A Case of Complete Ophthalmoplegia in Herpes Zoster Ophthalmicus

PURPOSE: To report a case with complete ophthalmoplegia after herpes zoster ophthalmicus. METHODS: A 70-year-old male patient visited a clinic because of vesicular eruptions over the left side of his face with severe pain. Drooping and severe swelling of the left eyelid were present, along with keratitis and uveitis. While the lid swelling and uveitis were improving, external ophthalmoplegia and exophthalmos were discovered. Intramuscular injections of dexamethasone 5 mg were given for 10 days, followed by oral administration of prednisolone at a dosage of 15 mg for two weeks and 10 mg for two weeks. RESULTS: The patient was fully recovered from the complete ophthalmoplegia and exophthalmos six months after the onset of the cutaneous lesion. CONCLUSIONS: Complete ophthalmoplegia is a rare ophthalmic complication of herpes zoster infection. Therefore, an evaluation of extraocular muscle and lid function should be performed during the examination of herpes zoster patients in order to screen for ophthalmoplegia.

Muscle Width and Distance from Limbus to Muscle Insertion Site in Strabismus Patient

PURPOSE: This study investigated the differences of muscle width and distance from limbus to muscle insertion site according to age and sex, and the correlation with ocular axial length and strabismus degree. METHODS: The study subjects were 100 eyes of 50 horizontal strabismus patients undergoing rectus muscles recession. Ocular axial lengths were measured at preoperation, while muscle width and distance from limbus to muscle insertion site were measured during operation. Preoperative and postoperative comparison items were retrospectively investigated with the medical records. Correlations of muscle width, distance from limbus to muscle insertion site and the comparison items were verified by ANOVA test. RESULTS: Muscle width was 10.05+/-0.86 mm in medial rectus muscle and 9.38+/-1.03 mm in lateral rectus muscle. Distance from limbus to muscle insertion site was 5.21+/-0.85 mm in medial rectus muscle and 6.37+/-1.01 mm in lateral rectus muscle. Muscle width and distance from limbus to muscle insertion site had no correlations with ocular axial length and strabismus degree, but ocular axial length was significantly longer in the older group compared to the younger group and in the male group compared to the female group. CONCLUSIONS: It is presumed that muscle width and distance from limbus to muscle insertion site have no relationship with age, sex and strabismus degree.

Fungus at Removed Silicone Tubes in Nasolacrimal Duct Obstruction Patients

PURPOSE: This study investigated the fungi of silicone tubes in the patients with nasolacrimal duct obstruction, and investigated the identification of fungi according to operation type, clinical features and detailed locations of silicone tubes. METHODS: The subjects of this study were 49 eyes of 40 patients operated on for nasolacrimal duct obstruction from July 2003 to April 2004. The removed silicone tubes were divided into the parts of conjunctiva, lacrimal drainage system and nasal cavity according to insertion state, after which fungus culture was performed using them. We classified patients into the silicone tube intubation group and the dacryocystorhinostomy group. Preoperative nasal problems, dacryolith on dacryocystorhinostomy, postoperative features of nasal cavity during the follow-up period and success of operation were retrospectively investigated with the medical records. Correlations of the results of fungus culture and clinical features were verified by Pearson Chi-Square test. RESULTS: Fungus culture rate was significantly higher in the dacryocystorhinostomy group (37.5%) than in the silicone tube intubation group (12.12%) (p-value<0.05). In total patients according to insertion site, fungus culture rate was significantly higher in the nasal cavity than in the lacrimal drainage system, and in the lacrimal drainage system than in the conjunctiva (p-value<0.05). The species of cultured fungi were in the following order: Candida, Trichosporon, Penicillium and Aspergillus. CONCLUSIONS: Fungal infection of the silicone tube in patients with nasolacrimal duct obstruction was found and fungi species were cultured. Further study is needed of fungi in the nasolacrimal duct before surgery for determining the fungal infection causing nasolacrimal duct obstruction.

Epidemiology of Infectious Keratitis(II): A Multi-center Study

To identify risk factors and causative organisms, and to evaluate clinical manifestations, methods and results of treatment in infectious keratitis, an epidemiological study was performed prospectively under the identical protocol from April 1995 to March 2000.Logistic regression analysis was used to evaluate possible risk factors. The 1474 cases of infectious keratitis reported from 22 hospitals were studied. Five hundred forty-four organisms(442 bacteria, 82 fungi, 20 A c a n t h a m o e b a)were detected in 1320 eyes with infectious keratitis excluding 154 herpetic keratitis. The Pseudomonas aeruginosa was the most common organism in bacterial keratitis, and Fusariumspp. was the major isolate in fungal keratitis. Contact lens wear and occupation(industry, forester, miner, fisherman)were the risk factors for bacterial keratitis. Risk factors in fungal keratitis were fifth decade of age, farmer, and systemic diseases(diabetes mellitus etc.). Risk factors in herpetic keratitis were male and occupation(office worker, service, student, housewife). Risk factors in Acanthamoeba keratitis was contact lens wear.

Immunohistochemical study of nitric oxide synthase in salivary glands / 대한해부학회지

Endogenous nitric oxide (NO) has been known to regulate the salivary secretion and glandular blood flow. However, nitric oxide synthase (NOS) responsible for NO synthesis has not been well studied in salivary glands. The present study was aimed to investigate the distribution of nitric oxide synthase isoforms (endothelial, neuronal, and inducible NOS). Immunohistochemistry, using monoclonal mouse anti-endothelial NOS, anti-neuronal NOS, and anti-inducible NOS, was performed in 3 major salivary glands of the rat. Endothelial NOS (eNOS)-positive immunoreactivity was observed in arterial endothelium, striated duct, granular convoluted duct of the submandibular gland, intercalated duct, and mucous acinar cells of the sublingual gland. eNOS-positive immunoreactivity was most prominent in the arterial endothelial layer and that of the striated and granular convoluted duct was well concentrated in columnar epithelial layer. However, eNOS-positive immunoreactivity of the intercalated duct and mucous acinus was weak. Neural NOS (nNOS)-positive immunoreactivity was seen in submandibular ganglion, autonomic postganglionic fiber, striated duct, granular convoluted duct, and intercalated duct. nNOS-positive immunoreactivity of the submandibular ganglion and autonomic postganglionic fiber was most prominent and that of the ductal system was well concentrated in epithelial layer. eNOS or nNOS-positive immunoreactivity was not detected either in excretory ducts or in serous acinar cell. Inducible NOS-positive immunoreactivity was not seen. There results reveal the presence of eNOS and nNOS in the salivary gland, which may be related with regulation of the glandular secretion and blood flow.

The Changes of Sensory Retinal Detachment in Central Serous Choriore tinopathy Patients

Patients with central serous chorioretinopathy complain of decreased vision, micropsia, metamorphopsia, and central scotoma due to sensory retinal detachment. Morphologic characteristics of the sensory retinal detachment were described using Heidelberg retina tomograph. We inspected the changes in morphology according to certain time interval in 28 eyes and correlated them with the changes in visual acuity and symptoms. The mean width,length, height, area and volume of the detached sensory retina at initial examina- tion were 2.86 +/-1.08 mm, 2.60 +/-0.97mm, 0.30 +/-0.10mm, 6.82 +/-4.70mm2 and 0.77 +/-0.68mm3, respectively. Of the 7 eyes that had been followed, improvement of vision preceded improvement of other symptoms but, this was not statistically significant. The extent of sensory retinal detachment reduced with time and the maximal reduction occurred during the first month from the initial visit. The volume reduction (87.4%) was greater than the area reduction (52.3%) at the time of visual improvement

Epidemiology of infectious KeratitisI A Multi-center Study

Infectious keratitis is the most common serious ocular infection, and may be caused by various bacteria, fungi, viruses and parasites. The authors performed prospectively an epidemiological study to identify risk factors and causative organisms, and to evaluate clinical manifestations, methods and results of treatment in infectious keratitis under the identical protocol from April 1995 to September 1997. Logistic regression analysis [univariate analysis and multivariate analysis] was used to evaluate possible risk factors. Six hundred sixty cases of infectious keratitis reported from 19 hospitals were studied. Two hundred eighty-three organisms[247 bacteria, 32 fungi, 4 acanthamoeba] were detected in 626 eyes with infectious keratitis excluding 34 pherpetic keratitis. The Pseudomonas aeruginosa, coagulase negative staphylococcus, Staphylococcus aureus and Serratia marcescens were the major orgnisms in bacterial keratitis. Aspergillus, Fusarium and Candida were the major isolates in fungal keratitis. Contact lens wear was a risk factor for bacterial keratitis. Female, age[less than 40 years] and occupation[student, house-wife, office worker, servise] were associated with bacterial keratitis. Risk factors in herpetic keratitis were age[between 40 and 59 years] and ocular adnexal diseases. Male was associated factor with herpetic keratitis.