Long-term Reliability of Diurnal Intraocular Pressure Patterns in Healthy Asians

Yeoun Sook Chun,In Ki Park,Ko Un Shin,Joon Mo Kim 대한안과학회 2017 Korean Journal of Ophthalmology Vol.31 No.2

Purpose: To determine the long-term repeatability of diurnal intraocular pressure (IOP) patterns in healthy Asian subjects without glaucoma. Methods: Twenty-three eyes in 23 healthy Asian subjects without glaucoma underwent diurnal IOP measurements using Goldmann applanation tonometry every 2 hours from 9 AM to 11 PM during two visits that were 8 weeks apart. To validate repeatability between visits, we calculated intra-class correlation coefficients (ICCs) mean IOP, peak IOP, minimum IOP, and IOP fluctuation at each time point and expressed the results as the difference between peak IOP and minimum IOP or as the standard deviation of all diurnal IOP values in the diurnal IOP curve. Results: IOP repeatability was excellent at all time points, with ICCs ranging from 0.812 to 0.946 (p < 0.001). The 9 AM IOP showed the best repeatability between visits (ICCs, 0.946). Repeatability of mean IOP, peak IOP, and minimum IOP was also excellent (ICCs ranging from 0.899 to 0.929). However, IOP fluctuations showed poor repeatability, with an ICC lower than 0.15. Conclusions: Long-term repeatability of diurnal IOP patterns in healthy Asian subjects was excellent. These findings suggest that IOP measurements at standardized times of the day will be useful for assessing the effectiveness of glaucoma therapy.

점안마취 및 이측투명각막절개술을 이용한 백내장수술이 중심각막내피세포에 미치는 영향

전연숙(Yeoun Sook Chun),이진학(Jin Hak Lee) 대한안과학회 1999 대한안과학회지 Vol.40 No.2

Bayonetlike Kinking of Vessel 과 시신경유두의 변화

전연숙(Yeoun Sook Chun),김동명(Dong Myung Kim) 대한안과학회 1999 대한안과학회지 Vol.40 No.5

보툴리눔 독소를 이용한 상윤부각결막염의 치료

전연숙(Yeoun Sook Chun),김재찬(Jae Chan Kim) 대한검안학회 2013 Annals of optometry and contact lens Vol.13 No.2

목적: Riolan 근육에 보툴리눔 독소를 주사한 후 상윤부각결막염의 증상 및 생체염색의 변화를 비교하여 그 치료 효과를 알아보고자 하였다. 대상과 방법: 수년간 안구건조증으로 치료받아왔으나 호전이 없는 환자 중 상윤부각결막염으로 진단된 5명, 10눈을 대상으로 검판 앞 눈둘레근육인 Riolan 근육에 보튤리늄 독소(2.5-5 unit)를 피하 주사하고 증상 변화, 플루오르신과 로즈벵갈 염색의 변화를 치료 전과 치료 후 1주, 2주, 4주, 그 후로 매달 6개월까지 검사하여 효과를 평가하였다. 결과: 평균 46.8세로 여자 4명, 남자 1명이었다. 안구건조증과 가로결막물결주름은 5명 모두에서 발견되었고, 상결막이완증은 3명, 헐거운 눈꺼풀 증후군은 1에서 발견되었다. 보툴리눔 독소 주사 후 증상은 1주 이내, 생체염색은 2주에 거의 소실되었고 그 효과는 평균 4.0개월(2-6개월) 지속되었고 안검하수는 발생하지 않았다. 결론: 눈꺼풀의 긴장을 유지하는 Riolan 근육의 보툴리눔 독소 주사는 상윤부각결막염의 증상과 징후를 매우 빠르고 효과적으로 치료 할 수 있는 방법이다. Purpose: To evaluate the changes of clinical symptoms and vital stainings before and after injection of botulinum toxin A into Riolan’s muscle in the treatment of patients with superior limbic keratoconjunctivitis (SLK). Methods: Ten eyes of 5 patients diagnosed with SLK were injected with botulinum toxin A into the pretarsal orbicularis muscle, or Riolan’s muscle. The changes of clinical symptoms and stainings with fluorescein and rose bengal were evaluated on the day of diagnosis and at 1 week, 2 weeks, 4 weeks, and then monthly 6 months after the injection. Results: The mean age was 46.8 years. Four patients were female and 1 was male. Dry eye syndrome and horizontal conjunctival corrugation were found in all 5 patients, superior conjunctivochalasis in 3 patients, and floppy eye lid syndrome in 1 patient. All five patients showed distinct improvement in clinical symptoms within 1 week after the injection. Improvement of vital stainings was observed at 2 weeks after the injection, and its effect maintained for 4.0 months (2-6 months). There was no ptosis associated with botulinum toxin injection. Conclusions: Injection of botulinum toxin into Riolan’s muscle, which maintains lid tone, resolved symptoms and signs associated with SLK very effectively and rapidly.

핀홀 안경이 눈에 미치는 기능적 변화

전연숙(Yeoun Sook Chun),김원수(Won Soo Kim),박홍현(Hong Hyun Park) 대한검안학회 2016 Annals of optometry and contact lens Vol.15 No.4

Multiple-pinhole glasses are currently sold in many countries with unproven and exaggerated advertisements, however, its objective and subjective effects have not been investigated. Therefore, we quantified the visual functional changes caused by multiple pinhole glasses with 125 pinholes in each glasses lens. Multiple pinhole glasses enlarged pupil diameter from 3.6 mm to 6.0 mm and improved uncorrected distance and near visual acuity, depth of focus, and accommodative amplitude. However, contrast sensitivity, stereopsis, and visual field (VF) parameters including mean deviation, pattern standard deviation, and visual field index deteriorated. In conclusions, pinhole glasses had positive effects from the pinhole effect; however, they had negative effects on visual quality. In spite of the increased luminance and preserved peripheral VF with multiple pinholes, particular attention is needed when wearing pinhole glasses while driving, playing, sport, or working with instruments.

Different Number of Sessions of Intense Pulsed Light and Meibomian Gland Expression Combination Therapy for Meibomian Gland Dysfunction

Seung Hyeun Lee(Seung Hyeun Lee),Minjeong Kim(Minjeong Kim),Won Jun Lee(Won Jun Lee),Yeoun Sook Chun(Yeoun Sook Chun),Kyoung Woo Kim(Kyoung Woo Kim) 대한안과학회 2022 Korean Journal of Ophthalmology Vol.36 No.6

Purpose: To evaluate the effect of the intense pulsed light (IPL) and meibomian gland (MG) expression (MGX) combination therapy according to the total numbers of sessions in the meibomian gland dysfunction (MGD). Methods: Ninety patients with MGD were included. Patients had maximal five sessions of IPL (Aqua Cel, Jeisys Medical) and MGX combination therapy at 2-week intervals. The ocular surface disease index (OSDI) questionnaire score, MG profile grades, tear matrix metalloproteinase-9 (MMP-9), tear break-up time (BUT), tear osmolarity, tear secretion, and corneal erosions were evaluated. Results: The number of patients who had a total of one to five sessions (1S to 5S) was 10, 25, 17, 20, and 18, respectively. The time-serial decrease of OSDI scores was significant in patients who had three or more sessions (3S, p = 0.002; 4S, p < 0.001; 5S, p < 0.001). The MG expressibility grade decreased with two or more sessions (2S–5S, p < 0.001), but the meibum quality significantly improved with all sessions (1S, p = 0.012; 2S, p = 0.024; 3S, p = 0.015; 4S, p < 0.001; 5S, p < 0.001). Although tear BUT increased even in patients with one session (1S, p = 0.040; 3S, p = 0.005; 4S, p = 0.006; 5S, p = 0.021), tear MMP-9, osmolarity, Schirmer I, and corneal erosions were not improved in every number of sessions. The female sex was the sole contributor to the final symptomatic improvement (p = 0.042), and the MGD stages were not related to the final OSDI decrease. Conclusions: The OSDI score, MGD grades, and BUT were improved after the IPL and MGX combination therapy in MGD patients. Unlike MGD grades and tear film instability might be improved just after a few sessions, the overall subjective relief was accomplished in three or more sessions.

The Effect of In Vivo Grown Corneal Epithelium Transplantation on Persistent Epithelial Defects with Limbal Stem Cell Deficiency

김지택,Yeoun Sook Chun,송계용,Jae Chan Kim 대한의학회 2008 Journal of Korean medical science Vol.23 No.3

We report our experience with corneal epithelium, grown in vivo, transplantation in three patients with persistent epithelial defect (PED). The three patients had ocular surface disease unresponsive to standard treatments and were therefore chosen for transplantation. They underwent transplantation of epithelial sheets, grown in vivo, to the most affected eye. In vivo cultivation was carried out in the cornea of a living related donor. After epithelialization was completed, the epithelium grown on an amniotic membrane was harvested gently; it was then transplanted into the patient’s eye after debridement of fibrovascular tissue. The cultivated epithelium was completely epithelialized by 2 weeks; it was well-differentiated with well-formed hemidesmosome. On immunohistochemical staining, p63, connexin 43, and Integrin β4 were expressed in the cells on the epithelial sheet. The PED was covered completely and maintained for 4 weeks in all cases. However, corneal erosion recurred after 5 weeks in two cases. This novel technique demonstrates the corneal epithelial cells can be expanded in vivo successfully on denuded amniotic membrane of a healthy cornea and harvested safely. A corneal epithelial sheet, grown in vivo, can be transplanted to treat eye with a severe ocular surface disease, such as total limbal deficiency.

통합된 두 눈 시야와 한 눈 시야의 Mean Deviation 비교

전연숙,박인기,Yeoun Sook Chun,In Ki Park 대한안과학회 2013 대한안과학회지 Vol.54 No.6

Purpose: To compare the mean deviation (MD) between monocular and integrated binocular visual field (BVF). Methods: Thirty-six patients with glaucoma in at least 1 eye were recruited for the present study. Seventy-two threshold sensitivities of the BVF were obtained without additional visual field test by the Best Location and Binocular Summation methods using the 2 monocular visual fields of central 30o. The MD of the BVF was obtained by comparison to the value distribution in the age-matched population with normal BVF. After defining the better eye with the better MD value from the 2 eyes, comparison of the MDs between individual eyes and the integrated BVF were assessed. In addition, the MDs between the integrated BVF and actual BVF were compared in 11 patients. Results: In patients with a mean age of 58.7 years, the MD of the better eye was -2.3 dB, and the worse eye was -4.9 dB (p < 0.01). There was a significant difference between the 2 MDs derived from Best Location and Binocular Summation (-1.7 and -2.0 dB, respectively p = 0.045). The MDs according to BVF more improved than the better eye (p < 0.01 for both). There was no significant difference in MDs between integrated BVF and actual BVF (-1.9 vs -2.0, -2.3 vs -2.0, respectively p > 0.1). Conclusions: The integrated BVF more improved than the better eye. When providing guidance to glaucoma patients regarding therapeutic decisions considering the MD of IVF may be important.

Clinical Factors Associated with the Early Reduction of Corneal Sensitivity in Herpes Zoster Ophthalmicus

Minjeong Kim,Yeoun Sook Chun,Nam Ju Moon,Kyoung Woo Kim 대한안과학회 2022 Korean Journal of Ophthalmology Vol.36 No.2

안내렌즈삽입술 후 안압과 전방각의 변화

전연숙,이종호,이제명,박인기,Yeoun Sook Chun,Jong Ho Lee,Jae Myung Lee,In Ki Park 대한안과학회 2005 대한안과학회지 Vol.46 No.2

Purpose: To evaluate the effects of ICL implantation on angle structures, intraocular pressure (IOP) and pupil diameter. Methods: A Staar implantable contact lens (ICL) was implanted in 81 eyes of 43 patients with spherical equivalent over -6D. Gonioscopy was done 1 day after laser iridotomy and 6 months after ICL implantation and postoperative changes in gonioscopic findings were evaluated. Also IOP and pupil diameter were examined. Results: There were occlusion or narrowing of the LI opening site in 10 eyes (12.3%). Width of angle was wide over 30° in all cases but that was narrowed under 20° in 16 eyes (19.8%) at postoperative 6 months. The mean pigmentation was 2.11 in inferior, 0.47 in nasal, 0.22 in temporal and 0.18 in superior angle at 6 months postoperatively by semiquantitative method (Grade 0~4). There was decrease of pigmentation in nasal and temporal angle but no change in inferior and superior angle after ICL implantation. There was temporary increase of IOP at 1 week and 1 month postoperatively due to steroid eye drops but returned to preoperative level and maintained until the 6 months postoperatively. There was significant decrease of pupil diameter at postoperative 1 and 3 months but returned to the preoperative level at postoperative 6 months. There was no evidence of pigment dispersion syndrome and pigmentary glaucoma. Conclusions: ICL implantation caused the narrowing of width of angle but did not increase trabecular pigmentation. We expect that ICL implantation is safe about pigment dispersion syndrome and pigmentary glaucoma.