결절맥락막혈관병증에서 광역학치료의 효과에 대한 다기관 연구

신재필,고형준,권오웅,김시열,김하경,남동흔,남우호,박규형,엄부섭,오재령,유승영,윤일한,윤희성,이성철,이은구,이재흥,이정희,정인영,진희승,허걸,곽형우 대한안과학회 2009 대한안과학회지 Vol.50 No.3

Purpose: To evaluate the efficacy of photodynamic therapy (PDT) with verteporfin for polypoidal choroidal vasculopathy (PCV) in Korean patients. Methods: Clinical data of patients who were treated with PDT for PCV and followed up for more than 6 months were collected from 14 hospitals around the country. The changes in the best corrected visual acuity, angiographic outcome, retinal thickness measured by optical coherence tomography (OCT), and adverse effects of treatment were evaluated. Results: Eighty six patients (86 eyes) were recruited (male: 75.6%, age: 65.9±8.3 years, mean follow-up: 14.8±10.2 months). The mean logMAR visual acuity at baseline was 0.55±0.32 and did not show any statistically significant difference from the final mean logMAR visual acuity (0.53±0.54) (p =0.639). The mean treatment session number of PDT was 2±1.2. Visual acuity stabilized or improved in 70.9% of patients. Visual acuity improved by more than 2 lines in 33 eyes (38.4%) and worsened by more than 2 lines in 21 eyes (24.4%) of patients. Vascular leakage decreased in 62.5% of patients in fluorescein angiography and polypoidal lesions disappeared or were reduced in 57.3% of patients in indocyanine green angiography. There was no systemic adverse effect of PDT, but increased subretinal hemorrhage after PDT occurred in 10 eyes (11.6%). Conclusions: In polypoidal choroidal vasculopathy, photodynamic therapy with verteporfin is safe and effective for preserving visual acuity and reducing vascular leakage and retinal thickness.

초자체내 Mitomycin C 의 망막독성

신재필(Jae Pil Shin),홍승표(Sung Pyo Hong),김상하(Sang Ha Kim) 대한안과학회 1995 대한안과학회지 Vol.36 No.4

실험적 부자 시신경병증에서 Methylprednisolone의 효능

신재필,이상희,서형덕,김인택 경북대학교 병원 1998 경북대학교병원의학연구소논문집 Vol.2 No.1

동물실험에서 aconite 또는 aconitine은 신경계통에 독성을 나타낸다고 이미 알려져 있다. 그러한 독성은 시유발전위와 병리조직에서 탈수초증으로 나타난다. 저자들은 실험적으로 aconite을 주입하여 탈수초신경증을 일으킨 후 고용량이 methylprednisolone(MP)투여가 효능이 있는지를 알아보고자 하였다. Aconite를 복강내 주입하고 곧 이어 가토의 이연정맥으로 MP를 주입한 군과 aconite만을 주입한 군으로 나누었고 이들을 서로 비교하였다. 그리고 이 두 군을 정상군과도 비교하였다. 시유발전위에서 aconite를 주입후 MP를 투여한 군에서 aconite만을 주입한 군에 비하여 onset latency와 peak latency 그리고 진폭 모두에서 2주째에 통계학적으로 의미있게 회복되었으나 (p<0.05) 정상군과 비교하여 의미있는 차이를 나타내지 아니하였다. 그러나 정상군과 비교하여 1개월과 2개월에서 onset latency은 의미있게 지연되었고 (p<0.05) peak latency와 진폭은 다소 회복되었으나 정상군의 평균값에는 미치지 못하였다. 병리조직에서 MP으로 치료한 군과 aconite만을 주입한 군 모두에서 수초의 탈수초변화가 관찰되었으나 MP으로 치료한 군은 상대적으로 탈수초변화가 현저하지 아니하였다. 본 연구에서 실험적으로 가토에 aconite를 전신에 투여하여 시신경병증을 일으킨 후 고용량의 MP를 즉시 투여한 경우에 시신경의 기능을 정상상태까지 회복시키는데는 한계가 있으나 부분적으로 시신경의 기능을 회복시키는데 도움이 될 것으로 생각된다(한안지 37:1730~1740, 1996). Studies in animals indicate that aconitine or aconite has toxic effects in the visual system of a rabbit model. Such a toxic effects causes myelo-optic neuropathy in the visually evoked cortical potential(VECP) and histopathologic studies. Whether the administration of intravenous high-does of methyprednisolone(MP) in the myelo-optic neuropathy caused by aconitine(1.5㎖/㎏, equivalent to 0.7㎎/㎏ of aconitine) is experimentally effective remains uncertain. The group treated with MP(daily 30㎎/㎏×2 for 3 days followed by 15㎎/㎏ for 3 days) in addition to aconite was compared with the aconite alone group and the normal control group. In the MP treated group, increased recovery of onset latency, peak latency, and amplitude in VECP in comparision with the aconite alone group was recorded at 2 weeks(p<0.05). The MP treated group in comparision with the normal control group showed a significant delay in onset latency at 1 month and 2 months(p<0.05). But, the amplitude in both the MP treated group and the aconite alone group increased at 2 months and did not show a significant difference in comparision with the normal group(p<0.05). In histopathologic study, pathologic findings of myelin sheath in the MP treated group were less severe than in the aconite alone group generally. The true benefit of high-does MP was at least clear within 2 weeks. The authors conclude that treatment with intravenous high-does MP immediate after aconite injection may have some beneficial effects in recovery of neurologic function although such a treatment do no have the definite recovery in aconite induced myelo-optic neuropathy(J Korean Ophthalmol Soc 37:1730~1740, 1996).

가토의 정상 진동소파전위

신재필(Jae Pil Shin),김상하(Sang Ha Kim) 대한안과학회 1995 대한안과학회지 Vol.36 No.3

증식당뇨망막병증에서 유리체내 혈관내피세포증식인자의 발현정도와 유리체수술후 예후

김상옥 ( Sang Ok Kim ) , 신재필 ( Jae Pil Shin ) , 김진오 ( Jin Oh Kim ) , 오창석 ( Tschang Seog Oh ) , 김시열 ( Si Yeol Kim ) 대한안과학회 2004 대한안과학회지 Vol.45 No.9

아토피 피부염에 동반된 열공성 망막박리

하승민 ( Ha Seung Min ) , 신재필 ( Sin Jae Pil ) , 김시열 ( Kim Si Yeol ) 대한안과학회 2004 대한안과학회지 Vol.45 No.3

A Case of Intravitreal Bevacizumab Injection for the Treatment of Choroidal Neovascularization in Angioid Streaks

이지웅,신재필,김시열 대한안과학회 2011 Korean Journal of Ophthalmology Vol.25 No.3

A 56-year-old Korean woman presented with decreased visual acuity of the right eye. She had a history of two pho-todynamic therapy treatments for choroidal neovascularization (CNV) due to angioid streaks in her left eye with cen-tral scarring and low visual acuity. She was diagnosed with subfoveal CNV due to angioid streaks in her right eye and treated with six intravitreal bevacizumab (1.25 mg / 0.05 mL) injections over one year. Best corrected visual acuity improved from 20 / 125 at baseline to 20 / 50 at the final visit. The area of CNV had changed into a fibrotic scar by the final visit, and fluorescein angiography and indocyanine green angiography revealed no evidence of leakage. Optical coherence tomography showed that central macular thickness decreased from 311 μm at baseline to 203μm with complete resolution of subretinal and intraretinal fluid at the final visit. Intravitreal bevacizumab for CNV as-sociated with angioid streaks prevented the progression of disease and resulted in the improvement of visual acuity after one year of follow-up in our patient.

Bilateral Nongranulomatous Uveitis with Infective Endocarditis

하상원,신재필,김시열,박동호 대한안과학회 2013 Korean Journal of Ophthalmology Vol.27 No.1

A 32-year-old male who had infective endocarditis complained of photophobia and blurred vision in both eyes. Biomicroscopic examination and fundus examination revealed anterior chamber reaction, vitritis, optic disc swelling, and Roth spots. He was diagnosed with bilateral nongranulomatous uveitis and treated with topical steroid eye drops and posterior sub-Tenon injection of triamcinolone. His visual symptoms were resolved within 1 week, and inflammation resolved within 4 weeks after treatment.

당뇨황반부종에 대한 트리암시놀론의 유리체강내 주입술과 테논낭하 주입술의 비교

권순재,신재필,김시열.Soon Jae Kwon. M.D.. Jae Pil Shin. M.D.. Si Yeol Kim. M.D. 대한안과학회 2008 대한안과학회지 Vol.49 No.1

`Purpose: To retrospectively evaluate the clinical effect of intravitreal (IVT) and posterior subtenon (PSTT) triamcinolone acetonide (TA) injection in diabetic macular edema. Methods: Fifty eyes of 43 patients with diabetic macular edema (DME) were included. Twenty-two eyes in the IVT group received 4 mg/0.1 ml intravitreal TA injections and 26 eyes in the PSTT group received 40 mg/1.0 ml subtenon TA injections. LogMAR visual acuity and intraocular pressure (IOP) were measured and, using OCT, central macular thickness (CMT) and total macular volume (TMV) were also measured before and 1, 3, and 6 months postoperatively. Results: Both groups showed significant decreases in the mean CMT and TMV. The mean CMT in the IVT group was significantly thinner than that of the PSTT group 1 month postoperatively. The percentage reduction in CMT and TMV were also greater in the IVT group than the PSTT group 1 month postoperatively. Both groups showed significant improvements in mean visual acuity, with no significant difference between the two groups. However, at 1-month postoperative improvement in visual acuity was significantly greater in the IVT group than the PSTT group. The mean IOP in the IVT group was also greater than that in the PSTT 1 month postoperatively. Conclusions: Both injections caused a significant increase in visual acuity and a decrease in CMT and TMV. The effect was more pronounced in the IVT group. However, the PSTT injection also appeared to be a safe and effective technique for the treatment of DME.`

신생혈관녹내장에서 아메드밸브삽입술의 장기 결과와 베바시주맙의 전방내 주사 효과

김종진,신재필,Jong Jin Kim,Jae Pil Shin 대한안과학회 2013 대한안과학회지 Vol.54 No.5

Purpose: To evaluate the long-term surgical results of Ahmed glaucoma valve implantation (AGVI) and the effects of intracameral bevacizumab injection in neovascular glaucoma (NVG) after diabetic vitrectomy. Methods: We reviewed the medical records of 57 patients with NVG after diabetic vitrectomy who underwent AGVI with or without intracameral bevacizumab injection. In each group, preoperative and postoperative intraocular pressure, the number of glaucoma medications, and best corrected visual acuity (BCVA) were compared. We analyzed the rates of surgical success, postoperative complications, and risk factors. Results: The cumulative probability of success was 87.7% at 1 year, 78.8% at 2 years, 70.5% at 3 years, and 61.6% at 5 years. Intraocular pressure and the number of glaucoma medications were significantly reduced and BCVA was significantly better at all postoperative follow-up time points in both groups. There were no differences in mean intraocular pressure, the number of glaucoma medications, BCVA, or the rates of surgical success between the two groups. The incidence of hypertensive phase was significantly reduced in the intracameral bevacizumab group, but neither the surgical success rate nor intraocular pressures were different compared with the control group. Conclusions: Ahmed glaucoma valve was a good therapeutic modality for long-term treatment of NVG occuring after diabetic vitrectomy. Intracameral bevacizumab injection had no effects on the surgical results of Ahmed glaucoma valve surgery. J Korean