The Clinical Study of Branch Retinal Vein Occlusion Associated with Systemic Hypertension

Branch Retinal Vein Occlusion(BRVO) is the second most retinal vascular abnormality after diabetic retinopathy. Systemic hypertension is the most common combined disease. The author evaluated 38 patients of BRVO with hypertension regarding the clinical manifestations, viual acuity changes and the results of treatment. Medical or Laser therapy was selected according to the degree of retinal nonperfusion, macular edema and neovascularization documented by fluorescein angiography. The most common age group was sixth decade(39.5%) and the most common affected site was superior temporal branch of retinal vein(60.5%). The sequelae were macular edema(39.4%), perifoveal non perfusion, retinal neovascularization and vitreous hemorrhage. There were no significant differences in visual prognosis due to the states of blood pressure, vein occlusion site and timing of laser therapy. The better visual prognosis was observed in cases of without soft exudate or without macular edema or capillary non perfusion less than 5 disc diameter. The increased visual acuity of 2 lines or more were noted in 10(71%), 13(76%), 9(60%) cases respectively and showed stastiscal correlations(p0.05). We suggest that the medical and laser therapy should be considered according to the status of high quality fluorescein angiography of retina.

The Clinical Study of Treatment of Blowout Fracture

The orbital blowout fractures has been increasing due to trauma and traffic accidents with time. The diagnostic confirmation is easily established by CT scan, but the indication for surgical treatment, the technique for repair, and timing of repair are still controversial. We have reviewed investigated the charts of 18 cases who had blowout fracture, including the clinical manifestation, surgical indication, surgical procedures, improvement of diplopia, and its complication. The follow up was at least 6 months in the past 5 years. In cases of diplopia only in the upward gaze limitation, or small orbital fracture in orbital CT scan and less degree of enophthalmos, these 8 cases were treated conservatively for 2 weeks and diplopia improved markedly. However, in 10 cases of severe diplopia and in large fracture and tissue incarceration, these were surgically managed using Silastic sheets. In these cases, the diplopia resolved within 1 month in 7 cases(70%). Residual diplopia waS seen in 3 cases, and we retreated surgically for the two cases of them. In the other non surgical cases, diplopia resolved on 6 months follow up except in 2 cases of mild diplopia. Therefore we should pay more attention to surgical indication.

The Clinical Study of 33 Cases of Congenital Blepharoptosis

The blepharoptosis is drooping of upper eyelid in primary gaze with various causes. The most common cause of ptosis is, in known as, underdevelopment of levator muscle. We evaluated the age and sexual distribution, clinical manifestation, result of treatment and it's complication of congenital blepharoptosis. The method of surgery and amount of muscle resection was decided according to several factors that is the amount of ptosis, the preoperative levator functon, and the Margin Limbal Distance(MLD). Most of patient was second decades(48.3%). In cases of unilateral ptosis, left lid was higher incidence(60%) than right lid and 4 cases(14%) were bilateral ptosis. The amount of ptosis was between 3 and 4mm in most cases(48.5%), and over the 5mm was 12 cases(36.3%). Preoperative levator function between 4 and 7mm of the patient was in 18 cases(54.5%) and 3mm or less was 12 cases(36.3%). Between 16 and 19mm muscle resection was 10 cases(43.5%), Between 12 and 15mm resection was 7 cases(30.4%). In initially corrected visual acuity with Hans Chart. 12 cases(36%) were 0.5-1.0 and 2 cases were 0.1 or less. There is no significant visual improvement after one year surgical correcton. The most common surgical procedure was levator muscle resection(73%) through anterior skin incision and followed by frontalis suspension in 9 cases(27%). The result of operation was good for the period of six months follow-up. The most common complication was undercorrection in 2 cases of levator muscle resection and 1 case of frontalis suspension. The other complications were overcorrectopn, exposure keratitis and entropion in each case, respectively.