선천녹내장에서 섬유주절개술을 병용한 섬유주절제술의 임상적 고찰

하승주 ( Seung Joo Ha ) , 안희배 ( Hee Bae Ahn ) , 유경원 ( Kyung Won Yoo ) , 노세현 ( Sae Heun Rho ) 대한안과학회 2003 대한안과학회지 Vol.44 No.4

Ocular Pulse Amplitude를 이용한 타플루프로스트의 임상적 효과 분석

문다루치,하승주,Da Ru Chi Moon,MD,Seung Joo Ha,MD 대한안과학회 2013 대한안과학회지 Vol.54 No.2

Purpose: To analyze the clinical effectiveness of tafluprost used in the treatment of glaucoma, using ocular pulse amplitude (OPA) measurements with dynamic contour tonometry (DCT). Methods: Sixty patients (119 eyes) with normal tension glaucoma (NTG) or primary open angle glaucoma (POAG) treated with tafluprost or other eyedrops were investigated in the present study. Intraocular pressure (IOP) was measured with Goldmann applanation tonometry (GAT), and OPA was measured with DCT, before and after treatment, retrospectively. Results: In 20 patients treated with tafluprost, IOP decreased from 17.1 mm Hg before treatment to 13.0 mm Hg 3 months after treatment (24.0% descent rate), and OPA decreased from 2.35 to 1.57 (33.2% descent rate). For 20 patients who switched from another monotherapy to tafluprost, IOP decreased from 15.7 mm Hg to 13.2 mm Hg from 15.7 mm Hg (15.3%) and OPA from 2.38 to 1.69 (27.7%). Conclusions: Tafluprost used to treat glaucoma has a large OPA and IOP lowering effect and, therefore can be applied to patients who have a large OPA with glaucoma progression in spite of well controlled IOP.

반맹에서 반시야 문양 시유발전위와 빛간섭단층촬영과의 일치성

박성용,박상혁,하승주,박성희,Sung Yong Park,Sang Hyouk Park,Seung Joo Ha,Song Hee Park 대한안과학회 2008 대한안과학회지 Vol.49 No.11

Purpose: To analyze the correlation between RNFL thickness changes measured by OCT and hemifield pattern VEP in hemianopic visual field loss. Methods: Twelve eyes of six patients with hemianopia were studied. Two patients had bitemporal hemianopia caused by chiasmal tumor, one patient had inferior hemianopia caused by traumatic optic neuropathy, and three patients had homonymous hemianopia caused by occipital lobe lesions. The retinal nerve fiber layer thickness around the optic disc was measured by optical coherence tomography (OCT) and visual pattern evoked potentials were measured using hemifield stimulations. Results: Normal eyes of traumatic optic neuropathy patients were excluded from the analysis. The retinal nerve fiber layer thickness as measured by OCT corresponded to the visual field defect in 9 of 11 eyes (81.8%) and the hemifield pattern VEP response corresponded to visual field defect in 7 of 11 eyes (63.6%). Conclusions: RNFL thickness measurement by OCT and hemifield PVEP are useful in evaluation of patients with hemianopia. However, they should be performed with caution, and compared with various clinical examinations because of their incomplete correlation with visual field defects. J Korean Ophthalmol Soc 2008;49(11):1819-1828

만성 안질환 환자들의 운전 행태에 대한 설문 조사

최준호,조아란,하승주,최경식,이성진,박성희,Jun Ho Choi,MD,A Ran Cho,MD,Seung Joo Ha,MD,Kyung Seek Choi,MD,Sung Jin Lee,MD,Song Hee Park,MD 대한안과학회 2012 대한안과학회지 Vol.53 No.4

Purpose: This study examines driving behaviors among patients treated for chronic ophthalmologic disorders and the effects of visual acuity and visual field on driving performance. Methods: A 15-item survey was given to 153 patients treated for chronic ophthalmologic disorders including diabetic retinopathy, glaucoma, retinal vessel occlusions, and senile macular degeneration. Six items questioned the patient’s discomfort based on a five-point scale according to different driving conditions and one item involved a self-assessment of driving problems. Results were compared with the best corrected visual acuity (BCVA) and visual fields of the patients. Results: In total, 16.2% of first-class drivers and 24.1% of second-class drivers rated below the evaluation standards of the driving license aptitude test. Overall, 82.6% of the patients continued to drive, while 7.8% renounced driving due to decreased visual acuity. Patient discomfort was significantly correlated with visual acuity (r = -0.503, p ≤ 0.01). Among the patients scoring below the evaluation standards, 74.2% responded that their visual acuity had become a problem while driving. Conclusions: These results call for appropriate driving programs and measures to educate people about responsive driving considering the visual function of patients treated for chronic ophthalmologic disorders. J Korean Ophthalmol Soc 2012;53(4):559-564

릴레이 경주 중에 발생한 대퇴직근 기시부의 완전 파열 - 증례보고 -

전승주,전호승,문찬삼,노행기,하승주,Jeon, Seung-Ju,Jeon, Ho-Seung,Moon, Chan-Sam,Noh, Haeng-Kee,Ha, Seung-Joo 대한정형외과스포츠의학회 2008 대한정형외과스포츠의학회지 Vol.7 No.2

대퇴직근은 슬관절을 신전하고 고관절을 굴곡하는 근육이며, 빠르고 강한 수축을 하는 제 2형 근섬유로 이루어져 있으며 두개의 관절을 거치므로, 운동 경기 중에 근위부 대퇴직근의 손상이 흔히 발생할 수 있다. 소아에서 발생하는 전하장골극에서의 대퇴직근 견열 골절이 가끔 보고가 되고 있고, 성인에서의 대퇴직근 근위부의 근-건 결합부 완전 파열은 반복적인 운동에 의해 드물게 발생하며, 외상과 관련이 없는 경우 대퇴부에서의 연부조직 종양으로 오인될 수 있다. 그러나, 릴레이 경주 중에 대퇴직근 근위부의 기시부가 급성으로 완전 파열된 예는 아직까지 보고된 바가 없다. 이에 저자들은 릴레이 경주 중에 발생한 중년 남성의 대퇴직근 기시부의 급성 완전 파열에 대하여 자기공명영상을 통하여 확인한 후 수술적 치료를 시행하였으며, 이를 문헌 고찰과 함께 보고하고자 한다. During sports activity, rectus femoris muscle can be commonly injured as the quadriceps contracts forcefully to extend the knee and flex the hip, and rectus femoris muscle has a high percentage of type II muscle fibers which enable it to produce rapid forceful activity and the muscle is the only biarticular muscle of the quadriceps. Avulsion fractures by the traction of rectus femoris from the anterior inferior iliac spine in children are often reported. Rarely, complete rupture of proximal musculotendinous junction of rectus femoris muscle in adult may occurs by chronic repetitive stimulation and may mimic soft tissue neoplasm in the case of no history of antecedent trauma. However, there has been no report of acute complete rupture of origins of the rectus femoris muscle during relay race till now. So, we report a case of acute complete rupture of origins of the rectus femoris muscle occurred during relay race in middle-aged man, diagnosed by magnetic resonance image and treated by surgical repair with review of current literature.

가토안에서 상직근 후전술 후 유착방지를 위한 양막이식의 효과

정우진 ( Woo Jin Jeung ),하승주 ( Seung Joo Ha ),박우찬 ( Woo Chan Park ),유경원 ( Kyung Won Yoo ) 대한안과학회 2002 대한안과학회지 Vol.43 No.2

연부조직 육종으로 오인된 대퇴부의 결절성 근막염 - 2예 보고 -

전호승,전승주,강유미,문찬삼,하승주,Jeon, Ho-Seung,Jeon, Seung-Ju,Kang, Yu-Mi,Moon, Chan-Sam,Ha, Seung-Joo 대한근골격종양학회 2007 대한골관절종양학회지 Vol.13 No.2

결절성 근막염은 섬유모세포와 근모세포의 증식에 의하여 발생하는 양성 질환으로 그 크기도 보통 3 cm 이내로 작다. 이 질환은 빠른 성장, 풍부한 세포충실성 및 유사 분열과 같은 특징들을 보일 수 있어 연부조직 육종으로 오인될 수 있다. 저자들은 기존의 보고와는 달리 그 크기가 5 cm 이상으로 큰 연부조직 육종으로 오인한 2예의 대퇴부에 발생한 결절성 근막염을 치험하였다. 그 중 1예는 임상적으로 뿐 아니라 조직학적으로까지 연부조직 육종으로 오인하였으나 외부의 숙련된 병리학자들의 도움으로 결절성 근막염으로 최종 진단되었으며, 2예 모두 2년 추시관찰에서 재발의 증거가 없었다. 저자들의 예들처럼 그 크기가 일반적인 것과는 달리 5 cm 이상으로 큰 종괴성 병변인 경우에는 연부조직 육종의 감별 진단으로서 매우 중요하기에, 대퇴부에 발생한 2예의 결절성 근막염을 문헌고찰과 함께 보고하는 바이다. Nodular faciitis is generally considered to be benign proliferation of fibroblasts and myoblasts, and it measures dimension up to 3cm. The characteristics such as rapid growth, abundant cellularity, and mitotic activity occasionally cause these lesions to mimic sarcoma. The authors experienced two cases of nodular fasciitis of the thigh, which were unusually large with dimension of more than 5cm. All of these two cases mimicked sarcoma and one of two cases, which initially mimicked sarcoma clinically and histologically in our hospital, was finally diagnosed as nodular fasciitis after requesting external consultation to several experienced pathologists. All of two cases had no evidence of recurrence at 2 years postoperatively. The lesions of unusually large dimension such as in our cases must be included in the differential diagnosis of soft tissue sarcoma. So we report two cases of nodular fasciitis of the thigh with a review of the current literature.

Travoprost와 Tafluprost의 안압 및 안구박동 크기 변화에 대한 연구

이경민(Gyeong Min Lee),하승주(Seung Joo Ha) 대한안과학회 2021 대한안과학회지 Vol.62 No.9

목적: 개방각녹내장 환자에서 travoprost 0.003%와 tafluprost 0.0015%를 장기 사용 후 안압하강 효과 및 안구박동 크기 변화에 대해 비교하고자 하였다. 대상과 방법: 2017년 1월부터 2019년 7월까지 본원에서 개방각녹내장으로 처음 진단된 환자들 대상으로 travoprost군 42안(23명), tafluprost군 26안(14명)을 비교하였다. 골드만압평안압계(Goldmann applanation tonometry, GAT)로 측정한 안압과 Dynamic Contour Tonometry로 측정한 corrected Ocular Pulse Amplitude (cOPA)를 1년 동안 경과 관찰하여 비교하였다. 결과: 1년간 travoprost와 tafluprost의 GAT, cOPA를 비교하였을 때 두 군 간 통계적으로 유의한 차이는 없었다(p=0.512, p=0.105). 초기 효과를 비교하였을 때 GAT의 변화량은 travoprost군이 -5.32 ± 2.63 mmHg, tafluprost군은 -3.79 ± 3.19 mmHg로 유의한 차이가 있었고(p=0.0457), cOPA는 travoprost군이 +0.04 ± 0.9 mmHg, tafluprost군이 -0.76 ± 0.97 mmHg로 유의한 차이를 보였다(p=0.0028). 결론: Travoprost와 tafluprost는 장기 안압하강 효과에 차이가 없으나 초기 효과에서는 travoprost가 더 빠르게 안압을 낮춰주었고, tafluprost가 OPA 변화에 더 많은 영향을 주었다. 상기 요인들을 고려하여 치료 목표에 따라 프로스타글란딘 제제를 선택할 수 있겠다. Purpose: To compare the intraocular pressure reduction and changes in ocular pulse amplitude of travoprost 0.003% and tafluprost 0.0015%. Methods: We assessed patients who were diagnosed with open-angle glaucoma from January 2017 to July 2019 for the first time at our hospital. Forty-two eyes were assigned to the travoprost group (23 patients) and 26 eyes were assigned to the tafluprost group (14 patients). Changes in intraocular pressure were measured by Goldmann applanation tonometry (GAT), and corrected ocular pulse amplitude (cOPA) was measured using dynamic contour tonometry. Changes in these parameters were observed and compared for 1 year. Results: No significant differences were observed between the GAT measurements and the cOPA of patients treated with travoprost and tafluprost for 1 year (p = 0.512, p = 0.105). The change in initial intraocular pressure on GAT observed after 1 week was -5.32 ± 2.63 mmHg for travoprost and -3.79 ± 3.19 mmHg for tafluprost (p = 0.0457). The initial change in cOPA was +0.04 ± 0.9 mmHg in the travoprost group and -0.76 ± 0.97 mmHg in the tafluprost group (p = 0.0028). Conclusions: Travoprost and tafluprost reached the targeted intraocular pressure with no difference in the long-term effects of reduced intraocular pressure. However, travoprost was initially better at lowering intraocular pressure faster, and tafluprost had a greater effect on lowering OPA. Prostaglandin analogs can be selected individually by considering the aforementioned factors.

아메드밸브 삽입술 후 합병증으로 발생한 초기 저안압과 방수유출관 폐쇄의 비수술적 치료 1예

김지욱(Jee Wook Kim),하승주(Seung Joo Ha) 대한검안학회 2011 Annals of optometry and contact lens Vol.10 No.2

목적: 신생혈관녹내장으로 양안의 아메드밸브삽입술을 시행한 후 합병증으로 전방소실을 동반한 초기 저안압과 방수유출관의 폐쇄가 발생하여 각각 조절마비제 점안과 Neodymium:YAG (Nd:YAG) 레이저를 이용한 막제거술로 치료하였기에 이를 보고하고자 한다. 대상과 방법: 51세 여자가 양안의 안통을 주소로 내원하였다. 초진시 안압은 우안 60 mmHg, 좌안 50mmHg이었으며 양안의 홍채혈관신생이 관찰되었다. 신생혈관녹내장으로 진단하여 양안의 아메드밸브삽입술을 시행하였다. 술후 우안은 과도한 섬유성 막으로 인해 방수유출관이 폐쇄되었고 안구지압에도 호전을 보이지 않아 Nd:YAG 레이저를 이용하여 관 입구 부위의 섬유성 막을 제거하였고 이후 안압이 하강하였다. 좌안은 술후 전방소실과 저안압이 발생하여 조절마비제를 하루 3회씩 사용하였으며 2일 후부터 전방깊이가 정상화되었다. 결과: 아메드밸브삽입술 이후에 합병증으로 방수유출관 폐쇄가 발생하였을 때 약물 및 수술적 치료가 어려운 경우 Nd:YAG 레이저를 이용한 막제거술을 이용할 수 있으며 전방소실과 함께 초기 저안압이 발생하였을 경우 조절마비제를 점안하여 수정체-홍채면을 후방으로 이동시키는 것이 치료에 도움을 줄 수 있다. Purpose: To report the case of successful treatment of postoperative complication including hypotony using cycloplegic agent and the valve obstruction using membranectomy with Neodymium:YAG (Nd:YAG) laser after Ahmed valve implantation in a neovascular glaucoma (NVG) patient. Methods: A 51-year-old female visited the hospital with ocular pain in both eyes. During her first visit, intraocular pressure (IOP) was 60 mmHg in the right eye and 50 mmHg in the left eye. In the anterior segment examination, neovascularizations of iris were noticed in both eyes. NVG was diagnosed and Ahmed valves were implanted in her both eyes. The next day after operation, obstruction of the end of the valve with massive fibrous membrane was observed in her right eye. IOP did not decreased sufficiently. Thus, we performed membranectomy using Nd:YAG laser at the end of the valve. Next day, IOP was normalized. Meanwhile in her left eye, three days after operation, hypotony was occurred with shallow anterior chamber. We used cycloplegic agent three times a day, and then the anterior chamber became deeper after two days. IOP was also normalized gradually. Results: We have experienced postoperative complications including valve obstruction and hypotony with shallow anterior chamber simultaneously. And we treated successfully with nonsurgical methods. We observed that membranectomy using Nd:YAG laser is effective to treat the valve obstruction in a patient who is difficult to undergo additional surgery or antifibrotic agent. And cycloplegic agent that induce posterior shift of the lens-iris diaphragm could be the one of the options to treat hypotony with shallow anterior chamber.

신생혈관 녹내장이 합병된 유리체출혈 환자에서 유리체절제술과 아메브밸브삽입술

문다루치,최경식,이성진,하승주,Da Ru Chi Moon,Kyung Seek Choi,Sung Jin Lee,Seung Joo Ha 대한안과학회 2012 대한안과학회지 Vol.53 No.6

Purpose: To compare the surgical outcomes between sequential -and simultaneous combined vitrectomy and Ahmed valve implantation (AVI) in neovascular glaucoma (NVG) patients with vitreous hemorrhage. Methods: The medical records of 22 eyes of 22 patients, who had NVG with vitreous hemorrhage treated with vitrectomy and AVI, were retrospectively reviewed. Surgical success was defined as 6 mm Hg ≤ IOP ≤ 21 mm Hg, with or without the use of antiglaucoma medications and failure was defined as cases that had no light perception during the study period and which required additional surgery. The authors of the present study evaluated the surgical success rates and factors affecting surgical success between sequential and simultaneous combined vitrectomy and AVI. Results: The cumulative surgical success rate by the Kaplan-Meier survival analysis was 45% in sequential combined vitrectomy and AVI (group1), and 18% in combined vitrectomy and AVI (group 2), at 1 year, a significant difference. Preoperative panretinal photocoagulation was related to surgical success rate by Cox’s regression model analysis. Conclusions: Simultaneous combined vitrectomy and AVI is considered as a primary procedure in a patient who has NVG with vitreous hemorrhage. Panretinal photocoagulation in the preoperative periods, is thought to increase the surgical success rate. J Korean Ophthalmol Soc 2012;53(6):801-806