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.

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.

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.

수정체안 열공망막박리의 유리체절제술에서 수정체 보존과 백내장 동시수술의 비교

변익수,박강윤,이승민,이지은,엄부섭,Ik Soo Byon,Kang Yeun Pak,Seung Min Lee,Ji Eun Lee,Boo Sup Oum 대한안과학회 2013 대한안과학회지 Vol.54 No.3

Purpose: To compare lens-save and simultaneous phacoemulsification with intraocular lens implantation in primary vitrectomy for phakic rhegmatogenous retinal detachment (RRD). Methods: A retrospective comparative analysis of 54 consecutive eyes from 54 phakic RRD patients who underwent vitrectomy with a minimum of 12 months of follow-up was performed. The patients were divided into the vitrectomy group and the combined group (patients who underwent vitrectomy with concurrent cataract surgery). The main outcome measures were the best corrected visual acuity (BCVA), anatomical success rate, complications and cataract status according to LOCSⅢ grading. Results: Baseline characteristics were similar in both groups, except for age and cataract status. The mean age was 46.9 year in the vitrectomy group (n = 20) and 60.5 years in the combined group (n = 34) (p < 0.001). The postoperative BCVA (log MAR) improved from 1.27 and 1.30 at baseline to 0.45 and 0.28 at 12 months (p < 0.05), respectively, which was not a significant difference between the 2 groups. In the vitrectomy group, cataract status was changed from 1.8 at baseline to 2.5 at 12 months (p = 0.001). Two patients (11.1%) had an additional cataract surgery performed. The primary anatomical success rate was 90.0% in the vitrectomy group and 94.1% in the combined group. Conclusions: The vitrectomy group and combined group had similar results in the repair of phakic RRD. Although postoperative cataract progression was noted, lens should be saved in vitrectomy for young patients, as significant cataract is uncommon.

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.

패턴 스캐닝 레이저과 기존 방법을 이용한 광응고술 후 가토 유리체강의 염증성 사이토카인

최영락,변익수,이승욱,신민규,이지은,엄부섭,Young Rock Choi,MD,PhD,Ik Soo Byon,MD,Seung Uk Lee,MD,Min Kyu Shin,MD,Ji Eun Lee,MD,PhD,Boo Sup Oum,MD,PhD 대한안과학회 2013 대한안과학회지 Vol.54 No.1

Purpose: To compare concentration of cytokines in the vitreous of rabbit eyes after photocoagulation using a short-pulse pattern scanning laser (PASCAL) or a conventional laser. Methods: Laser photocoagulation was performed using PASCAL (duration 0.02 seconds) in the right eyes and a conventional laser (duration 0.1 seconds) in the left eyes of 13 pigmented rabbits. To obtain ophthalmoscopically similar mild burns, power was adjusted during the photocoagulation. The rabbits were sacrificed at 1, 3 or 7 days after photocoagulation to investigate histological changes. Levels of interleukins (IL)-1β, IL-6, IL-8 and tumor necrosis factor (TNF)-α in the vitreous humors of ten rabbits were measured using enzyme-linked immunosorbent assay before treatment and at 1, 3 and 7 days after photocoagulation. Results: Histological changes were comparable between the two groups. IL-1β and TNF-α were not detectable. IL-6 did not change significantly. IL-8 increased at day 3 and day 7, but no significant difference was observed between the two groups (p>0.05). Conclusions: When ophthalmoscopically similar mild burn intensity was achieved, conventional and PASCAL treatments of rabbit eyes caused no difference in intravitreal concentration of inflammatory cytokines.

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

안외상으로 유리체절제술을 시행한 무수정체안에서 이차인공수정체삽입술의 임상 성적

김성일,변익수,이지은,Sung Il Kim,Ik Soo Byon,Ji Eun Lee 대한안과학회 2013 대한안과학회지 Vol.54 No.10

Purpose: To evaluate the clinical outcomes of secondary intraocular lens (IOL) implantation in eyes that underwent pars plana vitrectomy and lens removal due to ocular trauma. Methods: We retrospectively investigated 40 vitrectomized aphakic eyes that had received secondary IOL from March 2005 to January 2012. Various parameters including pre- and postoperative best corrected visual acuity (BCVA) were reviewed. Results: Incidence was higher in males (n = 35, 89.7%) and highest in the 6th decade of life (n = 13, 33.3%). Mean preoperative refractive error was +9.99 ± 2.80 D in spherical equivalent, and astigmatism was 1.80 ± 1.73 D. Mean BCVA (log MAR) was 0.53 ± 0.51 preoperatively and 0.54 ± 0.46 at 6 months postoperatively. Postoperative refractive error was -1.28 ± 1.40 D and the astigmatism was 2.54 ± 1.52 D. The difference between the target and postoperative refractive error was a myopic shift of -0.63 ± 1.44 D. Postoperative BCVA had no significant correlation with preoperative factors other than preoperative BCVA (p < 0.001). The most common complication was temporarily increased IOP in 4 eyes. Choroidal detachment, recurrence of retinal detachment, bullous keratopathy, and cystoid macular edema were each found in 1 eye. IOL dislocation was corrected with reoperation in 2 eyes. Conclusions: Secondary IOL implantation can be performed safely in vitrectomized aphakic eyes due to ocular trauma and can be recommended in patients with good preoperative BCVA. Myopic shift of the postoperative refractive error should be considered when calculating IOL power.

잠복외망막병증의 형태로 나타난 안매독

박성후,박종호,변익수,이지은,Sung Who Park,Jong Ho Park,Ik Soo Byon,Ji Eun Lee 대한안과학회 2014 대한안과학회지 Vol.55 No.5

Purpose: To report a case of ocular syphilis presenting as occult outer retinopathy. Case summary: A 42-year-old female presented with decreased visual acuity for one month in duration in the left eye. Her best-corrected visual acuity (BCVA) was 20/20 in the right eye and 20/250 in the left eye. There was no sign of inflammation in the anterior segment. Fundus examination showed no distinct abnormal findings including vitreous cell or haziness except mild diabetic retinopathy and subtle opacity of the macula. Spectral domain optical coherence tomography (OCT) showed a marked distortion of the inner segment-outer segment (IS-OS) junction in the photoreceptor layer without macular edema. Fluorescent angiography revealed diffuse subtle hyperfluorescence with microvasculitis in late phase. Full-field electroretinography (ERG) and multifocal ERG showed decreased amplitude; thus, acute zonal occult outer retinopathy (AZOOR) was considered as the diagnosis. Laboratory work-ups before steroid therapy revealed positive serology for active syphilis. One month after treatment with penicillin G (6 million international units per day for 14 days), best-corrected VA improved to 20/30, and restoration of the IS-OS junction was observed on OCT. Conclusions: Ocular syphilis may present as occult outer retinopathy resembling AZOOR, and serologic work-up is required to avoid misdiagnosis. In the present case, anatomical and functional recovery were obtained after antibiotic therapy. J Korean Ophthalmol Soc 2014;55(5):785-788

급성망막괴사에서 망막박리 발생의 위험인자

박성후,신민규,변익수,박현준,이지은,엄부섭,Sung Who Park,Min Kyu Shin,Ik Soo Byon,Huyn Jun Park,Ji Eun Lee,Boo Sup Oum 대한안과학회 2013 대한안과학회지 Vol.54 No.11

Purpose: Retinal detachment (RD) complicated in acute retinal necrosis (ARN) is difficult to be treated and a main cause of blindness. The factors associated with RD in ARN were investigated. Methods: Patients with ARN who were diagnosed and treated from Jan, 2008 to Dec, 2012 were reviewed retrospectively. The eyes were classified into the group I without RD, and the group II with RD. Early vitrectomy, history of ARN in the other eye, extent of necrosis, symptom duration and intravitreal injection of anti-viral drug were evaluated. Results: Of 22 eyes of 20 patients, 11 eyes were included in each group. Symptom duration of 8.0 days in the group I was shorter than 15.8 days in the group II (p = 0.005). There were no macular involvement at initial exam in the group I and 5 eyes (45%) in the group II (p = 0.017). Five eyes (45%) in the group I and 0 eye (0%) in the group II had history of ARN in the other eye (p = 0.017). Six eyes (55%) in the group I and 1 eye (9%) in the group II underwent early vitrectomy (p = 0.031). Age, baseline visual acuity, and intravitreal injection of antiviral agent were not related to RD (p = 0.294-0.699). Conclusions: Broader necrosis and longer symptoms duration were related to occurrence of RD. Correlation of Lower risk of RD with ARN history in the other eye would result from earlier diagnosis and treatment. Early vitrectomy seems to be effective to prevent RD in ARN. Korean Ophthalmol Soc 2013;54(11):1694-1699