Diurnal Blood Pressure Variation in the Retinal Vein Occlusion

PURPOSE: The purpose of this study was to determine the diurnal blood pressure variation with retinal vein occlusion (RVO) using 24-hour ambulatory blood pressure monitoring (24-hour ABPM). METHODS: The subjects in this study visited the department of ophthalmology from May 2012 to December 2012 and were diagnosed with RVO but had no history of hypertension (HTN). Non-dipper was defined as a nocturnal systolic blood pressure (SBP) decrease less than 10%. These values were used to compare the 24-hour ABPM values of the RVO and the control groups. RESULTS: The 24-hour ABPM values, with the exception of the mean nightly SBP, were statistically different whne the RVO group was compared with the control group. The odds of an RVO patient being a non-dipper compared to dipper were 1.81 times greater than in the control. Additionally, the clinical SBP and DBP in the RVO group were not significantly different when the HTN group and the non-HTN group were compared. In contrast, the mean 24-hour SBP and the mean DBP were significantly different in regard to HTN. CONCLUSIONS: Patients with RVO have a tendency to maintain high BP throughout the day and also during the night. A patient with non-dipper status can be at risk for RVO, even if the patient does not have HTN. Therefore, 24-hour ABPM is an effective management approach for HTN in addition to strict BP control in patients with RVO.

Photodynamic Therapy with Vertepofin for Short Time for Chronic Central Serous Chorioretinopathy

PURPOSE: To evaluate the clinical results of short duration photodynamic therapy (PDT) using verteporfin in patients with chronic central serous chorioretinopathy (CSC). METHODS: We retrospectively examined 15 eyes after PDT for chronic central serous chorioretinopathy. PDT for 83 seconds was evaluated for 8 eyes, and PDT for 60 seconds was evaluated for 7 eyes. Improvement in vision and changes in central macular thickness were evaluated with an optical coherence tomogram (OCT), and improvement in leaking was evaluated with a fluorescein angiogram (FA). Recurrence was also studied. RESULTS: Visual acuity improved from 0.39 to 0.57 (p=0.04), and the mean central macular thickness decreased from 426.29 micrometer to 184.71 micrometer (p<0.01) in 7 eyes treated with PDT for 60 seconds. There was no significant change in visual acuity between the two groups (p=0.77) or in central macular thickness (p=0.52). Central macular exudation resolved completely in all eyes. After PDT, there was no recurrence during the follow-up period. CONCLUSIONS: Short duration PDT with verteporfin appears to be a beneficial treatment option for patients with chronic CSC.

Exposure Incidence of Porous Orbital Implants

PURPOSE: We evaluated clinical results and incidence of exposures of orbital implants according to operative methods (enucleation or evisceration) and types of orbital implants. METHODS: We retrospectively reviewed the charts of 222 patients who underwent hydroxy apatite or Medpor(R) implantation after enucleation or evisceration and were followed up for more than 3 months from July, 1992 to November, 2001 at department of ophthalmology, Busan Paik hospital. RESULTS: In 222 eyes of 222 patients, who underwent hydroxyapatite and Medpor(R) implantaion, the exposure of implants occurred in 21 eyes (9.5%). In these cases, the exposure of implants occurred in 16 (12.8%) of 125 eyes with hydroxyapatite implantation and 5 (5.2%) of 97 eyes with Medpor(R) implantation. The exposure of implants occurred in 6 (7.1%) of 84 eyes after enucleation and in 15(10.8%) of 138 eyes after evisceration. The exposure of implants occurred in 12 (12.2%) of 98 eyes that used standard evisceration and in 3 (7.5%) of 40 eyes that used modified evisceration. CONCLUSIONS: The exposure of Medpor(R) implants was less than that of hydroxyapatite implants. But, it was influenced by types of orbital implants as well as operator and operative skill. There are few differences of exposure rate between the modified evisceration and enucleation.

Characteristics of Atopic Dermatitis Related to Ocular Complications / 대한피부과학회지

BACKGROUND: Long-standing atopic dermatitis patients frequently predispose to ocular complications. The ectodermal origin of the epidermis and of many eye structures explain the frequent associations observed in atopic dermatitis. OBJECTIVE: This study may help in evolving early diagnosis and in formulating standard therapeutic strategies to prevent and treat ocular complications by studying the types, frequency and dermatological characteristics of each ocular complication in atopic dermatitis. METHODS: We evaluated the ocular complications of 41 typical atopic dermatitis patients(26 males, 15 females) who had skin lesion around eyelids or complained of ocular symptoms. RESULTS: Mean age of the patients was 17.7 years. The onset of atopic dermatitis was during infancy in 21 patients, during childhood in 15 patients, and during adult in 5 patients and their mean duration of disease was 13.8 years. Mild ocular involvements including blepharitis in 29 patients(58 eyes, 70.7%), keratoconjunctivitis in 29 patients(58 eyes, 70.7%) were seen. More serious complications which may lead to decreased visual function including cataracts in 5 patients(10 eyes, 12.1%), retinal detachments in 3 patients(5 eyes, 6.0%) were seen. All the patients who had these two serious complications had facial dermatitis. And other ocular involvements including keratoconus in 2 patients(2 eyes, 2.4%), ocular herpes simplex in 1 patient(2 eyes, 2.4%), uveitis in 2 patients(2 eyes, 2.4%) were seen. CONCLUSION: It is important to perform an ophthalmologic examination in the early period of disease in long-standing atopic dermatitis patients especially those who have facial dermatitis for the early diagnosis and treatment of serious sight-threatening complications.

Terson's Syndrome in Aneurysmal Subarachnoid Hemorrhage

Terson's syndrome is the oculocerebral syndrome of retinal and vitreous hemorrhage associated with spontaneous subarachnoid hemorrhage(SAH) or all forms of intracranial bleeding. Recent observations indicate that the patients with spontaneous subarachnoid hemorrhage have an 18% to 20% concurrent incidence of retinal and vitreous hemorrhages and about 4% incidence of viterous hemorrhage alone. Therefore, clinical ophthalmologic findings may have a significant diagnostic and prognostic value for the clinician. Total of 627 consecutive patients with aneurysmal subarachnoid hemorrhage were retrospectively studied by means of indirect fundoscopy to address the question of occur and prognostic implications of vitreous hemorrhage after subarachnoid hemorrhage from January 1993 to December 1996. Among these, we experienced 21 patients with vitreous hemorrhage(Terson's syndrome). The patients with vitreous hemorrhage commonly occurred in anterior communicating and internal carotid artery aneurysm. Twelve patients had intraocular hemorrhage within 48 hours after SAH. There were bilateral involvement in 15 cases, and the 14 experienced complete recovery of vision following massive intravitreal hemorrhage. A favorable surgical outcome was obtained in 14 of 21 patients(66.7%) and a satisfactory result in vision was achieved in 15 cases among 17 survivors(88.2%). From these results, we emphasize the significance of ocular findings in patients with aneurysmal subarachnoid hemorrhage.

The Effect of the Antioxidant on the Tyxidty of Paraquat in Rat / 대한산업의학회지

This study was designed to examine the influences of antioxidants on toxicity of paraquat in male rats. Paraquat and ascorbic acid were given orally ad libitum with tap water containing paraquat 30 ppm and 100 ppm and ascorbic acid 1000ppm for 10 days, respectively, alpha-tocopherol(60 mg/kg) was administered orally by sonde at 2 days intervals for 10 days. Paraquat at given doses produced markedly a dose-related reduction in water-intake, ratio of liver weight/body weight and glutathione along with the increased aspartate aminotransferase, alkaline phosphatase, serum lipid and ratio of lung weight/body weight. However the combined administration of ascorbic acid and paraquat did not affect the toxic effects of paraquat, whereas combined administration of paraquat and alpha-tocopherol showed relative reduction in the toxicities of paraquat. From these experimental results, it could be concluded that alpha-tocopherol has detoxifying effect on paraquat poisoning as the antioxidant, meanwhile ascorbic acid, one of the antioxidance, does not exert any detoxifying effects.

A Clinical Study of 36 Cases of Retinal Artery Occlusion

Blockage of the retinal artery system may occur in the form of central retinal arterial obstruction, branch retinal arterial obstruction, or combination of aforementioned. It may be related to known pre-existing systemic disease or it may be the initial manifestation of a previous undiagnosed systemic abnormality. The authors evaluatea the clinical course of 35 cases of retinal artery occlusion at Department of Ophthalmology, Pusan Paik Hospital Inje Mgdical College from September, 1979 to June, 1988.

A Clinical Study on Central Retinal Vein Occlusion

Hayreh calssified central retinal vein occlusion(CRVO) into 2 groups as venous stasis retinopathy(VSR) and hemorrhagic retinopathy(HR) based on pathogenesis. VSR is a benign, nonischemic, and self-limited condition, while HR is a severe, ischemic, and potentially blinding disorder. This classification is beneficial to regarding the prognosis and management of CRVO. The author evaluated the clinical course of 69 cases of CRVO at the Department of Ophthalmology, Paik Hospital, Inje college from January, 1981 to June, 1986. The results were as follows; 1. Among the 69 patients of CRVO, 38 patients were classified as VSR(55.1%) and 31 patients as HR(44.9%). 2. The patients were comprised of 33 males and 36 females. The average age was 52.4 +/- 9.7 years in VSR, and 52.7 +/- 10.1 years in HR. 3. The mean interval between onset of symptom and first ophthalmic consultation was 22 days in VSR, and 8 days in HR. 4. The improvement of visual acuity more than 1 line in test chart was 39.5% in VSR, and 12.9% in HR. 5. The most common associated systemic disease was hypertension(42.0%) and the next was diabetes mellitus(8.7%). Open angle glaucoma was associated in 6 patients(8.7%). 6. Photocoagulation was given 3 cases of VSR and 8 cases of HR. Of the 23 untreated cases with HR, 26.1% developed neovascular glaucoma and none of the 8 cases with HR treated with panretinal photocoagulation developed neovascular glaucoma. 7. Cystoid macular edema was occurred in 39.5% of VSR and 54.8% of HR. Proliferative retinopathy and vitreous hemorrhage were occurred in 1 and 2 cases of HR respectively.

A Case of Marcus Gunn Syndrome

Marcus Gunn reported an unusual type of congenital ptosis with a peculiar associated movement of the affected lid in 1883. This movement is thought to be due to a congenital misdirection of some of the 5th cranial nerve fibers into the branch of the 3rd cranial nerve that supplies the levator muscle. Therefore, stimulation of the jaw-winking mechanism sends excess impulses into a poorly innervated levator muscle, enough to momentarily raise the eyelid. We experienced a case of Marcus gunn syndrome in a 14 year-old boy, whose chief complaint was the drooping of the left upper eyelid which was retracted in association with opening of mouth or lateral movement of the jaw to the right side since birth.

A Case of Marcus Gunn Syndrome

Marcus Gunn reported an unusual type of congenital ptosis with a peculiar associated movement of the affected lid in 1883. This movement is thought to be due to a congenital misdirection of some of the 5th cranial nerve fibers into the branch of the 3rd cranial nerve that supplies the levator muscle. Therefore, stimulation of the jaw-winking mechanism sends excess impulses into a poorly innervated levator muscle, enough to momentarily raise the eyelid. We experienced a case of Marcus gunn syndrome in a 14 year-old boy, whose chief complaint was the drooping of the left upper eyelid which was retracted in association with opening of mouth or lateral movement of the jaw to the right side since birth.

A Case of Orbital Leiomyosarcoma

Leiomyosarcoma is a malignant tumor of smooth muscle, that rarely occurs in the orbit. It has previously been reported mainly in older persons and is characterized by frequent local recurrences and metastatic lesions. The authors report a case of orbital leiomyosarcoma in a 29 year old male that we believe was fully excised.

A Case of Central Serous Retinopathy with Optic Pits Treated by Photocoagulation

The authors experienced a case of congenital pits of the optic nerve head associated with serous detachment of posterior retina in a 30 year-old male. The right optic disc was enlarged and showed 2 gray pits. They were located at 12 and 9 o'clock positions near the margin of the disc. There was a discrete, circular, 5 disc diameter sized serous retinal detachment superior and temporal to the optic disc. Fluorescein angiography revealed leakage of dye from the capillaries in the optic nerve head surrounding the optic pit, but there was no evidence of diffusion of dye into subretinal fluid. Diffuse fluorescence in the lower temporal border of serous retinal detachment, due to transmission of choroidal fluorescence through the defect of pigment epithelium, was demonstrated. Photocoagulation was applied along the superior margin of the disc, in an effort to close the communication between the pit and subretinal space. Subretinal fluid began to decrease within a few days after the laser treatment and in 2 months the detachment almost disappeared.