영아 눈떨림 환자에서 눈떨림파형분석을 통한 중심와 시간의 측정과 시력과의 관계

장지호,이종복,김수찬,한승한,Jee Ho Chang,MD,PhD,Jong Bok Lee,MD,Su Chan Kim,PhD,Seung Han Han,MD,PhD 대한안과학회 2010 대한안과학회지 Vol.51 No.6

Purpose: To report herein on Nystagmus Acuity Estimator Function (NAEF) based on the foveation time, obtained by analyzing waveforms of infantile nystagmus patients and comparing the results with the patients’ actual visual acuity. Methods: Electro-oculographic data of 27 patients with infantile nystagmus were reviewed. Data of patients only with jerk type nystagmus and reliable visual acuity were analyzed. The foveation time was measured, and NAEF was calculated and compared with the patients’ actual best corrected visual acuity. Results: A correlation analysis of the patients’ best corrected visual acuity with NAEF was performed, and the retrieved coefficient was 0.4266. The p-value calculated using the Pearson correlation coefficient was 0.0282, implying that high NAEF correlates positively with visual acuity. Conclusions: Estimated visual acuity, calculated based on the waveforms, positively correlates with the patients’ actual visual acuity with statistical significance. However, since the foveation time can be measured only in the patients with jerk-type nystagmus waveforms, further study should be performed on the measurement of the foveation time with other waveforms. Furthermore, the present study shows that such analysis is possible with electrooculogram settings in most general hospitals. J Korean Ophthalmol Soc 2010;51(6):875-880

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

주사전자현미경 소견을 통한 Supramid Extra 2(R)를 사용 선천성 안검하수 수술의 재발원인 분석

장지호 ( Jee Ho Chang ),이상렬 ( Sang Yeul Lee ),장재우 ( Jae Woo Jang ) 대한안과학회 2002 대한안과학회지 Vol.43 No.2

AMO PhacoFlex SI-30NB의 A상수에 대한 임상적 평가

장지호(Jee Ho Chang),임승정(Seung Jeong Lim),김홍복(Hong Bok Kim) 대한안과학회 1999 대한안과학회지 Vol.40 No.4

황반하 신생혈관의 수술적 제거성적

장지호(Jee Ho Chang),고형준(Hyong Jun Koh),김순현(Soon Hyun Kim),권오웅(Oh Woong Kwon) 대한안과학회 1999 대한안과학회지 Vol.40 No.9

굴절조절내사시에서 대상부전과 추가치료의 발생 및 위험요인

최경섭,장지호,장윤희,이종복,Kyoung Sub Choi,M,D,Jee Ho Chang,M,D,Yoon Hee Chang,M,D,Jong Bok Lee,M,D 대한안과학회 2006 대한안과학회지 Vol.47 No.1

Purpose: To examine the occurrence and risk factors of decompensation and the additional treatment of increased hyperopia in refractive accommodative esotropia. Methods: Seventy children with refractive accommodative esotropia were followed up for at least 2 years. Time of decompensation and additional treatment, initial refractive error, initial deviation, and controlled deviation were all studied. Results: Decompensation and additional treatment occurred on average at 21.8 months and 22.2 months in eight patients, respectively, and constant survival was achieved after 4 years of full correction of the refractive error, as shown on a Kaplan-Meier survival curve. In the decompensation, additional treatment and control groups, initial refractive errors were 3.97±1.07D, 4.06±1.92D and 4.60±1.29D, respectively; initial deviations were 36.25±12.75PD, 31.25±10.61PD and 26.02±8.62PD, respectively; and controlled deviations were 4.50±6.30PD, 4.50±4.63PD and 2.65±4.10PD, respectively. There was a significant difference in initial deviation between the decompensation and control groups (p=0.011). Conclusions: The treatment of decompensation and increased hyperopia warranted careful follow-up in the first 4 years after treatment, and patients with large initial deviation risked decompensation.

항상외사시를 보이는 영아외사시의 임상양상

김용민,장지호,이종복,Yong Min Kim,M,D,Jee Ho Chang,M,D,Jong Bok Lee,M,D 대한안과학회 2006 대한안과학회지 Vol.47 No.8

Purpose: The purpose of this study is to evaluate the clinical course and surgical outcomes of constant infantile exotopia developed in the first year of life. Methods: Eighteen patients diagnosed with constant infantile exotropia who underwent surgery between June 1993 and July 2003 were reviewed retrospectively. Age at diagnosis and surgery, refractive error, and preoperative and postoperative prism diopters were evaluated for all patients. Results: The mean age at diagnosis was 7.3±2.2 months (2~11 months) and mean deviation was 47.2±16.6 prism diopters (PD) (25~90 PD). Inferior oblique muscle overaction was found in 3 (17%) patients. Bilateral lateral rectus muscle recession was performed in all patients and mean amount of recession was 8.0±0.9 mm (7.0~9.0 mm). The mean age at surgery was 16.7±4.1 months (7~24 months) and the mean postoperative follow-up period was 34.3±23.0 months (7~83 months). Thirteen patients (76%) showed stable alignments after the first operation and 3 patients (18%) required reoperation due to undercorrection and recurrence. Among them, one patient (6%) required a third operation. Conclusions: Early surgical intervention in constant infantile exotropia resulted in good postoperative outcome and stable alignments after the first operation.

녹내장성 시신경유두함몰 지표로서의 기울기

안상일,장지호,Sang Il Ahn,Jee Ho Chang 대한안과학회 2013 대한안과학회지 Vol.54 No.3

Purpose: To objectively define the degree of cupping, the authors extracted 3-dimensional slope surface maps from Cirrus HDTM-OCT data and assessed their differentiating characteristics between normal subjects and glaucomatous patients. Methods: One eye from each of 40 normal subjects and 1 eye from each of 39 patients with glaucoma were examined using automated visual field perimetry and Cirrus HDTM-OCT. The Optic Disc Cube 200 × 200 protocol was performed. The individual OCT data were reconstructed as the 3-dimensional surface maps of the optic disc cup and the slope of each contour was calculated using custom-developed software. Several disc cup slope parameters were derived. The parameters measuring the internal features of the optic disc cup were calculated and compared between groups. Results: Sum of cup slope, sum of thresholded cup slope, and sum of thresholded cup slope / thresholded cup area parameters were differentiating factors between the normal and glaucoma groups (p < 0.05). The area under the receiver operating characteristic curve (AUROC) value of the slope parameters ranged from 0.718 to 0.753. The sum of thresholded cup slope / thresholded cup area parameter was well correlated with visual field mean deviation (r = -0.250, p = 0.028). Conclusions: The optic disc cup slope parameter obtained with OCT may be a useful parameter for representing glaucomatous cupping.

한국 정상인에서 명소 망막전위도의 ON 반응과 OFF 반응

박수은,장지호,최경식,이정희,온영훈,"Su-Eun Park,Jee Ho Chang,Kyung-Seek Choi,Jung-Hee Lee,Young-Hoon Ohn" 대한안과학회 2008 대한안과학회지 Vol.49 No.3

`Purpose: To explore the effects of stimulus duration, stimulus intensity, and background luminance on the amplitude and waveform of the ON- and OFF- responses of photopic ERG and to provide standard parameters of ON- and OFF- responses for normal Korean populations. Methods: Twenty normal subjects (20 eyes) were enrolled to record photopic ON-and OFF-responses using a contact lens electrode with built-in LEDs and an LED-driver. The influence of stimulus duration on wave amplitudes was studied at flash durations that varied from 5 to 200 ms. The influence of stimulus intensity was studied with 0.4, 0.7, 1.1, 1.4, 1.7, 1.9, 2.0, and 2.1 log cd/m2. In addition, the influence of background luminance was studied with 20, 30, 40, and 50 cd/m2. Result: Among 20 normal subjects, the d-waves in 16 subjects were isolated from b-waves with more than 50 ms of stimulus duration. The d-wave was observed for a 30-ms stimulus duration in 3 subjects and for a 100-ms duration in 1 subject. The amplitudes of the b-and d-waves increased as stimulus intensity was increased. The amplitudes of b-and d-waves decreased as background luminance was increased. Conclusions: Our results suggest that the clinical use of ON-and OFF-response recording can be obtained with stimulus parameters from 100 to 150 ms in duration and a 1.7-2.1 log cd/m2 intensity under 30-40 cd/m2 background luminance.`

영아 내사시의 임상양상과 수술결과

정은지,장윤희,장지호,한승한,이종복,Eun-Jee Chung,Yoon-Hee Chang,Ji-Ho Chang,Seung-Han Han,Jong-Bok Lee 대한안과학회 2005 대한안과학회지 Vol.46 No.5

Purpose: To study the clinical manifestations and surgical outcome of infantile esotropia. Methods: This review retrospectively examined 165 patients of infantile esotropia who had undergone recession of bilateral medial rectus muscles from April 1991 to September 2001 at our institute. We measured the binocular alignment and analyzed the long term surgical outcome. Results: The average angle of deviation of 165 patients was 45.9±13.99PD (25~90PD) and the average refractive error was +sph 1.18±2.25D (-sph 7.00~+sph 6.00D). Amblyopia was found in 48.4% of the patients, DVD in 12.7%, IOOA in 11.3%, and manifest latent nystagmus in 6.0%. A binocular alignment within 10 PD was achieved in 73.9% and 57.9% at the 2nd and 4th post-operative year respectively. Conclusions: The surgical outcome of bimedial rectus muscle recession in infantile esotropia was satisfactory in 74%, and 58% of the patients at the 2nd and 4th post-operative year respectively.