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시신경 주변부의 장액성 망막박리를 동반한 Leber 특발성 성상 시신경망막염
한대헌,손희진,이대영,남동흔 대한안과학회 2011 대한안과학회지 Vol.52 No.9
Purpose: To report a patient with Leber’s idiopathic stellate neuroretinitis accompanying peripapillary sensory retinal detachment detected with optical coherence tomography. Case summary: A 26-year-old woman complained of visual disturbance in her right eye for several months. Her best corrected visual acuity was 0.5 in the right eye and 0.9 in the left eye. A relative afferent papillary defect was present in the right eye. Severe disc swelling with retinal hemorrhage and stellate macular exudates were observed in the right eye. Fluorescein angiography revealed optic disc leakage. There appeared to be no leakage from the other retinal vessels or from the retinal pigment epithelium. OCT revealed outer nuclear-plexiform layer fluid accumulation in the papillomacular region. Eight weeks after steroid treatment, the best corrected visual acuity in the right eye had improved to 0.7, and the optic disc edema had improved. The OCT showed that the fluid in the outer nuclear-plexiform layer space had largely been absorbed. J Korean Ophthalmol Soc 2011;52(9):1109-1113
인도사이아닌그린 염색을 이용한 내경계막 제거여부에 따른 특발성 황반원공 수술결과
남동흔,황상준,허걸 대한안과학회 2004 대한안과학회지 Vol.45 No.7
Purpose: To compare the anatomical and visual outcomes in idiopathic macular hole surgery with or without indocyanine green (ICG)-stained internal limiting membrane (ILM) peeling. Methods: Thirty-six eyes of 36 patients who underwent idiopathic macular hole surgery were included. Follow-up period was longer than 6 months. In the initial 16 eyes, no ILM peeling was performed (non-ILM peeling group). The subsequent 20 eyes underwent surgery with ICG-stained ILM peeling (ILM peeling group). Results: There were no significant differences in the age, sex, hole size, symptom duration and preoperative best-corrected visual acuity between the two groups. The anatomical closure rates were 95% (19/20eyes) and 75% (12/16eyes) in the ILM peeling and non-ILM peeling groups, respectively (Fisher's exact test, p=0.15). Visual improvement of two or more lines occurred in 35% (7/20eyes) in the ILM peeling group and 43.8% (7/16eyes) in the non-ILM peeling group (Chi-square test, p=0.59). Conclusions: ICG stained ILM peeling was not statistically significant for anatomic and functional success in idiopathic macular hole surgery. Further studies of the toxicity of ICG and the result of ILM peeling should be performed. 목적 : 특발성 황반원공 수술시 Indocyanine green (ICG) 염색을 이용한 내경계막 제거여부에 따른 수술 결과를 비교하고자 하였다. 대상과 방법 : 특발성 황반원공으로 평면부 유리체절제술을 시행받고 6개월 이상 추적관찰이 가능하였던 36명 36안을 대상으로 ICG 염색을 이용한 내경계막 제거를 시행한 20안과 시행하지 않은 16안으로 구분하여 황반원공 수술의 해부학적 및 기능적 수술결과를 알아보았다. 결과 : 두 군간 연령, 성별, 원공크기, 증상발현기간 및 술전 최대교정시력의 유의한 차이는 없었다. 황반원공이 폐쇄된 해부학적 성공은 내경계막 제거군은 20안중 19안(95%), 내경계막을 제거하지 않은군은 16안중 12안(75%)으로 통계학적 차이는 없었으며(p=.15), 한식 시력표상 2줄 이상의 시력개선을 보인 기능적인 성공도 또한 내경계막 제거군은 20안중 7안(35%), 내경계막을 제거하지 않은군은 16안중 7안(43.8%)으로 통계학적 차이가 없었다(p=.59). 결론 : 특발성 황반원공 수술에서 ICG 염색을 이용한 내경계막 제거 유무에 따른 해부학적 및 기능적인 성공의 유의한 차이는 없었으며, 향후 ICG 및 다른 염색제의 독성연구와 장기적이고 전향적인 비교연구가 필요할 것으로 생각된다.
오플록사신, 레보플록사신 및 씨프로플록사신 점안 후 방수 내 농도 비교
한용수,남동흔,신경환,박지영,김경아,김선욱,송종석,Yong-Soo Han,Dong-Heun Nam,Kyung-Hwan Shyn,Ji-Young Park,Kyoung-Ah Kim,Sun-Wook Kim,Jong-Suk Song 대한안과학회 2005 대한안과학회지 Vol.46 No.4
Purpose: To evaluate the concentrations of commercially available ofloxacin 0.3%, levofloxacin 0.5%, and ciprofloxacin 0.3% topical ophthalmic solutions in human aqueous humor. Methods: Patients scheduled to undergo phacoemulsification and posterior chamber lens insertion for treatment of cataract were enrolled in this prospective study. After informed consent was obtained, patients were randomized to receive 1 drop of ofloxacin 0.3%, levofloxacin 0.5%, or ciprofloxacin 0.3% topical ophthalmic solution 5 times at 1-hour intervals from 6pm one day before surgery and 3 further times at 5-min intervals immediately before surgery. After aspirating approximately 0.1 mL of aqueous fluid by paracentesis, surgery was commenced. We recorded the interval between the last drop and paracentesis. Specimens were stored at -70℃ until assayed by high-performance liquid chromatography. Results: Thirty-four patients were enrolled. 14 male and 19 patients female. The mean age was 59.4 years. The mean concentrations of levofloxacin, ofloxacin and ciprofloxacin in aqueous humor were 577.8 ng/ml, 279.6 ng/ml and 53.0 ng/ml, respectively. The differences of concentration among the three groups were statistically significant. Conclusions: The concentration of levofloxacin 0.5% solution was highest, followed in order by ofloxacin 0.3% and ciprofloxacin 0.3%.
유리체망막수술시 테논낭하마취의 용량에 따른 안압 및 마취효과의 비교
문현승,남동흔,백혜정.Hyun Seung Moon. M.D.. Dong Heun Nam. M.D.. Hae Jung Paik. M.D. 대한안과학회 2006 대한안과학회지 Vol.47 No.11
Purpose: To compare the effects of different volumes of sub-Tenon`s anesthetic on intraocular pressure (IOP) and to evaluate the treatment efficacy of vitreoretinal surgery. Methods: A prospective, clinical trial was conducted on patients undergoing sub-Tenon`s anesthesea for vitreoretinal surgery. Patients were randomized to receive either 3 mL, 5 mL or 7 mL of anesthetic solution. IOPs were measured immediately prior to, immediately after, and at 2, 5 and 10 min after the injection. Pain scores were assigned using a numerical visual analogue scale immediately following surgery and again on postoperative day one. Results: A total of 108 patients (119 eyes) were studied, including 35 eyes in the 3 mL group, 48 eyes in the 5 mL group, and 36 eyes in the 7 mL group. There was significant elevation in mean IOP following injection in all groups and a trend toward a larger increase in the group receiving the larger volume (p<0.01). Mean IOPs were elevated immediately after the injections and reduced at all subsequent time intervals. But reduction to the pre-injection level was only achieved in the 3 mL group. There was no significant difference in patient-reported pain scores among the groups when assessed immediately after surgery or on postoperative day one. The incidence of chemosis and high IOP elevation (40 mmHg ≤) was more frequent in the 7 mL group than the other groups (p<0.05). Conclusions: Sub-Tenon`s anesthesia is effective in vitreoretinal surgery. It would appear that a 3-5 mL volume of anesthetic is safe even when complications are considered.
정훈석,남동흔,백혜정,이대영 대한안과학회 2012 Korean Journal of Ophthalmology Vol.26 No.2
Purpose: To evaluate the efficacy and safety of a pars plana Ahmed valve implantation combined with 23-gauge sutureless vitrectomy in the treatment of patients with medically uncontrolled neovascular glaucoma (NVG) in proliferative diabetic retinopathy (PDR). Methods: The authors retrospectively reviewed the records of 11 consecutive patients with refractory NVG in PDR who underwent a 23-gauge sutureless vitrectomy combined with pars plana placement of an Ahmed valve implant. Control of intraocular pressure (IOP), pre- and postoperative best-corrected visual acuity and the development of intra- and postoperative complications were evaluated during the follow-up. Results: The mean follow-up was 12.2 months (range, 8 to 25 months). Mean preoperative IOP was 35.9 6.3mmHg and mean postoperative IOP at the last visit was 13.3 3.2 mmHg. Control of IOP (8 to 18 mmHg) was achieved in all patients, but 91% (10 of 11 patients) needed antiglaucoma medication (mean number of medications,1.2 0.6). Postoperative visual acuity improved in 11 eyes, and the logarithmically to the minimum angle of resolution mean visual acuity in these eyes improved from 1.67 0.61 to 0.96 0.67. The complications that occurred were transient hypotony in one case, transitory hypertension in two cases, and postoperative vitreous hemorrhage which spontaneously cleared in two cases. Conclusions: We suggest the combination of 23-gauge pars plana vitrectomy and Ahmed valve implantation is safe and effective in PDR patients with refractory NVG.