Korean Journal of Ophthalmology : KJO最新文献

{"title":"Letter to the Editor: Comments on \"Acute Partial Oculomotor Nerve Palsy and Optic Neuritis Preceding Juvenile Idiopathic Arthritis: A Case Report\".","authors":"Su Min Kim, Jae Ho Jung, Seung Ah Chung","doi":"10.3341/kjo.2022.0130","DOIUrl":"https://doi.org/10.3341/kjo.2022.0130","url":null,"abstract":"","PeriodicalId":17883,"journal":{"name":"Korean Journal of Ophthalmology : KJO","volume":"37 1","pages":"93-94"},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/be/99/kjo-2022-0130.PMC9935060.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9156515","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":"Peripheral Defocus and Myopia Management: A Mini-Review.","authors":"Nir Erdinest,&nbsp;Naomi London,&nbsp;Itay Lavy,&nbsp;David Berkow,&nbsp;David Landau,&nbsp;Yair Morad,&nbsp;Nadav Levinger","doi":"10.3341/kjo.2022.0125","DOIUrl":"https://doi.org/10.3341/kjo.2022.0125","url":null,"abstract":"<p><p>Myopia is the most common refractive error in the world, and its' prevalence continually increases. The potential pathological and visual complications of progressive myopia have inspired researchers to study the sources of myopia, axial elongation, and explore modalities to arrest progression. Considerable attention has been given over the past few years to the myopia risk factor known as hyperopic peripheral blur, the focus of this review. The primary theories currently believed to be the cause of myopia, the parameters considered to contribute and influence the effect of peripheral blur, such as the surface retinal area or depth of blur will be discussed. The currently available optical devices designed to provide peripheral myopic defocus will be discussed, including bifocal and progressive addition ophthalmic lenses, peripheral defocus single vision ophthalmic lenses, orthokeratology lenses, and bifocal or multifocal center distance soft lenses, as well as their effectivity as mentioned in the literature to date.</p>","PeriodicalId":17883,"journal":{"name":"Korean Journal of Ophthalmology : KJO","volume":"37 1","pages":"70-81"},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6e/5e/kjo-2022-0125.PMC9935061.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9164692","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":"Analyses of Foveal Avascular Zone in Patients with General Blunt Ocular Trauma Using Optical Coherence Tomography Angiography.","authors":"Li Lyung Wang,&nbsp;Do Gyun Kim,&nbsp;Ji-Won Kwon,&nbsp;Ju-Yeun Lee","doi":"10.3341/kjo.2022.0081","DOIUrl":"https://doi.org/10.3341/kjo.2022.0081","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the effect of blunt ocular trauma (BOT) on foveal circulation, and in particular the foveal avascular zone (FAZ), using optical coherence tomography angiography (OCTA).</p><p><strong>Methods: </strong>This retrospective study consisted of 96 eyes (48 traumatized eyes and 48 nontraumatized eyes) from 48 subjects with BOT. We analyzed the FAZ area of deep capillary plexus (DCP) and superficial capillary plexus (SCP) immediately after BOT and at 2 weeks after BOT. We also evaluated the FAZ area of DCP and SCP in patients with and without blowout fracture (BOF).</p><p><strong>Results: </strong>There were no significant differences in FAZ area between traumatized and nontraumatized eyes at DCP and SCP in the initial test. In traumatized eyes, the FAZ area at SCP was significantly reduced on follow-up when compared to initial test (p = 0.01). In case of eyes with BOF, there was no significant differences in FAZ area between traumatized and nontraumatized eyes at DCP and SCP on initial test. No significant difference of FAZ area was found on follow-up relative to the initial test, whether in the DCP or SCP. In case of eyes without BOF, there was no significant differences of FAZ area between traumatized and nontraumatized eyes at DCP and SCP in initial test. Also, no significant difference of FAZ area at DCP was found on follow-up test compared to initial test. However, the FAZ area at SCP was significantly reduced in follow-up test compared with that in the initial test (p = 0.04).</p><p><strong>Conclusions: </strong>Temporary microvascular ischemia occurs in the SCP of patients after BOT. Patients should be warned of transient ischemic changes that may occur after trauma. OCTA can provide useful information regarding the subacute changes in the FAZ at SCP after BOT, even without evident findings of structural damage on fundus examination.</p>","PeriodicalId":17883,"journal":{"name":"Korean Journal of Ophthalmology : KJO","volume":"37 1","pages":"62-69"},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6d/bf/kjo-2022-0081.PMC9935071.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9164690","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":"Changes of Optical Coherence Tomography Parameters after Cataract Surgery in Primary Open-Angle Glaucoma Eyes.","authors":"SoHyeon Kim,&nbsp;Youn Hye Jo","doi":"10.3341/kjo.2022.0102","DOIUrl":"https://doi.org/10.3341/kjo.2022.0102","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the impact of uncomplicated cataract surgery on the measurement of Bruch's membrane opening-minimum rim width (BMO-MRW) and retinal nerve fiber layer thickness (RNFLT) using spectral domain optical coherence tomography (SD-OCT) in primary open-angle glaucoma (POAG) patients.</p><p><strong>Methods: </strong>This retrospective study included 63 eyes of 63 patients, including 32 POAG eyes and 31 normal eyes who underwent uneventful cataract surgery and follow-up for at least 6 months. Using SD-OCT, BMO-MRW and RNFLT were measured preoperatively and postoperatively at 6 months. Paired t-test was used to compare intraocular pressure (IOP), BMO-MRW, RNFLT, and image quality before and after surgery. These parameters and their changes were compared between POAG and normal groups. Univariate and multivariate linear regression analyses were performed to determine the factors associated with the postoperative change (Δ) in RNFLT and BMO-MRW.</p><p><strong>Results: </strong>BMO-MRW and RNFLT were significantly increased and IOP was decreased after phacoemulsification in both groups (p < 0.001, respectively). The ΔRNFLT was significantly greater in POAG eyes compared with the normal eyes (p < 0.001). The ΔRNFLT was associated with the postoperative IOP reduction and glaucoma diagnosis (p < 0.001 and p = 0.001, respectively). In the normal group, only the ΔIOP had a significant influence on the ΔRNFLT (p = 0.003), but in the POAG group, not only the ΔIOP (p = 0.044) but also preoperative visual field mean deviation (p = 0.029) showed a significant influence. The ΔBMO-MRW showed no difference between POAG and normal eyes.</p><p><strong>Conclusions: </strong>The postoperative increase of RNFLT was significantly greater in the POAG group, and the postoperative increase of RNFLT was associated with the preoperative visual field mean deviation and ΔIOP in POAG eyes and with the ΔIOP in normal eyes. Our results imply that RNFLT is more affected than BMO-MRW in POAG eyes compared to normal eyes by cataract surgery.</p>","PeriodicalId":17883,"journal":{"name":"Korean Journal of Ophthalmology : KJO","volume":"37 1","pages":"1-11"},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/26/b5/kjo-2022-0102.PMC9935070.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9216699","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":"Corneal Graft Rejection after Vaccination against COVID-19: A Case Report.","authors":"Ji Min Park,&nbsp;Jee Hye Lee,&nbsp;Je Hyung Hwang,&nbsp;Min-Ji Kang","doi":"10.3341/kjo.2022.0105","DOIUrl":"https://doi.org/10.3341/kjo.2022.0105","url":null,"abstract":"Dear Editor, Several SARS-CoV-2 vaccines, including messenger RNA vaccines (BNT162b2, Pfizer-BioNTech) and adenovirus vector vaccines (ChAdOX1 nCov-19, AstraZeneca), have been approved for use worldwide. However, ocular side effects have rarely been reported. Herein, we report the case of corneal graft rejection after ChAdOX1 vaccination. The patient provided written informed consent for publication of the research details and clinical images. A 64-year-old male patient had a history (2000 and 2017) of undergoing penetrating keratoplasty (PKP) for corneal opacity in his right and left eyes, respectively. In 2019, another PKP had been performed in his left eye due to graft rejection, which reoccurred 3 months after. Therefore, in 2020, he underwent Descemet stripping automated endothelial keratoplasty (DSAEK) and maintained a clear grafted cornea for 1 year (Fig. 1A). In May 2021, he received the first dose of the ChAdOx1 vaccine. After 3 hours, he experienced a pressing sensation in the left eye; 2 days later, he experienced blurred vision. At presentation, the uncorrected visual acuity was 20 / 50 and the intraocular pressure was 13 mmHg, unchanged compared with 6 months ago. Slit-lamp examination revealed slight conjunctival injection with mild corneal edema. Fine keratic precipitates were found in the central cornea, and a trace anterior chamber reaction was observed (Fig. 1B, 1C). Central corneal thickness had increased from 563 to 615 μm. The number of corneal endothelial cells and their degree of hexagonality decreased (Fig. 1D, 1E). The patient was diagnosed with graft rejection and treated with hourly administration of topical and systemic steroid. Three days later, the symptoms and signs of inflammation resolved, and central corneal thickness decreased to 537 μm. Steroid doses were tapered gradually, and there were no inflammation signs at the 3-month follow-up. However, the corneal endothelial cell count remained lower than on the previous specular microscopy before the rejection (Fig. 1F). No additional signs of graft rejection were observed after received a second dose. This is the f irst case report of graft rejection after SARS-CoV-2 vaccination in South Korea. There have been three reports of graft rejection in patients after BNT162b2 vaccination. Phylactou et al. [1] reported two cases of graft rejection after BNT162b2 vaccination in patients who underwent Descemet’s membrane endothelial keratoplasty. The rejection occurred a week after the first dose in one case and 3 weeks after the second dose in the other. Wasser et al. [2] reported two cases of graft rejection 2 weeks after the f irst dose in patients who had undergone a PKP. Abousy et al. [3] reported one case of bilateral graft rejection 4 days after receiving the second dose in a patient who underwent DSAEK. In this case, the patient received the ChAdOx1 vaccine, which uses a chimpanzee adenovirus that carries the SARS-CoV-2 spike protein. Although the exact mechanism unde","PeriodicalId":17883,"journal":{"name":"Korean Journal of Ophthalmology : KJO","volume":"37 1","pages":"85-87"},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1d/ab/kjo-2022-0105.PMC9935065.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9216701","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":"Filtering Bleb Size in the Early Postoperative Period Affects the Long-term Surgical Outcome after Trabeculectomy.","authors":"Yoon Kyung Jang,&nbsp;Eui Jun Choi,&nbsp;Dong Ook Son,&nbsp;Byung Heon Ahn,&nbsp;Jong Chul Han","doi":"10.3341/kjo.2022.0082","DOIUrl":"https://doi.org/10.3341/kjo.2022.0082","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate whether postoperative filtering bleb size affects the surgical outcome after trabeculectomy.</p><p><strong>Methods: </strong>In this study, we retrospectively reviewed 145 medically uncontrolled glaucoma patients with intraocular pressure (IOP) values >21 mmHg before surgery and data from ≥2 years of follow-up. Postoperative IOP, filtering bleb size including extent and height, and other clinical factors were measured after trabeculectomy. We divided bleb extent into quadrants and bleb height by 0.5 intervals of corneal thickness. The main outcome measure was surgical success. We confirmed complete success when the IOP was ≤21 mmHg and decreased by >20% from baseline without medication or additional procedures. Qualified success used the same criteria but allowed for medication or additional procedures. Cases with reoperation or two consecutive IOP measurements <6 mmHg were considered failures.</p><p><strong>Results: </strong>A total of 145 eyes of 145 patients was included. The average observation period was 30.8 ± 10.9 months. During multivariate Cox regression analysis, a larger extent of filtering bleb revealed significantly low hazard ratios in both complete and surgical success (0.509 and 0.494, respectively); however, there was no significant relationship between bleb height and surgical outcome.</p><p><strong>Conclusions: </strong>The extent of the filtering bleb was associated with surgical outcomes of trabeculectomy in glaucoma patients.</p>","PeriodicalId":17883,"journal":{"name":"Korean Journal of Ophthalmology : KJO","volume":"37 1","pages":"53-61"},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f7/97/kjo-2022-0082.PMC9935064.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9667027","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":"Long-term Effects of Uncomplicated Traumatic Hyphema on Corneal and Lenticular Clarity.","authors":"Ali Keles,&nbsp;Pinar Kosekahya,&nbsp;Furkan Emre Sogut,&nbsp;Mustafa Salih Karatepe","doi":"10.3341/kjo.2022.0098","DOIUrl":"https://doi.org/10.3341/kjo.2022.0098","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the long-term effects of uncomplicated traumatic hyphema on endothelial morphology, anterior segment structure, and corneal and lenticular densitometry.</p><p><strong>Methods: </strong>In this retrospective comparative study, eyes with a history of uncomplicated traumatic hyphema were compared with the healthy contralateral unaffected eyes. The corneal endothelial cell properties were captured using specular microscopy. Anterior segment analysis, corneal densitometry (12-mm corneal diameter), and lens densitometry measurements were performed using the Pentacam imaging system.</p><p><strong>Results: </strong>Measurements were obtained at a mean follow-up of 49.5 ± 15.8 months after injury. The average endothelial cell density was significantly lower in the study group than in the control group (2,506.6 ± 294.0 cells/mm² vs. 2,665.7 ± 195.0 cells/mm², p = 0.020). There was no difference between the groups in respect of polymegathism and pleomorphism (p = 0.061 and p = 0.558, respectively). All the investigated corneal tomographic and angle parameters were similar in both groups (all p > 0.05). The corneal densitometry values in all concentric zones and layers showed no statistically significant difference between the groups (p > 0.05 for all). The lens zone 1 densitometry value was significantly higher in the study group than in the control group (9.6% ± 1.1% vs. 8.9% ± 1.2%, p = 0.031). No difference was observed in zone 2 and 3 (p = 0.170 and p = 0.322, respectively). The degree of hyphema was not correlated with endothelial cell and lenticular clarity loss (p = 0.087 and p = 0.294, respectively).</p><p><strong>Conclusions: </strong>Even if traumatic hyphema is not complicated, long-term outcomes indicate endothelial cell loss and increased lenticular density.</p>","PeriodicalId":17883,"journal":{"name":"Korean Journal of Ophthalmology : KJO","volume":"36 6","pages":"501-508"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f4/7b/kjo-2022-0098.PMC9745343.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10397358","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":"Clinical and Genetic Characteristics of Retinal Capillary Hemangioblastoma in Korean Patients.","authors":"Sang Ha Lee,&nbsp;Kyu Hyung Park,&nbsp;Se Joon Woo,&nbsp;Sang Jun Park,&nbsp;Kwangsic Joo","doi":"10.3341/kjo.2022.0079","DOIUrl":"https://doi.org/10.3341/kjo.2022.0079","url":null,"abstract":"<p><strong>Purpose: </strong>We investigated the clinical features of Korean patients with retinal capillary hemangioblastoma (RCH) and genetic variants of the von Hippel-Lindau (VHL) gene.</p><p><strong>Methods: </strong>A retrospective analysis was performed on patients with RCH from 2003 to 2021 at Seoul National University Bundang Hospital. Sporadic and hereditary RCH associated with VHL disease were classified based on the specific tumors and family history. Clinical features, including the location and number of RCH and bilateral involvement, were investigated. Multiplex ligation-dependent probe amplification and direct sequencing targeting the VHL gene were performed for six RCH cases associated with VHL disease.</p><p><strong>Results: </strong>A total of 18 patients (23 eyes) were enrolled in this study. The mean age at diagnosis was 37 ± 15 years. Twelve patients had hereditary RCH associated with VHL disease, and six patients had sporadic RCH. All five patients with bilateral RCH were clinically diagnosed with VHL disease, and 13 patients had unilateral RCH. Juxtapapillary RCH was only observed in patients with VHL. The most common complication of RCH was the epiretinal membrane, followed by the subretinal fluid. Pathogenic variants were identified in four patients. All three patients with type 1 VHL had the well-known missense mutation p.Glu70Lys, and one patient with type 2 VHL had the nonsense mutation p.Trp88Ter.</p><p><strong>Conclusions: </strong>In Korean patients with RCH, bilateral involvement and juxtapapillary RCH are highly likely to be associated with VHL disease. Because RCH may be the first clinical manifestation in patients with VHL, active genetic testing of the VHL gene and systemic evaluation are required.</p>","PeriodicalId":17883,"journal":{"name":"Korean Journal of Ophthalmology : KJO","volume":"36 6","pages":"543-549"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c6/b7/kjo-2022-0079.PMC9745345.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10397639","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":"Dacryoendoscopic Findings of Patients with Lacrimal Drainage Obstruction Associated with Cancer Treatment.","authors":"Yuri Kim,&nbsp;Helen Lew","doi":"10.3341/kjo.2022.0051","DOIUrl":"https://doi.org/10.3341/kjo.2022.0051","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the diagnosis and treatment outcome of lacrimal drainage obstruction of patients who underwent systemic chemotherapy (CTx) or radioactive iodine treatment (RAI) by using dacryoendoscopy and at the same time performing dacryoendoscopy-guided silicone tube insertion (STI) to treat epiphora.</p><p><strong>Methods: </strong>From July 2017 to December 2020, the medical records of 11 patients (16 eyes) were diagnosed with lacrimal drainage obstruction after CTx or RAI and underwent dacryoendoscopy-guided STI were reviewed retrospectively. We tried to count the number of obstructive sites in total patients using slit-lamp examination and dacryoendoscopic findings.</p><p><strong>Results: </strong>A total of 11 patients, 16 eyes, were enrolled in this study. The onset of epiphora in the CTx group (3.0 ± 4.0 months) was significantly shorter than that in the RAI group (52.6 ± 36.5 months, p = 0.001). There were total 32 obstructive sites including 28 obstructive sites of dacryoendoscopic findings and four sites of punctual stenosis in total 16 cases. Using dacryoendoscopy, granulation findings was dominant in RAI patients (p = 0.038) and mucus finding was frequent mostly in lacrimal sac and canaliculus. In the CTx group, mucosal edema finding was dominant (p = 0.038) and fibrotic membrane finding was frequent in all levels of lacrimal drainage system. Regarding the obstructive location, lacrimal sac was the most frequently obstructed site in the two groups (p = 0.038).</p><p><strong>Conclusions: </strong>The onset of epiphora in the CTx group was significantly earlier than in the RAI group. In the CTx group, mucosal edema finding was frequent in all levels of lacrimal drainage system. In the RAI group, granulation finding was frequent mostly in lacrimal sac and canaliculus. Since the clinical outcome was satisfactory, intervention with dacryoendoscopy-guided STI could be a treatment of choice in patients with epiphora after CTx or RAI.</p>","PeriodicalId":17883,"journal":{"name":"Korean Journal of Ophthalmology : KJO","volume":"36 6","pages":"509-517"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/83/7a/kjo-2022-0051.PMC9745344.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10397357","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":"Trabecular Microbypass Stent Insertion for Medically Uncontrolled Glaucoma in a Patient with Central Serous Chorioretinopathy: A Case Report.","authors":"Won Kyung Park,&nbsp;Chungkwon Yoo,&nbsp;Ji-Hye Park,&nbsp;Yong Yeon Kim","doi":"10.3341/kjo.2022.0123","DOIUrl":"https://doi.org/10.3341/kjo.2022.0123","url":null,"abstract":"Dear Editor, Filtering surgery is indicated for treatment of glaucoma when medication or laser treatment is not sufficient to lower intraocular pressure (IOP); however, the use of topical corticosteroid is mandatory in its postoperative period for modulation of wound healing process to minimize the risk of bleb failure [1]. Such postoperative steroid use may activate the development or progression of central serous chorioretinopathy (CSC) in eyes with or at risk of CSC [2-4]. In this regard, angle-targeted minimally invasive glaucoma surgery (MIGS) may be a better surgical option in glaucoma patients comorbid with CSC because of the shorter use of weaker steroids. Here we describe a case where in whom trabecular microbypass stents were inserted to treat medically uncontrolled glaucoma in an eye with CSC. Written informed consent was obtained from the patient. A 68-year-old male patient with bilateral open angle glaucoma was referred due to uncontrolled IOP of his right eye despite maximal medical treatment. He had been using Hypadil (nipradilol 0.25%; Kowa, Nagoya, Japan), Alphagan-P (brimonidine 0.15%; Allergan, Seoul, Korea) and Travatan (travoprost 0.004%; Alcon, Korea) for 3 years and intolerant to dorzolamide/timolol fixed combination eyedrops. He also had systemic hypertension, diabetes mellitus and dermatitis treated with oral corticosteroids. On initial examination, corrected visual acuity and IOP of his right eye was 20 / 25 and 25 mmHg, respectively. Fundoscopy revealed macular edema in the right eye. Optical coherence tomography (OCT) showed the subretinal f luid and enlarged choroid beneath the macula of the right eye (Fig. 1A). Fluorescein and indocyanine green angiography demonstrated a focal lesion with fluorescein leakage in the same location. Although glaucoma surgery deemed necessary for control of medically unresponsive IOP of his right eye, we were concerned about the postoperative use of corticosteroid and the possible postoperative exacerbation of CSC. Therefore, we followed him up 3 weeks after cessation of the oral corticosteroid. We also added systemic acetazolamide 250 mg three times a day to his antiglaucoma medications. Thereafter, the subretinal fluid decreased on OCT; however, IOP of the right eye was 22 mmHg. To minimize the amount and duration of postoperative steroid use, trabecular microbypass stent insertion was performed in his right eye. Briefly, under the topical anesthesia a 2.2-mm temporal corneal incision was created in the right eye. After intracameral injection of the Provisc (Sodium hyaluronate 10 mg/ mL; Alcon, Seoul, Korea), two iStents (Glaukos, San Clemente, CA, USA) were inserted into at the nasal iridocorneal angle under visualization using a Swan Jacob gonioprism lens (Fig. 1B). His IOP of the right eye was lowered to 11 mmHg at postoperative day 1 and has remained below 17 mmHg with use of two antiglaucoma medications for the next 12 months. Fluorometholone 0.02% (Santen, Osaka, Japan) eyedrop w","PeriodicalId":17883,"journal":{"name":"Korean Journal of Ophthalmology : KJO","volume":"36 6","pages":"572-574"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/66/2b/kjo-2022-0123.PMC9745338.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10388901","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}