Association between Choroidal Vascularity and Prelaminar Tissue Thickness in Healthy and Glaucomatous Eyes

Purpose@#To assess the association between the choroidal vascularity index (CVI) and prelaminar tissue thickness (PTT) in healthy and glaucomatous eyes. @*Methods@#The study included 86 eyes with perimetric glaucoma (PG), 86 with pre‐perimetric glaucoma (PPG), and 43 agematched healthy eyes. Total choroidal area (TCA) and CVI were measured by image binarization of spectral‐domain optical coherence tomography (SD‐OCT) 3.5 mm from the center of Bruch’s membrane opening. The CVI was the percentage of choroidal vasculature to choroidal tissue. The association between CVI and PTT measured on a center‐horizontal scan of enhanced depth imaging SD‐OCT was assessed. @*Results@#The CVI was lowest in PG (61.67% ± 4.11%), followed by PPG (63.36% ± 3.54%), and healthy (64.84% ± 3.13%) eyes (p < 0.001). PG (102.05 ± 44.01 μm) had a significantly thinner PTT than PPG (106.16 ± 38.03 μm) and the healthy (154.98 ± 79.46 μm) eyes (p < 0.001). In a multivariate regression analysis, CVI was associated with PTT and TCA in all subjects, including healthy and glaucomatous eyes (p < 0.05). @*Conclusions@#The CVI and PTT had significantly lower values in glaucomatous eyes than in healthy eyes, and the two parameters were positively associated in all subjects, including healthy and glaucomatous eyes.

Differences in Heart Rate Variability Depending on Sex, Level of Stress, Anxiety, and Depression among College Students: on the Basis of Neurovisceral Integration Model

Purpose@#This descriptive study aimed to investigate heart rate variability (HRV) according to sex and to elucidate the influence of negative emotion such as levels of stress, anxiety and depression on HRV among Korean college students based on a neurovisceral integration model. @*Methods@#A descriptive study design was used. Eighty-six healthy college students participated in the study. Resting HRV and standing HRV on orthostatic stimulation were measured for 5 minutes during 4-6 p.m. in the afternoon. Levels of stress, anxiety and depression were assessed using the Global assessment of recent stress, State-Trait Anxiety Inventory and Beck Depression Index, respectively. @*Results@#Out of the 86 students, 47 (54.7%) were men and 39 (45.3%) were women. Root mean square of the differences between adjacent RR intervals (RMSSD) and normalized high frequency (nHF) on standing HRV were significantly lower in men than in women (p= .005, p= .019, respectively). Male gender (β= 0.30, p= .013), higher level of stress (β= -0.36, p= .009) and lower level of depression (β = 0.30, p = .044) exerted a significant influence on decreased nHF in the multiple regression analysis. @*Conclusion@#We suggest that men are more vulnerable to having reduced vagal activity on HRV than women. Since male gender, higher level of stress and lower level of depression level influenced decreased vagal activity, strategies are needed to improve stress and depression rather than anxiety especially for men, which contribute to promoting HRV to prevent cardiac health diseases.

Lifestyle and Genetic Predictors of Stiffness Index in Community-dwelling Elderly Korean Men and Women

PURPOSE: Differing lifestyle, nutritional, and genetic factors may lead to a differing stiffness index (SI) determined by quantitative ultrasound in elderly men and women. The purpose of this study was to determine SI and the gender-specific factors associated with low SI in a Korean elderly cohort. METHODS: This was a cross-sectional descriptive study identifying the gender-specific factors related to SI in 252 men and women aged 65 years and greater from local senior centers in Seoul, Korea between January and February 2009. RESULTS: The mean SI of elderly men was significantly higher than that of the women's. A multiple regression analysis reveals that age, nutritional status, and physical activity were predictive factors of lower SI in men, whereas age, alcohol consumption, educational level, and genetic polymorphism were predictive factors for elderly women. CONCLUSIONS: Low SI was common in both elderly men and women. We found gender differences in factors linked to low SI. In multiple regression analysis, nutritional status and physical activity were more important factors in men, whereas alcohol consumption, educational level, and genetic polymorphism were significant factors predicting low SI in women. Gender-specific modifiable risk factors associated with low SI should be considered when developing osteoporosis prevention programs for the elderly.

The Occurrence of Glaucoma and Association with Serum Estradiol Level in Postmenopausal Women / 대한폐경학회지

OBJECTIVES: To investigate the occurrence of glaucoma and association with the serum estradiol (E2) level in postmenopausal women. METHODS: We evaluated the serum E2 level, female reproductive factors and glaucoma related risk factors including intraocular pressure and optical coherence tomography (OCT) findings in 30 postmenopausal women who visited Obstetrics and Gynecology outpatient clinic. Patients who showed abnormal findings on the glaucoma screening test were classified to the glaucoma suspect group (group-G), and underwent a glaucoma confirmatory test. Serum E2 level, female reproductive and other menopausal health-related factors such as lipid profiles and bone mineral densities were analyzed in the group-G and non glaucomatous group (group-N). RESULTS: Eight out of thirty participants (26.7%) were classified to the group-G. One of them was diagnosed as having glaucoma that required treatment, and the other two were found to have early glaucomatous changes. Compared to the group-G, the group-N had a higher level of serum E2 (19.40 +/- 4.79 vs. 13.95 +/- 4.55 pg/mL) The difference, however, was not statistically significant (P = 0.525). The proportion of glaucoma suspect patients in the groups with a higher serum E2 level (> or = 20 pg/mL) and a lower serum E2 level (< 20 pg/mL) was similar (25.0 and 27.3%, P = 0.645). Multiple logistic regression analysis showed that no female reproductive factors were associated with the risk of glaucoma. CONCLUSION: Comprehensive glaucoma screening using an OCT in postmenopausal women could detect more glaucoma patients than prevalence in the similar age group. Statistical significance was not found in the association between serum E2 level and the risk of glaucoma.

Clinical Manifestations of Intraocular Lymphoma

PURPOSE: To investigate the clinical features and prognosis of primary intraocular lymphoma (PIOL). METHODS: A retrospective review of medical records was performed in 9 patients who were diagnosed and treated as PIOL in the Department of Ophthalmology, Seoul National University Hospital. RESULTS: Among patients who were enrolled in the study, 14 eyes were examined. Thirteen eyes (92.9%) showed yellowish subretinal or choroidal infiltrates which is a characteristic finding of PIOL in fundus examination and fluorescein angiography. Three patients presented with ocular symptoms initially, and 5 patients later presented with central nerve system (CNS) involvement. Only 1 patient showed PIOL without CNS involvement. Among 6 patients (9 eyes) that received systemic chemotherapy or ocular irradiation, 5 patients (7 eyes, 77.8%) responded. Among those patients, 3 patients (4 eyes) showed relapse of PIOL. Five patients died during the mean follow-up period of 43.3 months, and the median survival time was 47 months. CONCLUSIONS: The most common characteristic fundus finding of PIOL is subretinal or choroidal infiltration. Ocular irradiation combined with systemic chemotherapy is the first method of treatment, although long-term prognosis is poor.

Conjunctival MALToma Patient with Intraocular Manifestation: A Case Report

PURPOSE: To report one case of unilateral intraocular involvement of the MALToma (Mucosa Associated Lymphoid Tissue Lymphoma) in the patient with bilateral conjunctival MALToma which was cured by radiation therapy 8 years ago. METHODS: A 64 year old woman who was in remission status after radiation therapy of the bilateral conjunctival MALToma presented with vitreous opacity, inflammatory reaction in anterior chamber, iris posterior synechiae and keratic precipitate in her left eye. Visual acuity of her left eye decreased from 20/33 to 20/100. Pars planar vitrectomy and cytologic analysis of the vitreous sample were performed. RESULTS: Cytologic analysis of the vitreous sample showed atypical lymphoid cells containing vacuolar nuclei which were stained positive at CD20 marker in the immunohistochemistry. So radiation therapy of the left eye was performed in the diagnosis of intraocular involvement of the MALToma. CONCLUSIONS: If severe panuveitis occurs in the patient with radiation therapy of the conjunctival MALToma, intraocular involvement of the MALToma should be considered as one of the differential diagnosis.