Comparison of Bevacizumab and Combined Low-dose Bevacizumab and Triamcinolone in Central Retinal Vein Occlusion

PURPOSE: To report the effects and intraocular pressure (IOP) results of intravitreal injection of bevacizumab alone compared with intravitreal low-dose bevacizumab combined with low-dose triamcinolone injection in patients with central retinal vein occlusion. METHODS: In total, 40 eyes of 40 patients diagnosed with central retinal vein occlusion were evaluated. Of these, 20 eyes of 20 patients were injected with intravitreal bevacizumab (1.25 mg/0.05 mL), and 20 eyes of 20 patients were injected with low-dose bevacizumab (0.625 mg/0.025 mL) combined with low-dose triamcinolone (1 mg/0.025 mL). The best corrected visual acuity (BCVA), central macular thickness (CMT), and IOP of treated eyes were measured before injection and at 1 month, 2 months, and 3 months after injection. RESULTS: In both the intravitreal bevacizumab and the low-dose bevacizumab combined with low-dose triamcinolone groups, CMT decreased significantly at 1 month, 2 months, and 3 months after injection (p 0.05). The BCVA, IOP, and CMT at 1 month, 2 months, and 3 months after injection showed no significant differences between the intravitreal bevacizumab group and the low-dose bevacizumab combined with low-dose triamcinolone group (p > 0.05). CONCLUSIONS: The CMT of both groups decreased significantly, and BCVA of both groups increased significantly in patients with central retinal vein occlusion. Injection of low-dose intravitreal bevacizumab combined with low-dose intravitreal triamcinolone may be useful for the treatment of central retinal vein occlusion.

A Case of Anterior Migration of Fragmented Dexamethasone Intravitreal Implant

PURPOSE: To report a case of fragmentation and anterior migration occurred after dexamethasone intravitreal implant (Ozurdex®, Allergan, Irvine, CA, USA) injection in a branch retinal vein occlusion patient. CASE SUMMARY: A 66-year-old male was referred for blurred vision. He received cataract surgery in 1986 and was diagnosed with central retinal vein obstruction in 2011 in the right eye. For treatment of macular edema, dexamethasone intravitreal implant was performed in the right eye. One week after implantation, a fragment of the dexamethasone implant migrated to the anterior chamber with corneal edema and surgical removal was performed immediately. One day after removal, the remaining fragmented implant migrated to the anterior chamber and corneal edema still existed. The fragmented implant was removed with anterior chamber irrigation. After removal, corneal edema improved and visual acuity was recovered. CONCLUSIONS: Anterior migrated dexamethasone implant could induce corneal complications, such as corneal edema and corneal decompensation and might lower the corneal endothelial cell even if immediately removed. We report a case of corneal edema, which was induced by anterior migration of a fragmented dexamethasone implant and recovered with immediate surgical removal.

Successful Treatment of Infectious Scleritis by Pseudomonas aeruginosa with Autologous Perichondrium Graft of Conchal Cartilage

Infectious scleritis by Pseudomonas aeruginosa is a well-known vision-threatening disease. In particular, scleral trauma following pterygium surgery may increase the risk of sclera inflammation. Surgical debridement and repair is necessary in patients who do not respond to medical treatments, such as topical and intravenous antibiotics. We reports herein the effectiveness of an autologous perichondrium conchal cartilage graft for infectious scleritis caused by Pseudomonas aeruginosa. This procedure was performed on four eyes of four patients with infectious scleritis who had previously undergone pterygium surgery at Gyeongsang National University Hospital (GNUH), Jinju, Korea from December 2011 to May 2012. Pseudomonas aeruginosa was identified in cultures of necrotic scleral lesion before surgery. The conchal cartilage perichondrium graft was transplanted, and a conjunctival flap was created on the scleral lesion. The autologous perichondrium conchal cartilage graft was successful and visual outcome was stable in all patients, with no reports of graft failure or infection recurrence. In conclusion, autologous perichondrium conchal cartilage graft may be effective in surgical management of Pseudomonal infectious scleritis when non-surgical medical treatment is ineffective. Further studies in larger, diverse populations are warranted to establish the effectiveness of the procedure.

Two Cases of WIOL-CF(R) IOL Dislocation after Nd:YAG Laser Capsulotomy

PURPOSE: To report 2 cases of WIOL-CF(R) intraocular lens (IOL) (Gelmed International, Kamenne Zehrovice, Czech Republic) dislocation after neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy. CASE SUMMARY: A 78-year-old female was referred for IOL dislocation. She was implanted with WIOL-CF(R) IOL 18 months prior. Two months after WIOL-CF(R) implantation, she received Nd:YAG laser capsulotomy at a local clinic. Pars plana vitrectomy and transscleral fixation of IOL were performed. CONCLUSIONS: This is the first report of WIOL-CF(R) IOL dislocation after Nd:YAG laser capsulotomy in unvitrectomized eyes. When Nd:YAG laser capsulotomy is performed after WIOL-CF(R) IOL implantation, IOL dislocation should be considered even in unvitrectomized eyes.

A Case of Postpartum Macular Hole in a Young Woman

PURPOSE: To describe a case of macular hole (MH) in a 29-year-old non-myopic woman after uncomplicated delivery. CASE SUMMARY: A 29-year-old woman visited our clinic complaining of decreased visual acuity in her left eye after uncomplicated delivery. Fundoscopy and optical coherence tomography showed a full thickness macular hole in the left eye. However, we found not posterior vitreous detachment or vitreomacular traction in the posterior pole. The patient underwent pars plana vitrectomy, internal limiting membrane peeling, and SF6 gas tamponade. Three months after vitrectomy, the patient's visual acuity was improved and the macular hole was closed successfully. CONCLUSIONS: We experienced and treated a case of postpartum MH developed in a young woman without posterior vitreous detachment or vitreomacular traction in the posterior pole. This suggests another mechanism of MH formation. Postpartum MH was successfully treated by existing idiopathic macular hole surgery.

The Changes of Corneal High-Order Aberrations and Anterior Chamber Parameters after Trabeculectomy Using Pentacam(R)

PURPOSE: To evaluate changes in corneal keratometry, high-order aberrations (HOAs), and anterior chamber parameters after trabeculectomy using Pentacam(R) (Oculus Inc., Dutenhofen, Germany). METHODS: Forty eyes of 40 patients who underwent limbal-based trabeculectomy or fornix-based trabeculectomy between July 2011 and May 2012 were retrospectively reviewed. Intraocular pressure (IOP), corneal keratometry, central corneal thickness, anterior chamber depth, anterior chamber volume, and HOAs were measured using Pentacam(R) preoperatively and at 3 months postoperatively. RESULTS: The mean age of patients who underwent trabeculectomy was 58.26 +/- 16.28 years. IOP showed significant decrease after surgery in both groups compared to preoperative values (p 0.05). CONCLUSIONS: Postoperative corneal keratometry and anterior chamber parameters did not change significantly compared to preoperative values in glaucoma patients after performing trabeculectomy. Most HOAs that affected quality of vision were not changed in the limbal-based trabeculectomy or fornix-based trabeculectomy.

The Changes of Corneal High-Order Aberrations and Anterior Chamber Parameters after Trabeculectomy Using Pentacam(R)

PURPOSE: To evaluate changes in corneal keratometry, high-order aberrations (HOAs), and anterior chamber parameters after trabeculectomy using Pentacam(R) (Oculus Inc., Dutenhofen, Germany). METHODS: Forty eyes of 40 patients who underwent limbal-based trabeculectomy or fornix-based trabeculectomy between July 2011 and May 2012 were retrospectively reviewed. Intraocular pressure (IOP), corneal keratometry, central corneal thickness, anterior chamber depth, anterior chamber volume, and HOAs were measured using Pentacam(R) preoperatively and at 3 months postoperatively. RESULTS: The mean age of patients who underwent trabeculectomy was 58.26 +/- 16.28 years. IOP showed significant decrease after surgery in both groups compared to preoperative values (p 0.05). CONCLUSIONS: Postoperative corneal keratometry and anterior chamber parameters did not change significantly compared to preoperative values in glaucoma patients after performing trabeculectomy. Most HOAs that affected quality of vision were not changed in the limbal-based trabeculectomy or fornix-based trabeculectomy.

Dermatofibrosarcoma Protuberans in Abdominal Wall Aggravated during Pregnancy

Dermatofibrosarcoma protuberans is a rare tumor that occurs in the dermis or subcutaneous tissue of the trunk or extremities in relatively young adults. There are few reports of Dermatofibrosarcoma protuberans associated with pregnancy. We experienced a 28-year-old pregnant female patient with an abdominal wall mass, which grew rapidly during pregnancy. Excisional biopsy was performed and the pathologic diagnosis was fibrosarcoma transformed from Dermatofibrosarcoma protuberans. Dermatofibrosarcoma protuberans showed a positive CD34 immunostaining while fibrosarcoma showed a negative CD34. There was no recurrence or metastasis with the follow up period of 2 years. We report here a rare case of Dermatofibrosarcoma protuberans aggravated during pregnancy with a review of the literature.

Analysis of Maternal and Neonatal Factors Affecting Hematopoietic Parameters of Cord Blood / 대한수혈학회지

BACKGROUND: Cord blood (CB) is a useful source of hematopoietic stem cells. In public CB banks, only CB units with good hematopoietic potential are processed and stored because the processing and storage of CB are cost-consuming and labor-intensive procedures. Presently, we sought to determine factors correlated with, and influential to, hematopoietic parameters of CB units donated from Korean neonates and their mothers. METHODS: A total of 1,696 CB units that were donated and processed from August 1 - December 31, 2007 were enrolled. Donated CB volume, total nucleated cells (TNC), total mononucleated cells (MNC), CD34+ cells after processing, and cell viability before and after processing were analyzed according to sex and delivery method. We also determined whether maternal age, neonatal factors (gestational age, birth weight, sex, delivery method), CB volume, and processing time were correlated with hematopoietic parameters of CB. RESULTS: CB of female neonates had significantly higher mean TNC and CB obtained from vaginal delivery had significantly higher mean TNC, MNC, and CD34+ cells. The counts of TNC, MNC, and CD34+ cells were significantly positively correlated with CB volume, gestational age, and birth weight. Counts of TNC, MNC, and CD34+ cells, and pre- and post-viability of CB were significantly negatively correlated with processing time. CONCLUSION: The present data provide a baseline for standard methods of collection, processing, and storage in cord blood banking.

Effectiveness of Gastrectomy in Stage 4 Gastric Cancer with Hepatic Metastasis / 대한암학회지

PURPOSE: The prognosis for patients with stage IV gastric cancer is very poor. However, recently, some studies have reported benefits from a gastric resection for metastatic gastric cancer. This clinical study was performed to evaluate the effectiveness of a noncurative gastrectomy in treating stage IV gastric cancer with hepatic metastasis. MATERIALS AND METHODS: A retrospective analysis was performed on 98 gastric cancer patients who had undergone gastric resection, in spite of hepatic metastasis, between January 1990 and December 1996 at the Department of Surgery in 11 General Hospitals in Korea. RESULTS: The average age was 58 years old, and the male-to-female ratio was 69: 29. The laboratory tests were unable to predict hepatic metastasis. In 54 cases, hepatic metastasis was not identified before the surgery. The most common location of gastric cancer was antrum (72 cases). The most common gross type was Bonmann type III (78 cases). The serosa-exposed cases were 80. The peritoneal seeding was combined in 17 cases. A total gastrectomy was performed in 18 cases and a distal gastrectomy in 80. Lymph-node dissection was performed in 23 Dl, and 51 D2 cases. Hepatic resection was performed in 36 cases, The frequent histologic types were moderately differentiated and poorly differentiated tubular adenocarcinoma. Postoperative adjuvant chemotherapy was done in 70 cases. The complication rate (7%) was low. The median survival time was 15 months, with mean survival time of 18 months. The 2-year and 3-year survival rates were 23%, and 7%, respectively. In the univariate analysis, good survival was closely related to limitation of hepatic metastasis to one lobe, a few metastases to both lobes, negativity of peritoneal seeding and lymph node dissection more than D2 (p<0.05), CONCLUSIONS: An aggressive gastric resection for stage IV gastric cancer with hepatic metastasis might be beneficial in lengthening the survival period. A prospective study is needed, especiaUy one with an exact evaluation and analysis of the quality of life between the gastrectomy and nonresection groups.