산후기에 발생한 일스병 1예

Kang Yeun Pak,So Hee Kim,Sung Who Park,Ik Soo Byon,Ji Eun Lee 한국망막학회 2016 Journal of Retina Vol.1 No.1

목적: 산후 기간에 시작된 일스병을 경험하였기에 이를 보고하고자 한다증례요약: 31세 여자 환자가 우안 비문증과 시야장애를 주소로 내원하였다. 비문증은 2달 전인 출산 직후 발생하였고 이후 점진적으로악화되었다고 하였다. 최대교정시력은 양안이 1.0이었고, 우안의 안저에 망막출혈 및 정맥혈관염이 관찰되었다. 경과 관찰 중 양안에 다수의 새로운 망막 정맥혈관염이 관찰되었다. 혈관염은 전신 스테로이드 치료 후 호전되었으나 스테로이드 감량 후 악화되었다. 스테로이드 및 면역억제제 사용 후 혈관염은 조절되었고, 이후 망막허혈 및 신생혈관이 관찰되었다. 우안은 유리체 출혈이 발생하여 유리체절제술 및 레이저광응고술을 시행하였으며, 좌안에는 레이저광응고술을 시행하였다. 결론: 일스병은 산후기간에 발생할 수 있다. Purpose: To report a case of Eales disease in postpartum period. Case summary: A 31-year-old female presented with visual field defect and floaters in right eye. Symptom occurred just before labor and worsened after labor. The best corrected visual acuity was 1.0 in the right eye. Fundus examination revealed retinal hemorrhage and periphlebitis in the affected eye. After 2 weeks, newly developed retinal vasculitis was observed in the fellow eye as well as in the affected eye. She was treated with systemic corticosteroid and disease activity increased while tapering corticosteroid. After adding systemic immunomodulating agent, disease activity was controlled. Retinal neovascularization was observed in previous non-perfusion area. She underwent vitrectomy in the right eye due to recurrent vitreous hemorrhage, and prophylactic laser photocoagulation was performed in the left eye. Conclusions: Eales disease may develop in postpartum period.

Characterization of Umbilical Cord Derived Mesenchymal Stem Cells (hUC-MSCs) Depending on Their Isolation Methods

Sueng Yeun KANG,Hyeon Kyeong LEE,Su-Youne HAN,Hyun Woo LEE,Seung Hoon PAK,Jin Tac KIM,Ji Hyang KIM,Byung-Rok DO 한국생물공학회 2013 한국생물공학회 학술대회 Vol.2013 No.4

Yokoyama 술식으로 치료한 근시성 고정사시 1예

박강윤,정재호,최희영,Kang Yeun Pak,MD,Jae Ho Jung,MD,PhD,Hee Young Choi,MD,PhD 대한안과학회 2013 대한안과학회지 Vol.54 No.3

Purpose: To present a surgical result of Yokoyama procedure in myopic strabismus fixus. Case summary: A 51-year-old female patient presented with progressive esotropia and diplopia. According to the Krimsky test, the patient showed 70 prism diopter esotropia and 30 prism diopter hypotropia in her left eye. The axial length was 34.97 mm in the right eye and 33.71 mm in the left eye. The patient was diagnosed with myopic strabismus fixus. The authors performed the Yokoyama procedure on her left eye. Surgical examination revealed each medial rectus muscle was recessed. Half of the muscle bellies of the superior and lateral rectus muscles were sutured together without muscle splitting 15 mm posterior from their insertion. At 1 year postoperatively, the patient showed 30 prism diopter esotropia and 20 prism diopter hypotropia in her right eye by alternative prism cover test. The authors performed the same procedure on her right eye. At 2 months after the second surgery, the patient showed orthotropia in the primary position and gaze limitation was improved. Conclusions: The Yokoyama procedure can be an effective method for improving deviation and ocular motility in esotropia caused by high myopia.

소아 안와연조직염 환자의 임상 특징

박강윤,정재호,최희영,Kang Yeun Pak,Jae Ho Jung,Hee Young Choi 대한안과학회 2013 대한안과학회지 Vol.54 No.3

Purpose: The present study reviews the clinical features of orbital cellulitis in childhood for early diagnosis and proper treatment. Methods: The authors performed a retrospective study by computed tomography (CT) on children under 14 years of age diagnosed with orbital cellulitis and admitted to Pusan National University Hospital from 2003 to 2010. Results: In total, 27 patients were identified (range 4 months to 14 years). Periorbital swelling was the most common initiating symptom, followed by fever and conjunctival injection. Paranasal sinus disease was the most common predisposing factor. Preseptal cellulitis was the most common finding, followed by subperiosteal abscess, orbital cellulitis, and orbital abscess. All patients underwent a blood culture; none were positive. Intravenous antibiotics therapy was performed empirically and was effective in all cases. No patients suffered from permanent complications except recurrence. Conclusions: Orbital cellulitis in children presents with periorbital swelling, fever, conjunctival injection in association with sinusitis, and upper respiratory infection (URI). A CT study is a reliable diagnostic option for the early detection and localization in the pediatric orbital cellulitis. Early empirical antibiotic therapy is mandatory for successful treatment.

Establishment of Optimal Culture Conditions for Human Umbilical Cord Derived Mesenchymal Stem Cells(hUCMSCs)by Gene Expression Analysis

Hyeon Kyeong LEE,Sueng Yeun KANG,Su-Youne HAN,Hyun Woo LEE,Back Soo SHIN,Seung Hoon PAK,JinTac KIM,Ji Hang KIM,Byung-Rok DO 한국생물공학회 2013 한국생물공학회 학술대회 Vol.2013 No.4

Perioperative Evaluation after Cataract Surgery in Patients Taking Antithrombotic Medication

Hae Rang Kim,Kang Yeun Pak 대한검안학회 2019 Annals of optometry and contact lens Vol.18 No.3

Purpose: To investigate outcomes and complications of cataract surgery using clear corneal incision in patients taking antithrombotic medication. Methods: We reviewed medical records of 156 eyes of 103 patients taking antithrombotic medication who underwent cataract surgery from January 2011 to July 2017. Patients underwent standard phacoemulsification through clear corneal incision, and topical anesthesia was performed before the surgery. The patients were divided into two groups based on the adjustment in medication: the continuation group (group C) and the discontinuation group (group D). The primary outcome was the incidence of hemorrhagic and thromboembolic complications, and the secondary outcomes were the change in best corrected visual acuity (BCVA) and incidence of perioperative ocular complications. Results: The mean patient age was 69.7 ± 12.9 years and the proportion of female patients was 64.1% (66/103). Forty-five eyes were being treated with anticoagulants, 87 eyes with antiplatelet agents, and 24 eyes with a combined treatment. Group C comprised 68 eyes and group D comprised 88 eyes. There were no instances of serious hemorrhagic or thromboembolic complications in either group. In both groups, the BCVA increased significantly at one month after surgery (0.75 ± 0.81 to 0.18 ± 0.24 logMAR and 0.73 ± 0.71 to 0.26 ± 0.33 logMAR; p = 0.004 and 0.020, respectively) with no significant difference (p = 0.979). There was no significant difference between groups in the incidence of ocular complications such as posterior capsule rupture, corneal edema, and intraocular pressure elevation. Conclusions: Patients taking antithrombotic medication could safely undergo cataract surgery without major complications regardless of the discontinuation of medication.

안내후방콘택트렌즈 삽입술에 의해 발생한 색소녹내장 1예

박강윤,김해송,이지웅.Kang Yeun Pak. MD. Hae Song Kim. MD. PhD. Ji Woong Lee. MD. PhD 대한안과학회 2013 대한안과학회지 Vol.54 No.6

Purpose: To report a case of secondary pigmentary glaucoma after implantable contact lens (ICL) implantation successfully treated with trabeculectomy without ICL removal. Case summary: A 29-year-old woman presented with refractory intraocular pressure (IOP) increase in both eyes. IOP was 22 mm Hg in the right eye and 39 mm Hg in the left eye. The patient received posterior chamber phakic intraocular lens implantation in both eyes 22 months prior. Slit lamp examination revealed patent iridotomy sites in both eyes. Gonioscopy revealed open angles with 4-degree pigment deposits on the trabecular meshwork in both eyes. Ultrasound biomicroscopy examination confirmed contact between ICL and the posterior surface of the iris. In spite of well tolerated medical therapy and selective laser trabeculoplasty, IOP was 46 mm Hg in her left eye. Trabeculectomy was performed in her left eye without ICL removal. At 6 months postoperative, IOP measured 6 mm Hg without any anti-glaucoma medication and bleb was maintained in good condition in the left eye. Conclusions: The results from this case study indicate that ICL implantation can lead to secondary pigmentary glaucoma and trabeculectomy without ICL removal may help to decrease the IOP.

Posterior Vitreous Structures Evaluated by Swept-source Optical Coherence Tomography with En Face Imaging

Jun Woo Park,Joo Eun Lee,Kang Yeun Pak 대한안과학회 2018 Korean Journal of Ophthalmology Vol.32 No.5

Purpose: To evaluate posterior vitreous structures using swept-source (SS) optical coherence tomography (OCT) with en face imaging. Methods: We retrospectively reviewed OCT images of healthy individuals who did not have intra-ocular disease. We obtained high-definition horizontal and vertical line scans crossing the fovea and 3D scans using SS-OCT, with the 3D scan centered between the fovea and the optic-nerve head. An enhanced vitreous visualization function was used to highlight vitreous structures. En face mode was used to measure the area of Martegiani (AM) and bursa premacularis (BP). We performed all measurements using a built-in function of the viewing software. Results: We enrolled 24 eyes from 12 healthy individuals. The mean patient age was 28.7 ± 4.6 years (range, 24 to 39 years). The mean AM and BP areas were 5.73 ± 0.88 and 18.76 ± 6.95 mm2, respectively. In en face imaging, AM shape was most frequently a vertical oval (18 / 22, 81.8%), while the predominant BP shape was round (16 / 20, 80.0%). AM was in contact with the optic disc, either at the temporal-disc margin (13 eyes, 59.1%) or the nasal optic-disc margin (9 eyes, 40.9%). Conclusions: Posterior vitreous structures, such as AM and BP, were readily visualized using en face imaging with SS-OCT. Investigating normal vitreous configuration might help in understanding changes in vitreous structures associated with retinal pathology.

한국인 신경망막염 환자의 임상양상 및 예후

장수경(Su Gyeong Jang),박강윤(Kang Yeun Pak),권한조(Han Jo Kwon),이승민(Seung Min Lee),박성후(Sung Who Park),변익수(Ik Soo Byon),이지은(Ji Eun Lee) 대한안과학회 2017 대한안과학회지 Vol.58 No.2

목적: 신경망막염 환자의 임상 양상 및 예후에 관해 알아보고자 한다. 대상과 방법: 2012년부터 2015년 사이 진단된 신경망막염 환자 7명의 의무기록을 후향적으로 분석하였다. 결과: 7명 중 2명은 양안에 나타나 총 9안이 포함되었다. 5명의 남성과, 2명의 여성이 포함되었고, 나이는 평균 45.1 ± 13.2세였다. 인플루엔자 유사 증상이 선행했던 경우가 2명이었고, 나머지 5명은 시력저하 외 특이소견이 없었다. 내원 당시 교정시력은 평균 logMAR 0.48 ± 0.55 (0-1.6)였다. 혈청학적 검사에서 40세 이하 4명에서는 특이소견이 관찰되지 않았고, 40세 이상의 3명에서는 개회충증 항체 양성이 확인되었다. 개회충증 항체 양성을 보인 3명 중 2명은 Albendazole을 복용하였고 나머지 한 명은 복용하지 않았다. 개회충증 항체 양성임에도 구충제를 복용하지 않은 1안을 제외한 8안은 모두 20/30 이상으로 시력이 회복되었다. 결론: 국내에서 발생한 신경망막염환자 7명 중 3명에서 개회충증 항체가 검출되었다. 항체 양성이 나온 경우에는 구충제 처방을 고려해야 한다. Purpose: In the present study, the clinical characteristics and outcomes of neuroretinitis in Korea were investigated. Methods: Seven consecutive patients with neuroretinitis from 2012 to 2015 were retrospectively reviewed. Results: The present study included 9 eyes of 7 patients. The subjects consisted of 5 males and 2 females and the mean age was 45.1 ± 13.2 years. Two patients had Influenza-like symptoms and the others had no specific general symptoms. The mean best corrected visual acuity was logMAR 0.48 ± 0.55 (0-1.6) on the initial visit. Four patients 40 years of age or under had no abnormal findings in laboratory work-up. Conversely, 3 patients over 40 years of age were positive for Toxocara based on enzyme-linked immunosorbent assay (ELISA). Two of 3 patients positive for Toxocara were treated with albendazole and 1was not. Eight eyes had good visual recovery over 20/30 except for 1 patient who did not take the albendazole despite being positive for Toxocara detected using ELISA. Conclusions: Three of 7 patients with neuroretinitis in Korea showed positive results forToxocara based on ELISA. In cases with seropositive Toxocara ELISA results, albendazole treatment should be considered.

수정체안 열공망막박리의 유리체절제술에서 수정체 보존과 백내장 동시수술의 비교

변익수,박강윤,이승민,이지은,엄부섭,Ik Soo Byon,Kang Yeun Pak,Seung Min Lee,Ji Eun Lee,Boo Sup Oum 대한안과학회 2013 대한안과학회지 Vol.54 No.3

Purpose: To compare lens-save and simultaneous phacoemulsification with intraocular lens implantation in primary vitrectomy for phakic rhegmatogenous retinal detachment (RRD). Methods: A retrospective comparative analysis of 54 consecutive eyes from 54 phakic RRD patients who underwent vitrectomy with a minimum of 12 months of follow-up was performed. The patients were divided into the vitrectomy group and the combined group (patients who underwent vitrectomy with concurrent cataract surgery). The main outcome measures were the best corrected visual acuity (BCVA), anatomical success rate, complications and cataract status according to LOCSⅢ grading. Results: Baseline characteristics were similar in both groups, except for age and cataract status. The mean age was 46.9 year in the vitrectomy group (n = 20) and 60.5 years in the combined group (n = 34) (p < 0.001). The postoperative BCVA (log MAR) improved from 1.27 and 1.30 at baseline to 0.45 and 0.28 at 12 months (p < 0.05), respectively, which was not a significant difference between the 2 groups. In the vitrectomy group, cataract status was changed from 1.8 at baseline to 2.5 at 12 months (p = 0.001). Two patients (11.1%) had an additional cataract surgery performed. The primary anatomical success rate was 90.0% in the vitrectomy group and 94.1% in the combined group. Conclusions: The vitrectomy group and combined group had similar results in the repair of phakic RRD. Although postoperative cataract progression was noted, lens should be saved in vitrectomy for young patients, as significant cataract is uncommon.