Characteristics of Visual Field Defects in Korean Advanced Glaucoma

Purpose@#We investigated the clinical characteristics of visual field (VF) defects in Korean advanced glaucoma patients. @*Methods@#The present study included 109 eyes of 109 advanced glaucoma patients whose mean deviation (MD) is under -12 dB. The subjects were classified into primary open angle glaucoma (POAG) and normal tension glaucoma (NTG) group. Average numeric decibel in each VF points were visualized with color topographic image and dot graph image using python 3.5. VF was divided into four quadrants or two half fields, and the differences in the degree of VF defects in each locations were assessed with raw decibel data. Additionally, mean sensitivity of central 12 points were compared between the two groups. @*Results@#Generally the features of VF defects were severely depressed VF sensitivity at the superonasal quadrant and relatively preserved central area and inferotemporal quadrant in both of the glaucoma groups. But we found the extent of deflection for VF defect in the NTG eyes was higher than that of the POAG eyes (p < 0.05). The POAG eyes tended to show more diffuse and evenly distributed VF defect, whereas NTG eyes tended to have more severely depressed VF at the superonasal quadrant and relatively preserved VF at the inferotemporal quadrant. There was no significant difference in the degree of central VF defects between the two groups. @*Conclusions@#The characteristics of VF defect in Korean advanced glaucoma revealed different features based on the glaucoma diagnosis. The POAG eyes tended to show diffuse VF defects, whereas NTG eyes tended to have more severely depressed VF sensitivity at the superonasal quadrant and relatively preserved VF at the inferotemporal quadrant.

Clinical Evaluation of Unilateral Open-Angle Glaucoma: A Two-Year Follow-Up Study / 전남의대학술지

To evaluate the clinical characteristics of unilateral open-angle glaucoma, patients diagnosed with unilateral open-angle glaucoma from January 2017 to October 2018 were divided into primary open-angle glaucoma and normal-tension glaucoma groups according to the type of glaucoma diagnosed. The glaucoma and the contralateral eyes were compared, and the contralateral eye was analyzed for conversion to glaucoma and its risk factors were assessed during the 2-year follow-up period. Among 99 patients, 36 were diagnosed with primary open-angle glaucoma and 63 with normal-tension glaucoma. When comparing the glaucoma eye with the contralateral eye, the visual field mean deviation value (all p<0.001), peripapillary retinal nerve fiber layer thickness (all p<0.001), macular ganglion cell layer-inner plexiform layer thickness (p< 0.001, p=0.003), and optic nerve cup-disc ratio (p=0.005, p<0.001) were significantly different in both the primary open-angle glaucoma and normal-tension glaucoma groups. In normal-tension glaucoma, peripapillary retinal nerve fiber layer thickness was significantly thinner in the glaucoma conversion group than in the glaucoma non-conversion group (p=0.008). It was significantly associated with glaucoma conversion (odds ratio=0.97, p=0.023). In conclusion, in patients with unilateral open-angle glaucoma, the contralateral eye may develop glaucoma. In particular, if the peripapillary retinal nerve fiber layer thickness is decreased in normal-tension glaucoma, the possibility of glaucoma conversion is high; hence, careful examination is required.

Characteristics of Visual Field Defects in Korean Advanced Glaucoma

Purpose@#We investigated the clinical characteristics of visual field (VF) defects in Korean advanced glaucoma patients. @*Methods@#The present study included 109 eyes of 109 advanced glaucoma patients whose mean deviation (MD) is under -12 dB. The subjects were classified into primary open angle glaucoma (POAG) and normal tension glaucoma (NTG) group. Average numeric decibel in each VF points were visualized with color topographic image and dot graph image using python 3.5. VF was divided into four quadrants or two half fields, and the differences in the degree of VF defects in each locations were assessed with raw decibel data. Additionally, mean sensitivity of central 12 points were compared between the two groups. @*Results@#Generally the features of VF defects were severely depressed VF sensitivity at the superonasal quadrant and relatively preserved central area and inferotemporal quadrant in both of the glaucoma groups. But we found the extent of deflection for VF defect in the NTG eyes was higher than that of the POAG eyes (p < 0.05). The POAG eyes tended to show more diffuse and evenly distributed VF defect, whereas NTG eyes tended to have more severely depressed VF at the superonasal quadrant and relatively preserved VF at the inferotemporal quadrant. There was no significant difference in the degree of central VF defects between the two groups. @*Conclusions@#The characteristics of VF defect in Korean advanced glaucoma revealed different features based on the glaucoma diagnosis. The POAG eyes tended to show diffuse VF defects, whereas NTG eyes tended to have more severely depressed VF sensitivity at the superonasal quadrant and relatively preserved VF at the inferotemporal quadrant.

Clinical Evaluation of Unilateral Open-Angle Glaucoma: A Two-Year Follow-Up Study / 전남의대학술지

To evaluate the clinical characteristics of unilateral open-angle glaucoma, patients diagnosed with unilateral open-angle glaucoma from January 2017 to October 2018 were divided into primary open-angle glaucoma and normal-tension glaucoma groups according to the type of glaucoma diagnosed. The glaucoma and the contralateral eyes were compared, and the contralateral eye was analyzed for conversion to glaucoma and its risk factors were assessed during the 2-year follow-up period. Among 99 patients, 36 were diagnosed with primary open-angle glaucoma and 63 with normal-tension glaucoma. When comparing the glaucoma eye with the contralateral eye, the visual field mean deviation value (all p<0.001), peripapillary retinal nerve fiber layer thickness (all p<0.001), macular ganglion cell layer-inner plexiform layer thickness (p< 0.001, p=0.003), and optic nerve cup-disc ratio (p=0.005, p<0.001) were significantly different in both the primary open-angle glaucoma and normal-tension glaucoma groups. In normal-tension glaucoma, peripapillary retinal nerve fiber layer thickness was significantly thinner in the glaucoma conversion group than in the glaucoma non-conversion group (p=0.008). It was significantly associated with glaucoma conversion (odds ratio=0.97, p=0.023). In conclusion, in patients with unilateral open-angle glaucoma, the contralateral eye may develop glaucoma. In particular, if the peripapillary retinal nerve fiber layer thickness is decreased in normal-tension glaucoma, the possibility of glaucoma conversion is high; hence, careful examination is required.

Solitary Neurofibroma Occurred on the Eyelid Margin without Neurofibromatosis: A Case Report

PURPOSE: We report a rare case of solitary neurofibroma on the eyelid margin without neurofibromatosis. CASE SUMMARY: A 46-year-old male presented with a well-define small nodular lesion on the right upper eyelid margin that had not changed for 10 years. Surgical excision and biopsy were performed. Histological examination showed spindle-shaped cells in the fibrous stroma on hematoxylin & eosin staining, and immunohistochemical staining revealed S-100 protein-positive cells. Dermatologic, neurologic, and genetic evaluations showed no evidence of systemic neurofibromatosis. Six months after operation, there was no evidence of local recurrence. CONCLUSIONS: To the best of our knowledge, this is the first case of solitary neurofibroma involving the eyelid margin without neurofibromatosis in Korea. Neurofibroma should be considered in a differential diagnosis of eyelid mass and can be successfully managed with surgical excision.

Changes in the Clinical Manifestations of Ocular Injuries Induced by Power Lawn Mowers

PURPOSE: To investigate changes in the clinical manifestations of ocular injuries induced by power lawn mowers. METHODS: In a retrospective study of 172 patients with ocular injuries induced by power lawn mowers in 2006, 2010, and 2014. Best corrected visual acuity (BCVA) at the time of presentation and 6 months after trauma, age, sex and seasonal distribution were analyzed. We assessed the degree of injury using slit lamp biomicroscopy, fundus examination, and computed tomography and analyzed the prognoses according to open/closed injury and, anterior/posterior segment injury. All patients underwent medical or surgical treatment, and the factors affecting final BCVA were analyzed. RESULTS: The ratio of closed injuries increased significantly (p = 0.027), as did the ratio of corneal erosion (p = 0.020), and, the ratio of corneal laceration decreased significantly (p = 0.014) over time. In the multivariate analysis, initial BCVA was the only risk factor of poor visual outcome in both open and closed injuries. CONCLUSIONS: The proportion of open globe injury has decreased over time. In contrast, the proportion of simple injuries such as corneal erosion has increased in ocular injuries induced by power lawn mowers. Lower initial visual acuity was the only risk factor of poor visual outcome in both open and closed injuries.

Arteritic Anterior Ischemic Optic Neuropathy Associated with Giant Cell Arteritis in an Elderly Korean Man

No abstract available.

Clinical Manifestations and Prognosis of Traumatic Wound Dehiscence after Penetrating Keratoplasty

PURPOSE: To investigate clinical manifestations and prognosis of traumatic wound dehiscence after penetrating keratoplasty (PKP). METHODS: This is a retrospective study of patients with traumatic wound dehiscence after penetrating keratoplasty performed between January 2004 and July 2014. All patients underwent primary repair of wound dehiscence. Main outcome measurements included pre- and post-injury best corrected visual acuity (BCVA), mechanism of injury, indication of PKP, time interval from PKP to injury, time interval from injury to primary repair, extent of dehiscence, type of suture, presence of suture, prolapse of intraocular tissue, secondary operation, BCVA and graft state at 6 months after primary repair. RESULTS: The incidence of traumatic wound dehiscence after PKP was 3.96% (12/303). Mean post-injury BCVA and BCVA at 6 months after primary repair (log MAR) were 2.58 ± 0.95 and 2.50 ± 1.05, respectively, and visual acuity did not show significant improvement (p = 1.000). After primary repair, graft failure developed in 9 patients (75%) and evisceration in 2 patients; re-PKP was performed in 3 patients. Pars plana vitrectomy was performed in 1 patient due to retinal detachment. Visual prognosis was poor in patients with wound dehiscence greater than 180° than those with wound dehiscence less than 180° (3.24 ± 0.13 vs. 1.97 ± 1.11, p = 0.030), and in patients with iris prolapse than those without iris prolapse (3.17 ± 0.16 vs. 1.56 ± 1.05, p = 0.048). CONCLUSIONS: The prognosis of traumatic wound dehiscence after PKP was poor, and the visual prognosis was less favorable in cases with wound dehiscence greater than 180° and iris prolapse. Therefore, prevention of ocular trauma should be emphasized in all patients who undergo PKP.

Clinical Manifestations and Prognosis of Traumatic Wound Dehiscence after Penetrating Keratoplasty

PURPOSE: To investigate clinical manifestations and prognosis of traumatic wound dehiscence after penetrating keratoplasty (PKP). METHODS: This is a retrospective study of patients with traumatic wound dehiscence after penetrating keratoplasty performed between January 2004 and July 2014. All patients underwent primary repair of wound dehiscence. Main outcome measurements included pre- and post-injury best corrected visual acuity (BCVA), mechanism of injury, indication of PKP, time interval from PKP to injury, time interval from injury to primary repair, extent of dehiscence, type of suture, presence of suture, prolapse of intraocular tissue, secondary operation, BCVA and graft state at 6 months after primary repair. RESULTS: The incidence of traumatic wound dehiscence after PKP was 3.96% (12/303). Mean post-injury BCVA and BCVA at 6 months after primary repair (log MAR) were 2.58 ± 0.95 and 2.50 ± 1.05, respectively, and visual acuity did not show significant improvement (p = 1.000). After primary repair, graft failure developed in 9 patients (75%) and evisceration in 2 patients; re-PKP was performed in 3 patients. Pars plana vitrectomy was performed in 1 patient due to retinal detachment. Visual prognosis was poor in patients with wound dehiscence greater than 180° than those with wound dehiscence less than 180° (3.24 ± 0.13 vs. 1.97 ± 1.11, p = 0.030), and in patients with iris prolapse than those without iris prolapse (3.17 ± 0.16 vs. 1.56 ± 1.05, p = 0.048). CONCLUSIONS: The prognosis of traumatic wound dehiscence after PKP was poor, and the visual prognosis was less favorable in cases with wound dehiscence greater than 180° and iris prolapse. Therefore, prevention of ocular trauma should be emphasized in all patients who undergo PKP.

Risk Factors and Clinical Manifestations of Ocular Hypertension after Primary Repair of Open Globe Injury

PURPOSE: To investigate the risk factors and clinical manifestations of ocular hypertension (HTN) after repair of open globe injury (OGI). METHODS: In a retrospective study of 284 patients who underwent primary repair of open globe injury at the day of trauma, best corrected visual acuity (BCVA) at the time of trauma and 6 months postoperatively, length of laceration, location of laceration and mean intraocular pressure (IOP) at 1 month after primary repair were analyzed. Presence of iris injury, lens injury, intraocular foreign body (IOFB) and vitreous hemorrhage (VH) were also analyzed. Ocular hypertension was defined as elevation of IOP greater than or equal to 21 mm Hg over 3 measurements. RESULTS: Fourteen (4.93%) of 284 patients had ocular hypertension. BCVA (log MAR) at the time of trauma in the ocular HTN group was significantly worse than in the normal IOP group (2.43 +/- 1.04 and 1.76 +/- 1.30, respectively, p = 0.033). In the multivariate analysis, ocular HTN increased significantly with IOFB (p = 0.038; odds ratio [OR], 3.584; 95% confidence interval [CI], 1.075-11.941) and VH (p = 0.028; OR, 3.971; 95% CI, 1.157-13.624). BCVA increased significantly after repair in both groups and mean IOP was well controlled after medical therapy (9 eyes) or surgical treatment (5 eyes) in the ocular HTN group (28.1 +/- 4.7 and 15.8 +/- 3.8, respectively, p < 0.01). CONCLUSIONS: Ocular HTN increased significantly with IOFB and VH at the time of trauma after repair of OGI and can be effectively treated by medication or surgical approach.

Primary Systemic Amyloidosis of the Eyelid: A Case Report

PURPOSE: Amyloidosis involving the eyelid is a rare condition. We report a case of primary systemic amyloidosis of the eyelid. CASE SUMMARY: A 26-year-old female presented with multiple nodules on the bilateral upper and lower eyelids that had stopped growing several years prior. Multiple pearl-colored small nodular lesions were present on the upper and lower eyelid bilaterally and no clinically specific signs were observed. Surgical excision, biopsy and electrocauterization were performed. Histological examination showed amorphous and eosinophilic substances on hematoxylin & eosin (H&E) staining and orange-colored amyloid deposits stained with Congo-red. Systemic evaluation showed amyloid nodules invading the vocal cords and external auditory canal, therefore the patient was diagnosed with primary systemic amylodosis. At the postoperative 6-month follow-up, recurrence or inflammation at the operation site was not observed. CONCLUSIONS: To the best of our knowledge, this is the first case of primary systemic amyloidosis of the eyelid in Korea. Amyloidosis should be considered in a differential diagnosis of a mass in the eyelid and can be successfully managed with surgical excision and electrocauterization.

Clinical Efficacy of Topical 3% Diquafosol Tetrasodium in Short Tear Film Break-Up Time Dry Eye

PURPOSE: To evaluate the clinical efficacy of topical diquafosol tetrasodium 3% ophthalmic solution in patients with short tear film break-up time (BUT) dry eye. METHODS: This prospective study involved 30 eyes in 30 patients with dry eye who had tear film BUT values or =5 mm, and showed no improvement with non-preservative sodium hyaluronate (SH) 0.1% artificial tears. All patients were treated with topical diquafosol tetrasodium 3% 6 times a day, in addition to SH 0.1% artificial tears. Schirmer's 1 test, tear film BUT, keratoepitheliopathy score with fluorescein, conjunctival staining score with lissamine green, and Ocular surface disease index (OSDI) score were evaluated at before treatments, and 1 month and 3 months after treatments. RESULTS: Significant improvements of tear film BUT and OSDI were observed at 1 month and 3 months after diquafosol tetrasodium 3% administration. At before treatment, and followed up at 1 and 3 months, tear film BUTs were 3.3 +/- 1.2, 4.4 +/- 1.0 (p < 0.01) and 4.9 +/- 1.1 seconds (p < 0.01), respectively, and OSDI scores were 43.5 +/- 24.4, 34.6 +/- 25.0 (p = 0.01) and 26.7 +/- 21.5 (p < 0.01), respectively. There were no significant changes of Schirmer's score, keratoepitheliopathy, and conjunctival staining score. After diquafosol tetrasodium 3% administration, severe adverse effects were not found in any of the patients. CONCLUSIONS: Topical diquafosol tetrasodium 3% administration was shown to be an effective treatment for improvements of tear film stability and dry eye symptoms.

A Case of Psoriasis Exacerbated by Radioactive Iodine Therapy

No abstract available.

Clinical Characteristics of 75 Patients with Leukemia Cutis

Leukemia cutis (LC) is defined as a neoplastic leukocytic infiltration of the skin. Few clinical studies are available on recent trends of LC in Korea. The purpose of this study was to analyze the clinical features and prognosis of LC in Korea and to compare findings with previous studies. We performed a retrospective study of 75 patients with LC and evaluated the patients' age and sex, clinical features and skin lesion distribution according to the type of leukemia, interval between the diagnosis of leukemia and the development of LC, and prognosis. The male to female ratio was 2:1, and the mean age at diagnosis was 37.6 yr. The most common cutaneous lesions were nodules. The most commonly affected site was the extremities in acute myelocytic leukemia and chronic myelocytic leukemia except for acute lymphocytic leukemia. Compared with previous studies, there was an increasing tendency in the proportion of males and nodular lesions, and LC most often occurred in the extremities. The prognosis of LC was still poor within 1 yr, which was similar to the results of previous studies. These results suggest that there is a difference in the clinical characteristics and predilection sites according to type of leukemia.

Fixed Drug Eruption Caused by Mesna / 대한피부과학회지

A fixed drug eruption (FDE) is a cutaneous reaction caused by various drugs. Mesna is used to decrease urotoxic side effect of cyclophosphamide and there have been no previously reported cases in Korea for any adverse reactions to this drug. Herein, we report a case of a FDE caused by mesna. A 34-year-old woman presented with asymptomatic, brownish macules and patches on the face and back for the past 4 months. She had been treated for SLE with monthly pulses of intravenous cyclophosphamide and mesna for 6 months. She had experienced similar episodes after injection of mesna. The skin biopsy specimen taken from her showed vacuolar degeneration of the basal cell layer and perivascular lymphohistiocyte infiltration in the papillary dermis. We performed prick test, scratch patch test, and intradermal test with mesna and confirmed that a FDE was caused by this drug.

Mycobacterium fortuitum Infection after Footbath / 대한피부과학회지

Mycobacterium fortuitum is one of the rapidly-growing atypical mycobacteria, belonging to Runyon group IV. M. fortuitum infection is usually related to trauma, injections and surgical procedures, and is resistant to treatment with anti-tuberculous agents. Herein, we report on a case of M. fortuitum infection after footbath. A 51-year-old male presented with painful, erythematous nodules and plaques with crust and purulent discharge on the lower legs for 3 months. The skin lesion occurred after two herb and aroma footbaths and leg massage. He went to the massage shop again, and received the footbath one more time. The skin lesion aggravated and he visited a hospital, then the skin biopsy was performed but the result was unremarkable. He was treated with antihistamine and antibiotics but there was no improvement. So he visited our hospital, and culture demonstrated atypical mycobacterium, which was identified as M. fortuitum by polymerase chain reaction. He was treated with oral clarythromycin for 5 months, and the skin lesions have improved.

Extramammary Paget's Disease Presenting as a Huge Mass on the Perianal Area / 대한피부과학회지

No abstract available.

Milium-like Syringoma with Typical Histopathologic Features / 대한피부과학회지

No abstract available.