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만성중심장액맥락망막병증에서 절반 에너지보다 낮은 에너지를 이용한 광역학치료의 효과
오현주,장우혁,사공민,Hyun Ju Oh,MD,Woohyok Chang,MD,PhD,Min Sagong,MD,PhD 대한안과학회 2013 대한안과학회지 Vol.54 No.7
Purpose: To investigate the safe, effective light dose for photodynamic therapy (PDT) in the treatment of chronic central serous chorioretinopathy (CSC). Methods: Thirty-eight eyes of 37 patients with chronic CSC were recruited for this study. From November 2009 to July 2010 and from April 2011 to February 2012, PDT was performed using 50% and 25% of the full light dose in 27 eyes of 27 patients (group I) and 11 eyes of 10 patients (group II), respectively. The minimum follow-up period was 6 months. Mean change in best corrected visual acuity (BCVA) and central retinal thickness, hyperpermeability change from abnormal choriocapillaris, success rate, recurrence rate, and complications were analyzed. Results: Group I showed that BCVA (log MAR) improved significantly from 0.33 ± 0.17 to 0.14 ± 0.15 at 6 months (p < 0.001). However, there was no significant improvement of BCVA (p = 0.050) in group II. One eye out of 27 eyes (3.7%) in group I and 5 eyes out of 11 eyes (45.5%) in group II showed recurrence at the 6-month follow-up (p = 0.016). After initial PDT, hyperpermeability from abnormal choriocapillaris reduced or disappeared at 95.5% in group I and 54.5% in group II at month 3 (p = 0.016). No patient in either group experienced severe adverse events. Conclusions: PDT performed with 50% of the full light dose appears to be a more useful method in the treatment of chronic CSC, with less frequent recurrence, than PDT using 25% of the full light dose.
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장우혁 영남대학교 의과대학 2007 Yeungnam University Journal of Medicine Vol.24 No.2
일광망막병증은 드물지만 일반적으로 잘 알려진 황반질환이며 이는 직접적인 태양 관찰로 인해 일어난다. 21세 남자가 단안 망원경을 이용하여 좌안으로 약 30초간 태양을 관찰하고 약 48시간 후 시력저하와 중심암점을 호소하였다. 그로부터 약 8개월 후 중심시력은 1.0에서 0.1로 저하되었고 안저검사에서 황백색의 점상 침착물이 관찰되었고 형광안저 촬영에서 망막 색소상피의 결손으로 인한 창문 결손이 좌안 중심와에 나타났다. 시야검사에서는 중심 암점이 괸찰되었고 시력저하는 빛에 노출된 후 1년이 지난 후에도 지속되었다. Solar retinopathy is a rare but well-recognized clinical entity of macular damage, caused by viewing a solar eclipse or direct sun gazing. A 21-year-old man gazed at the sun for approximately thirty seconds at noon using a monocular telescope with his left eye. Forty-eight hours after sun gazing, the patient experienced symptoms uf blurred vision and central scotoma in the left eye. Eieht months after sun gazing, the visual acuity decreased from 1.0 to 0.1 in the left eye and the fundus examination showed a round, yellowish-white discoid lesion at the left fovea. Fluorescein angiography showed an early window defect in the fovea of the left eye, that persisted without size change during the late phase resulting from atrophy uf the retinal pigment cpithelium. A small, central scotoma of the left eye was also found in the visual field test. The visual acuity was unchanged at the end of a one-year follow-up period.
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( Jinseon Kim ),( Woohyok Chang ),( Min Sagong ) 대한안과학회 2010 Korean Journal of Ophthalmology Vol.24 No.4
We present a case of bilateral serous retinal detachment (SRD) as a presenting sign of Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ALL). A 45-year-old woman presented with decreased vision and was found to have bilateral serous retinal detachment. Peripheral blood smears revealed leukocytosis of 53.9x103/?L with 64.6% lymphoblasts. A bone marrow aspirate revealed the presence of lymphoblasts. Cytogenetic and molecular genetic analysis detected a reciprocal translocation between chromosome 9 and 22, t(9;22) (q34;q11). A diagnosis of Ph+ ALL was made. Following systemic chemotherapy, the bilateral SRD resolved completely with full recovery of vision. The sudden appearance of SRD should raise suspicion for leukemia. Prompt recognition of this disease is important for early systemic treatment and restoration of visual function.
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박주홍(Juhong Park),사공민(Min Sagong),장우혁(Woohyok Chang) 대한검안학회 2008 Annals of optometry and contact lens Vol.7 No.1
목적: 유리체황반견인증후군 환자에서 유리체와 황반간의 견인이 자연적으로 소실된 증례를 보고하는 바이다 대상과 방법: 74세 여자환자가 우안의 8개월간의 시력저하를 주소로 내원하였다. 광간섭단층촬영에서 후유리체와 황반부의 일부가 유착되어 있었고 심한 황반부종이 관찰되었다. 결과: 외래 경과 관찰 12개월째 시력은 향상되었으며 광간섭단층촬영에서 완전한 후유리체 박리가 일어나고 중심와 두께가 감소되었음을 확인 할수 있었다. 결론: 유리체황반견인증후군 환자의 일부에서 자연적인 관해가 나타날 수 있으므로 광간섭단층촬영으로 평가하면서 경과관찰 후 수술여부를 결정하는 것도 치료의 한 방법으로 고려해 볼 수 있다고 생각한다. Purpose: We report spontaneous resolution of vitreomacular traction syndrome without surgical intervention. Methods: A 74-year-old woman presented with a 8-month history of visual disturbance in her right eye. Optical coherence tomography showed attachment of the posterior hyaloids to the macula and significant macular elevation. Results: Twelve months after presentation, visual acuity was improved. OCT revealed complete posterior vitreous detachment and decreased foveal thickness. Conclusions: As spontaneous resolution may occur in some eyes with VMT, a period of observation with sequential OCT evaluation to assess the vitreous anatomy may be considered prior to surgical intervention.
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Miho Nozaki,Ian Y Wong,Ryo Kawasaki,Joo Eun Lee,Yoshihiro Takamura,Ji Eun Lee,Shigeo Yoshida,Jae Pil Shin,Teruyo Kida,Woohyok Chang,Eiko Tsuiki,Hidetaka Noma,Kiyoshi Suzuma 한국망막학회 2022 Journal of Retina Vol.7 No.2
Purpose: To compare the efficacy of a combination of anti-vascular endothelial growth factor (VEGF) and endpoint management (EpM) grid laser versus monotherapy with anti-VEGF in the management of diabetic macular edema (DME). Methods: This was a prospective, multicenter, open-label, nonrandomized interventional study (NCT02462304). Anti-VEGF therapy consisted of one initial injection administered pro re nata in both groups. EpM laser was performed within 1 month after the first anti-VEGF injection. The main outcome evaluated was the number of anti-VEGF injections performed in 6 months. Best-corrected visual acuity (BCVA) and central foveal thickness (CFT) were also evaluated monthly. The anti-VEGF agent used in Japan and Hong Kong was ranibizumab, while bevacizumab was used in Korea. Results: This study enrolled a total of 42 subjects, with 19 (45.2%) allocated to the monotherapy arm and 23 (54.8%) allocated to the combination arm (EpM group). Overall, there was no significant difference in the number of injections between patients in the two groups (+0.12, p = 0.81). Mixed regression analysis with all the covariates plus an interaction term for the ranibizumab/bevacizumab and the monotherapy/combination arm showed that the EpM group needed 0.94 less injections (95% confidence interval [CI], -1.73 to -0.15; p = 0.02). The logarithm of the minimum angle of resolution BCVA at 24 weeks was significantly improved in the monotherapy arm (p = 0.03), but not in the EpM group (p = 0.09). CFT at 24 weeks was significantly improved in both groups (p < 0.01). Conclusions: These data suggest that combination therapy with the EpM laser may be effective for reducing the number of anti-VEGF injections required for DME treatment.
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