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증식당뇨망막병증 환자에서 유리체절제술 후 신생혈관녹내장 발생의 위험인자 분석
정희영,정혜진,최진영,손준홍,정윤석,Hee Young Chung,Hye Jin Chung,Jin Young Choi,Joon Hong Sohn,Yun Suk Chung 대한안과학회 2013 대한안과학회지 Vol.54 No.12
Purpose: The use of pre- and intraoperative vitreous bevacizumab injection and combined lens extraction with vitrectomy in patients with proliferative diabetic retinopathy (PDR) is increasing. In this study we analyzed the incidence and risk factors of neovascular glaucoma (NVG) after vitrectomy for PDR.<br /> Methods: Patients who underwent vitrectomy for PDR from January 2004 to June 2011 were retrospectively reviewed. The minimum follow-up was 12 months. The cumulative incidence of NVG was calculated using the Kaplan-Meier survival analysis. The patients were divided into 4 groups according to lens status (preoperative pseudophakic group, simultaneous cataract surgery group, sequential cataract surgery group, non-cataract surgery group). The differences in incidence between the groups were determined by the Chi-square test. Finally, to analyze the risk factors associated with the occurrence of NVG, the Cox's regression model was used.<br /> Results: Of the 614 eyes (402 patients), 284 were males and 330 were females. The mean age was 55.8 ± 10.46 years (range 30-81 years) and the mean follow-up period was 36.6 months (range 1-93 months). Thirty-four of 614 patients (5.5%) developed postoperative NVG after vitrectomy. The probability of NVG occurrence at 6 and 12 months after vitrectomy was 0.7% and 2.5%, respectively. The incidence between the 4 groups did not show a statistically significant difference. The risk factors for postoperative NVG were male gender (RR = 3.01 p = 0.004), preoperative intravitreal bevacizumab injection (RR = 7.20, p < 0.001), and reoperation (RR = 3.18, p = 0.0037).<br /> Conclusions: The frequency of NVG after vitrectomy in patients with PDR was 5.5%. Lens status was not associated with NVG occurrence. The risk factors related to NVG were male gender, preoperative intravitreal bevacizumab injection, and reoperation.<br /> J Korean Ophthalmol Soc 2013;54(12):1868-1874
결막 경유 직접적 안구 내 침 시술로 인한 안구 천공 손상 1예
정희영(Hee Young Chung),이수찬(Su Chan Lee),최진영(Jin Young Choi),손준홍(Joon Hong Sohn),황덕진(Duck Jin Hwang) 대한안과학회 2016 대한안과학회지 Vol.57 No.1
Purpose: To report a case of ocular perforation by an acupuncture needle directly through the bulbar conjunctiva. Case summary: A 62-year-old male visited our clinic with acute ocular pain and decreased vision in his left eye. He had received intraocular acupuncture therapy one day earlier. A slit-lamp examination revealed conjunctival hyperemia and vitreous prolapse at the superonasal quadrant of the bulbar conjunctiva. Grade one of anterior chamber cells was found in the left eye. Dilated fundoscopy revealed three retinal hemorrhages at the superonasal quadrant of the retina; vitreous hemorrhage and opacity were also observed. Thus, vitrectomy and injections of intravitreal antibiotics were performed. Intraoperatively, we identified the entry site, located in the superonasal retinal quadrant, immediately behind the ora serratia. At the three-month postoperative follow- up, the patient’s visual acuity was 0.9 in the left eye and the retina remained flat with no postoperative complications. Conclusions: We observed a case of ocular perforation and endophthalmitis following ocular acupuncture treatment. This case illustrates the dangers of intraocular acupuncture therapy.
당뇨황반부종에서 베바시주맙 단독요법군과 베바시주맙-후테논낭하트리암시놀론 병합요법군 간의 치료효과 비교
이정현(Jung Hyun Lee),정희영(Hee Young Chung),이경민(Kyung Min Lee),박영숙(Young Sook Park),손준홍(Joon Hong Sohn),황덕진(Duck Jin Hwang) 대한안과학회 2016 대한안과학회지 Vol.57 No.12
목적: 당뇨황반부종에서 유리체강내 베바시주맙 주입술 단독요법과 유리체강내 베바시주맙 주입술 및 후테논낭하 트리암시놀론 주입술 병합요법의 임상결과를 비교하였다. 대상과 방법: 당뇨황반부종이 있는 증식성당뇨망막병증 66안을 대상으로 단독요법군 35안, 병합요법군 31안으로 나누어, 주사 시행전 및 시술 후 1, 2, 3개월의 시력, 중심황반두께, 전체황반부피, 경성삼출물 정도, 안압의 변화를 비교, 분석하였다. 결과: 두 군 모두에서 치료 후 1개월에만 유의한 시력호전을 보였다. 중심황반두께와 전체황반부피도 치료 후 1개월째 의미있는 감소를 보였으나 2개월째부터 다시 악화되었다. 치료 전후로 두 군 간에 시력, 중심황반두께, 전체황반부피의 의미있는 차이를 보이지 않았다. 경성삼출물 정도는 병합요법군에서 치료 3개월째 의미있는 감소(치료 전 2,899 ± 2,314 pixels vs. 3개월째 2,536 ± 1,981 pixels, p=0.041)를 보인데 비해, 단독요법군에서는 치료 3개월까지 차이를 보이지 않았다. 안압은 두 군 간 치료 전후로 차이를 보이지 않았다. 관찰 기간 중 안압상승이나 안내염 등의 합병증은 관찰되지 않았다. 결론: 유리체강내 베바시주맙 및 후테논낭하 트리암시놀론 주입술의 병합요법은 유리체강내 베바시주맙 주입술 단독요법과 비교하여 시력, 중심황반두께, 전체황반부피에서 부가적인 효과를 보이지 않았으나 3개월째 경성삼출물 정도를 줄이는 데 효과적이었다. Purpose: To investigate the outcome of intravitreal bevacizumab (IVB) combined with posterior subtenon triamcinolone acetonide injections compared to IVB injection alone in patients with diabetic macular edema (DME). Methods: IVB injection (IVB group) and combination therapy injection (combination group) were administered to 35 eyes and 31 eyes, respectively, diagnosed with proliferative diabetic retinopathy combined with DME. Changes in best corrected visual acuity (BCVA), central macular thickness (CMT), total macular volume (TMV), amount of hard exudates and intraocular pressure (IOP) were compared retrospectively between groups prior to injection and 1, 2 and 3 months after injection. Results: BCVA changes in both groups were only statistically significant at 4 weeks after injection. Reduction of CMT and TMV was maintained for 1 month after treatment in all groups, but CMT and TMV deteriorated 2 months after treatment. No significant differences in BCVA, CMT or TMV were detected between the IVB and combination groups. The amount of hard exudates were only significantly decreased at month 3 in the combination group whereas the amount of hard exudates was not significantly different at 3 months in the IVB group (at baseline 2,899 ± 2,314 pixels vs. at 3 months 2,536 ± 1,981 pixels, p-value = 0.041). IOP showed no significant difference between the groups. Elevated IOP or endophthalmitis were not observed. Conclusions: In terms of BCVA improvement, subtenon triamcinolone provided no additional benefit on CMT and TMV reduction. However, combination therapy was effective in reducing the amount of hard exudates at 3 months.