Korean Journal of Ophthalmology : KJO最新文献

{"title":"Preoperative and Postoperative Factors Affecting Functional Success in Anatomically Successful Retinal Detachment Surgery.","authors":"Mehmet Eren Guner,&nbsp;Melis Kabaalioglu Guner,&nbsp;Zafer Cebeci,&nbsp;Nur Kır","doi":"10.3341/kjo.2022.0057","DOIUrl":"https://doi.org/10.3341/kjo.2022.0057","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate preoperative and postoperative factors affecting functional success in anatomically successful retinal detachment surgery.</p><p><strong>Methods: </strong>Seventy-five eyes of 75 patients with rhegmatogenous retinal detachment who underwent anatomically successful surgery from 2014 to 2019 with more than 1 year follow-up were included in the study. Demographic characteristics, ocular examination findings, preoperative and postoperative spectral domain optic coherence tomography images were retrospectively evaluated.</p><p><strong>Results: </strong>The mean age was 53.9 ± 17 years (range, 11-85 years). The mean follow-up period was 36.7 ± 16 months (range, 14-72 months). The mean best-corrected visual acuity of the patients before surgery was 1.35 ± 1.24 and at postoperative 12 months was 0.66 ± 0.5 logarithm of the minimum angle of resolution. Patients who were operated in 7 days of visual symptoms onset were found to have better visual acuity at the first and subsequent postoperative exams. Preoperative proliferative vitreoretinopathy, vitreous hemorrhage, and extent of retinal detachment were found to have a negative effect on functional success at 12 months. Regeneration of the outer retinal layers had a positive effect on visual acuity at 12 months but did not significantly increase visual acuity after 12 months. Multivariate analysis showed that preoperative external limiting membrane integrity was significantly associated with better functional outcomes.</p><p><strong>Conclusions: </strong>Early intervention, presence of preoperative external limiting membrane integrity, and restoration of postoperative outer retinal layers positively affected functional success. The presence of preoperative vitreous hemorrhage, preoperative proliferative vitreoretinopathy, and the extent of retinal detachment had a negative effect on prognosis at 12 months.</p>","PeriodicalId":17883,"journal":{"name":"Korean Journal of Ophthalmology : KJO","volume":"36 6","pages":"477-485"},"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/59/d9/kjo-2022-0057.PMC9745350.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10397359","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":"Different Number of Sessions of Intense Pulsed Light and Meibomian Gland Expression Combination Therapy for Meibomian Gland Dysfunction.","authors":"Seung Hyeun Lee,&nbsp;Minjeong Kim,&nbsp;Won Jun Lee,&nbsp;Yeoun Sook Chun,&nbsp;Kyoung Woo Kim","doi":"10.3341/kjo.2022.0068","DOIUrl":"https://doi.org/10.3341/kjo.2022.0068","url":null,"abstract":"<p><strong>Purpose: </strong>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).</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":17883,"journal":{"name":"Korean Journal of Ophthalmology : KJO","volume":"36 6","pages":"527-542"},"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/0a/12/kjo-2022-0068.PMC9745351.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10397638","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":"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","DOIUrl":"https://doi.org/10.3341/kjo.2022.0089","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the fractal dimensions of the peripapillary microvasculature as obtained by optical coherence tomography angiography (OCTA) between primary open-angle glaucoma (POAG) and controls.</p><p><strong>Methods: </strong>Optic nerve head and peripapillary area images were taken using the 20° × 20°-scan of Spectralis OCTA (Heidelberg Engineering) in 97 subjects (64 POAG patients, 33 control patients). The optic nerve head microvasculature was evaluated according to predefined slabs: the superficial vascular complex (SVC) and the avascular complex (AVC). The en face image of each slab was processed by ImageJ software (National Institutes of Health) in order to calculate the vessel density and the fractal dimension using the box-counting method. For comparison, the peripapillary retinal nerve fiber layer (RNFL) thickness was obtained from Spectralis OCT circle scans. The utilities of the parameters for discriminating between the POAG and control groups were assessed using areas under the receiver operating characteristic curves (AUCs).</p><p><strong>Results: </strong>The SVC fractal dimension was lower in the POAG than in the control group (p < 0.001), while AVC showed no intergroup difference (p = 0.563). The fractal dimension showed a good correlation with the vessel density in both SVC and AVC (both p < 0.001). In a multivariable regression analysis, the SVC fractal dimension was negatively correlated with age (p < 0.001) and axial length (p < 0.001) and positively correlated with average RNFL thickness (p < 0.001), while the AVC fractal dimension was positively correlated with the Bruch's membrane opening size (p = 0.013). In terms of diagnostic utility, the AUC was significantly larger for the average RNFL thickness (AUC, 0.889) than for the SVC fractal dimension (AUC, 0.772; p = 0.008).</p><p><strong>Conclusions: </strong>The fractal dimension of SVC was associated with the average RNFL thickness and was reduced in POAG patients. Fractal dimension analysis could be used in evaluating peripapillary vascularity by OCTA.</p>","PeriodicalId":17883,"journal":{"name":"Korean Journal of Ophthalmology : KJO","volume":"36 6","pages":"518-526"},"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/30/57/kjo-2022-0089.PMC9745347.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9334326","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 in the Failed Silicone Tube Intubations without Dacryoendoscopy.","authors":"Do Ah Kim,&nbsp;Helen Lew","doi":"10.3341/kjo.2022.0087","DOIUrl":"https://doi.org/10.3341/kjo.2022.0087","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the clinical characteristics and dacryoendoscopic findings and clinical efficacy of silicone tube intubation (STI) in the patients who referred to our center due to failed with conventional STI.</p><p><strong>Methods: </strong>We retrospectively reviewed the medical records of 61 cases from 50 patients who underwent STI or endoscopic dacryocystorhinostomy using dacryoendoscopy from January 2016 to May 2021. Clinical characteristics, tear meniscus height, lacrimal irrigation test, dacryocystographic findings, dacryoendoscopic findings and surgical outcomes were evaluated.</p><p><strong>Results: </strong>The study included 12 male and 38 female patients (mean age, 64.1 ± 13.2 years). In the preoperative lacrimal irrigation test, passage was found in 33 eyes (54.1%) and no passage in 28 eyes (45.9%). The causes of lacrimal duct obstruction were in the order of stenosis (31.1%), mucus (27.9%), membrane (24.6%), granulation (13.1%), and stone (3.3%), and the location were in the order of nasolacrimal duct (39.3%), lacrimal sac (36.1%), canaliculus (21.3%), and inferior meatus (3.3%). As for the characteristics of obstruction, the secretory type was 21 eyes (34.4%), and structural change type was 40 eyes (65.6%). The STI group consisted of 57 eyes (93.4%) and endoscopic dacryocystorhinostomy consisted of four eyes (6.6%). The overall success rate was 83.9%. Clinical results were correlated with dacryoendoscopic finding (p = 0.015), but not with lacrimal irrigation test or dacryocystography. The structural change type had a higher surgical success rate than the secretory type (84.4% vs. 66.7%, p = 0.015). In particular, the structural change type showed higher success rate than the secretory type below the lacrimal sac (95.5% vs. 61.9%, p = 0.034).</p><p><strong>Conclusions: </strong>STI using dacryoendoscopy has a higher surgical success rate than conventional STI since dacryoendoscopy provides direct visualization of nasolacrimal duct obstruction. It could be useful in increasing the surgical success rate in patients with structural changes below lacrimal sac.</p>","PeriodicalId":17883,"journal":{"name":"Korean Journal of Ophthalmology : KJO","volume":"36 6","pages":"486-492"},"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/4f/7e/kjo-2022-0087.PMC9745341.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10397356","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":"Thin but Nonkeratoconic Cornea: A Case Report.","authors":"Na Eun Kim,&nbsp;Si Yoon Park,&nbsp;Hyun Min Ahn,&nbsp;Ikhyun Jun,&nbsp;Kyoung Yul Seo,&nbsp;Tae-Im Kim","doi":"10.3341/kjo.2022.0053","DOIUrl":"https://doi.org/10.3341/kjo.2022.0053","url":null,"abstract":"Dear Editor, The cornea is composed of five layers: epithelium, Bowman layer, stroma, Descemet membrane, and endothelium. In addition to healthy layers, it is also important to maintain necessary layer thickness to assure integrity and function. In previous studies, central corneal thickness less than 500 μm was regarded as clinically thin and was observed in a subpopulation of healthy young adults [1]. Central corneal thickness less than 480 μm is regarded as extremely thin cornea and is highly suggestive for keratoconic or ectasic cornea [2]. But standard measurement or thickness to diagnosis thin cornea remain debated [3]. Here, we introduce a case of extremely thin cornea, less than 400 μm, that was nonkeratoconic. The patient provided written informed consent for publication of her examination results and images. A 26-year-old female patient first visited Severance Hospital for refractive surgery evaluation. She had no previous systemic or ocular disease. Also, she had no family history for ocular disorder within three generations of her family. She has worn soft contact lenses about two or three times per week for 10 years but had stopped using them for 2 weeks before the examinations. The best-corrected distant visual acuities were 20 / 20 in both eyes. The manifest refraction was –5.50 Sphere –2.50 Cylinder × 180° in the right eye and –7.00 Sphere –2.00 Cylinder × 180° in the left eye. Fig. 1A-1H show the images of both eyes. The slit-lamp examination (Fig. 1A, 1E) for both eyes did show thin cornea without any other sign suggesting hypoxia or mechanical trauma on cornea. Fundus examination for both eyes also showed no remarkable sign. Corneal thickness measured with Scheimpflug tomography (Pentacam; Oculus, Wetzlar, Germany) was 383 μm at the thinnest point, 385 μm for the corneal apex of the right eye, 389 μm at the thinnest point, and 391 μm for the corneal apex of the left eye. Topography with placido-scanning-slit system (ORBscan II; Bausch & Lomb, Rochester, NY, USA), noncontact tono-pachymetry (NT-530P; Nidek, Gamagori, Japan), and specular microscope (EM-4000; Tomey, Nagoya, Japan) also showed central corneal thickness less than 400 μm, about 10% difference among measuring methods. Elevation and curvature maps of both eyes showed symmetric bow-tie pattern with-the-rule topography (Fig. 1D, 1H). In sagittal curvature map, inferior-superior asymmetry index was 1.0 for each eye, regarded as normal. Indices representing irregularity of cornea curvature, index of surface variance, index of vertical asymmetry, keratoconus index, central keratoconus index, index of height asymmetry, index of height decentration, and the smallest radius of sagittal/axial corneal curvature were all within normal range. The Belin/Ambrósio enhanced ectasia display (BAD) showed no significant elevation from a reference surface. The corneal thickness spatial profile curve showed progressive thickening of the cornea from the thinnest point to the periphery, wit","PeriodicalId":17883,"journal":{"name":"Korean Journal of Ophthalmology : KJO","volume":"36 6","pages":"565-567"},"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/cf/5d/kjo-2022-0053.PMC9745342.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10388898","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":"External Subretinal Fluid Drainage and Vitrectomy in Exudative Retinal Detachment Secondary to Central Serous Chorioretinopathy: A Case Report.","authors":"Ji Young Moon,&nbsp;Se Joon Woo,&nbsp;Soo Chang Cho","doi":"10.3341/kjo.2022.0099","DOIUrl":"https://doi.org/10.3341/kjo.2022.0099","url":null,"abstract":"Dear Editor, Bullous central serous chorioretinopathy (bCSC) is an atypical variant of CSC, characterized by exudative retinal detachment, especially in inferior quadrants [1]. Subretinal pigment epithelium (sub-RPE) fibrin and increased hydrostatic pressure in pigment epithelial detachment (PED) is speculated to induce a RPE tear [2]. Subsequently, intense accumulation of subretinal fluid (SRF) leads to exudative retinal detachment. Proper treatment choice for bCSC is unclear. Removal of risk factors, focal laser, photodynamic therapy (PDT), and surgery can be applied [2]. There are two methods for surgical draining SRF: internal and external approach. Internal drainage may lead to retinotomy-associated rhegmatogenous retinal detachment (RD) [3]. Pars plana vitrectomy (PPV) with external drainage does not need retinotomy, allowing laser photocoagulation with an improved view using perfluorocarbon liquid (PFCL) and immediate retinal reattachment [4]. We report a case of bCSC treated with external drainage and vitrectomy in which the retina was reattached and maintained without recurrence for more than 1.5 years. Informed consent was obtained from the patient for publication of this case report and relevant images. A 51-year-old male patient presented with blurred vision in his right eye that started 5 days ago. Uncorrected visual acuity was 20 / 20, and intraocular pressure was normal in both eyes. Anterior segment was unremarkable. Fundus showed inferior bullous RD and no breaks in the right eye (Fig. 1A). Fundus was normal in the left eye. Perifoveal PEDs were found in the right eye (Fig. 1B). SRF increased the day after admission (Fig. 1C, 1D). Fluorescein angiography showed multiple perifoveal leaking points, a main inferonasal leaking point, and consequent pooling to the subretinal space (Fig. 1E, 1F). Optical coherence tomography (OCT) showed RPE tear at the site corresponding to the main leaking point (Fig. 1G). Exudative RD secondary to CSC (i.e., bCSC) was diagnosed and laser photocoagulation at leaking points was performed. On the 3rd day of admission, best-corrected visual acuity (BCVA) was 20 / 40, fundus showed shifting of SRF after sleeping on one side (Fig. 1H). Indocyanine green angiography shows hyper-permeable and dilated choroidal vessels (Fig. 1I). SRF decreased in OCT (Fig. 1J). He was discharged on the 5th day of admission. However, SRF increased significantly, and BCVA was 20 / 67 at outpatient visit at 5 days after discharge. We decided to transfer him for PDT. The next day, he was transferred to another hospital. BCVA decreased to finger count. Exudative RD was extended and prominent (Fig. 1K, 1L). Therefore, PDT was considered ineffective. After waiting 1 week, RD was further extended, and surgery was performed by SJW (Fig. 1M-1O). External drainage, PPV with perfluorocarbon liquid, endolaser, and intravitreal sulfur hexafluoride 18% gas injection were performed (Supplementary Video 1). Three months after surgery, BCVA w","PeriodicalId":17883,"journal":{"name":"Korean Journal of Ophthalmology : KJO","volume":"36 6","pages":"575-577"},"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/7f/0d/kjo-2022-0099.PMC9745348.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10457061","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":"Immunoglobulin G4-related Ophthalmic Disease of the Caruncle: A Case Report.","authors":"Gyeong Min Lee,&nbsp;NamJu Kim,&nbsp;Jin Ho Paik","doi":"10.3341/kjo.2022.0076","DOIUrl":"https://doi.org/10.3341/kjo.2022.0076","url":null,"abstract":"Dear Editor, Immunoglobulin G4-related disease (IgG4-RD) is a rare systemic disease that affect various organs with elevated serum IgG4 levels and marked IgG4-positive lymphoplasmacytic infiltration [1]. In the field of ophthalmology, IgG4-related ophthalmic disease (IgG4-ROD) is most commonly found in the lacrimal gland, but also found in diverse ocular adnexal tissues such as the extraocular muscles, infraorbital nerve, and eyelid [2]. IgG4-ROD of the caruncle has not been described previously. The authors describe a patient with IgG4-ROD of the caruncle along with literature review. Informed consent for publication of the clinical photograph was obtained from the patient. A 41-year-old male patient presented with a mass in the left caruncle. The lesion was noted to have been present for a period of 2 weeks. Examination revealed a single, asymptomatic, round pinkish protruding mass in the left caruncle (Fig. 1A, 1B). There were no complaints of pain, discharge, or bleeding. The patient’s medical history and family history were unremarkable and a systemic search found no papules or nodular skin lesions. Magnetic resonance imaging revealed no abnormal mass lesion in the orbit. Under local anesthesia, the lesion was excised completely. On gross examination, it was a 0.3 × 0.3 × 0.4-cm mass. Histopathologic examination revealed nodular lymphoid proliferation with follicular hyperplasia pattern composed of several hyperplastic follicles and increased IgG4 positive cells (>300 cells per high-power field; IgG4 to CD138 ratio, >40%) (Fig. 1C-1J). Serum IgG4 level was not elevated. It was diagnosed as possible IgG4-ROD of caruncle with progressively transformed germinal center type of lymph nodes [1,3]. IgG4-RD is characterized by infiltrate of IgG4 positive plasma cells and elevated serum IgG4 levels, which can affect various organs [1]. In general, histopathological features of IgG4-RD are a dense lymphoplasmacytic infiltrate, storiform-type fibrosis, and obliterative phlebitis. However, in organs such as the lymph node, lung, minor salivary glands, and lacrimal glands, storiform-type fibrosis and obliterative phlebitis usually absent [3]. IgG4-ROD is a condition that IgG4-RD occurs in the ocular adnexal organs and most commonly affect the lacrimal gland, followed by trigeminal nerve branch, extraocular muscles, and orbital fat tissue [2]. However, it has never been reported in the caruncle. The caruncle contains skin elements, conjunctiva, and lacrimal glands, which can lead to a variety of disease entity. A case series of the caruncular lesion, lymphoid lesions were reported to be rare, with a frequency of about 3% [4]. However, since many ocular adnexal lesions, previously diagnosed as lymphoid hyperplasia or idiopathic orbital inflammation, have been rediagnosed as IgG4-ROD [5], some of the lymphoid caruncular lesions could also be rediagnosed as IgG4-ROD. In conclusion, we present the first case of possible IgG4-ROD in the caruncle. Although rare","PeriodicalId":17883,"journal":{"name":"Korean Journal of Ophthalmology : KJO","volume":"36 6","pages":"568-569"},"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/da/da/kjo-2022-0076.PMC9745340.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10388903","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":"Dynamic Ranges of Retinal Nerve Fiber and Optic Nerve Head Parameters Measured Using Optical Coherence Tomography in Glaucoma: A Longitudinal Study.","authors":"Nala Shin,&nbsp;Gi Seok Park,&nbsp;Kyung Nam Kim,&nbsp;Young Hoon Hwang","doi":"10.3341/kjo.2022.0048","DOIUrl":"https://doi.org/10.3341/kjo.2022.0048","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the dynamic range of retinal nerve fiber layer (RNFL) and optic nerve head (ONH) parameters measured using optical coherence tomography (OCT) in conditions ranging from nonglaucomatous status to advanced glaucoma by longitudinal observation.</p><p><strong>Methods: </strong>A total of 15 eyes from 12 participants with glaucoma progression from a nonglaucomatous status to advanced glaucoma were included. The RNFL and ONH parameters were compared between the nonglaucomatous and advanced stages within the same eye. The absolute and relative changes in OCT parameters were analyzed.</p><p><strong>Results: </strong>The median highest intraocular pressure was 42.5 mmHg (interquartile range, 37.5 to 54.5 mmHg), and the final mean deviation of the visual field test was -24.68 dB (interquartile range, -23.93 to -31.13 dB). The median relative changes in RNFL thickness were -40.6% in the overall area, and -51.9%, -21.4%, -51.1%, and -41.8% in the superior, nasal, inferior, and temporal quadrants, respectively (all p < 0.05). Relative changes in the rim area, disc area, average cup to disc ratio, vertical cup to disc ratio, and cup volume were -56.64%, 0.59%, 62.10%, 66.0%, and 337.90%, respectively (all p < 0.05, except for disc area with a p-value of 0.753).</p><p><strong>Conclusions: </strong>The dynamic range of the RNFL thickness ranged from 40.6% to 51.9%, and the dynamic range of the ONH parameters ranged from 56.64% to 337.90%. During the course of glaucoma progression, the cup volume showed the widest dynamic range. However, the disc area did not show significant changes.</p>","PeriodicalId":17883,"journal":{"name":"Korean Journal of Ophthalmology : KJO","volume":"36 6","pages":"493-500"},"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/61/19/kjo-2022-0048.PMC9745349.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10397355","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":"How to Better Treat Patients with Intermittent Exotropia: A Review of Surgical Treatment of Intermittent Exotropia.","authors":"Jeong-Min Hwang","doi":"10.3341/kjo.2022.0043","DOIUrl":"https://doi.org/10.3341/kjo.2022.0043","url":null,"abstract":"<p><p>Intermittent exotropia (X(T)) is the most common form of strabismus, especially in Asians. Treatment of X(T) includes occlusion, overminus lens, and surgery, of which, surgery is the mainstay of treatment. Commonly performed surgical procedures for X(T) are bilateral lateral rectus muscle recession or unilateral lateral rectus recession with medial rectus resection; however, it is unclear which of the two surgeries is more effective. The purpose of this review is to provide an insight on the surgical treatment of X(T). Randomized controlled trials, comparative observational studies, and case series with a large number of patients as well as a long follow-up period of over a year were included.</p>","PeriodicalId":17883,"journal":{"name":"Korean Journal of Ophthalmology : KJO","volume":"36 6","pages":"550-564"},"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/18/a7/kjo-2022-0043.PMC9745339.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10388900","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":"Ischemic Proliferative Retinopathy in a Korean Patient with Cutis Marmorata Telangiectatica Congenita: A Case Report.","authors":"Min-Ji Kim,&nbsp;Sang Jin Kim","doi":"10.3341/kjo.2022.0107","DOIUrl":"https://doi.org/10.3341/kjo.2022.0107","url":null,"abstract":"Dear Editor, Cutis marmorata telangiectatica congenita (CMTC) is a rare congenital vascular anomaly, clinically diagnosed based on cutaneous features [1]. It is characterized by congenital persistent reticular erythema, that does not respond to local warming, and the absence of venectasisa within skin lesions. Histopathological examination revealed dilation of the veins and capillaries within the dermal layer of the skin [2]. Systemic manifestations related to CMTC include body asymmetry, syndactyly, neurological disorders, and ocular abnormalities [3]. Ocular abnormalities include glaucoma, retinal vascular abnormalities, retinal perfusion defects, and retinal detachments [4,5]. Herein, we report a case of ischemic proliferative retinopathy in a Korean patient with CMTC. The Institutional Review Board of Samsung Medical Center waived the need for informed consent (No. 2022-02-058). A 1-month-old Korean male patient, diagnosed with CMTC, was referred to the retina clinic for evaluation of accompanying ophthalmic abnormalities. The patient was born via Cesarean section due to oligohydramnios at 38 weeks of gestation and weighed 2.3 kg. After birth, tachypnea and cyanosis were observed, and the patient was admitted to the neonatal intensive care unit. Echocardiography revealed pulmonary hypertension. On physical examination performed at the time of admission, pinkish blue colored reticular erythema was observed on the face, upper extremities, and lower extremities, and CMTC was diagnosed based on characteristic clinical f indings (Fig. 1A, 1B). On anterior segment slit-lamp examination, no abnormalities were observed in the cornea, iris, or lens. Fundus examination showed abnormally dilated retinal vessels with peripheral avascular retinas in both eyes and vitreous hemorrhage in the right eye (Fig. 1C, 1D). An examination under general anesthesia was performed, and intravenous fluorescein angiography revealed an extensive nonperfusion area and retinal neovascularization in both eyes (Fig. 1E-1H). Laser ablation of the avascular retina with laser indirect ophthalmoscope was performed on the nonperfusion areas of both eyes. After 1.5 months of laser photocoagulation, retinal hemorrhage was absorbed, and retinal neovascularization regressed completely. The patient died of pulmonary hypertension 3 months after laser photocoagulation, and no further follow-up was possible. Dedania et al. [5] reported variable ocular involvement with frequent retinal vascular abnormalities in patients with CMTC. Avascular retina was detected in six of nine patients and two patients showed retinal detachment. As ischemic proliferative retinopathy accompanied by CMTC may progress rapidly and can cause retinal detachment and blindness, the authors recommended prompt comprehensive ophthalmic evaluation in infants with suspected CMTC. In summary, we report the case of a Korean patient with ischemic proliferative retinopathy accompanied by CMTC treated with laser photocoagulat","PeriodicalId":17883,"journal":{"name":"Korean Journal of Ophthalmology : KJO","volume":"36 6","pages":"570-571"},"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/84/c5/kjo-2022-0107.PMC9745346.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10388902","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}