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이은경,정호경,김남주,이민정,권보상,곽상인,Eun Kyoung Lee,Ho-Kyung Choung,Nam Ju Kim,Min Joung Lee,Bo Sang Kwon,Sang In Khwarg 대한안과학회 2010 대한안과학회지 Vol.51 No.11
Purpose: To report a case of periorbital infantile capillary hemangioma treated with propranolol. Case summary: A 6-month-old girl visited our clinic for a mass on the right upper eyelid, which had been present since birth. A dome-shaped, red-purple colored mass occupying almost the entire right upper eyelid was observed, and overlying branch-shaped telangiectases were also detected. The visual axis of the right eye was partially obscured, due to the ptotic eyelid, and her ability to fix and follow was poor in the right eye. The patient was diagnosed with infantile capillary hemagioma. Because amblyopia in her right eye was suspected, treatment with propranolol was initiated. After 2.5 months of propranolol treatment, the hemangioma decreased in size and volume dramatically, changed from red-purple to light red color, and softened. The ptosis of the right upper eyelid improved, as well as the ability of the right eye to fix and follow. No significant adverse effects (e.g. hypotension, bradycardia, hypoglycemia, bronchospasm, or elevated liver enzymes) were observed, except transient QTc prolongation during cotreatment with ibuprofen, due to an upper respiratory infection. Conclusions: Propranolol should be considered as a treatment option for periorbital infantile capillary hemangioma. Further clinical studies are required to establish the optimal guidelines and long-term outcome. J Korean Ophthalmol Soc 2010;51(11):1513-1519
한의석,정호경,허장원,김성준,유영석.Eui Seok Han. M.D.. Ho Kyung Choung. M.D.. Jang Won Heo. M.D.. Seong Joon Kim. M.D.. Young Suk Yu. M.D.. Ph.D. 대한안과학회 2006 대한안과학회지 Vol.47 No.3
Purpose: To evaluate the clinical characteristics and treatment result of Coats’ disease in children. Methods: Data on demographics, clinical presentation, and ocular findings were analyzed for 67 eyes of 67 patients with Coats’ disease by retrospective chart review. Among these, treatment results were analyzed from 56 eyes which had received local treatment or subretinal fluid drainage (SRFD). Treatment was considered successful when telangiectatic vessels or exudates had regressed after local treatment or when pupillary block glaucoma was treated or prevented after SRFD. Results: Mean age at diagnosis was 5.0 years (5 months-15 years) and 90% were males. 67% of retinal telangiectasias were located in the temporal. There were exudative retinal detachments in 46 (69%) eyes. Among them, SRFD was performed in 19 (28%) to treat or prevent pupillary block glaucoma. The mean age at diagnosis of patients that underwent treatment was 5.1 years. In 37 of 56 patients, 95% of retinal telangiectasias were regressed after primary local treatment, and 21 eyes (31%) underwent SRFD. Management of glaucoma was achieved after SRFD in 16 patients, and one more SRFD was needed after primary SRFD in 5 patients. Conclusions: In Coats’ disease, it is necessary to eradicate retinal telangiectasia with local treatment and to follow up carefully for secondary glaucoma, which can be treated with SRFD in cases of severe exudative retinal detachment.
김미진,정호경,이민정,김영아,곽상인,Mijin Kim,Ho-Kyung Choung,Min Joung Lee,Young A Kim,Sang In Khwarg 대한안과학회 2010 대한안과학회지 Vol.51 No.12
Purpose: To report a rare case of medulloepithelioma originating from the retina. Case summary: A nine-year-old boy visited our clinic with conjunctival injection and decreased visual acuity in the left eye, which had developed two month previously. Slit lamp examination revealed a distorted pupil and an anteriorly protruding ciliary body displacing the peripheral iris toward the cornea on the inferonasal side. Funduscopic examination showed total retinal detachment accompanied by an inferior hypervascular mass. The examination of the right eye was unremarkable. On computer tomography imaging, a calcified mass was identified behind the iris of the left globe in the inferomedial aspect, and ultrasound biomicroscopy revealed a medium to high echogenic tumor with an uneven oval cystic cavity in the ciliary body. At the follow-up examination, the size of the mass was increased, so we performed enucleation of the left eye. Pathology demonstrated that the retrolental mass abutting the lens had arisen from the retina. Histological examination revealed that the tumor had originated from the retina and extended into the ciliary body, and most of the tumor was composed of hyaline cartilage with calicification. Tumor cells were identified in the periphery, forming elongated tubules and cord-like structures that were immunohistochemically positive for vimentin, neuron-specific enolase, and CD56 compatible with a teratoid medulloepithelioma. The patient was followed up for eight months without any metastasis in the orbit or elsewhere. Conclusions: Medulloepithelioma should be considered in the differential diagnosis of pediatric orbital mass accompanied by calcification. J Korean Ophthalmol Soc 2010;51(12):1665-1670
김남주,정호경,곽상인,Nam Ju Kim,Ho Kyung Choung,Sang In Khwarg 대한안과학회 2006 대한안과학회지 Vol.47 No.10
Purpose: Benign mixed tumor of the accessory lacrimal gland is a very rare neoplasm, with only one case with presumed origin of Wolfring`s gland in domestic literature. We report our experience with a case of a nodular lesion of the lateral lower eyelid which is completely excised and histologically diagnosed as benign mixed tumor from Krause`s gland. Methods: A 68 year-old woman presented with 1 cm-sized subcutaneous mass in right lateral lower eyelid. A hard non-tender movable mass was palpated. After 6 months of observation, the mass was excised through subciliary skin incision. Results: The mass was located deep to the subcutaneous tissue, inferior to lower border of tarsal plate, and was adherent to inferior forniceal conjunctiva. Round 1.2 cm-sized yellow-pink mass was completely excised. Histologic examination showed many glandular elements embedded in a myxoid ground substance, and glandular structures were composed of two layers of inner cuboidal and outer polygonal cell. It was diagnosed as benign mixed tumor from accessory lacrimal gland of Krause. Conclusions: In any case presenting lower eyelid mass lesion, benign mixed tumor of accessory lacrimal gland should be considered as one of the differential diagnosis.
이민정,정호경,곽상인,양희진.Min-Joung Lee. M.D... Ho-Kyung Choung. M.D... Sang-In Khwarg. M.D... Hee-Jin Yang. M.D. 대한안과학회 2005 대한안과학회지 Vol.46 No.6
Purpose: As orbital involvement in multiple myeloma is rare, the correct diagnosis is usually difficult. We report a case of multiple myeloma which involved the orbit, and which presented with unilateral ptosis. Methods: A 35-year-old man was referred for the evaluation of ptosis of the left eyelid for 1 month. The levator function was normal, and there was no proptosis. Orbital computerized tomography (CT) revealed an orbital mass lesion involving the superior orbital ridge with intracranial extension. Results: Excisional biopsy was performed through craniotomy and superior orbitotomy. Histopathologic examination and immunostaining result suggested a diagnosis of a plasmacytoma. The diagnosis of multiple myeloma was confirmed through bone marrow aspiration and biopsy showing diffuse infiltration of plasma cells. Conclusions: We experienced a case of multiple myeloma, which is rare in the orbit presenting unilateral ptosis. In addition, the possibility of orbital mass should be considered as an unusual cause of unilateral, acquired, progressive ptosis.
안성준,김남주,정호경,곽상인,Seong Joon Ahn,Namju Kim,Ho Kyung Choung,Sang In Khwarg 대한안과학회 2011 대한안과학회지 Vol.52 No.7
Purpose: To report a case of chondroid syringoma that involved the eyelid margin, was accompanied by cilia loss, and required differential diagnosis with other malignant eyelid masses. Case summary: A 46-year-old woman presented with a recurrent mass in the right lower eyelid margin, which was observed 10 years earlier, where incision and curettage had already been performed twice. The mass was neither tender nor ulcerated, was brighter in color than the neighboring skin, and had a smooth surface with cilia loss. The pathologic findings obtained from an incisional biopsy were compatible with a dermoid cyst. Full-thickness excision of the eyelid mass and direct closure were subsequently performed. The pathologic diagnosis after excisional biopsy was chondroid syringoma because cystic structures in the chondroid stroma were observed. J Korean Ophthalmol Soc 2011;52(7):859-862
황준서,김정훈,정호경,허장원,김성준,유영석.Joon Seo Hwang. M.D... Jeong Hun Kim. M.D... Ho Kyung Choung. M.D... Jang Won Heo. M.D... Seong-Joon Kim. M.D... Young Suk Yu. M.D.. 대한안과학회 2007 대한안과학회지 Vol.48 No.9
Purpose: To study the clinical characteristics and visual prognosis of Leber’s congenital amaurosis in Korea. Methods: Children who were diagnosed with Leber`s congenital amaurosis at Seoul Natioanl University Children`s Hospital between 1992 and 2004, were included in this study. The medical records pertaining to the clinical characteristics and visual outcomes of the patients were retrospectively reviewed. Results: The mean age of the patients at presentation and during the subsequent follow-up period was 15.5 and 62.7 months, respectively. The principal symptoms included lack of fixation (69.0%) and nystagmus (23.8%). At first observation, nystagmus was found in 40 patients, and the appearance of the fundi were variable, including `normal` (23.8%), pigmentary degeneration (54.8%), vascular attenuation (35.7%) and macular coloboma (19.0%). At the age of three to five years, 44.4% of patients had hyperopia greater than +5D. At the time of last follow-up, the visual acuities of the patients who were examined after the age of four were `hand motion` in 68.7%, ≥20/400 in 9.4%. No patient had visual acuity better than 20/200. Eight (25%) patients could read with glasses or low-vision aids. Conclusions: The visual prognosis of patients with Leber’s congenital amaurosis was poor in most cases, but a majority of our patients displayed a stable clinical course. Progression was rare, and one fourth of the patients were able to read with appropriate aides. In conclusion, regular follow-up care to assess visual function is necessary for optimal outcomes.