망막분지정맥폐쇄에 합병된 황반부종에서 유리체강내 트리암시놀론주입술과 베바시주맙주입술의 비교

김호숭,문상정,강재훈,윤희성 대한안과학회 2010 대한안과학회지 Vol.51 No.8

Purpose: To compare clinical outcomes after intravitreal injection of triamcinolone acetonide or bevacizumab for the treatment of macular edema secondary to branch retinal vein occlusion. Methods: Sixty-six patients received an intravitreal injection of either triamcinolone acetonide or bevacizumab. Patients were retrospectively reviewed. Thirty-three out of 66 patients were treated with an intravitreal injection of triamcinolone acetonide, while the other 33 patients received a bevacizumab injection. All patients underwent a visual acuity test, optical coherence tomography imaging and ophthalmoscopic examination throughout the follow-up. Results: In the triamcinolone group, central macular thickness (CMT) decreased from 496.69 ± 153.01 μm at baseline to 313.06 ± 150.14 μm at the six-month follow-up visit, while in the bevacizumab group, CMT decreased from 441.30 ± 185.79 μm to 295.67 ± 188.80 μm (p<0.05). In the triamcinolone group, best-corrected visual acuity (BCVA) improved from logMAR 0.92 ± 0.70 at baseline to logMAR 0.53 ± 0.43 at the six-month follow-up visit, and in the bevacizumab group, BCVA improved from logMAR 0.74 ± 0.47 to logMAR 0.34 ± 0.33 (p<0.05). Conclusions: The therapeutic effects of intravitreal triamcinolone acetonide showed no significant differences compared with those of intravitreal bevacizumab with regard to anatomical and functional outcomes. J Korean Ophthalmol Soc 2010;51(8):1071-1076

원추각막에서 각막링 삽입술 후 단기간 임상효과

김호숭,이태헌,이경헌 대한안과학회 2009 대한안과학회지 Vol.50 No.10

Purpose: To assess the safety and efficacy of intracorneal ring segment (Intacs ring) implantation in managing keratoconus. Methods: This retrospective case series comprised of 11 keratoconic eyes (11 patients) had Intacs ring (Addition Technology, Inc, California, USA) implantation. The main outcome measures were best corrected visual acuity, refraction, keratometry, topography, and pachymetry. Patients were examined before Intacs ring implantation as well as one week, one, three, and six months postoperatively. Results: The mean best corrected visual acuity improved from 0.60±0.33 logMAR preoperatively to 0.39±0.23 logMAR six months postoperatively (p >0.05) and the mean corneal thickness, from 432.82±41.17 μm preoperatively to 448.00±62.27 μm at six months (p >0.05). The mean cylinder improved from -5.36±2.70D preoperatively to -2.50±1.66D six months postoperatively (p <0.05) and the mean keratometry, from 47.99±2.38D to 42.83±1.72D at six months (p <0.05). In addition, the mean spherical equivalent improved from -6.64±3.49D preoperatively to -3.66±3.37D six months postoperatively (p <0.05). One eye had a risk of ring exposure, but the others had no significant complications. Conclusions: Intacs ring implantation appears to be effective in improving cylinder, spherical equivalent, and keratometry in patients with keratoconus. 목적: 원추각막의 치료로써 각막링 삽입술의 안전성과 임상효과를 알아보고자 하였다. 대상과 방법: 원추각막으로 진단받고 Intacs 각막링 삽입술을 시행 받은 환자 중 6개월 이상 경과 관찰이 가능했던 11명 11안을 대상으로 하였다. 술 전, 술 후 1주, 1개월, 3개월, 6개월에 시력검사 및 굴절검사, 각막곡률 및 각막두께 측정 등을 시행하여 결과를 분석하였다. 결과: 최대교정시력(logMAR)와 최소각막두께는 술 전 각각 0.60±0.33, 432.82±41.17 μm에서 술 후 6개월 각각 0.39±0.23, 448.00± 62.27 μm로 유의한 변화는 없었다(p >0.05). 난시, 구면렌즈대응치, 평균 각막곡률은 술 전 각각 -5.36±2.70D, -6.64±3.49D, 47.99± 2.38D에서 술 후 6개월 각각 -2.50±1.66D, -3.66±3.37D, 42.83±1.72D로 통계적으로 유의하게 감소하였다(p <0.05). 1안에서 각막링의 노출 위험이 있었으며 그 외 유의한 합병증은 관찰되지 않았다. 결론: 각막링 삽입술은 원추각막의 치료에 있어 난시 및 굴절교정에 효과적인 방법이라 생각된다.

나이관련황반변성에서 광역학요법 후 발생한 망막하출혈의 임상분석

윤재문,김호숭,강재훈,윤희성,Jae Moon Yoon,M,D,Ho Soong Kim,M,D,Jae Hoon Kang,M,D,Hee Sung Yoon,M,D,Ph,D 대한안과학회 2008 대한안과학회지 Vol.49 No.10

Purpose: To evaluate the clinical features of subretinal hemorrhage after photodynamic therapy in eyes with exudative age-related macular degeneration. Methods: We retrospectively reviewed data for 267 eyes of 243 patients who had undergone PDT for the treatment of ARMD between January 2005 and December 2006. Best corrected visual acuity, fundus photography, fluorescein angiography, and ICG angiography were performed before and after treatment. We followed up the patients at 1 week, 1 month, and 3 months after treatment and at 3-month intervals thereafter. Results: Postoperative subretinal hemorrhage was seen in 36 (13.4%) of 267 eyes. The pretreatment and post-treatment mean visual acuities were logMAR 0.80 and logMAR 1.05 respectively, representing a decrease of 2.05 lines. On FAG, two eyes were predominantly classic, four eyes were minimally classic, and 30 eyes were occult. The laser irradiation spot size was under 3,000 μm in one case and from 3,000 μm to 5,000 μm in 19 cases and over 5,000 μm in 16 eyes. Conclusions: Subretinal hemorrhage after PDT for ARMD can be a common complication in patients who have been treated for larger irradiation spot sizes and for pigment epithelial detachment (PED), so doctors should be aware of the risk of serious hemorrhagic complications in such situations. J Korean Ophthalmol Soc 2008;49(10):1603-1610

쯔쯔가무시병에서 발생한 전포도막염 1예

최은수,문상정,김호숭,이경헌,Eun Su Choi,Sang Jeong Moon,Ho Soong Kim,Kyung Hun Lee 대한안과학회 2010 대한안과학회지 Vol.51 No.10

Purpose: To report a single case of tsutsugamushi disease with anterior uveitis and eschars on the upper eyelid. Case summary: A 56-year-old female patient complained of ocular pain and gradually decreasing visual acuity in her right eye. On physical examination, lymphadenopathy was palpable on the right side of the neck, and eschars were observed on the forehead and upper eyelid. On slit lamp examination, conjunctival injection, episcleral vessel dilations and severe intraocular inflammatory reaction were observed. Fundus examination showed no abnormal findings. A blood test was submitted for analysis, and tsutsugamushi disease was diagnosed. The patient’s ocular manifestations responded well to treatment with steroids. After three weeks, the patient showed improvement on ocular examination, and no problems were observed at the six-month follow-up. Conclusions: Although ocular manifestation of tsutusgamushi disease with conjunctivitis and limbitis has previously been reported, ocular manifestation of tsutusgamushi disease with anterior uveitis has not been reported. Anterior uveitis may respond satisfactorily to steroid treatment, along with improvement in systemic conditions. J Korean Ophthalmol Soc 2010;51(10):1414-1418

망막대동맥류에 합병된 황반부종에서 유리체강내 베바시주맙 주입술의 치료효과

문상정,김상원,김호숭,강재훈,윤희성,Sang Jeong Moon,Sang Won Kim,Ho Soong Kim,Jae Hoon Kang,Hee Seong Yoon 대한안과학회 2012 대한안과학회지 Vol.53 No.4

Purpose: To study the short-term effect of intravitreal injection of bevacizumab in the treatment of macular edema secondary to retinal macroaneurysm. Methods: Eight eyes of 9 patients who underwent consecutive intravitreal bevacizumab injections for macular edema secondary to retinal macroaneurysm were prospectively evaluated. Complete eye examination including the best corrected visual acuity (BCVA), fundus examination and optical coherence tomography (OCT) were performed at baseline and follow- up visits at 2, 4 and 6 months. Results: The mean age was 73.6 ± 6.9 years, and the mean study period was 7.3 ± 2.6 months. At the final visit, BCVA improved from log MAR 1.92 ± 0.67 to log MAR 0.87 ± 0.57. The mean central macular thickness on OCT image decreased from 388 ± 168 μm at the initial visit to 200 ± 39 μm at the final visit. Three eyes without subretinal hemorrhage presented better visual outcome than eyes with subretinal hemorrhage. All eyes showed some decrease in angiographic leakage. No adverse side effects were observed following the injections. Conclusions: Intravitreal bevacizumab injection can be used as a selective alternative treatment modality for macular edema secondary to retinal macroaneurysm. J Korean Ophthalmol Soc 2012;53(4):522-527

고도근시와 난시 치료를 위해 시행한 ICL 및 반대안 토릭 ICL 삽입술의 임상결과

한상엽,문상정,김호숭,이태헌,이경헌.Sang Youp Han. MD. Sang Jung Moon. MD. Ho Soong Kim. MD. Tae Hun Lee. MD. Kyung Hun Lee. MD 대한안과학회 2010 대한안과학회지 Vol.51 No.6

Purpose: We compared intra-individual visual outcomes and patient satisfaction after implantable contact lens (ICL) and Toric ICL implantation. Methods: Twenty-eight eyes of 14 patients were enrolled in this retrospective study. One eye of each patient was assigned to ICL (ICL Group), and the contralateral eye was allocated to Toric ICL (Toric ICL Group). All patients were examined for visual acuity, refraction, intraocular pressure, slit lamp measurements, and satisfaction one week, one month, two months, and six months postoperatively. Results: Mean spherical equivalents of the two groups were corrected from -7.83D (ICL Group) and -5.55D (Toric ICL Group) to 0.13D and 0.20D, respectively, and the mean refractive cylinders were corrected from 0.92D and 2.60D to 0.42D and 0.27D, respectively, at six months postoperatively. The myopias of these two groups and the astigmatism of the Toric ICL group were effectively corrected. The uncorrected visual acuity (UCVA) of the two groups were 1.02 and 1.05, respectively, at six months postoperatively. The safety index, efficacy index, predictability, and stability were favorable. There were no significant differences between the two groups in terms of postoperative UCVA, intraocular pressure(IOP), vaulting, noticeable complications, or patient satisfaction. Conclusions: The results show ICL implantation is effective treatment for high myopia, and Toric ICL implantation is a viable surgical option for the treatment of compound myopia astigmatism. Selection of proper phakic intraocular lens(IOL) is recommended for correcting astigmatism. J Korean Ophthalmol Soc 2010;51(6):802-808

급성폐쇄각녹내장에서 백내장 술 후 홍채섬유주접촉지표 변화

박재홍(Jae Hong Park),김호숭(Ho Soong Kim),이태헌(Tae Heon Lee),이경헌(Kyung Heon Lee) 대한안과학회 2016 대한안과학회지 Vol.57 No.9

목적: 급성폐쇄각녹내장 환자에서 백내장 술 후 홍채섬유주접촉지표(iris-trabecular contact index, ITC index)의 변화를 알아보고자 하였다. 대상과 방법: 급성폐쇄각녹내장 기왕력이 있는 12명 17안에서 백내장 수술 전후에 파장 가변 빛간섭단층촬영을 시행하였다. 수정체아치높이(lens vault, LV), ITC index와 안압, 전방 깊이, 전방 부피, 전방각 수치의 상관관계를 백내장 수술 전후로 분석하였다. 결과: 백내장 수술 후 안압(p=0.007), 전방 깊이(p<0.001), 전방 부피(p<0.001), 전방각 지표(p=0.001)와 ITC index (p=0.012)는 모두 유의하게 호전되었다. ITC index는 백내장 수술 전 88.42 ± 23.59%에서 수술 후 48.91 ± 35.13%로 감소되었다(p=0.012). 수술 전 LV는 전방 깊이(p=0.075), 전방 부피(p=0.864), 전방각 수치(p=0.112-0.707), ITC index (p=0.288)와 유의한 상관관계를 보이지 않았다. ITC index는 수술 전 안압(p=0.021), 전방 깊이(p=0.002), 전방 부피(p<0.001), 전방각 수치(p=0.001-0.030)와 유의한 상관관계를 보였으나 수술 후에는 이들 지표와 유의한 상관관계가 없었다(p=0.223/0.206/0.761/0.096-0.819). 결론: 급성폐쇄각녹내장 환자에서 백내장 술 후 ITC index는 유의하게 호전되었으나, 전방각 폐쇄는 일부 남아 있었다. Purpose: To evaluate the change of iris-trabecular contact index (ITC index) after cataract surgery in acute angle closure glaucoma. Methods: Twelve patients (17 eyes) who had a history of acute angle closure glaucoma underwent swept source optical coherence tomography before and after cataract surgery. Correlations between lens vault (LV), ITC index and intraocular pressure (IOP), anterior chamber depth (ACD), anterior chamber volume (ACV), and angle parameters were analyzed before and after cataract surgery. Results: IOP (p = 0.007), ACD (p < 0.001), ACV (p < 0.001), angle parameters (p = 0.001), and ITC index (p = 0.012) were improved after cataract surgery. ITC index decreased from 88.42 ± 23.59% to 48.91 ± 35.13% after cataract surgery (p = 0.012). There was no correlation between LV and ACD (p = 0.075), ACV (p = 0.864), angle parameter (p = 0.112-0.707), or ITC index (p = 0.288) before cataract surgery. The correlations between ITC index and IOP (p = 0.021), ACD (p = 0.002), ACV (p < 0.001), and angle parameter (p = 0.001-0.030) were statistically significant before surgery but not statistically significant (p = 0.223/0.206/0.761/ 0.096-0.819) after surgery. Conclusions: ITC index significantly improved after cataract surgery, but part of angle closure was not resolved in some cases of acute angle closure glaucoma.