Yongwun Cho, Jeongwoo Kwon, Jin-Seok Seo, Gyu-Nam Kim, Woong-Sun Yoo, In Young Chung
{"title":"Neovascular Glaucoma as the Initial Presentation of Ocular Tuberculosis","authors":"Yongwun Cho, Jeongwoo Kwon, Jin-Seok Seo, Gyu-Nam Kim, Woong-Sun Yoo, In Young Chung","doi":"10.3341/jkos.2023.64.9.859","DOIUrl":"https://doi.org/10.3341/jkos.2023.64.9.859","url":null,"abstract":"Purpose: To report a case of ocular tuberculosis that first manifested as neovascular glaucoma.Case summary: A 76-year-old male visited our hospital complaining of decreased visual acuity in the left eye. He had undergone tuberculosis treatment 1 year prior, and had been cured. At the time of his visit, decreased visual acuity, increased intraocular pressure, and iris neovascularization were observed in the left eye. He was diagnosed with neovascular glaucoma and was started on treatment to lower the intraocular pressure. At the time of the visit, we also noticed vitreous opacity in both eyes. The patient did not attend his scheduled follow-up visit, but returned 2 months later complaining of decreased visual acuity in both eyes. The vitreous opacity in the retinae of both eyes had become aggravated. Diagnostic vitrectomy was performed on both eyes, and multiple yellowish-white circular lesions were observed throughout the retinae. Systemic abnormalities were suspected, and thus additional tests were performed. Bronchoalveolar lavage fluid analysis revealed recurrence of pulmonary tuberculosis, and tuberculosis treatment was recommenced. Temporary increases in ocular inflammation and deterioration were observed but improved after the addition of systemic steroids. The patient has been under observation without recurrence for about 1 year.Conclusions: Ocular tuberculosis can be expressed in the form of neovascular glaucoma, so ocular tuberculosis should be suspected if there is a history of tuberculosis and abnormal retinal findings.","PeriodicalId":17341,"journal":{"name":"Journal of The Korean Ophthalmological Society","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135355086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Trichofolliculoma in the Medial Canthal Area","authors":"In Seok Jeong, Seong Jae Kim, Seong Wook Seo","doi":"10.3341/jkos.2023.64.9.851","DOIUrl":"https://doi.org/10.3341/jkos.2023.64.9.851","url":null,"abstract":"Purpose: We report a case of trichofolliculoma located in the medial canthal area that was initially clinically suspected to be basal cell carcinoma.Case summary: A 93-year-old female patient presented to our hospital with a 1.2 × 1.4 cm mass in the right medial canthal area that had been present for 8 months. She had experienced continuous bleeding-like secretions during this time, leading to suspicion of basal cell carcinoma due to the absence of hair and a painless central ulcer lesion. Excision and biopsy were performed; the biopsy results revealed trichofolliculoma. The patient underwent complete resection and has remained recurrence-free for 6 months with regular follow-up observations.Conclusions: Trichofolliculoma is a rare follicular hamartoma characterized by a nodule with dilated pores and dense hair in the center. Given its clinical similarity to benign and malignant tumors, such as basal cell carcinoma and squamous cell carcinoma, it is essential to differentiate this condition through excision and biopsy.","PeriodicalId":17341,"journal":{"name":"Journal of The Korean Ophthalmological Society","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135353896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Tear Film and Drainage after Selective Punctal Occlusion Using Polydioxanone Plugs in Dry Eye Patients","authors":"Sung Eun Im, Hee Chul Lee, Sang Soo Kim","doi":"10.3341/jkos.2023.64.9.759","DOIUrl":"https://doi.org/10.3341/jkos.2023.64.9.759","url":null,"abstract":"Purpose: To assess changes in the tear film and delayed tear drainage after upper or lower, or combined upper and lower, punctal occlusion using dissolvable polydioxanone plugs in patients with dry eye.Methods: In total, 40 dry eye patients (80 eyes) were enrolled: four groups of 10 (20 eyes) with no, lower, upper, and lower and upper punctal occlusions. Dissolvable polydioxanone plugs were placed. The tear break-up time (tBUT) and the tear meniscus height (TMH) were measured, and the Schirmer I test and dye disappearance test (DDT) were performed at baseline and 2 weeks after the procedure.Results: Compared to the control group, all three test groups exhibited significant changes in the tBUT, the DDT test, and the TMH after polydioxanone plug placement (all <i>p</i> < 0.05). The group with both upper and lower punctal occlusions exhibited more delayed tear drainage than the other test groups. A lower punctal occlusion significantly delayed tear drainage to a greater extent than did an upper punctal occlusion (<i>p</i> = 0.010).Conclusions: In dry eye patients, a polydioxanone plug improved the tBUT and TMH, and the DDT score. The tear drainage delay increased in the order: both, lower, and upper punctal occlusion(s).","PeriodicalId":17341,"journal":{"name":"Journal of The Korean Ophthalmological Society","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135353901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Unilateral Eyelid Swelling Secondary to Local Palpebral Conjunctival Amyloidosis in a Young Patient","authors":"Haeeun Shin, Youjeong Seo, Ji Won Jung","doi":"10.3341/jkos.2023.64.9.854","DOIUrl":"https://doi.org/10.3341/jkos.2023.64.9.854","url":null,"abstract":"Purpose: We report a young patient with unilateral eyelid swelling secondary to local, palpebral conjunctival amyloidosis.Case summary: A 31-year-old male was referred with a 6-month history of mild, right upper eyelid swelling but without redness or tenderness. Slit-lamp examination revealed a diffuse hemorrhagic papilliform lesion on the right upper palpebral conjunctiva, this raised a suspicion of giant papillary conjunctivitis. As the lesion was unilateral, there was no history of allergic disease or contact lens use, and the lesion was refractory to topical anti-inflammatory treatment so, excisional biopsy of the right upper palpebral conjunctiva was performed. During the operation, the papilliform lesion was removed, it peeled off on the blade. After surgery, the eyelid swelling improved. Histopathological examination revealed an eosinophilic amorphous deposit consistent with amyloidosis. Further evaluation ruled out systemic amyloidosis; there were no abnormal findings. Thus, we diagnosed primary localized amyloidosis of the palpebral conjunctiva. At the 1-year follow-up, no recurrence was detected.Conclusions: Although primary localized amyloidosis of the palpebral conjunctiva is rare, this should be considered if chronic eyelid swelling accompanied by another conjunctival lesion such as giant papillary conjunctivitis is encountered.","PeriodicalId":17341,"journal":{"name":"Journal of The Korean Ophthalmological Society","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135355088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Corneal Topographic Changes after Botulinum Toxin-A Injection in Patients with Essential Blepharospasm","authors":"Sangyoon Kim, Jung Hyo Ahn","doi":"10.3341/jkos.2023.64.9.845","DOIUrl":"https://doi.org/10.3341/jkos.2023.64.9.845","url":null,"abstract":"Purpose: To compare the corneal topographic change before and after botulinum toxin A injection in patients with essential blepharospasm.Methods: From September 2015 to December 2020, we enrolled total 20 patients, 40 eyes diagnosed with essential blepharospasm. We estimated the corneal refractive power and astigmatism before and after Nabota<sup>®</sup> (Daewoong Co. Ltd, Seoul, Korea) botulinum toxin injection at 1 and 3 months using iTrace<sup>®</sup> Topography (Software version 4.2.1., Tracey technology Inc., Houston, TX, USA). Corneal refractive power was analyzed in superior, inferior, nasal and temporal location at 1 mm, 3 mm zone. Also, steep and flat keratometry, astigmatism was measured by topography.Results: Corneal refractive power showed significant difference in superior and inferior location of 1 mm zone at 1 month after botulinum toxin injection (<i>p</i> = 0.038, <i>p</i> = 0.042). There was no significant difference in all four locations of 3 mm zone. At 1 month after toxin injection, steep keratometry was only significant reduced (<i>p</i> = 0.046) and with-the-rule astigmatism was shifted to against-the-rule astigmatism. At 3 months after toxin injection, keratometry and astigmatism was resolved to before toxin injection.Conclusions: At 1 month after Nabota<sup>®</sup> (Daewoong Co. Ltd) botulinum toxin injection, corneal refractive power at vertical axis was flattened and steep keratometry was significantly reduced. At 3 months after toxin injection, corneal topographic change was changed to before toxin injection.","PeriodicalId":17341,"journal":{"name":"Journal of The Korean Ophthalmological Society","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135355092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Changes in Angle of Exodeviation According to Distance after Monocular Occlusion in Intermittent Exotropia","authors":"Moon Young Park, Hyun Jin Shin","doi":"10.3341/jkos.2023.64.9.832","DOIUrl":"https://doi.org/10.3341/jkos.2023.64.9.832","url":null,"abstract":"Purpose: This study investigated changes in the angle of exodeviation at different distances and the characteristics of a group that showed an increased angle following monocular occlusion in intermittent exotropia.Methods: In all, 102 patients diagnosed with basic intermittent exotropia were enrolled. The deviation angle was measured using a mirror at 33 cm, 3 m, 6 m, 12 m, and 6 m. Moreover, the deviation was measured at 33 cm and 3 m after patching the non-dominant eye for 1 hour. Patients with a higher deviation angle at 33 cm after occlusion were categorized as the ‘increased group’, whereas those with lower deviation angles were classified as the ‘stationary group’.Results: There was a male-to-female ratio of 46:56 and an average age at surgery of 9.23 years. No significant differences were observed in deviation measurements taken at 3, 6, 12, and 6 m using a mirror. However, after occlusion, there was a significant increase in deviation at 33 cm (<i>p</i> < 0.01). The average log value of near stereoacuity was 1.96 ± 0.35 in the increased group and 2.16 ± 0.41 in the stationary group. The group with an increased near deviation after occlusion demonstrated a significantly improved near stereoacuity (<i>p</i> = 0.01) and an increased proportion of good results in the near Worth 4 dot test (<i>p</i> = 0.03).Conclusions: Preoperative measurement of maximum deviation after 1 hour of monocular occlusion can help reduce recurrence and insufficient correction, particularly in patients with good fusional ability.","PeriodicalId":17341,"journal":{"name":"Journal of The Korean Ophthalmological Society","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135353895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jae Yul Hwang, Jae Yun Sung, Min Su Kim, Yeon-Hee Lee
{"title":"Relationship between Thyrotropin Binding Inhibitory Immunoglobulin and Strabismus-associated Thyroid Eye Disease Stability","authors":"Jae Yul Hwang, Jae Yun Sung, Min Su Kim, Yeon-Hee Lee","doi":"10.3341/jkos.2023.64.9.825","DOIUrl":"https://doi.org/10.3341/jkos.2023.64.9.825","url":null,"abstract":"Purpose: To investigate the relationship between thyrotropin binding inhibitory immunoglobulin (TBII) and deviation angle stability in strabismus-associated thyroid eye disease.Methods: A total of 25 strabismus-associated thyroid eye disease patients who were followed up for > 6 months without surgery were enrolled. To investigate the correlation between TBII levels and changes in the deviation angle, a test period of 6 months from the date of TBII measurement was established and 55 test units of the corresponding TBII levels were obtained.Results: The deviation angle had a positive correlation with the TBII levels (r = 0.473, <i>p</i> < 0.001), but did not correlate with sex, age, and thyroid hormone levels. Changes in the horizontal, vertical, and total deviation angles were significantly greater in the high-TBII test units compared to the normal-TBII test units (<i>p</i>= 0.029, = 0.032, and = 0.009, respectively).Conclusions: TBII levels were related to deviation angle stability in strabismus-associated thyroid eye disease. TBII may be a useful indicator for deviation angle stability in these patients over a period of 6 months.","PeriodicalId":17341,"journal":{"name":"Journal of The Korean Ophthalmological Society","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135355087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Implications of Central Corneal Thickness-corrected Intraocular Pressure in Normal-tension Glaucoma with Reduced Central Corneal Thickness","authors":"Sang Muk Lee, Sung Uk Baek","doi":"10.3341/jkos.2023.64.9.811","DOIUrl":"https://doi.org/10.3341/jkos.2023.64.9.811","url":null,"abstract":"Purpose: Reduced central corneal thickness (CCT) is a risk factor for glaucoma progression and can impact intraocular pressure (IOP) measurement. Therefore, we investigated the glaucoma progression pattern and associated risk factors among individuals with normal-tension glaucoma (NTG) and reduced CCT.Methods: This retrospective study enrolled 187 eyes of 187 NTG patients with an open angle and a baseline IOP < 20 mmHg, adjusted for CCT. Reduced CCT was defined as < 500 µm thickness in both eyes. Patients with a history of corneal disease or surgery affecting CCT were excluded. We used Goldmann tonometry to measure baseline and CCT-corrected IOP (ccIOP; [IOP - [CCT - 545]/50 × 2.5]). The participants were divided into progressing and stable subgroups.Results: The mean CCT was 481.2 ± 17.5 µm and the mean follow-up period was 6.3 ± 2.5 years. The baseline IOP and ccIOP were 13.7 ± 2.4 and 16.6 ± 2.5 mmHg, respectively. The average visual field progression rate was -0.79 ± 1.26 dB/yr. Of the participants, 47 (26.6%) and 140 (73.4%) were in the progressing and stable group, respectively. Participants in the progressing group were older, had a higher baseline ccIOP, and had a higher proportion of pseudophakia than those in the stable group. Multivariate analysis showed that baseline ccIOP was a significant risk factor.Conclusions: Individuals presenting with NTG and reduced CCT had a relatively stable glaucoma progression rate. However, glaucoma progression was associated with old age, pseudophakia, and high baseline IOP in individuals with reduced CCT. In particular, the only significant factor associated with glaucoma progression was ccIOP. Therefore, ccIOP is a clinically significant factor in individuals with NTG and reduced CCT.","PeriodicalId":17341,"journal":{"name":"Journal of The Korean Ophthalmological Society","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135355089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Four-flanged Technique for Scleral Fixation of a Dislocated Four-eyelet Intraocular Lens","authors":"Byung Su Lim, Jun Su Kwon, Jae Yon Won","doi":"10.3341/jkos.2023.64.9.803","DOIUrl":"https://doi.org/10.3341/jkos.2023.64.9.803","url":null,"abstract":"Purpose: To define and evaluate the short-term clinical outcomes of the four-flanged technique for scleral fixation of a dislocated four-eyelet intraocular lens (IOL).Methods: Eleven eyes of 11 patients who underwent scleral fixation of dislocated four-eyelet intraocular lenses using a four-flanged technique were studied retrospectively. We measured the best-corrected visual acuity (BCVA), corneal endothelial cell density, intraocular pressure (IOP), spherical equivalent, astigmatism, IOL tilt and decentration, and postoperative complications.Results: The BCVA was 0.25 ± 0.11 logarithm of the minimal angle of resolution (logMAR) before surgery and 0.14 ± 0.12 logMAR 6 months later (<i>p</i> < 0.001). The corneal endothelial cell count was 2,427 ± 384 and 2,367 ± 298/mm<sup>2</sup> before and after surgery, respectively (<i>p</i> = 0.285). The spherical equivalent was 6.02 ± 4.90 and 0.11 ± 0.36 before and after surgery, respectively. There was no significant difference in astigmatism before and after surgery. The mean IOL tilt and decentration were 2.44 ± 1.68° and 0.23 ± 0.09 mm, respectively. The refractive difference was 0.11 ± 0.24 diopters (D). Postoperative complications occurred in one eye; one flange lay outside the scleral tunnel, triggering hyperemia and conjunctival inflammation.Conclusions: The four-flanged scleral fixation technique for a dislocated four-eyelet IOL improved the BCVA but did not significantly affect corneal endothelial cell loss. The procedure significantly reduced postoperative IOL tilt, decentration, and astigmatism, and may be a useful alternative to scleral fixation of a dislocated four-eyelet IOL.","PeriodicalId":17341,"journal":{"name":"Journal of The Korean Ophthalmological Society","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135353898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Short-term Efficacy and Safety of Omidenepag Isopropyl 0.002% w/v Therapy for Patients with Primary Open-angle Glaucoma and Ocular Hypertension","authors":"Jung Soo Kim, Jung Lim Kim","doi":"10.3341/jkos.2023.64.9.819","DOIUrl":"https://doi.org/10.3341/jkos.2023.64.9.819","url":null,"abstract":"Purpose: To analyze the short-term efficacy and safety of omidenepag isopropyl 0.002% (w/v) in patients with primary open-angle glaucoma and ocular hypertension.Methods: Data on 36 patients with primary open-angle glaucoma and ocular hypertension treated with omidenepag isopropyl 0.002% (w/v) from January 2021 to May 2022 were retrospectively analyzed. We investigated whether the drug lowered the intraocular pressure (IOP) at 1 and 3 months compared to baseline. Possible side effects were sought at each visit.Results: The mean patient age was 59.2 years at the time of treatment. Of the 36 patients, 33 had primary open-angle glaucoma and 3 had ocular hypertension. The baseline IOP was 15.9 ± 3.6 mmHg, which significantly decreased to 13.7 ± 2.8 and 13.4 ± 2.9 mmHg at 1 and 3 months, respectively, following instillation of omidenepag isopropyl 0.002% (w/v) (both <i>p</i> < 0.01). Twelve patients (29.2%) experienced side effects including hyperemia, ocular pain, and itching but only two (5.5%) stopped using the medication.Conclusions: In the short-term, ominedepag isopropyl 0.002% (w/v) is effective and safe in patients with primary open-angle glaucoma and ocular hypertension.","PeriodicalId":17341,"journal":{"name":"Journal of The Korean Ophthalmological Society","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135353897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}