Original Articlet:Macular Hole Formation in Rhegmatogenous Retinal Detachment after Scleral Buckling

( Ik Soo Byon ),( Han Jo Kwon ),( Gun Hyung Park ),( Sung Who Park ),( Ji Eun Lee ) 대한안과학회 2014 Korean Journal of Ophthalmology Vol.28 No.5

Purpose: To describe early macular hole (MH) development in rhegmatogenous retinal detachment (RRD) afterscleral buckling (SB) based on optical coherence tomography (OCT) findings. Methods: The medical records and spectral domain OCT images of patients in whom MH developed after RRDrepair were evaluated retrospectively. Results: A postoperative MH was detected in five eyes that underwent SB during a 6-year period. All had fovea-off RRD without MH at the time of surgery. OCT showed partial loss of the inner retina with a preservedphotoreceptor layer in early postoperative days. On average, 7 days (range,5 to 8 days) after surgery, outerretinal tissues disappeared, resulting in the full-thickness MH. Conclusions: Serial OCT findings revealed that partial-thickness lamellar holes progressed to full-thicknessMHs, which were formed by the degeneration of the outer retina in eyes with preceding loss of the glial conein the fovea.

눈꺼풀올림근의 기능이 불량한 선천성눈꺼풀처짐 환자에서 눈꺼풀올림근절제술과 이마근걸기술 비교

변익수,최희영,Ik-Soo Byon,M,D,Hee-Young Choi,M,D 대한안과학회 2005 대한안과학회지 Vol.46 No.10

Purpose: To compare anterior levator resection with frontalis sling in congenital ptosis with poor levator function. Methods: We performed a retrospective review of 19 patients (25 eyes) undergoing anterior levator resection and 25 patients (28 eyes) undergoing frontalis sling for congenital ptosis with poor levator action of 5 mm or less from January 1995 to December 2001. Results: The mean postoperative MRD1 were 2.4±0.95 mm in the anterior levator resection group and, 2.6±0.94 mm in the frontalis sling group. Surgical outcomes were good, fair and poor in 11, 10, and 4 eyes of the anterior levator resection group and in 14, 9, and 5 eyes of the frontalis sling group, respectively. Success rates were 84.0% and 82.1% in each group. There were no statistically significant differences between the two groups (P>0.05). Conclusions: In congenital ptosis with poor levator function, the surgical outcomes of anterior levator resection were as good as those of frontalis sling.

Triamcinolone-Induced Intraocular Pressure Elevation: Intravitreal Injection for Macular Edema and Posterior Subtenon Injection for Uveitis

( Seung Youn Jea ),( Ik Soo Byon ),( Boo Sup Oum ) 대한안과학회 2006 Korean Journal of Ophthalmology Vol.20 No.2

유리체절제술 및 실리콘기름 충전눈에서 트리암시놀론의 유리체강내 주사

변익수,이지은,엄부섭,Ik Soo Byon,Ji Eun Lee,Boo Sup Oum 대한안과학회 2006 대한안과학회지 Vol.47 No.8

Purpose: To evaluate safety and efficacy of intravitreal triamcinolone acetonide (TA) injection at the end of pars plana vitrectomy with silicone oil tamponade. Methods: Eyes which underwent pars plana vitrectomy with silicone oil placement were enrolled. They were followed up for at least 6 months. GroupⅠ (twenty-three consecutive eyes) received an intravitreal injection of 4 mg TA at the end of the surgery, whereas GroupⅡ (twenty-six eyes) did not. Results: Postoperative vision improved by 2 lines or more in 9 eyes (39.1%) of GroupⅠ and 9 eyes (34.6%) of GroupⅡ. The posterior pole was attached in all of GroupⅠ(100.0%) and twenty-four eyes (92.3%) of GroupⅡ (P=0.17). The postoperative BCVA was 5/200 or better in fifteen eyes (65.2%) of GroupⅠand fourteen eyes (53.8%) of GroupⅡ (P=0.51). Eight eyes (34.8%) in GroupⅠ and six eyes (23.1%) in GroupⅡ had an intraocular pressure higher than 21 mmHg (P=0.36). All of them were controlled with medications. Two eyes in GroupⅡ required an additional operation due to recurrence of tractional retinal detachment from the fibrous membrane. Visually significant ocular complications related with TA injections were not noted. Conclusions: The intravitreal injection of TA into silicone-filled vitrectomized eyes seems safe and efficient. But, a prospective study is necessary to demonstrate the long-term safety and efficacy.

간시클로버 점안겔에 의한 단순포진성 안질환의 치료 4예

변익수,이지은,이종수,Ik Soo Byon,Ji-Eun Lee,Jong Soo Lee 대한안과학회 2005 대한안과학회지 Vol.46 No.1

Purpose: We report the therapeutic effect of ganciclovir gel instead of acyclovir ointment usually used in the case of herpes simplex superficial ocular disease such as herpetic dendritic keratitis and erosive blepharitis. Methods: Three patients clinically diagnosed with herpes simplex dendritic keratitis and one as erosive blepharitis were treated with the topical ophthalmic gel of 0.15% ganciclovir three times a day for 2 to 4 weeks. Ocular complications and recurrence were evaluated under slit-lamp examination for the follow-up periods. Results: Dendritic keratitis and erosive blepharitis were completely recovered with no recurrence during the 5 months follow-up. There is no respective comparison here. In one case of herpes simplex keratitis, the keratitis wound was repaired after debridement of corneal epithelial layer and application of ganciclovir gel. Complications including burning sensation and superficial punctate keratitis did not develop and visual acuity improved. Conclusions: Ganciclovir ophthalmic gel should be considered one of the effective therapeutic drugs for the herpes simplex ocular disease.

항알러지 점안약이 배양된 가토의 결막세포에 미치는 영향

변익수,박재성,이지은,이종수,Ik Soo Byon,M,D,Jae Sung Park,M,D,Ji Eun Lee,M,D,Jong Soo Lee,M,D 대한안과학회 2006 대한안과학회지 Vol.47 No.8

Purpose: To investigate the biological effects and cytotoxicity of anti-allergic ophthalmic agents on the cultured conjunctival cells of rabbit in vitro. Methods: Conjunctival cells of rabbit were exposed to anti-allergic ophthalmic agents. Azelan? (Taejoon, Korea), Zaditen? (Novartis, USA), Patanol? (Alcon, USA) at a concentration 10, 20 and 30% for a period of 30 minutes, 4, 12, and 24 hours respectively. Cell injury assay was performed using lactate dehydrogenase (LDH) leakage assay. We checked the composition, pH, osmolarity of three anti-allergic agents. Light and transmission electron microscopy were performed to compare the cellular damage of rabbit conjunctival cells under various culture treatments. Results: In cultured conjunctival cells of rabbit, the LDH titers increased up to 4 hours after exposure, maintained until 12 hours and then decreased 12 hours after exposed. Azelan? and Zaditen? showed a higher LDH titer and severe cellular damage of the conjunctival cells, compared with Patanol?. Of anti-allergic solutions, Azelan? and Zaditen? revealed markedly lower Na+, Cl- and pH levels than Patanol?. However, there was no difference in the concentration of preservative or osmolarity of the eye solution among the three anti-allergic agents. Conclusions: Patanol? caused markedly less damage to cultured rabbit conjunctival cells than Azelan? and Zaditen?. If these anti-allergic agents are clinically used for long periods of time, they may induce the cellular damage of conjunctival cells depending on the composition and pH of anti-allergic drugs.

망막분지정맥폐쇄에 합병된 황반부종에서 유리체강내 베바시주맙 주입과 격자광응고술 병합요법

이승민,변익수,이지은,엄부섭,Seung Min Lee,Ik Soo Byon,Ji Eun Lee,Boo Sub Oum 대한안과학회 2012 대한안과학회지 Vol.53 No.10

Purpose: To evaluate clinical outcomes of a combined therapy of intravitreal bevacizumab and grid laser photocoagulation for macular edema in branch retinal vein occlusion (BRVO). Methods: In the present retrospective study, medical records of patients who were treated with intravitreal bevacizumab injection for macular edema due to BRVO were reviewed. The eyes were divided into 2 groups, the combined therapy group of intravitreal bevacizumab and grid laser photocoagulation, and the monotherapy group of intravitreal bevacizumab. Visual acuity and central subfield macular thickness were investigated at 1, 2 and 6 months. Recurrence rate was compared between the 2 groups. Results: Among 49 eyes, 18 eyes underwent macular grid photocoagulation and 31 eyes did not receive laser treatment. Laser photocoagulation was performed at 1.2 months after injection on average. Visual acuity improved significantly at 2 and 6 months in the combined therapy group, and at 1, 2 and 6 months in the monotherapy group. Macular thickness decreased significantly compared to baseline at all visits in both groups. There was no significant difference in visual acuity and foveal thickness between the 2 groups. Recurrence at 6 months was significantly less frequent in the combined therapy group (3 eyes, 17%) then in the monotherapy group (14 eyes, 45%, p = 0.046). Conclusions: Combined grid photocoagulation after intravitreal bevacizumab injection lowered the recurrence rate of macular edema complicated with BRVO. J Korean Ophthalmol Soc 2012;53(10):1458-1464

특발성 망막앞막에서 유리체절제술과 동반된 테논낭하트리암시놀론 주사의 효과

이지은(Ji Eun Lee),변익수(Ik Soo Byon),박성후(Sung Who Park),김성일(Sung Il Kim) 대한안과학회 2015 대한안과학회지 Vol.56 No.8

목적: 특발성 망막앞막 환자에서 유리체절제술과 함께 시행한 뒤테논낭하 트리암시놀론 주사의 효과에 대해 알아보고자 한다. 대상과 방법: 특발성 망막앞막으로 진단 받고 유리체절제술 및 막제거술을 시행 받은 환자 40명 40안을 대상으로 하였다. 주사군 20안은 유리체절제술을 종료할 때 트리암시놀론 40 mg을 뒤테논낭하로 주사하였다. 비주사군 20안은 대조군으로 수술 전 최대교정시력, 중심황반두께를 주사군과 대응시켜 선택하였다. 두 군 간의 수술 전후 최대교정시력, 중심황반두께, 안압, 합병증 발생을 비교하였다. 결과: 주사군의 최대교정시력(logMAR)은 수술 전 0.56 ± 0.23에서 수술 후 1, 3, 6개월에 0.52 ± 0.36, 0.44 ± 0.39, 0.38 ± 0.41로 향상되었다. 중심황반두께는 수술 전 456.2 ± 86.2 μm에서 수술 후 1, 3, 6개월에 399.0 ± 60.1 μm, 377.1 ± 71.5 μm, 353.1 ± 57.4 μm로 감소하였다. 비주사군의 최대교정시력은 수술 전 0.56 ± 0.23에서 수술 후 1, 3, 6개월에 0.53 ± 0.25, 0.41 ± 0.20, 0.37 ± 0.24로 향상되었다. 중심황반두께는 수술 전 456.4 ± 74.8 μm에서 수술 후 1, 3, 6개월에 394.9 ± 63.5 μm, 377.2 ± 56.8 μm, 358.0 ± 57.2 μm로 감소하였다. 수술 전후 각 시기에서 두 군 간의 최대교정시력 및 중심황반두께의 유의한 차이는 없었다. 두 군사이 안압과 합병증 발생도 차이가 없었다. 결론: 특발성 망막앞막 환자에서 유리체절제술과 함께 시행한 뒤테논낭하 트리암시놀론 주사는 수술 결과에 해부학적 및 기능적으로 영향을 주지 않았다. Purpose: To evaluate the effect of posterior sub-Tenon triamcinolone acetonide injection combined with vitrectomy for idiopathic epiretinal membrane (ERM). Methods: This study included 40 eyes of 40 patients who underwent vitrectomy and membrane peeling for idiopathic ERM. Triamcinolone acetonide (40 mg) was injected into the posterior sub-Tenon space following vitrectomy in 20 eyes of the injected group. The other 20 eyes that did not receive the injection were selected as the control group to match preoperative visual acuity and central macular thickness with the injected group. Pre- and postoperative best-corrected visual acuity, central macular thick-ness, intraocular pressure, and complications were compared between the 2 groups. Results: The average visual acuity in the injected group improved from 0.56 ± 0.23 (log MAR) at baseline to 0.52 ± 0.36 at 1 month, 0.44 ± 0.39 at 3 months, and 0.38 ± 0.41 at 6 months postoperatively. Central macular thickness decreased from 456.2 ± 86.2 to 399.0 ± 60.1 at 1 month, 377.1 ± 71.5 at 3 months, and 353.1 ± 57.4 at 6 months postoperatively. In the control group, average vis-ual acuity improved from 0.56 ± 0.23 at baseline to 0.53 ± 0.25 at 1 month, 0.41 ± 0.20 at 3 months, and 0.37 ± 0.24 at 6 months postoperatively. Central macular thickness decreased from 456.4 ± 74.8 to 394.9 ± 63.5 at 1 month, 377.2 ± 56.8 at 3 months, and 358.0 ± 57.2 at 6 months postoperatively. Significant differences in visual acuity and central macular thickness were not observed between the 2 groups before surgery and during the follow-up period. Intraocular pressure and complications were similar. Conclusions: Posterior sub-Tenon injection of triamcinolone acetonide combined with vitrectomy for idiopathic epiretinal mem-brane did not affect postoperative anatomical and functional outcomes.

망막분지정맥폐쇄에 합병된 황반부종에서 유리체강내 베바시주맙 주입과 격자광응고술 병합요법

이승민 ( Seung Min Lee ),변익수 ( Ik Soo Byon ),이지은 ( Ji Eun Lee ),엄부섭 ( Boo Sub Oum ) 한국안전학회(구 한국산업안전학회) 2003 International Journal of Safety Vol.2 No.1

목적: 망막분지정맥폐쇄로 인한 황반부종 환자에서 유리체강내 베바시주맙 주입술 단독요법과 격자광응고술과의 병합요법의 임상적결과를 비교하였다. 대상과 방법: 망막분지정맥폐쇄에 의한 황반부종으로 베바시주맙 주입술을 받은 환자의 의무기록을 후향적으로 분석하였다. 병합요법군과 단독요법군으로 나누어 술전과 술후 1, 2, 그리고 6개월에 교정시력 및 빛간섭단층촬영의 중심황반두께를 조사하고 황반부종의재발 빈도를 비교하였다. 결과: 총 49안 중 18안에서 술후 평균 1.2개월에 격자광응고술을 하였으며 31안은 광응고술을 시행하지 않았다. 시력은 병합요법군에서 술후 2, 6개월에, 단독요법 군에서 술후 1, 2, 6개월에 유의하게 향상되었고, 중심황반두께는 두 군 모두 술후 모든 시기에서 유의하게 감소하였으나, 시력과 중심황반두께에서 두 군 사이에 유의한 차이는 없었다. 주사 후 6개월간 황반부종의 재발은 단독요법군에서 14안(45%)으로 병합요법군의 3안(17%)에 비해 유의하게 많았다(p=0.046). 결론: 망막분지정맥폐쇄에서 베바시주맙의 유리체강내 주사와 병합하여 시행한 격자광응고술은 황반부종의 재발로 인한 반복적인 재 주입술을 줄일 수 있었다. Purpose: To evaluate clinical outcomes of a combined therapy of intravitreal bevacizumab and grid laser photocoagulation for macular edema in branch retinal vein occlusion (BRVO). Methods: In the present retrospective study, medical records of patients who were treated with intravitreal bevacizumab injection for macular edema due to BRVO were reviewed. The eyes were divided into 2 groups, the combined therapy group of intravitreal bevacizumab and grid laser photocoagulation, and the monotherapy group of intravitreal bevacizumab. Visual acuity and central subfield macular thickness were investigated at 1, 2 and 6 months. Recurrence rate was compared between the 2 groups. Results: Among 49 eyes, 18 eyes underwent macular grid photocoagulation and 31 eyes did not receive laser treatment. Laser photocoagulation was performed at 1.2 months after injection on average. Visual acuity improved significantly at 2 and 6 months in the combined therapy group, and at 1, 2 and 6 months in the monotherapy group. Macular thickness decreased significantly compared to baseline at all visits in both groups. There was no significant difference in visual acuity and foveal thickness between the 2 groups. Recurrence at 6 months was significantly less frequent in the combined therapy group (3 eyes, 17%) then in the monotherapy group (14 eyes, 45%, p = 0.046). Conclusions: Combined grid photocoagulation after intravitreal bevacizumab injection lowered the recurrence rate of macular edema complicated with BRVO. J Korean Ophthalmol Soc 2012;53(10):1458-1464

Case Reports : A Case of Tjalma Syndrome Coincidentally Accompanied by an Ovarian Teratoma Successfully Treated with Intravenous Immunoglobulin-G Adjunctive Therapy

( Eun Kyoung Park ),( Seung Geun Lee ),( Ik Soo Byon ),( Sun Hee Lee ),( Seong Jun Lee ),( Yoon Jeong Nam ),( Ji Hye Park ),( Geun Tae Kim ),( Young Eun Park ),( Seong Hu Park ),( Joung Wook Lee ),( J 대한류마티스학회 2014 대한류마티스학회지 Vol.21 No.2

Tjalma or pseudo-pseudo Meigs` syndrome is a clinical condition that is characterized with ascites, pleural effusion, and increased serum CA-125 levels in patients with systemic lupus erythematosus (SLE) without the presence of ovarian tumor. On the other hand, Meigs` and pseudo-Meigs` syndromes represent the same manifestations with ovarian tumor. In this case report, we present a 43-year-old SLE patient suffering from Tjalma syndrome with the coexistence of incidental ovarian teratoma, who was successfully treated with intravenous immunoglobulin-G adjunctive therapy after inadequate response to surgical excision of the ovarian tumor, steroid, and cyclophosphamide pulse therapy.