A Case of VADS Induced by Immunosuppessants Therapy in Uveitis Patient

VAHS is characterized by viral-like prodromal symptoms, high fever' malaise, hepatosp lenomegaly, pancytopenia. The dignosis is based on a bone marrow biopsy specimen that demonstrates histiocytic hyperplasia with prominent hemophagocytosis of red blood cells, platelets, and nucleated hematopoietic cells Recently, the use of immunosuppressants tends to increase due to increase of autoimmune disease and organ transplantation patients. A large portion of leukemia and organ transplant patients developed VAHS as a secondary viral infection after anticancer drug and immunosuppressants therapy was administered In the field of ophthalmology, VAHS can occur by administration of immunosuppressants in corneal transplantation and autoimmune uveitis patients. Recently we experienced a case of fatal VAHS in a young uveitis patient who had been treated with immunosuppressants. We report this specfic case with literature review bec,lUse of the need for careful observation of general findings occurring during treatment of immunosuppressants such as corticosteroid.

Clinical Studies of 19 Cases of Acute Posterior Multifocal Placoid Pigment Epitheliopathy

Acute posterior multifocal placoid pigment epitheliopathy (APMPPE) is an inflammatory disease of the retina characterized by rapid loss of central vision, secondary to multiple flat yellow-whitish placoid lesions at the level of the pigment epithelium on the posterior pole. The fluorescein angiography demonstrates initial hypofluorescence in the lesion, where shows hyperfluorescence later. Usually, the central vision is recovered spontaneousely despite of permanent alterations in the pigment epithelium. The authors describe the clinical analysis of 19 cases of APMPPE treated at Department of Ophthalmology, Pusan Paik Hospital, Inje Medical college from January 1986 to July 1990. The results were as follows: 1) Ten cases(54%)occurred in the third decade. 2) Bilateral involvement occurred in 17 cases(90%) and 4 cases of those showed a different onset of symptoms in both eyes. 3) Nine cases(48%) occurred in the summer. 4) The symptoms of upper respiratory tract infection(URI) preceded by an average six days. 5) The symptoms of URI was indicated by 13 of the patients(68%). 6) Seventeen eyes(47%) showed uveitis as the combined ocular sign. 7) The lymphocytosis of cerebrospinal fluid was shown in four of eight cases(50%). In the complete blood count, leukocytosis was shown with 78% of all. 8) The visual acuity was below 0.4 in 83% of all at the time of presentation, and the final visual acuity was above 0.5 in 89% of all. 9) The visual acuity improved an average of eight weeks after the onset of symptoms.

Clinical Observation on Silicone Intubation in Obstruction of lacrimal Drainage System

We report 23 cases of silicone stents intubation for obstruction of lacrimal drainage system in 23 patients with tearing and mucopurulent material discharge from January 1985 to April 1988. The success rate of silicone stents intubation was 47.4% and the most common site of obstruction was nasolacrimal duct(56.5%). 30.3% of patients had complications related to silicone stents, conjunctivitis, punctal erosion etc. With these results, we consider that congenital dacryostenosis, partical and complete nasolacrimal duct obstruction is mainly indicated for silicone stents intubation and better results will be gained if be done with acryocystorhinostomy to prevent complications related to silicone stents.

Effect of Fibrin Glue(Tissel(R))in Experimental Corneal Perforation

Fibrinogen is converted into fibrin by the action of thrombin under presence of calcium. In addition to its hemostatic effect, fibrin coagulum has tissue adhesive effect and fibroblast stimulating effect in the healing process. Perforating wounds about 1mm X 3mm in size were made in the center of rabbit corneas, and then were treated with fibrin glue. Simple full-thickness lacerations were also made in the central cornea of the other eye without any treatment as a control group. These eyes were enucleated after various periods of interval and the wound sites were studied with light and electron microscope. Tissue defect of perforated cornea was closed well by fibrin glue and active proliferation of the fibroblasts was seen near the glue. From these results, fibrin glue may be useful in the treatment of human corneal perforation and it will be used for the other ocular surgery.

Effect of Fibrin Glue(Tissel(R))in Experimental Corneal Perforation

Fibrinogen is converted into fibrin by the action of thrombin under presence of calcium. In addition to its hemostatic effect, fibrin coagulum has tissue adhesive effect and fibroblast stimulating effect in the healing process. Perforating wounds about 1mm X 3mm in size were made in the center of rabbit corneas, and then were treated with fibrin glue. Simple full-thickness lacerations were also made in the central cornea of the other eye without any treatment as a control group. These eyes were enucleated after various periods of interval and the wound sites were studied with light and electron microscope. Tissue defect of perforated cornea was closed well by fibrin glue and active proliferation of the fibroblasts was seen near the glue. From these results, fibrin glue may be useful in the treatment of human corneal perforation and it will be used for the other ocular surgery.

Clinical Evaluation of Visual Conversion Reaction

Visual conversion reaction is characterized by fluctuating visual acuity and tubular fields in the absence of any organic lesion. It is thought that the environmental and psychological factors contribute to the onset of symptom. Twenty-two cases of visual conversion reactions were evaluated clinically and the results were as follows. 1. Visual conversion reaction is more frequent in females and children and low vision is almost always affected bilaterally. 2. Sixteen cases(72.7%) showed tubular and constricted fields inspite of normal CT and electrophysiologic responses. 3. Of the cases, 86.4%(19/22) had improved their reduced visual acuity to over 0.8 after treatment with suggestion, placebo, plano lenses and some kind of psychotheraphy.

Three Cases of Typical Ocular Colobomas

Coloboma is a lacking of a portion of structure of the eye. Congenital colobomas are due to some interference with the normal closure of the emoryonic cleft, the aberration lying primarily in the epiblast of the cup and occur between the time of invagination of the vesicle and closure of the cleft. The authors have experienced 3 cases of the typical colobomas of iris, ciliary body, choroid, retina and optic nerve. Two of the cases had familial history. Extracapsular cataract extraction was performed in one eye of the case and resulted in slight improvement in vision.