망막정맥폐쇄환자에서 황반부종의 양상에 따른 단기 시력예후

박가희,노인호,Ka Hee Park,In Ho Rho 대한안과학회 2012 대한안과학회지 Vol.53 No.9

Purpose: To study the short-term visual outcomes affected by the patterns of macular edema in retinal vein occlusion patients. Methods: In a retrospective study, 33 eyes of 33 consecutive patients with macular edema from retinal vein occlusion received an intravitreal injection of bevacizumab. Macular edema was classified according to OCT patterns and the effect on visual outcome evaluated: Diffuse macular edema (DME) vs. focal macular edema (FME), and macular edema with serous retinal detachment (SRD) vs. macular edema without serous retinal detachment (non-SRD). Results: Nine patients had CRVO, 24 patients had BRVO and the follow-up period was 3.6 months. In the FME group, the mean baseline BCVA was 0.61 ± 0.34 and the final BCVA was 0.26 ± 0.29, a difference that was statistically significant (p < 0.01). In the DME group, the mean baseline BCVA was 0.85 ± 0.44 and the final BCVA was 0.73 ± 0.37, a difference that was not statistically significant (p = 0.07). In the non-SRD group, the mean baseline BCVA was 0.76 ± 0.43 and the final BCVA was 0.38 ± 0.36, a difference that was statistically significant (p < 0.01). In the SRD group, the mean baseline BCVA was 0.73 ± 0.40 and the final BCVA was 0.64 ± 0.42, a difference that was not statistically significant (p = 0.07). Conclusions: Visual outcome was significantly better in the FME and non-SRD groups. The patterns of macular edema measured according to OCT were a prognostic factor for visual outcome. J Korean Ophthalmol Soc 2012;53(9):1276-1284

망막분지정맥폐쇄환자에서 정맥폐쇄 위치에 따른 임상적 양상

박가희,최경식,Ka Hee Park,MD,Kyung Seek Choi,MD 대한안과학회 2013 대한안과학회지 Vol.54 No.8

Purpose: To evaluate clinical patterns according to the occlusion site in patients with branch retinal vein occlusion. Methods: Ninety-one branch retinal vein occlusion patients were divided into 4 groups according to the occlusion site based on the description by Duke-Elder and Wybar: Papillary retinal vein occlusion group (group A), main retinal vein occlusion group (group B), minor retinal vein occlusion group (group C), and retinal venule occlusion group (group D). The following factors were analyzed retrospectively: baseline/final visual acuity, visual improvement, macular thickness, and macular circulatory states. Results: The macular thickness (μm) was 575.33 ± 178.44 in group A, 511.92 ± 218.02 in group B, 397.21 ± 144.51 in group C, and 336.68 ± 120.55 in group D. The retinal ischemic area (DD) was 22.00 ± 13.28 in group A, 18.26 ± 10.12 in group B, 12.52 ± 10.52 in group C, and 12.36 ± 11.92 in group D, which was found to be significantly greater in the group with the higher branch occlusion site (p < 0.05). However, visual acuity, macular circulatory states and other clinical characteristics were not significantly different. Conclusions: Occlusion site is a relating factor for retinal ischemic area and macular thickness in patients with Branch retinal vein occlussion, but which is not a prognostic factor for final visual acuity.

변형된 하라다-이토 수술 후 안구회선의 교정효과

박가희,신진희,김소영,Ka Hee Park,Jin Hee Shin,So Young Kim 대한안과학회 2012 대한안과학회지 Vol.53 No.4

Purpose: We evaluated the efficacy of the modified Harada-Ito operation for excyclotorsion in acquired superior oblique palsy patients after trauma. Methods: This study represents a retrospective review of 10 eyes in 9 patients who were surgically treated for excyclotorsion. Cyclotorsion was measured with the double maddox-rod test and fundus photographies preoperatively and postoperatively. Results: The median measured change in excyclotorsion before and after the surgery in the primary gaze was reduced from 15.67 ± 6.00 to 4.78 ± 3.42 according to fundus photographies and from 12.30 ± 6.27 to 2.45 ± 3.73 according to the double maddox-rod test. Subjective and objective changes in excyclotorsion werer not significantly different. Conclusions: The Modified Harada-Ito operation is an effective treatment for correcting excyclotorsion. Although not statistically significant, the amount of excyclotorsion on fundus photography is exaggerated. This point should be considered to achieve effective surgery. J Korean Ophthalmol Soc 2012;53(4):565-571

아스파라거스(Asparagus officinalis L.) 뿌리 추출물의 항염증 및 항통풍 효과

이현주(Hyeon Ju Lee),한준희(Joon-Hee Han),홍민(Min Hong),최다혜(Da-Hye Choi),김종희(Jong-Hui Kim),박가희(Ka-Hee Park),박연희(Yeon-Hee Park),이재희(Jae Hee Lee),강해주(Hae Ju Kang),권태형(Tae-Hyung Kwon),안용조(Yong Jo Ahn) 한국식품과학회 2022 한국식품과학회지 Vol.54 No.6

본 연구에서는 ARW의 항염증 및 항통풍 효능을 평가하였다. LPS가 처리된 RAW 264.7 대식 세포에서 독성을 보이지 않았으며, ARW는 NO 생성 비율을 250 μg/mL 농도에서 87.3±3.3%, 500 μg/mL 농도에서 73.5±4.7%으로 NO 생성을 억제하였다. 또한 LPS를 단독 처리한 군의 경우 iNOS, COX-2 mRNA 발현이 증가하였고 LPS 및 ARW 500 μg/mL 처리한 농도군에서 COX-2 및 iNOS의 mRNA와 단백질 발현 수준이 감소함을 확인할 수 있었다. MSU를 주입하여 통풍을 유도한 마우스 발 부종은 ARW를 섭취한 군과 비교하여 감소하였다. 통풍 유도 마우스의 혈중요산, creatinine 및 BUN의 농도를 측정한 결과 ARW 투여군에서 creatinine과 요산이 감소하였으며, 마우스 신장에서 URAT1과 GLUT9의 mRNA와 단백질 발현 분석 결과 또한 감소하였다. HLPC를 이용하여 ARW의 지표성분 분석 결과 caffeic acid 함량은 1.25 mg/g, 루틴 함량은 0.08 mg/g으로 측정되었다. 국내에서 아스파라거스는 순 부위만 식용으로 사용하고 뿌리 등은 식품 원료로 등록되지 않아 모두 폐기되고 있다. 따라서 본 연구를 통해 ARW의 기능성 소재로서의 개발 가능성을 확인하였고, 향후 독성 평가 및 원료의 특성 분석 등을 통하여 한시적식품원료 등록 및 기능성 소재로서의 개발에 도움이 될 것으로 사료된다. This study aimed to evaluate the anti-inflammatory and anti-gout effects of asparagus root water extract (ARW). ARW was not cytotoxic up to 500 μg/mL and effectively inhibited nitric oxide production in lipopolysaccharide-induced RAW 264.7 macrophages. It was confirmed that the mRNA and protein expression levels of COX-2 and iNOS decreased at an ARW concentration of 500 μg/mL. We also explored the anti-gout effects using a monosodium urate-induced mouse model. Decreased concentrations of uric acid, creatinine, and blood urea nitrogen were observed at an ARW concentration of 400 μg/mL. The mRNA and protein expression of URAT1 and GLUT9 in the mouse kidney decreased to the level of the positive control (allopurinol 50 μg/mL) at an ARW concentration of 400 μg/mL. We analyzed the caffeic acid and rutin contents in the ARW using HLPC; the results obtained were 1.25 and 0.08 mg/g, respectively. We suggest that ARW can be used as a functional materials agent, for its anti-inflammatory and anti-gout properties.

아메드 방수유출장치 삽입수술과 병합수술의 효과

김현아,박가희,박태관,온영훈,Hyun A Kim,Ka Hee Park,Tae Kwann Park,Young Hoon Ohn 대한안과학회 2014 대한안과학회지 Vol.55 No.4

Purpose: To evaluate surgical results after combined operation associated with Ahmed glaucoma valve (AGV) implantation. Methods: A retrospective review was performed for 71 eyes of 67 patients who underwent combined operation associated with AGV implantation from June 2003 to August 2012. Results: Pars plana vitrectomy or phacoemulsification combined with AGV implantation were performed for 16 eyes and AGV implantation alone was performed in 55 eyes. Mean IOP (mm Hg) and the number of antigluacoma agents for both the combined and single groups showed a statistically significant decrease (combined/single; <em>p</em> = 0.008/0.000, 0.002/ 0.000). Visual acuity (log MAR) was improved, but these differences were not statistically significant (combined/single; <em>p</em> = 0.309/0.052). Conclusions: Combined vitrectomy or phacoemulsification and AGV implantation for intractable glaucoma with vitreoretinal disease or cataract is considered to be the primary procedure because of its equivalent efficacy in lowering IOP, improving visual acuity and decreasing the number of glaucoma agents. J Korean Ophthalmol Soc 2014;55(4):578-584

녹내장에서 파장가변 빛간섭단층촬영을 이용한 황반부 신경절세포층의 진단력

이응석(Eung Suk Lee),장지호(Jee Ho Chang),박태관(Tae Kwan Park),온영훈(Young Hoon Ohn),박가희(Ka Hee Park) 대한안과학회 2016 대한안과학회지 Vol.57 No.6

목적: 녹내장 환자에서 파장가변 빛간섭단층촬영(DRI OCT-1, Topcon Co., Tokyo, Japan)을 이용하여 황반부 신경절세포복합체 (macular ganglion cell complex, mGCC)와 황반 신경절세포 및 내망상층(macular ganglion cell inner plexiform layer, mGCIPL)의 두께를 분석해 보고 두 방법의 진단력을 확인해 보고자 한다. 대상과 방법: 2014년 8월부터 2015년 7월까지 본원에 내원한 109명 109안을 대상으로 파장가변 빛간섭단층촬영을 이용하여 mGCC와 mGCIPL의 두께를 측정하여 정상군, 초기, 진행된 녹내장군 간의 차이를 확인해 보고, 각각의 진단력, 민감도, 특이도를 구하여 유두주위 망막신경섬유층(circumpapillary retinal nerve fiber layer, cpRNFL) 두께 분석 방법과 비교해 보았다. 결과: 초기와 진행된 녹내장에 대한 area under the curve를 비교해 보았을 때 mGCC는 0.78과 0.99 cpRNFL과 유의한 차이가 없었으나 mGCIPL은 0.70으로 cpRNFL과 초기 녹내장을 진단하는 경우 cpRNFL의 진단력과 유의한 차이를 나타내었고(p=0.018),녹내장 진단에 대한 민감도와 특이도는 mGCC가 0.95와 0.97, mGCIPL은 0.92와 0.97로 측정되었다. 결론: 두 가지 방법 모두 녹내장을 진단하는 데 있어 높은 민감도와 특이도를 지닌 진단 방법이나, mGCC의 두께 분석 방법이 녹내장의 초기 변화를 감지하는 데 보다 나은 진단력을 가지고 있는 것으로 생각된다. <대한안과학회지 2016;57(6):941-950> Purpose: To evaluate diagnostic ability of macular ganglion cell complex (mGCC), macular ganglion cell inner plexiform layer (mGCIPL) measurements in glaucoma using swept source deep range imaging optical coherence tomography (DRI OCT-1, Topcon Co., Tokyo, Japan). Methods: From August of 2014 to July of 2015, 109 eyes of 109 subjects were assessed for the average thickness and sectional thickness of both mGCC and mGCIPL to determine whether there exists any significant difference among advanced stage glaucoma group, early stage glaucoma group and normal group in Swept source OCT. Comparisons were also made between the above measurements and circumpapillary retinal nerve fiber layer (cpRNFL) thickness measurements in their diagnostic accuracy, sensitivity, and specificity. Results: The diagnostic ability of mGCC based-mean thickness value (area under the curve [AUC] = 0.78/ 0.99) in detecting early stage glaucoma group as well as advanced stage group was not significantly different from that of cpRNFL thickness measurement. However, there was a significant difference in thickness between mGCIPL (AUC = 0.70) and cpRNFL in early stage glaucoma groups (p = 0.018). The sensitivities and specificities of mGCC were 0.95/0.97, and those of mGCIPL were 0.92/0.97, respectively. Conclusions: The two swept source OCT based methods measuring retinal ganglion cell layer thickness appeared to have a good diagnostic accuracy, high sensitivity and specificity in detecting glaucomatous eyes. Nevertheless, of the two methods, mGCC thickness measurement was more efficient in detecting early glaucomatous changes. J Korean Ophthalmol Soc 2016;57(6):941-950

한국인 정상안에서 파장가변 빛간섭단층촬영으로 측정한 시신경유두주위 망막신경섬유층의 두께

최순호(Soon Ho Choi),온영훈(Young Hoon Ohn),박가희(Ka Hee Park) 대한안과학회 2017 대한안과학회지 Vol.58 No.10

목적: 한국인 정상안을 대상으로 파장가변 빛간섭단층촬영(Swept Source OCT, SS-OCT)으로 측정한 시신경유두주위 망막신경섬유층 두께의 연령에 따른 평균 분포를 알아보고자 하였다. 대상과 방법: 2014년 7월부터 2016년 2월까지 본원에 내원한 정상안 309안을 대상으로 SS-OCT (DRI OCT-1, Atlantis SS-OCT, Topcon, Tokyo, Japan)를 시행하여 시신경유두주위 신경섬유층의 두께를 측정하였으며, 연령에 따라 20세 이상 39세 이하(85안), 40세 이상 59세 이하(140안), 60세 이상 79세 이하(84안)로 나누어 각 군의 전체 평균 두께 및 4분면과 12시각에서의 평균 두께를 확인하고 각 군 간의 차이를 비교하여 보았다. 결과: 세 군 모두에서 시신경유두주위 신경섬유층의 두께는 하측이 가장 두꺼웠으며, 상측과 하측이 두꺼워진 두 개의 봉우리모양의 양상을 나타내었다. 세 군 간 비교 시 유두주위 망막신경섬유층의 전체 평균 두께는 연령이 높을수록 감소하는 양상으로 나타났으며, 4분면 두께 중 비측 영역(p=0.068)을 제외한 모든 영역에서는 통계학적으로 유의한 차이를 보였다(p<0.05). 결론: SS-OCT로 측정한 한국인 정상안의 시신경유두주위 망막신경섬유층 두께는 연령에 따른 차이가 있으며, 각 연령별 정상 수치를 분석하는 것은 추후 각 질환을 진단하는 데 있어 유용할 것으로 생각된다. Purpose: To investigate retinal nerve fiber layer (RNFL) thickness using swept source (SS)-optical coherence tomography (OCT) in healthy Koreans and to evaluate the effects of age on the distributional variability of thickness. Methods: We performed a retrospective review of 309 normal eyes presenting for examination of peripapillary nerve fiber layer thickness measured by SS-OCT (DRI OCT-1, Atlantis SS-OCT, Topcon, Tokyo, Japan) from July 2014 to February 2016. The patients were between the ages of 20 and 79 without systemic or ocular disease. The patients were divided into 3 age groups of 20 to 39 years (85 eyes), 40 to 59 years (140 eyes), and 60 to 79 years (84 eyes). The groups were matched based on average RNFL thickness and quadrant and 12 o’clock position RNFL thickness. Results: The average RNFL thickness of the inferior quadrant was the thickest of the layers and revealed a bimodal distribution. In the three groups, the thicknesses of the average RNFL, quadrant, and 12 o’clock RNFL decreased with age. There was significant difference in the measurements (p < 0.05) of quadrant RNFL thickness except that in the nasal quadrant (p = 0.068). Conclusions: The thickness of the circumpapillary retinal nerve fiber layer measured by SS-OCT differs according to age and analysis of normal values by age can be useful in the diagnosis of disease.

개방각녹내장과 뇌척수압 및 사상판경유압력차의 관계: 제5기 국민건강영양조사 자료

김윤경(Yoon Kyung Kim),Undarmaa Tumurbaatar,온영훈(Young Hoon Ohn),하승주(Seung Joo Ha),박가희(Ka Hee Park) 대한안과학회 2016 대한안과학회지 Vol.57 No.9

목적: 한국인에서 개방각녹내장과 뇌척수압 및 사상판경유압력차의 관계를 알아보고자 하였다. 대상과 방법: 본 연구는 제5기 국민건강영양조사 자료를 바탕으로 19세 이상의 성인 6,132명(10,801안)을 대상으로 정상안, 개방각녹내장 의심군, 개방각녹내장군으로 분류하였다. 대상군의 연령, 체질량 지수, 이완기 혈압 및 안압을 바탕으로 뇌척수압 및 사상판경유압력차를 추정하였고 각 군 간 뇌척수압 및 사상판경유압력차의 분포를 비교하였다. 결과: 정상안에서 추정한 평균 뇌척수압은 11.6 ± 3.7 mmHg였고 평균 사상판경유압력차는 2.2 ± 4.4 mmHg였다. 녹내장의심군의 평균 추정 뇌척수압은 11.2 ± 3.8 mmHg, 평균 사상판경유압력차는 3 ± 4.7 mmHg였으며 녹내장군의 평균 추정 뇌척수압은 8.7 ± 3.3 mmHg, 평균 사상판경유압력차는 5.7 ± 4.4 mmHg로 두 군 모두 정상군과 비교하여 뇌척수압은 유의하게 낮았으며(p<0.001) 사상판경유압력차는 유의하게 높았다(p<0.001). 단순 선형 회귀분석 및 다중 선형 회귀분석을 통해 뇌척수압 및 사상판경유압력차와 연관 있는 인자를 확인한 뒤 이를 보정하였을 때 녹내장의심군은 정상군과 비교하였을 때 유의한 뇌척수압 분포의 차이는 없었으며 (p=0.111; beta: 0.022; B: 0.241; 95% CI: -0.056, 0.538) 사상판경유압력차는 유의하게 높은 분포를 보였고(p<0.001; beta: 0.099; B: 1.349; 95% CI: 0.977, 1.72), 녹내장군은 정상군보다 뇌척수압이 유의하게 낮게 분포하였으며(p<0.001; beta: -0.12; B: -2.306;95% CI: -2.717, -1.895) 사상판경유압력차는 유의하게 높은 분포를 보였다(p<0.001; beta: 0.118; B: 2.776; 95% CI: 2.264, 3.289). 결론: 한국인에서 뇌척수압과 사상판경유압력차는 녹내장성 시신경 손상에 주요한 역할을 하며 개방각녹내장의 발병에 중요한 위험인자가 될 수 있다. Purpose: To investigate the relationships between estimated cerebrospinal fluid pressure (CSFP) and trans-lamina cribrosa pressure difference (TLCPD) in open-angle glaucoma (OAG) in Korean population. Methods: A total of 10,801 eyes were included from the Korean National Health and Nutrition Examination Survey V. All participants (aged 19 years or older) were classified as non-glaucomatous group, OAG suspect group and OAG group. CSFP was calculated as CSFP (mm Hg) = 0.44 body mass index (kg/㎡) + 0.16 diastolic blood pressure (mm Hg) - 0.18 age (years) - 1.91. TLCPD was calculated by subtracting CSFP from intraocular pressure. Results: The mean estimated CSFP was (8.7 ± 3.3 mm Hg vs. 11.6 ± 3.7 mm Hg, 11.2 ± 3.8 mm Hg vs. 11.6 ± 3.7 mm Hg) was lower, and the mean TLCPD (5.7 ± 4.4 mm Hg vs. 2.2 ± 4.4 mm Hg, 3 ± 4.7 mm Hg vs. 2.2 ± 4.4 mm Hg) was higher in the OAG group and in the OAG suspect group than in the non-glaucomatous control group, respectively (p < 0.001). After adjusting relating factor with CSFP and TLCPD using simple linear regression and multivariate analyses, the mean estimated CSFP was distributed lower (p < 0.001; beta: -0.12; B: -2.306; 95% confidence interval [CI]: -2.717, -1.895) in OAG group than in non-glaucomatous group and the mean TLCPD was distributed higher (p < 0.001; beta: 0.099; B: 1.349; 95% CI: 0.977, 1.72; p < 0.001; beta: 0.118; B: 2.776; 95% CI: 2.264, 3.289) in OAG suspect group and in OAG group than in non-glaucomatous group, respectively. Conclusions: Estimated CSFP and calculated TLCPD showed essential association with OAG presence. It supports the potential role of low CSFP in the pathogenesis of OAG.