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남기엽(Kiyup Nam),김정열(Jung Yeul Kim) 대한검안학회 2011 Annals of optometry and contact lens Vol.10 No.2
목적: 특별한 전신적, 안과적 과거력이 없는 중년 여성에서 빛 자극에 대해 갑작스럽게 웅크린 후 발생한 발살바 망막증 1예를 보고하고자 한다. 증례 요약: 48세 여자환자가 누워서 자던 중 형광등 불빛을 피하려고 갑작스럽게 몸을 웅크린 후 발생한 좌안 시력저하를 주소로 내원하였다. 특별한 전신적, 안과적 과거력은 없었다. 내원 시 시력은 우안 2.0, 좌안은 0.04였으며 교정되지 않았다. 안저검사 상 황반부를 중심으로 상이측 및 하이측 망막혈관궁에 이르는 원형의 망막전출혈과 하비측의 2 유두직경 크기의 독립된 망막전출혈이 관찰되었고 시신경유두의 부종과 유두출혈도 보였다. 환자의 병력과 안저소견을 통해 발살바 망막증으로 의심하였다. 좌안 유리체 절제술을 시행하였고, 수술 2개월 후 좌안 시력은 0.6으로 호전되었다. 결론: 드물지만 빛자극에 대한 회피반응의 일환인 갑작스런 웅크림이 발살바 망막증을 일으킬 수 있음을 알 수 있었다. Purpose: To report a case of Valsalva retinopathy occurred after sudden crouching to avoid bright light. Case summary: 48 year old woman was presented with visual decrease in her left eye after sudden crouching to avoid bright light while sleeping. She had no history of systemic or ocular illness. During the initial visit, visual acuity was 2.0 in her right eye and 0.04 in her left eye. Fundus examination revealed a large preretinal hemorrhage extended to the inferotemporal and superotemporal vascular arcade, a 2-disc diameter preretinal hemorrhage on the inferonasal area of retina and optic disc edema and disc hemorrhage. Valsalva retinopathy was suspected due to her history and fundus finding. 2 months after vitrectomy of her left eye, visual acuity improved to 0.6. Conclusion: A sudden crouching of body to avoid light can cause valsalva retinopathy.
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눈물 흘림을 호소하는 결막이완증 환자의 수술적 치료에서 파이브린 글루의 유용성
남기엽,조영준,이성복,Kiyup Nam,Young Joon Jo,Sung Bok Lee 대한안과학회 2010 대한안과학회지 Vol.51 No.4
Purpose: To investigate the efficacy of fibrin glue used in conjunctival resection for conjunctivochalasis with epiphora Methods: Twenty-three patients (42 eyes) with conjunctivochalasis without nasolacrimal duct obstruction underwent conjunctival resection using either absorbable sutures (11 patients, 20 eyes, Group 1) or fibrin glue (12 patients, 22 eyes, Group 2) to attach the conjunctiva to the sclera. Outcomes recorded were improvement of epiphora, postoperative discomfort, and operation time. Postoperative discomfort was analyzed only in one eye (right eye) in case that the both eyes were operated. Results: Epiphora completely improved in 6 eyes (30%) in Group 1 and 8 eyes (36.4%) in Group 2, partially improved in 9 eyes (45%) and 8 eyes (36.4%), and did not improved in 5 eyes (25%) and 6 eyes (27.2%), respectively (p=1.000). On the first day postoperatively, postoperative eye discomfort developedin 7 eyes (63.6%) in Group 1 and 5 eyes (41.7%) in Group 2 (p=0.414). Throughout the following week, the discomfort lasted in 6 eyes (54.5%) in Group 1 and 1 eye (13.6%) in Group 2 (p=0.027). The mean operation time was 25.0 (±2.6) minutes in Group 1 and 12.0 (±2.4) minutes in Group 2 (p<0.001). Conclusions: The success rates were similar in the two groups. However, the use of fibrin glue significantly reduces the postoperative discomfort and the operation time. Therefore, the use of fibrin glue in conjunctival resection of conjunctivochalasis seems to be an effective method. J Korean Ophthalmol Soc 2010;51(4):498-503
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섬모체망막동맥폐쇄가 첫 임상 증후로 나타난 안매독 환자 1예
이연희,남기엽,김정열,Yeon Hee Lee,Kiyup Nam,Jung Yeul Kim 대한안과학회 2011 대한안과학회지 Vol.52 No.10
Purpose: To report a case of a neurosyphilis patient with cilioretinal artery occlusion as the first manifestation. Case summary: A 58-year old man presented with a visual impairment which developed 5 days earlier in his right eye. During initial evaluation, the visual acuity in the right eye was 0.02. On fundus examination, a whitening adjacent to the macula was observed and fluorescein angiography showed filling delay and late leakage of the cilioretinal arteries. The patient was diagnosed with cilioretinal artery occlusion. Two weeks after his initial visit, visual acuity in the patient’s right eye improved to 0.7 and retinal whitening was decreased on fundus examination. Three months later, a visual decrease in the right eye reoccurred and the visual acuity was 0.01. Anterior chamber cell reaction with hypopyon was observed on slit lamp examination and vitreal opacity was noted during fundus examination. Among the numerous tests performed in order to determine the cause of uveitis, RPR antibody and treponemal antibody were found positive. The patient was diagnosed with neurosyphylis and 2 weeks after intravenous administration of penicillin, visual acuity improved to 0.7 and anterior chamber cell reaction as well as vitreal opacity decreased. Conclusions: The authors reported a case of cilioretinal artery occlusion suspected secondary to neurosyphilis. J Korean Ophthalmol Soc 2011;52(10):1254-1258
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