Reproliferation of Idiopathic Epiretinal Membrane after Spontaneous Separation

PURPOSE: To report the reproliferation of membrane after a spontaneous separation in a patient with idiopathic epiretinal membrane (ERM). CASE SUMMARY: A 62-year-old woman complained of metamorphopsia in the left eye. Her vision without correction was 0.8. On fundus examination, the epiretinal membrane was covering the fovea with posterior vitreous detachment. Optical coherence tomography (OCT) showed the ERM and thickened macula. Retinal break, intraocular inflammatory disease, and retinal vascular disease were not noted. We diagnosed her with idiopathic ERM and followed up regularly. At month 7, a partial separation of the membrane from the retinal surface was noted. At month 12, complete spontaneous separation of the ERM from the macula except that in the temporal area was accompanied by improvement of vision to 1.0. OCT, showing recovery of the fovea contour. However, her corrected vision decreased to 0.7 at month 17, and the ERM was again observed to cover the macula. Thickening of the ERM progressed further, and her corrected vision decreased to 0.5 at month 21. CONCLUSIONS: Spontaneous separation of membrane is a rare phenomenon in idiopathic ERM. Reproliferation of membrane can develop and induce visual impairment. Therefore, regular examination is recommended in patients with spontaneous separation of membrane.

The Effectiveness of Pediatric Blood Culture Bottle in Endophthalmitis

PURPOSE: To investigate the effectiveness of the pediatric blood culture bottle for vitreous sample culture in endophthalmitis patients. METHODS: All consecutive cases with clinically suspected endophthalmitis treated and cultured in our institution between January 2009 and June 2013 were included in the study. Vitreous samples were obtained by vitreous needle aspiration (tap), anterior chamber aspiration, or mechanized vitreous biopsy (vitrectomy). The samples obtained using the conventional method until August 2011 were classified as group I. Since August 2011, the BacT/Alert PF pediatric blood culture bottle (bioMerieux, Marcy l'Etoile, France) was used for culture in group II. We investigated age, gender, biopsy method, cause of infection, use of antibiotics, bacterial culture, and culture positive rate. RESULTS: Thirty-three cases were included in group I and 17 cases in group II. There was no significant difference in age, gender, sampling technique, cause of infection, and use of antibiotics between the 2 groups. The culture positive rate in group II (60.7%) was significantly higher than group I (33.3%, p = 0.032). In group II, Enterococcus feacalis was the most common pathogen (8 eyes). In group I, Streptococcus pneumoniae and Pseudomonas aeruginosa were confirmed in 3 cases. CONCLUSIONS: The pediatric blood culture bottle can be used successfully in the examination of clinically suspected endophthalmitis. The method showed higher culture positive rate compared with the conventional method. This technique is simple and maintaining a supply of fresh agar media is not necessary.

Vitrectomy with Perfluorocarbon Liquid versus Combined Encircling for Retinal Detachment with Giant Retinal Tear

PURPOSE: To evaluate the clinical usefulness of additional encircling in patients treated for retinal detachment with giant retinal tear and without proliferative vitreoretinopathy, compared to single vitrectomy using perfluorocarbon liquid. METHODS: Patients who underwent surgery for retinal detachment with giant retinal tear were divided into either the vitrectomy alone group or combined vitrectomy and encircling group. We reviewed the primary anatomical success rate, final anatomical success rate and best corrected visual acuity (BCVA) at the last follow-up (log MAR). Additionally, BCVA at the first visit, intraocular pressure, lens status, history of intraocular surgery, high myopia, trauma history, time from symptom onset to surgery, location and size of the giant retinal tear, extent of retinal detachment and foveal detachment were reviewed. RESULTS: Among a total of 29 eyes, the vitrectomy alone group included 8 eyes and the combined group 21 eyes. Location and size of the giant retinal tear, extent of retinal detachment and foveal detachment, intraocular pressure, history of intraocular surgery, lens status, high myopia, trauma history and time from symptom onset to surgery were not different between the 2 groups. The primary success rate was 87.5% in the vitrectomy group and 85.7% in the combined group; the final surgery success rate was 100.0% and 95.2%, respectively. There was no significant difference in the anatomical success rate between the 2 groups. The postoperative BCVA was similar in both groups (0.80 vs. 0.92). CONCLUSIONS: When vitrectomy using perfluorocarbon liquid was performed for the treatment of giant retinal tear without proliferative vitreoretinopathy, an encircling provided no additional benefit for the anatomical success rate and visual recovery. Only intensive vitrectomy of peripheral retina was considered capable of achieving a successful retinal attachment in patients without proliferative vitreoretinopathy.

Autologous Transplantation of Internal Limiting Membrane for the Treatment of Large Macular Hole

PURPOSE: To evaluate the surgical outcome of autologous transplantation of internal limiting membrane (ILM) for the treatment of large macular hole. METHODS: Twenty-five gauge pars plana vitrectomy was performed for the treatment of patients with full thickness macular hole larger than 400 microm. ILM was stained using 0.025% brilliant blue G. ILM around the hole was circumferentially peeled as large as 2.5 disc diameter (DD) in size and then transplanted inside the hole. ILM was peeled out additionally approximately 1.5 DD in size. Fluid-air exchange and gas injection were performed. After surgery, the hole was scanned using spectral domain optical coherence tomography. RESULTS: A total of 5 eyes were included in the present study. The mean age was 65.0 +/- 11.8 years (52-77) and mean best corrected visual acuity (log MAR) was 0.80 +/- 0.27. The mean refractive error was -2.0 +/- 2.2 diopter, mean horizontal size of hole was 701.4 +/- 129.4 microm, mean vertical size was 630.2 +/- 202.8 microm, mean hole base size was 1,043.4 +/- 225.0 microm and hole height was 464.4 +/- 218.9 microm. At the first day after surgery, transplanted ILM was detected inside the hole in all 5 eyes and complete closure of the hole occurred in 4 eyes. One hole was closed between postoperative days 4 and 7. Foveal contour improved gradually but photoreceptor integrity did not during the follow-up period. Two eyes showed visual improvement but 3 did not after surgery. CONCLUSIONS: Macular hole was closed successfully and quickly using the autologous ILM transplantation technique. Based on our results, the autologous ILM should be considered the treatment of choice for large macular holes.

Visual Field Defect Developed after Internal Limiting Membrane Peeling in a Patient with Epiretinal Membrane

PURPOSE: To report a case of visual field defect developed after internal limiting membrane (ILM) peeling in a patient with macular epiretinal membrane (ERM). CASE SUMMARY: A 33-year-old female without a history of specific diseases presented with a gradually decreased visual acuity in the right eye for 3 years. The patient was diagnosed as having macular ERM and underwent vitrectomy. During ILM peeling, retinal hemorrhage occurred in the superior region of macula, which spontaneously disappeared 2 weeks after surgery. Transmission electron microscopy showed Muller cell end feet with damaged appearance adherent to the ILM. At 3 months after surgery, the patient developed retinal nerve fiber layer (RNFL) defect in the area where the spot retinal hemorrhage had occurred. Optical coherence tomography showed focal RNFL thinning in the superotemporal region. The automated perimetry revealed corresponding inferior nasal step and scotomas in the right eye. Intraocular pressure was normal throughout the follow-up period and there was no evidence of glaucomatous optic disc change. CONCLUSIONS: The results obtained from the patient in the present study indicated that visual field defect may be the result of a mechanical damage to the RNFL during ILM peeling.

Clinical Effect of Intravitreal Bevacizumab Injection in Myopic Choroidal Neovascularization

PURPOSE: To evaluate the therapeutic effect of bevacizumab in treating myopic choroidal neovascularization (CNV). METHODS: Medical records of the eyes that underwent intravitreal bevacizumab injection for myopic CNV and were followed up for more than one year were reviewed retrospectively. Best corrected visual acuity (BCVA), foveal thickness in optical coherence tomography and fluorescein angiography were investigated. RESULTS: Twenty eyes of 18 patients were included in the present study. The average age was 41.5 years, average axial length was 28.5 mm, and average refractive error was -11.0 diopters. Visual acuity was maintained in all eyes, and 13 eyes improved by LogMAR 0.3 or more. Visual acuity improved significantly from 0.71 (0.2~2.0) to 0.40 (0.1~2.0, p=0.02) at six months and to 0.41 (0.1~2.0, p=0.03) at one year. Central foveal thickness significantly decreased from 247.0 micrometer to 207.5 micrometer (p=0.03) at six months and to 208.5 micrometer (p=0.04) at one year. CONCLUSIONS: Anti-VEGF therapy using bevacizumab for the treatment of myopic CNV was effective in maintaining visual acuity.

Effect of Artificial Tears Used in Contact Lens-wearing Eyes on Human Corneal Epithelial Cells in Vitro

PURPOSE: To investigate the biologic effects of topical ocular artificial tears used in patients wearing contact lens on in vitro corneal epithelial cells. METHODS: The efficacies of the topical artificial tears Iris(R), Irisplus(R), Eyemiru contact pure(R), and Eye2O(R) were evaluated using the MTT and wound healing assays. Cell damage was determined using lactate dehydrogenase (LDH), and the solution ingredients were analyzed. Cellular morphologies were examined by inverted light microscopy and transmission electromicroscopy. RESULTS: Metabolic activity of corneal epithelial cells, as determined by the MTT assay, decreased in the Iris(R) eye drop group, but those of the other groups were similar to that of the control. The LDH titers increased up to one hour after Iris(R) eye drop use, and the increased level was maintained for 24 hours. The other three artificial tears showed similar low LDH titers to that of the control. Cellular migration was not observed, although cellular damage to the corneal epithelial cells, such as chromatin margination and cytoplasmic organelle swelling, was prominent with Iris(R) use. CONCLUSIONS: Among four brands of topical artificial tear drops used among patients wearing contact lens, Iris(R) caused markedly more severe damage to cultured human corneal epithelial cells than did Irisplus(R), Eyemiru contact pure(R), or Eye2O(R).

Cinical Effect of Restasis(R) Eye Drops in Mild Dry Eye Syndrome

PURPOSE: To evaluate changes in tear secretion and symptoms in patients with mild dry eye syndrome after using Restasis(R). METHODS: From patients diagnosed with mild dry eye syndrome, Restasis(R) was administered to 46 eyes of 23 patients. The clinical parameters and symptoms were checked over a period of six months. The clinical parameters evaluated were the symptoms of dry eye syndrome using an OSDI scoring scale, the Schirmer test, and tear break-up time. RESULTS: Eight male patients and 15 female patients were included in the study. The mean age was 50.5 years. Before treatment, the values for the OSDI score, BUT, and Schirmer test were 32.3, 5.3 mm, and 8.1 seconds, respectively. After treatment, the OSDI score, BUT, and Schirmer test were 22.9, 8.1 mm, and 12.1 seconds at six months, respectively. The subjective parameter (OSDI score) improved two months after treatment (p=0.003), and the objective parameters (BUT, Schirmer test) improved three months after treatment (p=0.03, p=0.04, respectively). CONCLUSIONS: In the present study, Restasis(R) increased tear secretion and improved clinical symptoms of patients with mild dry eye.

Marker test for attenuation of varicella-zoster viruses isolated in Korea

No abstract available.

Propagation of varicella-zoster virus isolated in Korea

No abstract available.

Restriction fragment length polymorphism analysis of varicella-zoster virus isolated in Korea

No abstract available.

Histological Grade of Prostatic Adenocarcinoma

The authors attempted to choose what has the best reproducibility and predictability for prognosis of the prostatic adenocarcinoma among four most widely used gradings methods; the Gleason's Mostofi's, Bocking and MD Anderson hospital systems. According to these gradings systems, each of two pathologists made histologic gradings of 40 consecutive prostatic adenocarcinomas which had been diagnosed with the surgically resected specimens. Correlation between the histological grades and the clinical stages was studied and a comparison was made among each system. For the comparison, the Gleason's and MDAH systems were revised as 3 grades and adjusted to the other gradings systems. In this study, MDAH grading system yielded the highest reproducibility as represented by 90% agreement, as compared with the other systems which showed 82.5~87.5% agreement. By the Gleason's, Mostofi's and Bocking's systems, 46.2%, 23.1% and 46.2% of grade 3 tumors respectively fell under the clinical stage A. On the contrary, there were no cases of grade 3 in stage A and no cases of grade 1 in stage D, by MDAH gradings system. These results suggest that MDAH gradings system is superior to the other systems in reproducibility and for predicting the biological behavior.