안과종합검진의 유용성

임수현(Soo Hyun Lim),김국영(Kook Young Kim),정재근(Jae Keun Chung)한재욱(Jae Wook Han),김응수(Ungsoo Samuel Kim) 대한검안학회 2020 Annals of optometry and contact lens Vol.19 No.2

Purpose: To investigate the efficacy and detection rate of disease in the customized eye examination program. Methods: We reviewed the medical charts of 122 patients who have conducted the customized eye examination program from January 2018 to January 2019 in Kim’s Eye Hospital retrospectively. The customized eye examination program consisted of visual acuity test, intraocular pressure measurement, color vision test, slit-lamp examination, visual field tests, fundus photography, spectral domain optical coherence tomography (Cirrus HD-OCT, Zeiss), Optical Quality Analysis System (OQAS, Visiometrics, Terrassa, Spain), and dry eye test (LipiView II TearScience, Morrisville, NC, USA). The rate of newly diagnosed diseases and vision-threatening disorders including glaucoma and retinal disorders were calculated. Results: A total of 122 patients (46 males and 76 females, mean age; 47.8 ± 14.0 years old, from 22 to 85 years) were included. Nine patients (14 eyes) had a poor vision of less than 0.8. Newly detected diseases were found in 17 patients (13.9%), and among them, 10 glaucoma (8.2%) and retinal disorders (5.7%) were included. When it comes to glaucoma, 7 patients were diagnosed with definite glaucoma with visual field loss, and 3 patients had preperimetric glaucoma. Retinal disorders were composed of 5 epiretinal membranes, 1 diabetic retinopathy, and 1 central serous chorioretinopathy. Conclusions: Various diseases were identified by the customized eye examination program, and vision-threatening diseases such as glaucoma and retinal disorders were found. Therefore, a regular eye examination is needed to detect the serious ocular diseases in the early stage.

Effect of Amiloride to Retinal Toxicity Induced by Tissue Plasminogen Activator

( Ungsoo Samuel Kim ),( Hyun Sub Oh ),( Oh Woong Kwon ),( In Chung ),( Sung Ho Lee ),( Joon Haeng Lee ) 대한안과학회 2012 Korean Journal of Ophthalmology Vol.26 No.5

Purpose: The effects of amiloride on cellular toxicity caused by tissue plasminogen activator (tPA) in mouse primary retinal cells were investigated. Methods: Primary retinal cell cultures were maintained using glial conditioned medium. Commercial tPA and L-arginine were added, and the level of cyclic guanosine monophosphate (cyclic-GMP) in the culture supernatant was assessed using an ELISA assay. We measured the cell viability of cultured retinal cells pretreated with three different concentrations of amiloride (1, 10, and 100 um) in addition to commercial tPA or L-arginine treatment. Results: After exposing the cultured mouse retinal cells to tPA plus L-arginine or L-arginine alone, cyclic-GMP concentrations were 61.9 ± 5.1 pmole/mL and 63.1 ± 6.1 pmole/mL, respectively. However, the control group had a significantly lower concentration of cyclic-GMP (37.2 ± 3.4 pmole/mL, p < 0.01). The cyclic GMP-dissolved solution did not cause retinal cell death. In the control group and the group treated with 1 um amiloride and tPA containing L-arginine, the cell viability was 43.7% and 44.5%, respectively. However, cell viability increased to 70.6% with 10 um amiloride and 78.4% with 100 um amiloride (p = 0.015). Conclusions: L-arginine increases intracellular cyclic-GMP and may give rise to retinal cells through this mechanism. In addition, amiloride in concentrations greater than 10 um protects against L-arginine-induced retinal cell death.

Case Report : Complete Visual Recovery after Mycotic Aneurysm Embolization Complicated by Cavernous Sinus Thrombophlebitis

( Ungsoo Samuel Kim ),( Ji Soo Kim ),( O Ki Kwon ),( Jeong Min Hwang ) 대한안과학회 2010 Korean Journal of Ophthalmology Vol.24 No.5

A 62-year-old woman has been suffered from cavernous sinus thrombophlebitis which was confirmed by four-vessel angiography, orbit magnetic resonance imaging, and blood culture. Three weeks after recovery of cavernous sinus thrombophlebitis, right eye proptosis and complete third, fourth, and sixth cranial nerve palsies developed. Best-corrected visual acuity decreased to 20/70 in the right eye. Repeat magnetic resonance imaging demonstrated a 1.5-cm-sized mass in the right cavernous sinus, suspicious for mycotic aneurysm. Amphotericin B supplementation was begun and was followed by successful transarterial Guglielmi detachable coil embolization. Four months later, extraocular movement was normalized, and visual acuity improved to 20/25 in the right eye.

근시의 약물치료

김응수(Ungsoo Samuel Kim) 대한검안학회 2018 Annals of optometry and contact lens Vol.17 No.1

The prevalence of myopia is up to 80% in young Korean population. The myopia can develop serious complications such as choroidal neovascularization, retinal detachment and glaucoma. As a result, several studies to prevent progression of myopia have been conducted. Among them, muscarinic antagonists are the more effective at slowing progression than other methods including orthokeratology and designed glasses. Recent studies have reported that low-dose atropine is also effective to slow progression of the myopia and it has fewer complications than high-dose atropine. However, long term side effect has not been clarified, and the commercial low-dose atropine is not available currently in Korea. Thus, in-depth studies about low-dose atropine should be considered.

직업군별 채용신체검사에서 안과규정에 대한 조사

김응수(Ungsoo Samuel Kim) 대한안과학회 2021 대한안과학회지 Vol.62 No.10

목적: 직업군별 채용신체검사에서 안과와 관련된 규정을 알아보고자 하였다. 대상과 방법: 신체검사가 규정된 9개의 직업군(군인, 육군장교, 공군장교, 해군장교, 철도공무원, 소방공무원, 경찰공무원, 일반공무원, 항공조종사) 및 운전면허취득 기준을 조사하였으며 각 군의 신체검사 규정을 비교 분석하였다. 시기능장애는 시력장애, 시야장애, 굴절이상, 색각이상, 사시 및 기타 질환으로 구분하였고, 각 직업군에서 제시하는 추가적인 제한 사항에 대해 조사하였다. 결과: 직업군별로 다양한 기준을 제시하고 있다. 시력장애는 공군사관학교에서 1.0의 가장 높은 기준을 제시하였다. 육군사관학교와 해군사관학교는 0.6 이상, 소방공무원, 경찰공무원은 0.8 이상의 시력을 갖고 있어야 하나 일반공무원신체검사규정에서는 시력 기준이 없다. 시야장애는 소방공무원과 철도운전사만 1/3 이하로 명시되어 있고 다른 직종에서는 뚜렷한 기준이 없다. 색각장애도 직종별로 차이를 보였으며 항공관련과 철도운전사는 색각장애가 있으면 지원할 수 없다. 굴절이상 및 사시에 대해서는 각 직종별로 기준에 차이를 보였다. 결론: 각 직종별로 안과신체검사에 대한 기준이 매우 상이하므로 이에 대한 의사 및 환자의 이해가 필요하며, 기준 마련에 대한 과학적 근거에 대한 논의가 필요할 것으로 생각된다. Purpose: To investigate physical ophthalmological parameters relevant to job choice. Methods: I analyzed the ophthalmological demands imposed on those engaged in military service and on applicants for army officer, air force officer, naval officer, railroad officer, firefighting officer, police officer, state public officer, and pilot positions; the visual requirements for a driver’s license were also examined. Visual dysfunction was classified into loss of visual acuity, visual field defects, refractive errors, color vision disorders, strabismus, and other disorders. Additional restrictions imposed by each occupation were investigated. Results: Various standards were imposed on the occupational groups. Applicants to the Air Force Academy required 1.0 visual acuity; the visual acuity for applicants to the military and naval academies were ≥0.6, and those for fire and police personnel ≥0.8. The general public official regulations do not mention visual acuity. In terms of visual field defects, such defects must be <33% for firefighters and railroad drivers; no clear standard was set for other occupations. The importance of color vision differed by job type; pilots and railroad drivers must have full color vision. In terms of refractive error and strabismus, the standards differed among occupations. Conclusions: As the ophthalmological standards vary extensively by occupation, both ophthalmologists and clients must be aware of this information. The scientific basis of the various standards requires attention. J Korean Ophthalmol Soc 2021;62(10):1415-1419

눈떨림의 수술적치료

김응수(Ungsoo Samuel Kim) 대한검안학회 2017 Annals of optometry and contact lens Vol.16 No.2

Surgery is the one of the option of treatment of nystagmus. When it comes to the patients with abnormal head posture including head turn, chin-up, chin-down and head tilt, we could consider the repositioning of the extraocular muscles into null point. In the patients without abnormal head posture, four-muscle recession or tenotomy could be considered. The surgical treatment of nystagmus may not only reduce the amplitude of nystagmus but also improve visual acuity.

Voretigene Neparvovec for the Treatment of RPE65-associated Retinal Dystrophy: Consensus and Recommendations from the Korea RPE65-IRD Consensus Paper Committee

Jinu Han(Jinu Han),Kwangsic Joo(Kwangsic Joo),Ungsoo Samuel Kim(Ungsoo Samuel Kim),Se Joon Woo(Se Joon Woo),Eun Kyoung Lee(Eun Kyoung Lee),Joo Yong Lee(Joo Yong Lee),Tae Kwann Park(Tae Kwann Park),San 대한안과학회 2023 Korean Journal of Ophthalmology Vol.37 No.2

Mutations in the RPE65 gene, associated with Leber congenital amaurosis, early-onset severe retinal dystrophy, and retinitispigmentosa, gained growing attention since gene therapy for patients with RPE65-associated retinal dystrophy is available inclinical practice. RPE65 gene accounts for a very small proportion of patients with inherited retinal degeneration, especiallyAsian patients. Because RPE65-associated retinal dystrophy shares common clinical characteristics, such as early-onset severenyctalopia, nystagmus, low vision, and progressive visual field constriction, with retinitis pigmentosa by other geneticmutations, appropriate genetic testing is essential to make a correct diagnosis. Also, fundus abnormalities can be minimal inearly childhood, and the phenotype is highly variable depending on the type of mutations in RPE65-associated retinal dystrophy,which makes a diagnostic difficulty. The aim of this paper is to review the epidemiology of RPE65-associated retinaldystrophy, mutation spectrum, genetic diagnosis, clinical characteristics, and voretigene neparvovec, a gene therapy productfor the treatment of RPE65-related retinal dystrophy.

Horizontal Effects of 10-mm Inferior Oblique Recession versus 14-mm Inferior Oblique Recession

Jae Min Kim,Ungsoo Samuel Kim 대한안과학회 2018 Korean Journal of Ophthalmology Vol.32 No.6

Purpose: The aim of this study was to investigate the quantitative effect of inferior oblique (IO) 10- and 14-mm recession on postoperative horizontal deviation. Methods: Patients (22 men and 18 women) who underwent IO recession were divided into two groups for comparison studies: group 1 (10-mm IO recession, 15 patients) and group 2 (14-mm IO recession, 25 patients). Preoperative and postoperative horizontal deviations were measured, and the resulting horizontal deviations from the 10- and 14-mm IO recession surgeries were compared. The effects of superior oblique underaction, IO overaction, and combined exodeviation on postoperative horizontal deviation were analyzed. Results: Although group 1 did not show a significant horizontal deviation change after surgery (1.9 ± 4.5 prism diopters [PD], p = 0.452), group 2 had a meaningful horizontal change after 14-mm recession (2.2 ± 3.8 PD, p = 0.022). Both groups showed a significant esodrift in horizontal deviation (group 1, p = 0.017; group 2, p = 0.030) in patients with exodeviation over 8 PD. The mean change in horizontal deviation was 6.0 ± 5.4 PD for group 1 and 9.0 ± 5.0 PD for group 2. Although the amount of superior oblique underaction did not affect the extent of change in horizontal deviation, patients with severe IO overaction showed a significant change in horizontal deviation after 14-mm IO recession. Conclusions: Fourteen-millimeter IO recession could make a statistically significant change in horizontal deviation after surgery. In addition, esodrift should be considered after IO recession in patients with a preoperative exodeviation greater than 8 PD or severe IO overaction.

Letter to the Editor : Quantitative Analysis of Optic Disc Color

( Jonathan Chun Ho Ho ),( Ungsoo Samuel Kim ) 대한안과학회 2012 Korean Journal of Ophthalmology Vol.26 No.3

Large Thrombosed Basilar Artery Aneurysm Presenting with Homonymous Left Hemianopia: A Case Report

Dong Hee Ha,Ungsoo Samuel Kim 대한안과학회 2024 Korean Journal of Ophthalmology Vol.38 No.1