Risk Factors Associated With Pterygium and Its Subtypes in Korea: The Korean National Health and Nutrition Examination Survey 2008–2010

Rim, Tyler Hyung Taek,Nam, JaeSung,Kim, Eung Kweon,Kim, Tae-im Lippincott Williams Wilkins, Inc. 2013 Cornea Vol.32 No.7

PURPOSE:: To assess the sociodemographic and health-related risk factors associated with pterygium and its subtypes in Korea. METHODS:: From 2008 to 2010, a total of 14,920 randomly selected national representative participants of the Korean National Health and Nutrition Examination Survey underwent additional ophthalmologic examinations by the Korean Ophthalmologic Society. The risk factors for pterygium in general or according to subtype (atrophic, intermediate, and fleshy) were identified using multivariate logistic regression analysis. RESULTS:: The prevalence of pterygium was 6.7% (95% confidence interval, 5.9–7.5) in subjects aged 30 years or older. Older age, male sex, lower educational level, rural habitation, nonsmoking, and sun exposure were independent risk factors for pterygium. Among subjects with pterygium, older age, male sex, lower educational level, and nonsmoking were independent risk factors for all types of pterygium. Sun exposure for >5 h/d was the independent risk factor for the severe pterygium subtype. CONCLUSIONS:: Socioeconomic disparities in pterygium development exist. Proper ocular examination and education to avoid excessive sun exposure would be helpful in reducing disease risk.

Treatment of upper eyelid retraction related to thyroid-associated ophthalmopathy using subconjunctival triamcinolone injections.

Lee, Sung Jun,Rim, Tyler Hyung Taek,Jang, Sun Young,Kim, Chan Yun,Shin, Dong Yeob,Lee, Eun Jig,Lee, Sang Yeul,Yoon, Jin Sook Springer-Verlag 2013 Graefe’s archive for clinical and experimental oph Vol.251 No.1

<P>To evaluate the efficacy of subconjunctival triamcinolone injection for treating upper eyelid retraction caused by thyroid-associated ophthalmopathy (TAO).</P>

장애인과 시력장애인의 인구사회학적 차이: 제3기 국민건강 영양 조사자료

임형택,이동민,이승규,Tyler Hyung Taek Rim,Dong Min Lee,Christopher Seung Kyu Lee 대한안과학회 2012 대한안과학회지 Vol.53 No.12

Purpose: To identify the disparities of socio-demographic factors between visually disabled people and other people with disabilities. Methods: The fourth Korea National Health and Nutrition Examination Survey (KNHANES III) is a nationwide survey. The present study included 25,125 people who completed the KNHANES III. For analysis, the participants were divided into 3 groups: subjects without disabilities, subjects with disabilities but without visual disabilities, and subjects with visual disabilities. The gender, age, monthly house income, occupation, education, residential area, and health insurance were investigated. Multivariate logistic regression analysis was used to determine the most differentiating factor. Results: Visually disabled people were proportionally older (40 to 64 years), were male, living in a non-metropolitan area except Seoul/Pusan/Gyunggi compared to other disabled people and also had a higher proportion of the above factors, as well as lower education compared to non-disabled people. Conclusions: Socio-demographic factors showed disparities in visually disabled people and people with other disabilities. Ophthalmologists should understand these disparities and be involved in establishing policies to reduce the disparities. Ophthalmologists also need to provide holistic and comprehensive medical care using the Blindness is Preventable! Korea Foundation for the Prevention of Blindness, consultation with social work teams in hospitals and other institutions, as well as evaluating the visual impairment.

한국인의 백내장에 대한 인지도 역학 조사: 제4기 국민건강영양조사자료

임형택,박선영,김태임,Tyler Hyung Taek Rim,MD,Sun Yung Park,MD,Tae-im Kim,MD 대한안과학회 2013 대한안과학회지 Vol.54 No.1

Purpose: To identify cataract awareness in the Korean population. Methods: The present study included 3,662 subjects who were diagnosed with a cataract by ophthalmic examination out of 11,058 subjects in the fourth Korea National Health and Nutrition Examination Survey (KNHANES IV). Among the 3,662 participants, 944 were aware that they already had a cataract. The socio-demographic disparities in cataract awareness were identified using multivariate analysis. Results: The mean age of the study population was 65.6 years (standard deviation, 0.2). The awareness calculated based on total weighted population was 24.6% in people over 19 years of age (95% confidence interval, 22.5-26.6%). In multivariate logistic analysis, subjects with higher income, living in a rural area, having a spouse, and binge alcohol use were less likely to be aware of their cataract. In multivariate linear regression analysis after adjusting for confounding factors, there were statistically significant differences of mean in age and monthly house income. Deajeon (11%), and Gwangju (16%) were the lower ranked regions for cataract awareness in Korea. Conclusions: The cataract awareness in Korea was lower than in other developed countries. Public education and strategies to improve cataract awareness in susceptible people are necessary. More effort is needed to improve cataract awareness based on the Korean society’s acceptance of ophthalmologists as in other countries.

저교정 굴절이상 유병률 및 관련 요인 분석

강민재(Min Jae Kang),임형택(Tyler Hyung Taek Rim),김성수(Sung Soo Kim),대한안과학회 역학조사위원회 대한안과학회 2016 대한안과학회지 Vol.57 No.8

목적: 국내 저교정 굴절이상의 유병률과 이와 관련된 요인을 밝히고자 하였다. 대상과 방법: 2008년부터 2012년까지 국민건강영양조사를 완료한 36,162명의 우안을 기준으로 유병률을 산출했다. 저교정 굴절이상은 시력 교정을 하였을 때, 시력이 나안 시력 혹은 안경이나 콘택트렌즈를 착용하고 있을 때보다 시력이 2줄 이상 호전을 보이는 것으로 정의하였다. 직업군별로 저교정 굴절이상의 분율을 제시하고, 사회인구통계학적인 요인과 관련성을 다변량 로지스틱 회귀분석을 사용하여 제시하였다. 결과: 총 36,162명의 대상자 중 6,954명이, 40세 이상 19,884명 중 3,980명이 저교정 굴절이상에 해당하였고, 이는 전 연령대상 18.5%, 40세 이상에서 18.8%의 유병률로 추정되었다. 기존의 시력교정기구를 착용하는 군과 시력교정기구가 없는 군을 나누어서 보았을 때, 시력교정기구가 없는 군에서 저교정 굴절이상의 유병률은 23.1%로 높았다. 4줄 이상 시력 상승을 보인 군은 전체에서 7.2%(2,606)를 차지하였다. 직업군에서는 농업, 어업 등에 종사하는 군과 단순노동자에서 각각 22.8% (570/2,499), 20.2% (497/2,457)로 저교정된 굴절이상의 분율이 높았다. 연령별로는 30대를 기준으로 10대와 70대, 80대에서, 여성, 저소득층, 저학력층, 동거인이 없는 경우가 관련 요인으로 조사되었다. 결론: 저교정 굴절이상과 고령, 여성, 낮은 사회경제적 상태가 관련 있으므로, 이러한 취약층에 대한 공중보건학적인 접근이 필요하며, 적절한 시력 교정을 통한 저시력 예방 노력이 필요하다. Purpose: To assess the prevalence and risk factors of undercorrected refractive error in South Korea. Methods: We analyzed 36,162 participants for estimating prevalence using the Korean National Health and Nutrition Examination Survey (KNHANES, 2008-2012). Undercorrected refractive error was defined as an improvement of at least 2 lines in best corrected visual acuity compared with the presenting visual acuity in the right eye. Proportion of undercorrected refractive error by occupation was presented, and associated sociodemographic factors were evaluated by multivariable logistic regression. Results: The prevalence of undercorrected refractive error among all participants and among adults was 8.5% (n/N, 6,954/36,162) and 18.8% (n/N, 3,980/19,884), respectively. The proportion of undercorrected refractive error was higher among those with did not wear spectacles or contact lenses (23.1%) than among spectacle or contact lens wearers (8.1%). The proportion of participants who gained more than four or more lines of best corrected visual acuity was 7.2% (n = 2,606) for the all age group. In terms of occupation, farming, fishing, and forestry occupations (22.8%, 570/2,499) and laborer (20.2%, 497/2,457) were more likely to have undercorrected refractive error. Age groups of 10s, 70s, or 80s (30s as a reference group), female sex, lower income, lower education level, and living without a spouse were associated with undercorrected refractive error. Conclusions: People of older age, female sex, and lower socioeconomic status were more likely to have undercorrected refractive error. This suggests that a public-health approach is needed for preventing visual impairment via proper vision correction.

Effect of Voriconazole and Ultraviolet-A Combination Therapy Compared to Voriconazole Single Treatment on <i>Fusarium solani</i> Fungal Keratitis

Choi, Kyoung Sub,Yoon, Sang Chul,Rim, Tyler Hyung Taek,Han, Soo Jung,Kim, Eun-Do,Seo, Kyoung Yul Mary Ann Liebert 2014 JOURNAL OF OCULAR PHARMACOLOGY AND THERAPEUTICS Vol.30 No.5

국내 백내장 수술 현황과 향후 전망: 국민건강 영양 조사자료

임형택,우영제,박현주,김성수,대한안과학회역학조사위원회,Tyler Hyung Taek Rim,Young Jae Woo,Hyun Joo Park,Sung Soo Kim,The Epidemiologic Survey Committee in the Korean Ophthalmological Society 대한안과학회 2014 대한안과학회지 Vol.55 No.12

Purpose: To identify socio-demographic factors in cataract surgery in Korea and expect future effect of the bundle of service system. Methods: We analyzed the number of people undergoing cataract surgery and associated factors such as surgery ratio, region, age, income, and insurance status of 28,980 patients older than 40 years using data from the fifth Korea National Health and Nutrition Examination Survey 2008-2012 (KNHANES). Results: Among total population in 2012, 47.5% of elderly aged 80 years and older have received cataract surgery. According to region in patients older than 40, Jeollanam-do showed the highest proportion of patients undergoing cataract surgery, at 12%, Daejeon showed the lowest proportion of 3.6%, and Seoul showed 6.8%. Regional analysis was also performed by analyzing the number of cataract patients per ophthalmologist. Jeollanam-do showed the highest with 40,115 patients per ophthalmologist, and Seoul showed the least with 1,094 patients per ophthalmologist. The sociodemographic factors such as education or income, were not associated with cataract surgery after adjusting for age and regional difference. On the other hand, subjects with medicaid were associated with 1.6-fold (95% confidence interval, 1.3-2.0) higher rate of cataract surgery than subjects with national health insurance. Conclusions: Regional disparity was found in the cataract surgery rate and surgery rate per an ophthalmologists, whereas sociodemographic factors were not significant in receiving benefits of cataract surgery. Before the amount of bundled payment is changing, down-leveling of quality of care and deepening of disparities among health care provider should be considered.J Korean Ophthalmol Soc 2014;55(12):1772-1778

Stage 3 플러스 징후를 동반한 미숙아 망막병증에서 일차 유리체강내 베바시주맙 주입술의 효과

김성은,임형택,이승규,Sung Eun Kim,Tyler Hyung Taek Rim,Christopher Seungkyu Lee 대한안과학회 2015 대한안과학회지 Vol.56 No.1

Purpose: To evaluate the efficacy and safety of primary intravitreal bevacizumab injection in stage 3 retinopathy of prematurity with plus signs. Methods: We reviewed retrospectively the medical records of 30 eyes of 16 patients diagnosed with stage 3 retinopathy of prematurity with plus signs treated with primary intravitreal bevacizumab injection between March 1, 2011 and February 28, 2013 and followed up for at least 9 months. Results: Mean gestational age was 26 + 4 weeks ± 11 days and mean birth weight was 822 ± 251.4 g. The locations of disease were zone II in 24 eyes and zone III in 6 eyes. Intravitreal bevacizumab injection was performed after the mean 1.3 ± 1 day after plus signs were detected. Mean postconceptional age at treatment was 38 + 2 weeks ± 16 days. Mean follow-up period was 16.6 ± 6.9 months. Plus signs started to regress after the mean 4.6 ± 2.3 days after injection and completely regressed after the mean 24.3 ± 12.4 days. Cataract extraction was performed in 1 eye due to a cataract that appeared not associated with the injection procedure, but was regarded as a treatment failure. There were no local or systemic complications. Conclusions: Primary intravitreal bevacizumab injection in stage 3 retinopathy of prematurity with plus signs demonstrated excellent short-term efficacy and safety. J Korean Ophthalmol Soc 2015;56(1):62-69

한국인 망막 열공 환자에서 초광각 안저촬영술의 진단적 유용성

안현민(Hyun Min Ahn),임형택(Tyler Hyung Taek Rim),정은지(Eun Jee Chung) 대한안과학회 2016 대한안과학회지 Vol.57 No.8

목적: 망막 열공 환자에서 산동 후 안저검사와 초광각 안저촬영술을 비교함으로써 초광각 안저촬영술의 유용성을 알아보고자 하였다. 대상과 방법: 망막 전문의에 의해 산동 후 안저검사에서 망막 열공 소견을 확인한 이후, 초광각 안저촬영술을 시행한 160명의 환자(230개의 병변)의 의무기록을 후향적으로 환자 특징 및 병변의 위치에 따라 분석하였다. 병변의 위치는 적도부 기준으로 전후 망막으로, 그리고 전후 망막을 각각 4개 구역(상측, 하측, 이측, 비측)으로 나누어 초광각 안저촬영술의 민감도와 특이도를 구하였다. 결과: 초광각 안저촬영술 민감도는 72% (95% 신뢰구간[95% confidence interval {CI}] 65-79%), 특이도는 94% (95% CI 90-98%)였다. 앞뒤 망막으로 비교를 하였을 때, 뒤쪽 망막의 경우, 민감도는 89% (95% CI 85-93%)였으며, 앞쪽 망막의 경우, 민감도는 72%(95% CI 66-78%)였으며, 앞뒤 망막에서 초광각 안저촬영술의 민감도는 통계학적으로 유의한 차이가 있었다(p=0.007). 부위별로 민감도를 비교하였을 때, 상, 이, 비측 부위별 민감도에서는 앞뒤 망막의 차이가 없었으나, 하측 민감도의 경우 앞뒤 망막의 민감도 차이가 있었으며, 앞쪽 망막의 하측 민감도는 43% (95% CI 29-57%)였다. 결론: 한국인 망막 열공 검사에 있어서 초광각 안저촬영술은 전체적으로 양호한 민감도를 보였으나 앞쪽 하측의 민감도는 상대적으로 낮은 것을 확인할 수 있었다. 따라서 초광각 안저 촬영술은 산동 후 안저 검사에 보조 장비로 사용할 수 있으나, 병변의 위치에 따라 민감도가 유의한 차이를 보이므로 산동 후 안저검사가 병행되어야 할 것으로 사료된다. Purpose: To evaluate the availability of ultra-wide-field fundus photography compared to fundus examination after pupil dilatation in Korean patients with retinal break. Methods: For this retrospective case review of consecutive 160 patients, 230 lesions with retinal breaks were recruited. The ultra- wide-field images were taken after fundus examination with pupil dilatation performed by a retinal specialist. We analyzed ultra- wide-field images according to patient characteristics and separated area. We divided lesions into anterior and posterior areas, and each area was separated into 4 quadrants (superior, inferior, temporal, and nasal). Results: The sensitivity of ultra-wide-field imaging for detecting retinal break was 72% (95% confidence interval [CI] 65-79%), and the specificity was 94% (95% CI 90-98%). The sensitivity of detection of posterior retina was 89% (95% CI 85-93%), and that of anterior retina was 72% (95% CI 66-78%); this difference was significant (p = 0.007). There was a significant statistical difference at the inferior quadrant between anterior and posterior retina, but not at superior, temporal, or nasal quadrants. The sensitivity of detection in the inferior quadrant in the anterior retina was 43% (95% CI 29-57%). Conclusions: Ultra-wide-field fundus photography can detect retinal break, but there is limitation in anterior retinal lesions, especially the inferior area. Therefore, ultra-wide-field fundus photography cannot be an alternative method instead of fundus examination with pupil dilatation.