Comparison of Therapeutic Effects of 3% Diquafosol Tetrasodium with Aging in Dry Eye

PURPOSE: The aim of this study was to evaluate the clinical effect of 3% diquafosol in dry eye patients aged around 60 years. METHODS: In total, 68 patients with dry eye syndrome were divided by age into 2 groups, Group I (29 patients, 29 eyes) under the age of 60 years and Group II (39 patients, 39 eyes) over the age of 60 years. To evaluate the effectiveness of 3% diquafosol, we measured the tear film break-up time (tBUT), performed the Schirmer I test, and used the corneal staining score as an objective indicator and the ocular surface disease index (OSDI) score as a subjective indicator at initial visit, 1 month, 2 months, and 4 months. RESULTS: Significant improvements in the tear film break-up time, Schirmer I test, and OSDI were observed at 1,2, and 4 months after treatment with 3% diquafosol tetrasodium in both dry eye groups, but significant difference in the corenal staining score were not observed (p > 0.05). There were statistically significant improvement between the 2 age groups in the tBUT at 1 month (p = 0.012), 2 months (p = 0.005), and 4 months (p = 0.005), and improvements in the Schirmer I test between the 2 age groups at 1 month (p = 0.015), 2 months (p = 0.005), and 4 months (p = 0.005) were also observed. But, there was no significant difference in the corneal staining score and OSDI score between the 2 groups at 1, 2, and 4 months (p > 0.05). CONCLUSIONS: Topical 3% diquafosol tetrasodium administration was shown to be an effective treatment to improve clinical symptoms and objective indicators in dry eye patients regardless of age, showing significant improvements in tBUT and the Schirmer I test under the age of 60.

Long-Term Effect of Preservative-Free Sodium Hyaluronate Eye Drop on Human Corneal Epithelial Cell

PURPOSE: To investigate the biological effects of preservative-free artificial tear drops on cultured human corneal epithelial cells in vitro. METHODS: The effects of the preservative-free artificial tear drops (Kynex(R) 0.1%, Kynex II(R) 0.18% [Alcon, Seoul, Korea] and Hyaluni eye drops(R) 0.15%, 0.3% [Taejun, Seoul, Korea]) on the human corneal epithelial cells were evaluated. An methyl thiazolyl tetrazolium (MTT)-based colorimetric assay was performed to assess the cellular metabolic activity and a lactate dehydrogenase (LDH) leakage assay was used to determine cellular toxicity. The eye drop ingredients were analyzed for electrolyte composition, pH, and osmolarity. We performed a scratch assay and cellular morphology test using electronic microscopy. RESULTS: The metabolic activity of corneal epithelial cells was higher than controls at 24 hours after exposure and then decreased at 48 and 72 hours after exposure (p < 0.05). The LDH titers of the 4 eye drops were higher compared with controls (p < 0.05). Sodium hyaluronate 0.18% contained lower concentrations of Na+ or Cl- and showed lower osmolarity values compared with the other eye drops. The cellular migration based on the scratch assay was more delayed and cellular damage such as loss of microvilli, rough endothelial reticulum (RER), and mitochondria dilatation was greater than controls based on electron microscopy. CONCLUSIONS: Long-term exposure to preservative-free sodium hyaluronate eye drops may induce decreased metabolic activity and cellular damage. Thus, preservative-free artificial tears should be used carefully to prevent cellular toxicity.

Confocal Microscopic Findings of Avellino Corneal Dystrophy According to Disease Severity

PURPOSE: In this study we analyzed and objectified the characteristics of the Avellino corneal dystrophy patients considering disease severity using in vivo confocal microscopy (IVCM). METHODS: Each corneal layer of 36 eyes in 18 patients with Avellino corneal dystrophy was examined using IVCM (ConfoScan 4.0, NIDEK, Co. Ltd., Albignasego, Italy). Patients were classified into 3 groups based on disease severity (mild, moderate, or severe). RESULTS: In the mild group, hyper-reflective granular deposits without dark shadows were observed in the anterior stroma. As the disease progressed, corneal deposits were also found at the posterior stroma and epithelium, and clusters of hyper-reflective corneal deposits resembling stromal opacity were noted. The range of corneal deposits measured using Z-scan optical pachymeter was 111.14 +/- 30.95 um in the mild group, 157.47 +/- 25.00 um in the moderate group, and 193.42 +/- 52.23 um in the severe group (p < 0.05). CONCLUSIONS: The origin of the corneal deposits in Avellino corneal dystrophy may be related to corneal stromal cells and distributed from the corneal epithelial layer to the stromal layer. IVCM might be useful for the standardization of disease severity by digitalizing the range of deposits.

Delayed Closure of Idiopathic Macular Hole after Vitrectomy, Internal Limiting Membrane Peeling, and Gas Tamponade

PURPOSE: To report a case of delayed idiopathic macular hole closure after vitrectomy, internal limiting membrane peeling, and gas tamponade. CASE SUMMARY: A 69-year-old female complained of visual disturbance in her left eye. At presentation, her visual acuity was 20/100 in the left eye. Fundus examination and optical coherence tomography revealed a full-thickness macular hole 489 microm in diameter as well as posterior vitreous detachment. Hence, vitrectomy, concurrent cataract surgery, internal limiting membrane peeling and gas tamponade were performed. One month postoperatively, the hole remained unclosed, although decreased in size to 378 microm. At 2 months, cystoid macular edema developed and postoperatively the hole diameter decreased gradually to 311 microm, 252 microm and 156 microm at 2, 3, and 5 months, respectively. Finally, the hole was closed upon the resolution of macular edema at 9 months. However, the visual acuity of 20/100 remained unchanged. CONCLUSIONS: Delayed closure of holes which may be related to cystoid macular edema, can develop after macular hole surgery.

Effect of Preservative-Free Healon Eye Drop on Human Corneal Epithelial Cell in Vitro

PURPOSE: To investigate the biologic effects of preservative-free artificial tear drops on cultured human corneal epithelial cells in vitro. METHODS: The effects of preservative-free artificial tear drops (sodium hyaluronate 0.1% (Kynex(R), Alcon, Seoul, Korea), sodium hyaluronate 0.18% (Kynex2(R), Alcon, Seoul, Korea), and sodium hyaluronate 0.3% (Hyaluni eye drops 0.3%(R), Taejoon, Seoul, Korea)) on human corneal epithelial cells were evaluated. Cellular proliferation was determined using MTT (3- (4,5-dimethylthiazol-2yl)-2,5-diphenyl-2H-tetrazolium bromide) and Ki-67 assays. Cellular migration was determined using CD44 and scratch wound assays. Cell damage was determined using the lactate dehydrogenase (LDH) assay and cellular morphologies using electronic microscopy and inverted microscopy. RESULTS: Proliferation of corneal epithelial cells, as determined by the MTT and Ki-67 assays, was not significantly different between the different eye drops (p > 0.05). The measured value of cellular migration after exposure of the sodium hyaluronate 0.3%, as determined by mean CD44 percentage and scratch wound assay, was higher than that of the sodium hyaluronate 0.1% and sodium hyaluronate 0.18%, but the CD44 value was not significantly different (p > 0.05). The LDH titer tended to increase as the concentration of sodium hyaluronate increased (p > 0.05), but influence on cytoplasm, as determined by electronic microscopy, was not different. CONCLUSIONS: Among 3 preservative-free artificial tear drops, sodium hyaluronate 0.3% demonstrated increased migration of corneal epithelial cells. As the concentration of sodium hyaluronate in eye drops increased, the corneal cytotoxicity of corneal epithelial cells also increased. However, there was no significant difference among the 3 tear drops.

A Case of Optic Atrophy and Visual Field Defect in Periventricular Leukomalacia

PURPOSE: To report a case of visual field defect and optic atrophy in a patient with periventricular leukomalacia. CASE SUMMARY: A 22-year-old woman was referred to our hospital for further glaucoma evaluation. She was diagnosed with normal tension glaucoma by her local ophthalmologist. Best corrected visual acuity and intraocular pressure were 1.0 and 16 mm Hg in both eyes, respectively. Fundus examination showed a cup disc ratio of 0.36 in the right eye and 0.34 in the left eye. However, the optic disc had temporal pallor. Red-free photograph and optical coherence tomography showed supratemporal retinal nerve fiber layer atrophy. Visual field examinations revealed inferior visual field defect in both eyes. The patient was born at 34 weeks of gestation with a birth weight of 1600 g. Brain magnetic resonance imaging (MRI) showed periventricular leukomalacia. CONCLUSIONS: The author presents a case of periventricular leukomalacia with inferior visual field defect and optic atrophy in a patient who was previously diagnosed with glaucoma. If non-specific clinical features that differ from typical glaucomatous clinical features are observed in a patient with a history of prematurity, a brain MRI can aid the diagnosis.

Early Capsular Block Syndrome after Phacoemulsification with Posterior Chamber IOL Insertion Combined with Vitrectomy

PURPOSE: To report early capsular block syndrome (CBS) after phacoemulsification with posterior chamber intraocular lens (IOL) insertion combined with vitrectomy. METHODS: Medical records of 622 eyes of 589 patients who had combined phacoemulsification, IOL implantation and vitrectomy between March 2009 and December 2011 were retrospectively reviewed. Among patients with CBS occurring within 1 month of surgery, the patient's baseline characteristics, type of IOL and ophthalmic viscoelastic devices were analyzed. RESULTS: Nine patients (1.45%) developed CBS with typical capsular bag distension. All CBS occurred within 2 weeks after the surgery. Hydrophilic, large optics and no angulation between optic and haptic were related with the occurrence of CBS. Nd:YAG laser capsulotomy (5 eyes), and surgical capsulectomy (2 eyes) resolved CBS successfully. In 2 eyes with gas tamponade, CBS resolved without intervention with the absorption of gas. CONCLUSIONS: CBS may develop after phacoemulsification with PC IOL insertion combined with vitrectomy and/or vitreous tamponade. Hydrophilic material, large optics and no angulation were risk factors of capsular block by enhancing adhesion between the capsulorrhexis and the optic.

A Case of Primary Hyperparathyroidism Associated with Proximal Renal Tubular Acidosis and Postoperative Hungry Bone Syndrome / 대한내분비학회지

Primary hyperparathyroidism is a generalezed disorder of calcium, phosphorus and bone metabolism due to an increased secretion of parathyroid hormone. Single parathyroid adenoma is the most common cause of primary hyperparathyroidism. Because parathyroid hormone has been proposed as an important inhibitor of renal bicarbonate reabsorption of proximal tubule, proximal renal tubular acidosis is not rare in primary hyperparaphyroidism. After parathyroid resection, significant hypocalcemia and hypophosphatemia requiring prolonged medical management may develop, termed hungery bone syndrome. We experienced a case of primary hyperparathyroidism associated with proximal renal tubular acidosis, and severe hungry bone syndrome after resection of the adenoma of parathyroid gland.

A case of Churg-Strauss syndrome with manifestations of esophageal ulcer, acute acalculous cholecystitis and ischemic colitis / 대한내과학회지

No abstract available.

Twenty cases of reflex sympathetic dystrophy syndrome / 대한내과학회지

No abstract available.