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중심와를 침범한 감염성 포도막염에서 발생한 황반원공의 자연폐쇄 1예
김민우(Min Woo Kim),김동윤(Dong Yoon Kim),김윤전(Yoon Jeon Kim),조수근(Soo Geun Joe),이주용(Joo Yong Lee),김중곤(June Gone Kim) 대한안과학회 2016 대한안과학회지 Vol.57 No.1
Purpose: To report a case of macular hole secondary to presumptive infectious posterior uveitis involving the fovea that spontaneously resolved after medical treatment. Case summary: A 33-year-old male visited our clinic for decreased visual acuity in his left eye. He was treated with immunosuppressive therapy including steroid after bone marrow transplantation. Best corrected visual acuity (BCVA) was 0.05 in the left eye. Slit lamp examination showed mild anterior vitritis, and fundus examination showed a macular hole with surrounding whitish infiltration at the fovea. Spectral domain optical coherence tomography (SD-OCT) revealed a full thickness macular hole with surrounding hyper-reflective masses with an infiltration-like appearance involving all retinal layers. Serum anti-toxocara IgG was positive (ELISA), and eosinophil count and immunoglobulin E was elevated. Under diagnosis of presumptive ocular toxocariasis, the patient was treated with albendazole. After medical treatment for toxocariasis, the whitish foveal infiltration became smaller and more discrete. SD-OCT revealed spontaneous closure of the macular hole, and BCVA was improved to 0.4 after a 4-month follow-up. Conclusions: We report a macular hole complicated by presumptive infectious posterior uveitis that experienced spontaneous closure after medical treatment for underlying infection.
심규영,김윤전,김중곤,윤영희,이주용,Kyu Young Shim,Yoon Jeon Kim,MD,June Gone Kim,MD,Young Hee Yoon,MD,Joo Yong Lee,MD 대한안과학회 2013 대한안과학회지 Vol.54 No.3
Purpose: To investigate clinical characteristics of post-traumatic intraocular foreign body (IOFB), which occurred between 2006 and 2010, and prognostic factors associated with final visual outcome. Methods: A retrospective chart review was performed of patients with IOFB who visited our clinic from January 1, 2006 to December 31, 2010, and who were followed up for more than 6 months. Cross tabulation and correlation analyses were conducted to evaluate the predictive factors related to final visual acuity. Results: A total of 36 eyes (35 patients) were included in this study. The mean age was 44.2 years, and 33 patients (94.3%) were male. The most common cause of IOFB was lawnmower-related activity (12 patients; 33.3%) and hammering-related activity (11 patients; 30.1%). Among analyzed prognostic factors, only initial visual acuity was significantly correlated with visual outcomes (p < 0.001). Conclusions: Compared with previous studies, lawnmower and hammering-related activities were still the most common causes of IOFB, however, the incidence of occurrence in the 40’s and 50’s was relatively higher than in previous studies. Considering the poor visual outcome of IOFB even after proper surgical treatment, using proper eye protection should be emphasized in a dangerous work environment to prevent ocular trauma.
김재형,최재완,윤영희,김중곤.Jae-Hyung Kim. M.D.. Jae-Wan Choi. M.D.. Young-Hee Yoon. M.D.. June-Gone Kim. M.D. 대한안과학회 2005 대한안과학회지 Vol.46 No.4
Purpose: To investigate the correlation between ultrasonographic findings and clinical features of infectious endophthalmitis. Methods: We analyzed ultrasonographic findings of 38 eyes of 36 patients who had been diagnosed as having infectious endophthalmitis with various etiologies. The correlation between ultrasonographic findings and clinical features such as initial and final visual acuities were studied. Results: Fourteen eyes were diagnosed with endogenous endophthalmitis and 11 eyes with postoperative endophthalmitis. Posterior vitreous opacity in the endophthalmitis secondary to keratitis was more severe and subhyaloid opacity in the traumatic endophthalmitis was less severe. Coagulase negative staphylococcus was the most common causative agents. Subhyaloid opacity in the eyes where cultures were not performed, was more severe than in those where coagulase negative staphylococcus was identified. Among the various ultrasonographic findings only the degree of the posterior vitreous opacity was correlated with the initial visual acuity, and none of the findings was significantly related with the final visual acuity. Treatment modalities included intravitreal antibiotics injections in 13 eyes, immediate vitrectomies and antibiotics injection in 6 eyes, conversion to vitrectomy after antibiotics injection in 17 eyes, and eviscerations in 2 eyes. The grades of posterior vitreous opacity of the patients with conversion to vitrectomy after antibiotics injection were lower than those of the other groups. Conclusions: Ultrasonographic findings might be a useful factors in the diagnosis and the determination of treatment modality and may therefore be helpful in the prognosis of patients with suspected infectious endophthalmitis.
한예은(Ye Eun Han),김현아(Hyun-Ah Kim),김중곤(June-Gone Kim) 대한안과학회 2021 대한안과학회지 Vol.62 No.9
목적: 망막박리와 동반된 출혈성 거대망막낭의 성공적 치료를 보고하고자 한다. 증례요약: 33세 남자가 1주 전부터 시작된 좌안의 시력저하로 내원하였다. 좌안의 최대교정시력은 20/40이었다. 안과 및 전신적으로 주목할 만한 과거력은 없었다. 안저검사에서 좌안의 상비측에 경계가 명확한 반투명 돔 형태인 8유두직경 이상의 출혈성 거대망막낭과 황반부를 침범한 망막박리가 확인되었다. 초음파검사에서 출혈성 거대망막낭은 경계가 명확한 망막내 낭성종괴로 확인되었고, 낭 내부에는 체위에 따라 움직이는 혈액이 관찰되었다. 망막유착을 위해 23게이지 유리체절제술, 망막열공 부위 및 망막낭 경계 장벽레이저, 실리콘기름 주입을 시행하였고, 이외 출혈성 거대망막낭에 대한 추가적 시술은 시행하지 않았다. 수술 후 2주간 고개를 숙인 자세를 유지하도록 하였다. 수술 3개월 후에 출혈성 거대망막낭의 완전 소실 및 망막재유착이 확인되었고, 6개월 후에 최대교정시력은 20/30으로 개선되었다. 수술 1년 뒤 실리콘기름 제거 후에도 출혈성 거대망막낭 소실 및 망막재유착은 안정적으로 유지되었다. 결론: 망막박리와 동반된 출혈성 거대망막낭은 유리체절제술 및 실리콘기름 주입술로 성공적인 치료가 가능하다. Purpose: To report a satisfactory clinical outcome of hemorrhagic retinal macrocyst with retinal detachment after pars plana vitrectomy and silicone oil injection. Case summary: A 33-year-old man visited our clinic with a 1-week history of visual disturbance in his left eye. His ocular and medical history were unremarkable, and best-corrected visual acuity (BCVA) in the left eye was 20/40. Fundoscopic examination of the left eye showed a hemorrhagic retinal macrocyst that was well-demarcated, semi-transparent, dome-shaped, and larger than 8 disc diameters at the superonasal location, with macular-off retinal detachment. B-scan ultrasonography also confirmed the presence of an intra-retinal cystic lesion with internal mobile echogenic signals representing blood. The patient underwent 23-gauge pars plana vitrectomy, barrier laser photocoagulation around the retinal tear and boundary of the cyst, and silicone oil injection, without any other additional procedures for the hemorrhagic retinal macrocyst. After the surgery, the patient stayed in the face down position for two weeks. Three months postoperatively, a completely collapsed hemorrhagic retinal macrocyst with successful retinal reattachment was observed. Six months later, the BCVA in the left eye had improved to 20/30. One year later, even after silicon oil removal, the collapsed hemorrhagic retinal macrocyst and reattached retina remained stable. Conclusions: A hemorrhagic retinal macrocyst with retinal detachment was successfully treated with pars plana vitrectomy and silicone oil tamponade.