A Case of Ciliary Body Melanocytoma Presenting as a Painful Iris Mass

Christopher Seungkyu Lee,Do Kyung Kim,Sung Chul Lee 대한안과학회 2010 Korean Journal of Ophthalmology Vol.24 No.1

We report a case of ciliary body melanocytoma in a Korean patient, which presented as an intermittently painful pigmented iris mass and was successfully managed by iridocyclectomy. A 52-year-old healthy man presented with an irregularly-shaped and heavily-pigmented mass at the iris root of his right eye. Visual acuity of the right eye was 20/20 with normal intraocular pressure. Ultrasound biomicroscopy showed a 1.5x1.3-mm ciliary-body mass with extension into the iris root. Iridocyclectomy with scleral resection under a lamellar scleral flap was performed, and the histopathologic features of the resected tissue were consistent with melanocytoma of the ciliary body. The patient`s visual acuity remained 20/20 with good postoperative cosmesis. During one year of follow-up, no signs of tumor recurrence were seen, and the patient reported resolution of the intermittent ocular pain in the involved eye.

CENTRAL SEROUS CHORIORETINOPATHY AFTER RENAL TRANSPLANTATION

Lee, Christopher Seungkyu,Kang, Eui Chun,Lee, Kyu Sung,Byeon, Seok Ho,Koh, Hyoung Jun,Lee, Sung Chul The Ophthalmic Communications Society, Inc. 2011 Retina Vol.31 No.9

PURPOSE:: To describe the demographic and clinical characteristics of central serous chorioretinopathy (CSC) after renal transplantation (RT). METHODS:: A retrospective medical chart review was performed on 451 among 2,980 patients, who underwent RT and visited vitreoretinal clinic at Yonsei Medical Center from 1979 to 2009. Correlation between daily corticosteroid dosage and remission time and factors relating to final visual acuity of <20/40 were studied. RESULTS:: Twenty-eight patients (39 eyes) developed CSC at a median of 63 months after RT (range, 2 months to 20 years), and 18 (64%) patients were men. Accordingly, the prevalence of CSC after RT was estimated to be between 1% and 6%. All patients received a combination of corticosteroid and at least one other immunosuppressant agent at presentation. Reducing the daily corticosteroid dosage by 25% to 50% in CSC with classic pattern resulted in twice as faster remission (2 months) compared with the maintained dosage group (P = 0.025). Central serous chorioretinopathy recurrence (P = 0.002), intrinsic renal disease as cause of RT (P = 0.003), severe CSC variant (P = 0.009), and presenting visual acuity <20/40 (P = 0.009) predicted a final visual acuity <20/40. CONCLUSION:: Central serous chorioretinopathy develops relatively often after RT and varies in presentation and severity. The cause of CSC after RT appears to be multifactorial and closely related to corticosteroid.

Central Retinal Vein Occlusion in a 13-Year-Old COVID-19 Patient: A Case Report

Sokheang Sin(Sokheang Sin),Hyun Goo Kang(Hyun Goo Kang),Christopher Seungkyu Lee(Christopher Seungkyu Lee ) 대한안과학회 2023 Korean Journal of Ophthalmology Vol.37 No.3

Clinical and Genetic Findings in Korean Patients with Choroideremia

Woo Gyeong Jo,Christopher Seungkyu Lee,Jinu Han 대한안과학회 2023 Korean Journal of Ophthalmology Vol.37 No.4

Purpose: We share and analyze the clinical presentations and genotypes of Korean male patients and female carriers who visited our clinic. Methods: Six male patients and three female carriers with comprehensive ophthalmic examinations and next-generation sequencing were included. Detailed clinical features were identified using visual field (VF) test and multimodal imaging including color fundus photography, fundus autofluorescence (FAF), and optical coherence tomography (OCT). Results: Six male patients were diagnosed with choroideremia at the median age of 25 years. Before genetic testing, three patients (50.0%) were clinically diagnosed with choroideremia, while the other three patients (50.0%) with retinitis pigmentosa. Patients showed different types of hemizygous CHM variants, including two nonsense variants, c.715C>T:p.(Arg239*) and c.799C>T:p.(Arg267*); two frameshift variants, c.1584_1587del:p.(Val529Hisfs*7) and c.403_404del:p.(Asp135Phefs*9); one splicing variant c.1511-28_1511-2del; and one exon 2-8 duplication. The latter three variants were novel. Two female carriers had heterozygous exon 2-8 duplication and the other one female carrier had heterozygous nonsense variant c.715C>T:p. (Arg239*). Fundus showed diffuse yellow-whitish scleral reflex and granular pigmented lesions. FAF showed multiple patchy hypofluorescence lesions, sparing macula. OCT showed thinning of outer nuclear layer, ellipsoid zone, retinal pigment epithelium layer, choroid thickness, interlaminar bridges, outer retinal tubulations, and microcysts in the inner nuclear layer. VF showed ring scotoma pattern with small amount of remaining central field. Asymptomatic female carriers showed variable fundus findings and mild changes in OCT. Conclusions: A detailed description of the genotypes with three novel mutations and phenotypes of six choroideremia patients and three CHM mutation female carriers are presented.

Effects of Posterior Extension on the Clinical Characteristics and Surgical Outcomes of Ciliary Body Tumors

Soo Han Kim,Christopher Seungkyu Lee,Jihwan Lee,Sung Chul Lee 한국망막학회 2019 Journal of Retina Vol.4 No.1

Purpose: To describe the effects of ciliary body tumor posterior extension on clinical characteristics and surgical outcomes. Methods: A chart review was performed on patients with ciliary body tumor that visited between January 1, 2005 and December 31, 2015. Patients were divided into three groups based on tumor posterior extension, as follows; group 1, posterior extension within 6 mm of the limbus; group 2, posterior extension of 6-12 mm; and group 3, posterior extension of more than 12 mm from the limbus. Results: Sixty-one patients were screened, and 49 had pathologically confirmed ciliary body tumors. Malignant melanoma (28 cases, 57.1%) was the most common type of ciliary body tumor. Benign neoplasm was common when the tumor was confined to the ciliary body (group 1), and a higher malignancy rate was observed in those with advanced posterior extension (groups 2, 3) than in group 1 (p = 0.001). Final visual acuity was poorer in patients with advanced posterior extension (p < 0.001), and postoperative retinal detachment rates were higher in these patients (p = 0.007). Conclusions: Ciliary body tumors with advanced posterior extension had a higher malignancy rate and were associated with poorer visual outcomes.

두 종류의 스펙트럼영역 빛간섭단층촬영기를 사용한 정상 한국인의 맥락막 두께 측정의 재현성

이광현,이성철,이승규.Kwang Hyun Lee. MD. Sung Chul Lee. MD. Christopher Seungkyu Lee. MD 대한안과학회 2013 대한안과학회지 Vol.54 No.9

Purpose: To investigate the reproducibility of choroidal thickness measurements in healthy Koreans using two spectral domain optical coherence tomography (SD-OCT) instruments: Zeiss Cirrus HD-OCT (Carl Zeiss Meditec Inc., Dublin, CA, USA) and Heidelberg Spectralis (Heidelberg Engineering, Heidelberg, Germany). Methods: Images were obtained in 60 eyes of 30 healthy undilated volunteers without ocular pathology in a clinical setting. The choroid was imaged in all subjects using Cirrus HD 1-line raster and Spectralis enhanced depth imaging (EDI). The choroid was measured subfoveally, 1500 μm temporal, and 1500 μm nasal to the fovea. All measurements were performed by two independent observers. One-way analysis of variance (ANOVA), Pearson correlation, and Bland–Altman analysis were used to compare measurements. Results: The study group consisted of 15 males and 15 females. The mean age was 50.73 ± 15.09 years (range, 24-75 years). There was no significant difference in the mean choroidal thickness (p > 0.05) between systems for any location. The choroidal thickness measurements using two instruments (Cirrus vs. Spectralis) were also strongly correlated (p < 0.001). Conclusions: In the present study of healthy Korean adults, good reproducibility was observed between choroidal thickness measurements of images obtained from Cirrus and Spectralis.

한국의 개방성 안구손상 환자의 유형 및 시력의 예후인자

김혜선,이성철,이승규,Hye Sun Kim,MD,Sung Chul Lee,MD,Christopher Seungkyu Lee,MD 대한안과학회 2012 대한안과학회지 Vol.53 No.10

Purpose: To characterize epidemiologically open-globe injuries and to identify prognostic factors for visual outcomes after open-globe injuries in Korea. Methods: The medical records of 138 patients with open-globe injuries presenting to the Severance Hospital between January 2005 and June 2011 were retrospectively reviewed. Results: Out of 138 patients, 85.5% were men. The types of injury included penetrating injury (44.2%), intraocular foreign body (15.9%), blunt injury (35.5%), and perforating injury (3.6%). The most common cause of injury was accidents at work (49.3%) and 60.9% of these injuries were a penetrating wound in zone I limited to the cornea. Predictors of poor visual outcome using univariate analysis included wound extended to posterior sclera, wound length of 10 mm or more, poor initial visual acuity of hand motion or less, and presence of associated ocular injuries at presentation including hyphema, lens injury, vitreous hemorrhage, and retinal detachment. Initial visual acuity and wound size were independent prognostic factors of visual outcome. Conclusions: Accidents at work are the most important cause of open-globe injuries in Korea. Accordingly, protective measures such as appropriate eyewear and safety education at work are warranted. Initial visual acuity and wound size predicted favorable visual outcome. J Korean Ophthalmol Soc 2012;53(10):1505-1511

A three-dimensional human neural cell culture model of Alzheimer’s disease

Choi, Se Hoon,Kim, Young Hye,Hebisch, Matthias,Sliwinski, Christopher,Lee, Seungkyu,D’Avanzo, Carla,Chen, Hechao,Hooli, Basavaraj,Asselin, Caroline,Muffat, Julien,Klee, Justin B.,Zhang, Can,Wainger, B Nature Publishing Group, a division of Macmillan P 2014 Nature Vol.515 No.7526

Alzheimer’s disease is the most common form of dementia, characterized by two pathological hallmarks: amyloid-β plaques and neurofibrillary tangles. The amyloid hypothesis of Alzheimer’s disease posits that the excessive accumulation of amyloid-β peptide leads to neurofibrillary tangles composed of aggregated hyperphosphorylated tau. However, to date, no single disease model has serially linked these two pathological events using human neuronal cells. Mouse models with familial Alzheimer’s disease (FAD) mutations exhibit amyloid-β-induced synaptic and memory deficits but they do not fully recapitulate other key pathological events of Alzheimer’s disease, including distinct neurofibrillary tangle pathology. Human neurons derived from Alzheimer’s disease patients have shown elevated levels of toxic amyloid-β species and phosphorylated tau but did not demonstrate amyloid-β plaques or neurofibrillary tangles. Here we report that FAD mutations in β-amyloid precursor protein and presenilin 1 are able to induce robust extracellular deposition of amyloid-β, including amyloid-β plaques, in a human neural stem-cell-derived three-dimensional (3D) culture system. More importantly, the 3D-differentiated neuronal cells expressing FAD mutations exhibited high levels of detergent-resistant, silver-positive aggregates of phosphorylated tau in the soma and neurites, as well as filamentous tau, as detected by immunoelectron microscopy. Inhibition of amyloid-β generation with β- or γ-secretase inhibitors not only decreased amyloid-β pathology, but also attenuated tauopathy. We also found that glycogen synthase kinase 3 (GSK3) regulated amyloid-β-mediated tau phosphorylation. We have successfully recapitulated amyloid-β and tau pathology in a single 3D human neural cell culture system. Our unique strategy for recapitulating Alzheimer’s disease pathology in a 3D neural cell culture model should also serve to facilitate the development of more precise human neural cell models of other neurodegenerative disorders.

Stage 3 플러스 징후를 동반한 미숙아 망막병증에서 일차 유리체강내 베바시주맙 주입술의 효과

김성은,임형택,이승규,Sung Eun Kim,Tyler Hyung Taek Rim,Christopher Seungkyu Lee 대한안과학회 2015 대한안과학회지 Vol.56 No.1

Purpose: To evaluate the efficacy and safety of primary intravitreal bevacizumab injection in stage 3 retinopathy of prematurity with plus signs. Methods: We reviewed retrospectively the medical records of 30 eyes of 16 patients diagnosed with stage 3 retinopathy of prematurity with plus signs treated with primary intravitreal bevacizumab injection between March 1, 2011 and February 28, 2013 and followed up for at least 9 months. Results: Mean gestational age was 26 + 4 weeks ± 11 days and mean birth weight was 822 ± 251.4 g. The locations of disease were zone II in 24 eyes and zone III in 6 eyes. Intravitreal bevacizumab injection was performed after the mean 1.3 ± 1 day after plus signs were detected. Mean postconceptional age at treatment was 38 + 2 weeks ± 16 days. Mean follow-up period was 16.6 ± 6.9 months. Plus signs started to regress after the mean 4.6 ± 2.3 days after injection and completely regressed after the mean 24.3 ± 12.4 days. Cataract extraction was performed in 1 eye due to a cataract that appeared not associated with the injection procedure, but was regarded as a treatment failure. There were no local or systemic complications. Conclusions: Primary intravitreal bevacizumab injection in stage 3 retinopathy of prematurity with plus signs demonstrated excellent short-term efficacy and safety. J Korean Ophthalmol Soc 2015;56(1):62-69

Retinal Artery Occlusion and the Risk of Stroke Development : Twelve-Year Nationwide Cohort Study

Rim, Tyler Hyungtaek,Han, Jinu,Choi, Yoon Seong,Hwang, Seung-sik,Lee, Christopher Seungkyu,Lee, Sung Chul,Kim, Sung Soo American Heart Association 2016 Stroke Vol. No.

<P>Background and Purpose-Our aim was to evaluate the risk of subsequent stroke development after retinal artery occlusion (RAO). Methods-National registry data were collected from the Korean National Health Insurance Service, comprised 1 025 340 random subjects. Patients diagnosed with RAO in 2002 and 2003 were excluded. The RAO group was composed of patients with an initial diagnosis of either central or other RAO between January 2004 and December 2013 (n=401). The comparison group was composed of randomly selected patients (5 per RAO patient; n=2003) who were matched to the RAO group according to sociodemographic factors and year of RAO diagnosis. Each sampled patient was tracked until 2013. Cox proportional hazard regression was used. Results-Stroke occurred in 15.0% of the RAO group and in 8.0% of the comparison group (P < 0.001). RAO was associated with an increased risk of stroke occurrence (hazard ratio, 1.78; 95% confidence interval, 1.32-2.41). The magnitude of the RAO effect for stroke was larger among younger adults aged < 65 years (hazard ratio, 3.11) than older adults aged >= 65 years (hazard ratio, 1.26). However, the risk of subsequent stroke was significantly increased in older adults aged >= 65 years at the 4-year follow-up (hazard ratio, 1.58; 95% confidence interval, 1.01-2.48). Conclusions-RAO was significantly associated with subsequent stroke after adjusting for comorbidities and sociodemographic factors. These findings are limited by uncontrolled confounding factors and need to be replicated by other observational studies.</P>