을 시행하였다. 결과: 대상 환자들은 중등도 이하의 마이봄샘 기능 이상 환자로 치료 전 MGE의 평균은 3.08 ± 1.77, MGS의 평균은 4.11 ± 3.05였다. 자동 온열 압박 치료 이후 안구 건조 증상(SPEED, OSDI)과 안구 표면 지표(BUT, Oxford scale), 마이봄샘 기능 지표(MGE, MGS)는 치료 2주 후와 1달 후에 치료 전에 비해 모두 유의한 호전이 있었다(p<0.05). 또한 치료 전 증상이 심했던 군과 치료 전 마이봄샘기능 이상 정도가 심했던 군에서 치료 후 개선 정도가 컸다(p<0.05). 치료 후 마이봄샘의 기능 개선 정도(MGE 변화량)는 안구 표면상태의 호전(BUT, Oxford scale 변화량)과 유의한 관계를 보였지만, 건조 증상의 개선(SPEED, OSDI 변화량)과는 유의한 관계가 없었다. 치료기간 동안 임상적으로 유의한 부작용은 관찰되지 않았다. 결론: 마이봄샘 기능 이상 환자에서 자동 온열 압박 치료 기기는 안전성 있게 마이봄샘 기능 이상 및 안구 건조증을 호전시켰으며, 특히 중등도 이하의 마이봄샘 기능 이상에서는 안구 건조 증상과 마이봄샘 기능 이상 정도가 심한 경우에서 더욱 효과적이었다. Purpose: To evaluate the effect and prognostic factors of automated thermodynamic treatment (thermal compression therapy device [KCL 1100??]) for Meibomian gland dysfunction (MGD). Methods: Patients (48 eyes of 24 subjects) with MGD were recruited for a prospective clinical trial. Patients received 15-minute treatments twice a day using the KCL 1100??. Severity of dry eye symptoms were evaluated using the Standard Patient Evaluation for Eye Dryness (SPEED) and Ocular Surface Disease Index (OSDI), and severity of Meibomian gland function was evaluated using the Meibomian gland expressibility (MGE), Meibomian gland secretion (MGS) score and lipid layer thickness measured by LipiView??. To evaluate ocular surface, we measured tear break-up time (BUT) and fluorescein corneal staining score (Oxford scale). Data were presented for baseline and at 2 weeks and 1 month post-treatment. Results: Dry eye symptom (SPEED, OSDI), Meibomian gland function (MGE, MGS), and ocular surface index (BUT, Oxford scale) of patients were significantly improved from baseline to 2 weeks (p < 0.05) and 1 month post-treatment (p < 0.05). In addition, patients with more severe dry eye symptom and Meibomian gland index at baseline examination achieved improvement in mild to moderate MGD (p < 0.05). Improvement of Meibomian gland function (MGE) was associated with improvement of ocular surface index (BUT, Oxford scale) (p < 0.05), but not with improvement of dry eye symptom (SPEED, OSDI) (p > 0.05). There were no significant adverse events during the treatment. Conclusions: KCL 1100?? automated thermodynamic treatment is an effective and safe treatment for MGD. Additionally, KCL 1100?? is more effective in patients with moderate dry eye symptom and MGD.

수정체초음파유화술 후에 생긴 인공수정체 탈구의 선행 요인의 빈도와 치료 결과

윤제문(Je Moon Yoon),현주(Joo Hyun),임동희(Dong Hui Lim),정의상(Eui Sang Chung),정태영(Tae Young Chung) 대한안과학회 2016 대한안과학회지 Vol.57 No.1

Purpose: To report the predisposing factors and surgical outcomes of intraocular lens dislocation (IOL) after phacoemulsification. Methods: We performed a retrospective study of 131 eyes in 120 patients who were diagnosed with IOL dislocation after phacoemulsification between January 2008 and December 2013. The main outcomes are possible predisposing factors, characteristics of IOL dislocation, and outcomes of rectification surgery, including visual acuity (VA), and refractive status before and at 3 months after surgery. Results: The main conditions associated with IOL dislocation were as follows: status after vitrectomy (27.5%), long axial length(9.2%), neodymium-doped yttrium aluminium garnet (Nd:YAG) posterior capsulotomy (8.4%), uveitis (6.1%), trauma (5.3%), mature cataract (3.8%), and pseudoexfoliation (2.3%). Mean uncorrected VA improved significantly after rectification surgery (p= 0.00), and best-corrected VA also improved significantly (p = 0.01). Mean value of spherical equivalent tended to decrease, although the decrease was not significant (p = 0.07). Whereas astigmatism showed a significant increase (p = 0.01). 6 eyes (4.6%)were associated with recurrence of IOL dislocation. Conclusions: Possible major predisposing factors for IOL dislocation are status after vitrectomy, long axial length, Nd:YAG posterior capsulotomy, uveitis, and trauma. The surgical outcome and improvement of postoperative visual acuity were satisfactory.