Korean Journal of Ophthalmology : KJO最新文献

{"title":"Neovascular Glaucoma Associated with Chronic Rhegmatogenous Retinal Detachment.","authors":"Dong Ik Kim,&nbsp;Min Seok Kim,&nbsp;Se Joon Woo","doi":"10.3341/kjo.2022.0066","DOIUrl":"https://doi.org/10.3341/kjo.2022.0066","url":null,"abstract":"<p><strong>Purpose: </strong>To demonstrate the clinical features and natural course of chronic retinal detachment-associated neovascular glaucoma.</p><p><strong>Methods: </strong>Ten patients, diagnosed with chronic retinal detachment-associated neovascular glaucoma during 2007-2016 were retrospectively investigated. Besides chronic retinal detachment, no patients had any neovascular glaucoma-predisposing conditions, such as carotid artery disease. Retinal perfusion status was evaluated from the fundus fluorescein angiography images.</p><p><strong>Results: </strong>The mean age of patients was 57.5 years (range, 22-78 years). Complete retinal reattachment was achieved in three eyes, while partial or total chronic retinal detachment persisted in seven eyes. Wide-angle fundus fluorescein angiography revealed peripheral retinal capillary obstruction and severe nonperfusion. Neovascular glaucoma developed 213.4 months (range, 17-634 months) after retinal detachment. Three eyes received Ahmed valve implantation, while five eyes received intravitreal bevacizumab injection. Intraocular pressure was controlled in 10 eyes. Two eyes developed phthisis bulbi during follow-up.</p><p><strong>Conclusions: </strong>In eyes with a chronic retinal detachment history, iris neovascularization and neovascular glaucoma can develop due to retinal capillary obstruction and chronic retinal ischemia, even after achieving retinal reattachment. We suggest regular follow-up examinations for patients with chronic retinal detachment, particularly for eyes with retinal nonperfusion, as detected on fundus fluorescein angiography.</p>","PeriodicalId":17883,"journal":{"name":"Korean Journal of Ophthalmology : KJO","volume":"37 3","pages":"224-229"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fc/96/kjo-2022-0066.PMC10270770.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9696573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Corneal Epithelial Wound Healing between Topical RCI001, Solcoseryl, and Polydeoxyribonucleotide in the Murine Ocular Alkali Burn Model.","authors":"Myung-Sun Song,&nbsp;Young Ah Ku,&nbsp;Seunghoon Kim,&nbsp;Myung Hee Chung,&nbsp;Yong Ho Kim,&nbsp;Dong Hyun Kim","doi":"10.3341/kjo.2023.0019","DOIUrl":"https://doi.org/10.3341/kjo.2023.0019","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the corneal epithelial wound healing effects of RCI001, Solcoseryl, and polydeoxyribonucleotide (PDRN) in a rat alkali burn model.</p><p><strong>Methods: </strong>In 40 male Sprague-Dawley rats, we induced alkali burn using filter paper soaked in 0.2N sodium hydroxide. The rats were then treated with topical 0.5% RCI001, 1.0% RCI001, Solcoseryl, or PDRN twice a day for 2 weeks. Corneal epithelial integrity and epithelial healing rate were measured at day 0, 3, 5, 7, 10, and 14. Histologic and immunohistochemistry findings were also assessed.</p><p><strong>Results: </strong>Both the 0.5% and 1.0% RCI001 groups showed significantly more epithelial healing compared to the control group at day 5, 7, 10, and 14 (each p < 0.05). No statistical difference was found between the 0.5% and 1.0% RCI001 groups. Neither the Solcoseryl nor the PDRN groups showed a significant difference from the control. RCI001 treatment resulted in significantly reduced stromal edema, and a trend towards less inflammatory cell infiltration.</p><p><strong>Conclusions: </strong>Topical application of RCI001 showed enhanced corneal epithelial wound healing in the murine corneal alkali burn model, presumably by suppressing inflammation. Meanwhile, Solcoseryl and PDRN did not show sufficient therapeutic effects compared to RCI001.</p>","PeriodicalId":17883,"journal":{"name":"Korean Journal of Ophthalmology : KJO","volume":"37 3","pages":"236-244"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b3/ff/kjo-2023-0019.PMC10270771.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9643489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Each Eye According to the Order of Noninvasive Keratographic Tear Film Evaluation.","authors":"Haeeun Shin,&nbsp;Soyeon Jung,&nbsp;Ji Won Jung","doi":"10.3341/kjo.2022.0135","DOIUrl":"https://doi.org/10.3341/kjo.2022.0135","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the effect of order of examination on the results of noninvasive keratograph tear film evaluation using Keratograph5M in dry eye patients.</p><p><strong>Methods: </strong>One hundred and four patients with dry eye symptoms were analyzed retrospectively. All patients underwent bilateral noninvasive tear film evaluation using measurements of tear meniscus height (TMH) and noninvasive keratograph break-up time (NIKBUT) obtained using Keratograph5M. Measurements were performed sequentially in the order of right TMH, left TMH, right NIKBUT, and left NIKBUT.</p><p><strong>Results: </strong>There was no statistically significant difference in TMH values between the right and left eyes (0.24 ± 0.08 and 0.23 ± 0.08 mm, respectively). Mean NIKBUT-first (time at first tear film break-up) and mean NIKBUT-average (the mean of all tear film break-up time over the entire cornea) were 6.17 ± 3.28 and 10.00 ± 3.97 seconds, respectively, for right, and 7.43 ± 3.86 and 11.57 ± 4.34 seconds, respectively, for left eyes. In addition, mean NIKBUT-first between right and left eyes, and mean NIKBUT-average between them were statistically significant (p = 0.013 and p = 0.007, respectively). Mean NIKBUT and mean TMH differences were not significantly influenced by right or left eyes, age, or sex (all p > 0.050). Spearman correlation analyses of TMH, NIKBUT-first, and NIKBUT-average results showed moderate positive correlations between right and left eyes (r = 0.470, r = 0.322, and r = 0.576, respectively; p < 0.001).</p><p><strong>Conclusions: </strong>TMH evaluation was not affected by test order; however, NIKBUT measurement was affected by test order, because of reflex tearing due to forced eye opening during the examination. Therefore, TMH should be evaluated before NIKBUT, and sufficient time interval and caution should be needed between NIKBUT measurements on both eyes.</p>","PeriodicalId":17883,"journal":{"name":"Korean Journal of Ophthalmology : KJO","volume":"37 3","pages":"230-235"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3f/e1/kjo-2022-0135.PMC10270773.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9643486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tractional Retinal Detachment in Eyes with Vitreous Hemorrhage and Proliferative Diabetic Retinopathy and Posterior Vitreous Detachment in Fellow Eye.","authors":"Chan Woong Joo,&nbsp;Yerim An,&nbsp;Yong-Kyu Kim,&nbsp;Yong Dae Kim,&nbsp;Sung Pyo Park,&nbsp;Kyoung Lae Kim","doi":"10.3341/kjo.2022.0161","DOIUrl":"https://doi.org/10.3341/kjo.2022.0161","url":null,"abstract":"<p><strong>Purpose: </strong>To predict the presence of tractional retinal detachment (TRD) in eyes with dense vitreous hemorrhage (VH) and proliferative diabetic retinopathy (PDR) by evaluating the status of posterior vitreous detachment (PVD) in fellow eyes using optical coherence tomography (OCT).</p><p><strong>Methods: </strong>A total of 44 eyes from 22 patients who underwent vitrectomy due to dense VH with PDR were enrolled. Using OCT, the PVD status in the fellow eye was divided into two groups (incomplete and complete PVD). The incomplete PVD group included eyes without PVD and eyes with partial PVD. B-scan ultrasonography was performed on eyes with dense VH to evaluate the presence of TRD. Both OCT and B-scan images were reviewed by four ophthalmologists (two novices and two experienced), and the interobserver agreement was evaluated.</p><p><strong>Results: </strong>There was a difference in the interobserver agreement regarding the presence of TRD in eyes with dense VH evaluated by B scan between novice and experienced ophthalmologists (novice, κ = 0.421 vs. experienced, κ = 0.814), although there was no difference between novice and experienced ophthalmologists in the interobserver agreement regarding the status of PVD in the fellow eye evaluated by OCT (novice, κ = 1.000 vs. experienced, κ = 1.000). All observed TRD during vitrectomy occurred in eyes with incomplete PVD in the fellow eye. Logistic regression analysis revealed a statistically significant relation between TRD and the age of the patient (odds ratio [OR], 0.874; p = 0.047), and between TRD and incomplete PVD in the fellow eye evaluated by OCT (OR, 13.904; p = 0.042).</p><p><strong>Conclusions: </strong>Evaluation of the PVD status in the fellow eye using OCT may be a useful predictor for detecting the presence of TRD in eyes with dense VH and PDR.</p>","PeriodicalId":17883,"journal":{"name":"Korean Journal of Ophthalmology : KJO","volume":"37 3","pages":"207-215"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/dd/0c/kjo-2022-0161.PMC10270780.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9640276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kimura Disease with Lacrimal Sac and Nasolacrimal Duct Involvement: A Case Report.","authors":"Hyeong Ju Byeon,&nbsp;JaeSang Ko,&nbsp;Jun Yong Kim,&nbsp;Jin Sook Yoon","doi":"10.3341/kjo.2023.0013","DOIUrl":"https://doi.org/10.3341/kjo.2023.0013","url":null,"abstract":"Dear Editor, Kimura disease (KD) is a rare allergic or autoimmune chronic inflammatory disease of the soft tissue in the head and neck region. Painless subcutaneous masses are presented in the salivary glands, lymph nodes, or deep subcutaneous tissue, which frequently occur in young Asian men. The periocular invasion has been reported in orbit, lacrimal gland, and medial canthus [1,2]. However, the invasion of the nasolacrimal duct along the inside of the lacrimal sac has not been reported. Compared to the angiolymphoid hyperplasia with eosinophilia (ALHE), KD extends to deeper tissue, and when the lacrimal sac or nasolacrimal duct is invaded, epiphora can be the main symptom. Furthermore, in a fibroinf lammatory disease spectrum, immunoglobulin G4-related disease (IgG4-RD) should be differentially diagnosed. Herein, we report a case of KD with lacrimal sac and nasolacrimal duct involvement, along with the differential diagnosis process. Informed consent for publication of the research details and clinical photographs was obtained from the patient. A 64-year-old man presented with enlarged swelling of both his inner canthus accompanied by bilateral tearing for ten months (Fig. 1A). He had no history of surgery or trauma at the periorbital area and only had a medical history of hypertension and hypertensive chronic renal failure. On physical examination, a hard palpable mass at the medial canthus and tear trough area was noted in both eyes, and the lymph nodes behind the ear were palpated. Orbital magnetic resonance image revealed T1-weighted contrast-enhanced soft tissues not only in both medial canthi but also in the lacrimal sac and along nasolacrimal ducts (Fig. 1C, 1D). He underwent an incisional biopsy on the mass at his left medial canthus. In histopathological examination, lymphoid follicles with germinal centers and eosinophilic abscess were formed in the stromal fibrosis, and abundant eosinophils and IgG4 plasma cells were infiltrated (Fig. 1E–1H). Blood samples showed eosinophilia (15.6%; normal range, 0%–7%), elevation in serum IgE level (>5,000 IU/mL; normal range, 0–100 IU/mL), and normal range of serum IgG quantitation (1,253 mg/dL; normal range, 700–1,600 mg/dL) and IgG4 concentrations (1,120 mg/L; normal range, 30–2,010 mg/L). Based on the patient’s clinical features, histological examination, and blood tests, the patient was diagnosed with KD. After the patient was administered 30 mg of prednisolone for a week, the symptoms improved (Fig. 1B), and the steroid was tapered out. The patient in the present report had KD invasion in the lacrimal sac and nasolacrimal duct as well as medial canthus, causing epiphora and palpable masses. For a differential diagnosis with ALHE and IgG4-RD, the location of occurrence, clinical features, histopathology, and serology should be comprehensively considered. Unlike ALHE, which is a benign vascular proliferative tumor manifested as more superficial hemangiomatous papules or nodules on Received: F","PeriodicalId":17883,"journal":{"name":"Korean Journal of Ophthalmology : KJO","volume":"37 3","pages":"281-283"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/75/c2/kjo-2023-0013.PMC10270775.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10017445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Head Postural Changes in a Child with the Dominant Eye Affected by Superior Oblique Palsy: A Case Report.","authors":"Taekyoung Woo,&nbsp;Seung Ah Chung","doi":"10.3341/kjo.2022.0143","DOIUrl":"https://doi.org/10.3341/kjo.2022.0143","url":null,"abstract":"Dear Editor, Patients suffering superior oblique (SO) palsy usually adopt a head tilt contralateral to the affected eye to reduce the hypertropia. However, a paradoxical head tilt ipsilateral to the affected eye is seen in up to 3.4% of patients with SO palsy [1,2]. It is thought that patients with a paradoxical head tilt may prefer increasing image separation or using suppression to maintaining unstable binocular single vision [1–4]. Herein we reported a child with left SO palsy who changed the directions of head tilt when amblyopia developed in the right eye. Written informed consent for publication of the research details and clinical images was obtained from the patient's parents. To the best of our knowledge, this is the first report that found the moment developing a paradoxical head tilt in the unilateral SO palsy. A 4-year-old boy without any trauma or medical history was referred for abnormal head posture. He was born full term with no perinatal history. He previously had a persistent head tilt to the right as shown in video taken at home and whole spine x-ray at the age of 3 years (Fig. 1A, 1B), while there were no abnormal musculoskeletal findings. However, he demonstrated a left head tilt of 15° at the presentation, which was eliminated by patching on the left eye (Fig. 1C, 1D). His best-corrected visual acuity was 20 / 50 in the right eye and 20 / 32 in the left eye with mild hyperopic astigmatism correction (+0.75 +1.25 × 90 for the right eye and +0.50 +0.75 × 90 for the left eye). In primary position, he had a left hypertropia of 6 prism diopters (PD), worsening in the right gaze and on the left head tilt. Versions were consistent with a left SO palsy. Fundus examination showed 8° extorsion in the right eye instead of the left eye, indicating that he preferred the left eye fixation (Fig. 1E, 1F). He started the amblyopia treatment with patching on the left eye. On the patching treatment, he showed a right face turn (Fig. 1G). However, he still showed a left paradoxical head tilt at the age of 5 years when achieving 20 / 20 in both eyes (Fig. 1H). During the 2 years follow-up, he had a left hypertropia of 6 to 8 PD in primary position, that measured 16 PD in the right gaze and orthotropic in the left gaze. The left hypertropia was 10 to 12 PD on the left head tilt and orthotropic on the right head tilt. Ocular motility of the left eye demonstrated +2 overelevation in adduction with –2 underdepression in adduction (Fig. 1I). Worth 4-dot testing revealed a right suppression at 5 m and on the left head tilt while a binocular fusion at 1/3 m. The coronal image of the orbit computed tomography showed symmetric SO muscles in both eyes. He underwent a left inferior oblique myectomy. Intraoperatively, the exaggerated forced ductions testing did not show laxity of the left SO tendon. A month after surgery, he showed improvement in the head position (Fig. 1J). Three months after surgery, he exhibited a mild left head tilt (<5°) with recurrenc","PeriodicalId":17883,"journal":{"name":"Korean Journal of Ophthalmology : KJO","volume":"37 3","pages":"278-280"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a7/7b/kjo-2022-0143.PMC10270776.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10000167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Fractal Dimension of Peripapillary Vasculature in Primary Open-Angle Glaucoma.","authors":"Chae Hyun Song,&nbsp;Seok Hwan Kim,&nbsp;Kyoung Min Lee","doi":"10.3341/kjo.2022.0089.e1","DOIUrl":"https://doi.org/10.3341/kjo.2022.0089.e1","url":null,"abstract":"","PeriodicalId":17883,"journal":{"name":"Korean Journal of Ophthalmology : KJO","volume":"37 2","pages":"200"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/63/bb/kjo-2022-0089-e1.PMC10151171.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9403339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Voretigene Neparvovec for the Treatment of RPE65-associated Retinal Dystrophy: Consensus and Recommendations from the Korea RPE65-IRD Consensus Paper Committee.","authors":"Jinu Han, Kwangsic Joo, Ungsoo Samuel Kim, Se Joon Woo, Eun Kyoung Lee, Joo Yong Lee, Tae Kwann Park, Sang Jin Kim, Suk Ho Byeon","doi":"10.3341/kjo.2023.0008","DOIUrl":"10.3341/kjo.2023.0008","url":null,"abstract":"<p><p>Mutations in the RPE65 gene, associated with Leber congenital amaurosis, early-onset severe retinal dystrophy, and retinitis pigmentosa, gained growing attention since gene therapy for patients with RPE65-associated retinal dystrophy is available in clinical practice. RPE65 gene accounts for a very small proportion of patients with inherited retinal degeneration, especially Asian patients. Because RPE65-associated retinal dystrophy shares common clinical characteristics, such as early-onset severe nyctalopia, nystagmus, low vision, and progressive visual field constriction, with retinitis pigmentosa by other genetic mutations, appropriate genetic testing is essential to make a correct diagnosis. Also, fundus abnormalities can be minimal in early childhood, and the phenotype is highly variable depending on the type of mutations in RPE65-associated retinal dystrophy, which makes a diagnostic difficulty. The aim of this paper is to review the epidemiology of RPE65-associated retinal dystrophy, mutation spectrum, genetic diagnosis, clinical characteristics, and voretigene neparvovec, a gene therapy product for the treatment of RPE65-related retinal dystrophy.</p>","PeriodicalId":17883,"journal":{"name":"Korean Journal of Ophthalmology : KJO","volume":"37 2","pages":"166-186"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/07/b5/kjo-2023-0008.PMC10151174.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9750775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Atypical Presentation of Optic Disc Melanocytoma: A Case Report.","authors":"Rosa L Pinheiro,&nbsp;Rui B Proença,&nbsp;Maria Cristina F Fonseca","doi":"10.3341/kjo.2022.0153","DOIUrl":"https://doi.org/10.3341/kjo.2022.0153","url":null,"abstract":"Dear Editor, Optic disc melanocytoma is a unilateral benign tumor of the optic disc. Usually, the optic disc melanocytoma is asymptomatic and remains a stable flat dark pigmented juxtapapillary lesion throughout the patient’s life, and local complications, such as choroidal neovascularization (CNV), have been reported in less than 1% of the cases [1,2]. We describe a case report of a patient with an atypical presentation of an optic disc melanocytoma associated with CNV in which differential diagnosis of a malignant lesion was crucial to avoid unnecessary diagnostic or therapeutic procedures, such as radiotherapy. Informed consent for publication of the research details and clinical images was obtained from the patient. A healthy young man presented with progressive visual loss in the right eye (OD) over 2 months. Visual acuity (VA) was counting fingers in his OD and 20 / 20 in his left eye. Slit-lamp biomicroscopy findings and intraocular pressure were unremarkable bilaterally. Dilated fundoscopy of the OD revealed a peripapillary dark pigmented lesion surrounded by a halo of retinal atrophy, with a slightly elevated nodular portion, near the temporal border (Fig. 1A). There was also a macular edema and two subretinal hemorrhages located inferiorly to the macula. Optical coherence tomography (OCT) of the OD revealed distortion and elevation of the retinal layers towards the nasal macula, as well as an ill-defined subretinal lesion with heterogeneous internal ref lectivity near the optic disc and subretinal f luid (Fig. 1B, 1C). Ultrasonography showed a peripapillary elevated hyperechogenic lesion with a largest basal diameter of 3.18 mm and a thickness of 1.85 mm associated with shallow subretinal fluid (Fig. 1D, 1E). Differential diagnosis of the peripapillary lesion included optic disc melanocytoma with secondary CNV, choroidal melanoma, choroidal nevus, congenital hypertrophy of the retinal pigmented epithelium (CHRPE), and combined hamartoma of retina and retinal pigmented epithelium (RPE). Fine-needle biopsy is seldom necessary to distinguish between benign and malignant tumors, because ultrasound features and clinical examination yield high diagnostic accuracy. The presence of symptoms, subretinal fluid and proximity to the optic nerve are all risk factors predictive of choroidal nevus growth of and transformation into a choroidal melanoma, according to the Collaborative Ocular Melanoma Study (COMS) [3]. However, ultrasound features such as thickness <2 mm and base <5 mm (also according to the COMS), high internal reflectivity, and lack of acoustic hollowness (characteristic of melanoma), along with the juxtapapillary location and patient’s age, suggested a benign pigmented lesion. A combined hamartoma of the retina and RPE was excluded, because combined hamartomas are restricted to the retinal layers and combined hamartomas are usually nonpigmented lesions. On fundoscopy, the lesion could resemble peripapillary CHRPE, except for the lack ","PeriodicalId":17883,"journal":{"name":"Korean Journal of Ophthalmology : KJO","volume":"37 2","pages":"192-194"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fa/2e/kjo-2022-0153.PMC10151173.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9401654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Optical Coherence Tomography Biomarkers between Bevacizumab Good Responders and Nonresponders Who were Switched to Dexamethasone Implant in Diabetic Macular Edema.","authors":"Jeong Hyun Lee,&nbsp;Joo Young Shin,&nbsp;Jeeyun Ahn","doi":"10.3341/kjo.2022.0109","DOIUrl":"https://doi.org/10.3341/kjo.2022.0109","url":null,"abstract":"<p><strong>Purpose: </strong>To compare volumetric optical coherence tomography (OCT) biomarkers in bevacizumab responsive and bevacizumab refractory diabetic macular edema (DME) patients switched to the dexamethasone implant to ultimately identify possible prognostic indicators.</p><p><strong>Methods: </strong>Retrospective analysis of DME patients treated with bevacizumab were done. Patients were divided into those who showed response to bevacizumab (bevacizumab only group) and others who were switched to the dexamethasone implant due to lack of response to bevacizumab (switching group). Volumetric OCT biomarkers such as central macular thickness (CMT), inner and outer cystoid macular edema (CME) volume, serous retinal detachment (SRD) volume, retinal volume (CME + SRD volume) within the 6-mm Early Treatment of Diabetic Retinopathy Study circle were calculated. OCT biomarkers were followed up throughout treatment.</p><p><strong>Results: </strong>Among total of 144 eyes, 113 patients were included in the bevacizumab only group and 31 patients were included in the switching group. Compared to the bevacizumab only group, the switching group showed higher baseline CMT (558.00 ± 209.60 µm vs. 454.96 ± 125.88 µm, p = 0.003), larger inner CME (6.02 ± 1.43 mm3 vs. 5.12 ± 0.87 mm3, p = 0.004) and SRD volume (0.32 ± 0.40 mm3 vs. 0.11 ± 0.09 mm3, p = 0.015) and higher proportion of patients with SRD (58.06% vs. 31.86%, p = 0.008). In the switching group, CMT, inner CME and SRD volume all showed significant reduction after switching to the dexamethasone implant.</p><p><strong>Conclusions: </strong>DME with large SRD and inner nuclear layer edema volume may be more effectively treated with the dexamethasone implant than bevacizumab.</p>","PeriodicalId":17883,"journal":{"name":"Korean Journal of Ophthalmology : KJO","volume":"37 2","pages":"137-146"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8d/12/kjo-2022-0109.PMC10151166.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9766824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}