Correlation of Progression Rate between Optic Disc Cupping and Visual Field Damage in Treated Primary Open Angle Glaucoma

PURPOSE: To know the rate of optic disc cupping and visual field progression with correlation among them, and identify clinical factors associated with them. METHODS: Forty patients with POAG who treated over 10 years were evaluated, Cup progression rate was evaluated by using computer-aided planimetry and visual field declination was evaluated with Goldmann perimetry and manual grid template system. Optic disc cupping and visual field progression correlations were estimated using linear regression and all related clinical factors were evaluated using a multiple regression model. RESULTS: Optic disc cupping progression started from inferotemporal to superonasal, to superotemporal and to inferonasal portion (total 0.0067/year) and visual field loss progressed superonasal, inferonasal, superotemporal, inferotemporally (total -1.07%/year) in order with significant correlation. Incisional surgery before visit and higher yearly average higher intraocular pressure showed faster optic disc cup progression and higher initial intraocular pressure and lesser antiglaucoma medications at initial visits showed faster visual field progression. CONCLUSIONS: In treated patients with POAG, the rate of disc cupping and visual field decline showed slow progression rate with significant correlation and various clinical factors affected.

Comparision of Clinical Findings between Phakic Retinal and Pseudophakic Retinal Detachment

We reviewed our medical records of primary retnal detachment(239 patients, 243 eyes) to compare the clincal findings of phakic retinal detachment(206 eyes) and pseudophakic retinal detachment(37 eyes). Pseudophakic retinal detachment was more common in male(73.0%) than in female(27.0%) and occurred more frequently in aged 60 years or more than phakic retinal detachment(10.4%)(P<0.001). Associated ocular finding such as high myopia(35.0%), peripheral retinal degeneration(23.3%0, retinal tear in fellow eye(5.8%) were more commonly seen in phakic retinal retinal detachment. Rupture of posterior capsule(40.5%), high myopia(18.9%), small pupil(13.5%) were associate with pseudophakic retinal detachment. In pseudophakic retinal detachment, more than 3 quadrant retinal detachment(73.0%) and macular involvement(78.4%) were more common than in phakic retinal detachment(P<0.01), but atropic hole(29.7%), or 2 or more retinal break(10.8%) were less common than in phakic retinal detachment(P<0.01) where the success rate of first operation(59.5%) and the overall success rate(81.1%) were lower in paeudophakic retinal detachment than phakic retinal detachment. The degree of visual recovery was nearly equal between two.

Characteristics of Retinal Detachment in Pseudophakic Eyes

To evauate the clinical characteristics of pseudophakic retinal detachments, 20 eyes were reviewed retrospectively. We identified the following characteristics of pseudophakic retinal detachment ; age in period of 40 (35%) and 60(30%), male(65%), rupture of posterior capsule (intraoperative and YAG laser capsulotomy)(50%). 15(75%) of the 20 pseduophakic retinal detachment eyes occured within 24months from the time of cataract surgery. Within 6 months after cataract surgery, the incidence of retinal detachment after posterior capsule rupture was higher than after uncomplicated cataract surgery, but there was no statistical significance. Retinal breaks were not detected in 7 eyes(35%). Retinal breaks were principally located in the upper quadrant in 6 eyes, horsehoe tear and atropic hole were most commonly encountered. More than 3 quadrant retinal detachment was observed in 80% of patients at the time of presentation and macular detachment, in 75%, Anatomic success rates were 85%. All of the failures were due to proliferative vitreoretinopathy.

Plasmacytoma on the upper cyclid

Plasmacytoma is one of the plasma cell dyscrasia. It occurs commonly on nasopharynx and paranasal sinus, but rare on the eyelid. If it involves the orbit, variable symptoms are presented, such as painless growing mass, proptosis, diplopia, decrease of vision, eyeball deviation etc. Irradiation is generally accepted as the treatment of choice for extramedullary plasmacytoma. Although the patient treated with irradiation safisfactory, wer must carefully follow up the patient about progression of multiple myeloma. We experienced a 15-years-old female who had a progressive growing palpable and non-tender mass on the right upper eyelid. The mass was confirmed as plasmacytoma by pathologic examination. We treated the mass with radiation. So, We present a case of plasmacytoma on the upper eyelid.

The Management of Giant Retinal Tear by use of Perfluorodecalin(DK-line(R) and Silicone Oil

Recently, various types of perfluorocarbon liquids are used to treat the retinal detachment due to giant tear. The authors treated 3 cases of giant retinal tear with perfluorodecalin and silicone oil. After pars plana vitrectomy, posterior retinal flap was unfolded by injection of perfluorodecalin and exchanged it for silicone oil subsequently. Silicone oil was removed after 4 weeks. Endophotocoagulation and scleral buckling were taken in all cases, and lensectomy for normal lens in 1 case. After the close observation for 6 months or more, retina was reattached successfully in 2 of 3 cases. Because of proliferative vitreoretinopathy, reinjection of silicone oil was needed in 1 case. Perfluorodecalin and silicone oil were useful materials to reattach the folded retinal flap of giant retinal tear.