시신경 유두 경계 차이에 따른 레이져시신경유두분석기와 광간섭촬영의 검사 결과 비교

도상희,박찬기,Sang-Hee Doh,Chan-Kee Park 대한안과학회 2005 대한안과학회지 Vol.46 No.12

Purpose: The purpose of this study was to evaluate whether there is the significant difference in the parameters associated with the optic nerve head between HRT and OCT. We also evaluated the influence of a tilted optic disc, temporal neural rim loss and peripapillary atrophy, in high myopia particularly. Methods: Two hundred and sixty-eight eyes of 147 patients evaluated HRT and OCT disc analysis, were enrolled retrospectively to evaluate differences in common parameters (e.g., disc area, cup area, CD area ratio, rim area, and rim volume) among the two examination, using a paired t-test. Results: Disc area, cup area and CD area ratio were greater when measured by OCT than HRT. Rim area and volume were smaller by OCT measures than by HRT. There was no difference in disc area and cup area of the high myopia group, but measures of CD area ratio were greater in OCT. Rim area and volume had higher measures in HRT of patients with high myopia. Conclusions: Because HRT and OCT analyze different optic nerve heads, the common parameters of HRT cannot be applied to OCT. In the high myopia group, tilted optic disc was not different between the two examinations, but OCT was superior in detecting the problem of temporal rim loss and an RPE margin that had been worrisome according to peripapillary atrophy was not a serious problem according to OCT.

원추각막에서 술 전 각막두께가 각막이식 후 공여각막의 난시와 내피세포에 미치는 영향

도상희,김만수.Sang-Hee Doh. M.D.. Man-Soo Kim. M.D. 대한안과학회 2005 대한안과학회지 Vol.46 No.12

Purpose: Corneal transplantation is ultimately required in progressed keratoconus, although initial treatment involves a non-surgical method. We attempted to explore the time point at which corneal transplantation becomes necessary by comparing of postoperative astigmatism and corneal endothelial cells between hydrop and non-hydrop groups. Methods: Among keratoconus patients who received corneal transplantation between January 2000 and January 2003 from one surgeon, postoperative Sim K, astigmatism, endothelial cells and visual acuity were checked and compared with preoperative data in 20 hydrops eyes and 16 non-hydrops eyes. Finally we evaluated the correlation of postoperative astigmatism with preoperative astigmatism and decreased corneal thickness. Results: There was no significant difference in postoperative Sim K, astigmatism, visual acuity, or endothelial cell reduction rate between the two groups, and the correlation of postoperative astigmatism with large preoperative astigmatism and thin cornea was also not significant. Conclusions: There is no prognostic difference between eyes undergoing penetrating keratoplasty prior to and after the development of hydrops. Based on our results, keratoconus should be treated conservatively until corneal transplantation becomes inevitable.

비측 안와에서 발생한 이소성 눈물샘 선상 낭포암 1예

도상희,황형빈,양석우,Sang Hee Doh,Hyung Bin Hwang,Suk-Woo Yang 대한안과학회 2007 대한안과학회지 Vol.48 No.7

Purpose: We report a case of ectopic adenoid cystic carcinoma developed on the nasal orbital side adjacent to the nasal cavity. Methods: A 60-year-old man developed progressive right ocular proptosis and pain for 3 years. The patient had undergone regular medical examination in a hospital but eventually visited our hospital due to aggravated symptoms. Orbit MRI and CT showed a 24×36×17 mm-sized lower signal mass on the medial side of the right medial rectus muscle and also showed erosion of the orbital bone in the superior and medial orbital walls. An endoscopic biopsy was done after transferring him to the ENT department. A frozen section of the tissue in the operating room showed no malignant evidence, and the mass was excised by endoscopic surgery. The permanent pathological result was adenoid cystic carcinoma. The authors recommended orbital exenteration, but the patient refused the procedure and was seen in follow-up visits after receiving chemotherapy and radiologic therapy. Some orbital mass remained in the posterior orbital area immediately directly after endoscopic excision. The patient underwent his first session of Cyberknife radiosurgery therapy after concurrent chemotherapy and radiologic therapy. Conclusions: Ectopic adenoid cystic carcinoma should be considered as a differential diagnosis of nasal orbital mass lesions.

상안검에 생긴 원발성 지방육아종 1예

도상희,이상규,양석우.Sang Hee Doh. M.D.. Sang Kyu Lee. M.D.. Suk Woo Yang. M.D. 대한안과학회 2008 대한안과학회지 Vol.49 No.12

Purpose: We report one case of primary giant lipogranuloma in the whole upper lid. Case summary: A 37-year-old man with a left whole upper lid mass that developed 3 months prior to admission visited our hospital. Biopsy was performed, and lipogranuloma was diagnosed. We attempted to remove the lesion by non-surgical local triamcinolone injection with no effect, so we finally removed the lipogranuloma by surgical resection. In the postoperative histological findings, the upper lid mass showed variously sized multiple cystic spaces surrounded by macrophage infiltration and fibrosis consistent with lipogranuloma. Conclusions: We report the first case of primary giant lipogranuloma in the upper eyelid in Korea. We considered repeated intralesional triamcinolone injections to be a better treatment method than surgical resection. Final surgical resection might be more effective, however, after an intralesional steroid injection to reduce the size of the lipogranuloma.

치성 감염에서 비롯된 눈주위 괴사성 근막염 1예

황형빈,도상희,양석우,Hyung Bin Hwang,Sang Hee Doh,Suk Woo Yang,Ph,D 대한안과학회 2008 대한안과학회지 Vol.49 No.6

Purpose: We report a case of periocular necrotizing fasciitis originating from dontogenic infection. Case summary: A 53-year-old man, who had suffered from severe periodontitis one week prior, visited our clinic due to a 2-day history of rapidly progressing left mandibular and periorbital swelling and pain. By the time of his visit, he had lost vision in the left eye and had moderate swelling, expression of pus, and skin explosion with necrotizing discoloration of the left lid and lower facial area. MRI of the orbits revealed soft tissue necrosis, gas accumulation, and subperiosteal abscess formation of the left orbit. We administered systemic antibiotics and surgically excised the left periorbital necrotic tissue. A constant expression of pus material was also achieved, decreasing painful swelling. We considered exenteration of the left eye to block the spread of necrosis to adjacent intact tissue; however, the left eye was fairly well-preserved with the exception of mild lagophthalmos developed by the excision of necrotic skin. Streptoccocal species was observed in microbiologic cultures of pus and necrotic tissue and ‘necrotizing inflammation’ was described on tissue biopsy, with the findings consistent with necrotizing fasciitis. Conclusions: Through the diagnosis of necrotizing fasciitis originating from an odontogenic infection, the proper administration of antibiotics and surgical management were achieved. As a result, we were able to preserve the eye. J Korean Ophthalmol Soc 49(6):993-999, 2008

소아에서 발생한 안와의 B-세포 림프모구성 림프종 1예

김정섭,노창래,도상희,박경신,양석우,Jung Sub Kim,M,D,Chang Rae Rho,M,D,Sang Hee Doh,M,D,Gyeong Sin Park,M,D,Suk Woo Yang,M,D 대한안과학회 2007 대한안과학회지 Vol.48 No.1

Purpose: We report a case of orbital B-cell lymphoblastic lymphoma in a 7-year-old boy. Methods: A 7-year-old boy presented with proptosis and periorbital swelling of his left eye following a periorbital blunt trauma 1-month prior. During the course of routine ophthalmologic and radiologic examinatinos, the swelling spontaneously subsided without specific treatment. An outpatient follow-up was planned, but the swelling recurred 6 months later. An orbital CT and MRI showed an irregular mass with an indistinct margin in the left orbit, for which an incisional biopsy was performed. Results: The orbital mass consisited of monotonous small to medium sized lymphoid cells with evenly dispersed open chromatin, thin nuclear membrane and inconspicuous nucleoli. Immunohistochemistry revealed that the cells were positive for CD79a and TdT, but negative for CD3 and CD5. These findings were compatible with a diagnosis of B cell lymphoblastic lymphoma. Conclusions: Lymphoblastic lymphoma of the orbit should be suspected and considered in the differential diagnosis for children with acutely progressing orbital mass.

현미경하 표피 절제 후 전기 소작술을 이용한 아래눈꺼풀 사마귀 제거 1예

김수아(Su Ah Kim),도상희(Sang Hee Doh) 대한검안학회 2010 Annals of optometry and contact lens Vol.9 No.1

목적: 아래 눈꺼풀 사마귀 치료법으로 현미경하 표피 절제 후 전기 소작술이 우수한 예후를 보였기에 이를 소개하고자 한다. 증례요약: 46세 여자환자에서 4년 전 발생하여 점점 커지는 좌측 아래 눈꺼풀테 소엽상 종괴를 현미경하 표피 절제 후 남은 진피유두는 전기 소작술로 제거하였다. 수술 후 7일간 친수성 드레싱을 이용하여 표피 재생을 보완하였으며, 1개월간 항생제 안연고를 도포하여 감염 위험을 낮추었다. 5주째 흉터를 남기지 않고 회복되었고, 수술 후 2년까지 재발없이 경과 관찰 중이다. 결론: 현미경하 표피 절제 후 전기 소작술을 추가한 사마귀 제거 수술법은 진피 손상을 줄여 흉터나 육아조직 발생을 최소화할 수 있다. 또한 비수술적 치료에 비해 빠른 치유를 기대할 수 있고 병변이 눈꺼풀테에 인접하여 안과적 합병증의 가능성이 높은 경우에는 효과적인 일차적 치료법으로 시도해 볼 수 있으리라 사료된다. Purpose: To introduce the effective treatment of Verruca Vulgaris on the lower eyelid by microscopic epithelial resection with electrocauterization. Case summary: A 46 year-old female patient presented with a four year history of growing lobulated mass on the left lower eyelid. The mass was removed using microscopic epithelial resection and remained dermal papilla was removed with electrocauterization. Hydrocolloid dressing was carried out for the management of surgical wound for seven days after surgery and it helped re-epithelialization of the skin. Topical antibiotic ointment was applied to the wound for prevent to bacterial infection during 1 month after surgery. 5 weeks later, skin healed without scar formation, and at 2-year clinical follow-up, there were no signs of recurrence. Conclusions: Microscopic epithelial resection with electrocauterization can be a useful way to decrease scar and granuloma formation by avoiding deep dermal destruction in the space of wart treatment. And this method led to shorter outcome than did non-surgical treatment. Thus, this new method of surgical treatment is appeared to be a primary beneficial treatment in case of increased ophthalmologic risk from adjacent eyelid lesion.

마이봄샘 기능 이상 환자에서 빛간섭단층촬영을 이용한 눈물띠 분석

전수지(Soo Ji Jeon),백지원(Ji Won Baek),도상희(Sang Hee Doh),정성근(Sung Kun Chung) 대한안과학회 2015 대한안과학회지 Vol.56 No.11

목적: 마이봄샘 기능 이상 건성안 환자에서 푸리에도메인 빛간섭단층촬영(Fourier-domain optical coherence tomography, FD-OCT) 을 이용한 눈물띠 수치를 정상안 및 눈물분비 부족 건성안과 비교하고자 한다. 대상과 방법: 정상 대조군 33안, 눈물분비 부족 건성안(aqueous tear deficient, ATD) 79안, 마이봄샘 기능 이상 건성안(meibomein gland dysfunction, MGD) 48안을 대상자로 하여 FD-OCT를 이용하여 눈물띠의 높이(tear meniscus height, TMH), 깊이(tear meniscus depth, TMD), 넓이(tear meniscus area, TMA)를 측정하고, 쉬르머검사, 눈물막 파괴시간, 플루오레신 각막염색을 시행하 여 집단 간 수치를 비교하였다. 결과: TMH, TMD, TMA의 평균은 정상안에서 각각 295.58 ± 58.36 μm, 166.67 ± 30.43 μm, 0.0360 ± 0.01100 mm , 눈물분비 부족 건성안에서 226.43 ± 42.18 μm, 147.44 ± 38.38 μm, 0.0209 ± 0.01015 mm, 마이봄샘 기능이상 건성안에서 272.81 ± 64.21μm, 159.37 ± 44.05 μm, 0.0295 ± 0.01271 mm였다. 세 군을 비교해 보았을 때 눈물분비 부족 건성안에서 눈물띠 수치가 가장 감소되었고 TMH, TMD, TMA 수치 모두 통계적으로 유의하였다. 마이봄샘 기능 이상 건성안 군의 눈물띠 수치는 눈물분비 부족 건성 안의 수치보다는 높았으나 정상안의 수치보다는 낮았고, 그중 TMA만 통계적으로 유의하였다. 결론: 마이봄샘 기능 이상 건성안 환자의 FD-OCT를 이용한 눈물띠 수치들은 눈물생성부족 건성안 환자의 수치보다는 높은 경향을 보이며, 정상안과 유의한 차이를 보이지 않았다. 이는 마이봄샘 기능 이상 건성안의 병태생리에 의한 것으로, 건성안의 기전이 다름에 따라 눈물띠 수치도 다른 경향을 나타내는 것을 고려하여 진단 및 치료 결정에 참고하여야 할 것이다. Purpose: This study compared tear meniscus parameters between normal control, aqueous tear deficient dry eye, and meibo-mein gland dysfunction groups using Fourier-domain optical coherence tomography (FD-OCT). Methods: This study included 33 normal eyes, 79 aqueous tear-deficient dry eyes (ATD), and 48 meibomein gland dysfunction dry eyes (MGD). Following routine examination including Schirmer test, tear break-up time, corneal staining, and tear meniscus parameters such as tear meniscus height (TMH), tear meniscus depth (TMD), and tear meniscus area (TMA) were obtained us-ing FD-OCT. The differences among groups were assessed. Results: The averages of TMH, TMD, and TMA were 295.58 ± 58.36 μm, 166.67 ± 30.43 μm, and 0.0360 ± 0.01100 mm 2 in nor-mal eyes, respectively, 226.43 ± 42.18 μm, 147.44 ± 38.38 μm, and 0.0209 ± 0.01015 mm 2 in ATD, respectively, 272.81 ± 64.21 μm, 159.37 ± 44.05 μm, and 0.0295 ± 0.01271 mm 2 in MGD, respectively. Tear meniscus parameters were significantly lower in ATD. Tear meniscus parameters in MGD were higher than ATD and lower than normal eyes, but the TMA was the only statisti-cally significant value. Conclusions: Although tear meniscus parameters in MGD were higher than ATD, they could not be distinguished from normal eyes. Tear meniscus evaluation using FD-OCT could be a useful measurement system in classification and treatment choice for dry eye patients.

甲狀腺과 心臟疾患

都相禧 대한의학협회 1960 대한의학협회지 Vol.3 No.7