The Influence of Axial Myopia on Diabetic Retinopathy

PURPOSE: To investigate the association of axial myopia with the incidence and progression of diabeticretinopathy. METHODS: One hundred eyes of diabetic group and one hundred eyes of non-diabetic group were included. We divided one hundred eyes of diabetic group into 5 groups according to their axial length, compared the incidence and progression of diabetic retinopathy at first hospital visit and after three year follow up. RESULTS: In severe myopic eye(axial length>28mm), the grade of diabetic retinopathy incidencence at the first visit is 1.23(near mild non proliferative diabetic retinopthy) and the grade of diabetic retinopathy progression is 1.17(nearly no change between the first hospital visit and after three year follow up). We found that axial length is inversely related with incidence and progression of diabetic retinopathy. CONCLUSION: From this result, we knew that axial myopia is protective for the development of diabetic retinopathy and we suggest there'll be association with decrease in ocular perfusion pressure and axial myopia patients with diabetic retinopathy.

Neodymium: YAG Laser Discission of Postoperative Pupillary Membrane: Peripheral Phtodisruption

PURPOSE: To treat pupillary membrane which developed after cataract operation and vitrectomy,steroid eye drops with mydriatics or, in sever case, tPA has been used. However steroid eye drops needs prolonged treatment and tPA has many complications such as, infection, or hemorrhage. We tried to remove pupillary membrane with Nd-YAG laser by using peripheral quadrantic disruption technique. METHODS: We treated 8 eyes from Jan. 1996 to Oct. 1999, and observed within 24 hours following Nd-YAG laser treatment. The pupillary membrane was cut with Nd-YAG laser and subsequently absorbed within 24 hours. RESULTS: There was no such complicaitons, as increased IOP, hemorrhage, and IOL damage. Immediately after Nd-YAG laser, visual acuity was improved and fundus was examined. CONCLUSION: Therefore we recommend Nd-YAG laser membrenectomy in cases of pupillary membrane, which did not respond to steroid therapy.

Angiogenesis of Retina in Diabetic Retinopathy / 대한내분비학회지

No abstract available.

Neurotropic Effect of Basic Fibroblast Growth Factor on Laser Wound

In order to analyze the potential role of basic fibroblast growth factor (bFGF)on retinal wound after laser photocoagulation, we studied the expression of GFAP and the morphologic changes in the retina of pigmented rats. A multiline krypton laser was used to produce laser lesions. After irradiation, eyes were intravitreally injected with 1 microliter vehicle or 1 microgram of bFGF in l microliter of vehicle. And we examined the expression of GFAP at 1 day, 3 days, 7 days and 14 days after treatment.We also measured the size of defect in outer nuclear layer at 7 days after laser. The results were as follows : 1. GFAP immunoreactivity of M ü ller cell begins to appear within 24 hours in whole retina area.It sharply increases until 7 days and then decreases slowly. 2. bFGF stimulates the expression of GFAP and it is statistically significant(p<0.05) 3. BFGF prevents cell death of photoreceptor in the laser lesions(p<0.05 ) From these results, we concluded that bFGF stimulates Müller cell reactivity after laser phtocoagulation and prevents photoreceptor loss. These results may be important to understand the healing mechanism of laser phtocoagulation and to minimize the complications of laser phtocoagulation.

Measurement and Analysis of Neurosensory Retinal Detachment in Central Serous Chorioretinopathy Using Heidelberg Retina Tomograph

No Abstract Available.

The Role of VEGF and Bruch's Membrane in the Development Choroidal Neovascularization

A major cause of blindness in elderly people is choroidal neovascularizapathogenesis and stimulating factor of CNV is not clearly understood. Vascular endothelial growth factor(VEGF)is a major stimulating factor for retinal neovascularization in ischemic retinopathy such as diabetic retinopathy, retinopathy of prematurity. But it is not known if VEGF is a stimulating factor for CNV. In this study, we have treated VEGF transgenic mice and C57BL/6 mice with laser. Different laser parameter for damage to retina pigment epithelium(RPE)only and for break of Bruch's membrane were used each. We were not able to induce CNV with only RPE damage. CNV wes induced when the break of Bruch's membrane was made and there was profuse CNV in VEGF transgenic mice rather than C57BL/6. These data suggest that the damage of Bruch's membrane may be the prerequisition for CNV formation and VEGF is the important stimulating factor for CNV.

Postoperative Endophthalmitis Following Intraocular Surgery

No abstract available.

A Clinical Study on Rhegmatogenous Retinal Detachment by Macular Involvement

We reviewed charts of 148 patients(148 eyes) who were diagnosed with rhegmatogenous retinal detachment and operated from January 1994 to December 1995 and followed for at least 3 months postoperatively at kangnam St. Mary's hospital. We compared preoperative findings, surgical methods, ultimate anatomic success and visual outcome by macular involvement, and evaluated the causes of decrease in visual acuity after operation. Fifty four eyes were A group without involved macula and 94 eyes were B group with involved macula. There were no differences betwetm the two groups according to age, sex distribution, preoperative refractive error and location of retinal breaks. In the eyes with detached macular(B group), the duration and the extent of retinal detachment and the numbers of retinal breaks were more than those of A Group. Postoperatively 52 eyes(96.3%) with spared macular and 84 eyes(89.4%) with detached macular were anatomically reattached. Forty two eyes(77.8%) with spared macula achived visual acuity of 0.3 or better, in contrast to 2.5 eyes(26.6%) with detached macula. The most common causes of decrease in visual acuity after operation were proliferative vitreoretinopathy, macular pucker, cystoid macular edma and subretinal hemorrhage.

A Case of Nanophthalmos

Nanophthalmos is a rare disease that results from arrested development of the globe after closure of the embryonic fissure and is characterized by a small eye with thickened sclera, uveal effusion, non-rhegmatogenous retinal detachment and narrow angle glaucoma. Treatments include medical, laser and surgical theraphy for glaucoma, and surgical treatments like scleral resection, anterior sclerotomy and vortex vein decompression surgery for the drainage of the uveal effusion, etc. We experienced a case of nanophthalmos with narrow angle glaucoma and choroidal effusion in 34 year-old male patients. Anterior sclerotomy for the drainage of the uveal effusion was performed and the scleral tissue obtained. Histopathologic study on the sclera showed abnormal collagen fibers.

Central Retinal Vein Occlusion in Multiple Myeloma Associated with Hyperviscosity Syndrome

Multiple myeloma is a malignant proliferation of the atypical plasma cells which usually involves antibody synthesis in the immune system. Systemic manifestations include anemia, renal failure, osteoporosis, immune deficiency symptom. Ophthalmolgically this disease involves cornea, conjunctiva, uvea, iris, ciliary body, retinal vessels, extraocular muscles and optic nerve. The authors experienced a case of multiple myeloma with hyperviscosity syndrome who presented with central retinal vein occlusion in both eye.

Tissue Plasminogen Activator for Treatment of Subretinal Hemorrhage

We report removing a large subretinal hemorrhage by means of vitrectomy combined with the use of tissue plasminogen activator(tPA) to facilitate clot removal. A 25-year-old man had a 4 days history of visual loss in the right eye after blunt trauma. The right fundus had a large subretinal hemorrhage involving macula. Surgery was performed the following day. A small retinotomy was made, through which tPA was injected into the subretinal space and through which the dissolved clot was removed. The use of tPA minimizes surgical manipulation of the retina and greatly reduces the size of the retinotomy reguired for evacuation of subretinal bood. Although the long-term prognosis is guarded, this case does suggest that tPA may be a useful adjunct in managing of subretinal hemorrhage.

Effects of 5-fluorouracil on culture of Bovine Retinal Pigment Epithelial cells

Inspite of technical advances, long term retinal reattachment of proliferative vitreoretinopathy following the successful surgery is often disturbed by the occurrence of cell proliferation and traction. A variety of antimetabolite or anticancer drugs have been tried to use for testing their antiproliferative effects on proliferative vitreoretinopathy. To evaluate the antiproliferative property of 5-FU, we treated with the different concentration of 5-FU(0.5, 1, 5, 10 mg/L) on cultured bovine retinal pigment epithelial cells and performed dose inhibition studies. We also examined the 5-FU treated bovine retinal pigment epithelial cells by inverted microscope daily to evaluate the morphologic change for 5 days. The results were as follows; 1. 5-FU inhibited proliferation of bovine pigment epithelial cells in a dose dependent and a time dependent manner. 2. The drug concentration required for 50% inhibition of cell growth(ID50) was found to be 1.87 mg/L. 3. As the drug concentration increased, the cell density gradually decreased and the degenerative changes such as irregular shape of cells, cytoplasmic vaculoes and cell debris were aggravated. In 10 mg/L of 5-FU treated well, disruption of cell membrane and cell death were noted from the first day of incubation. These results show that 5-FU has a potent antiprolifertive effects in retinal pigment epithelial cell and toxic effet in high dose.

Filtering Surgery in Aphakia and Pseudophakia

Aphakic or pseudophakic glau-oma is known to be at high risk for failure after filtration surgery. The authors retrospectively investigated the results of trabeculectomy in 14 eyes of 14 patients with glaucoma, seven aphakic and seven pseudophakic eyes, which were followed from six months to three years with an average ot 16.5 months. A conventional trabeculectomy without using antifibrotic agents was performed in all the eyes. The site of conjunctival incision was prepared on the virgin area of the conjunctiva; 8 superonasal, 4 inferonasal and 2 inferotemporal approaches. An average postoperative intraocular pressure reduction was 13.4 mmHg. The number of medications decreased in 11 eyes. A spontaneously developed functioning bleb was found in seven eyes. In other four eyes, the filtering bleb was formed with an aid of massage or needling. The remallllllg three eyes did not show a functioning bleb. Postoperative complications included hyphema in 3 eyes, overfiltration in 2 eyes, choroidal detachment in 1 eye, corneal edema in 1 eye and endophthalmitis in 1 eye.

Clinical Evaluation of Kefatoconus

Seventy-six patients who visited Kang-Nam St. Mary's Hospital with keratoconus from 1982 to 1987 were reviewed retrospectively. At the time of diagnosis, the age-specific prevalence were greatest in the younger groups, with the rate for males being somewhat greater than that for females and the rate of bilateral involvement was greater than that of unilateral involvement. Of 126 eyes with. keratoconus, 76 achieved visual acuity of 0.3 or better with hard contact lens at the time of diagnosis. Thirty-nine received corneal graft and 38(97%) achieved visual acuity of 0.3 or better with correction. Keratoplasty can be delayed or avoided in many keratoconus patients by using contact lens, especially the specially designed lenses. Also keratoconus eyes often need contact lenses after keratoplasty.

Clinical Evaluation of Kefatoconus

Seventy-six patients who visited Kang-Nam St. Mary's Hospital with keratoconus from 1982 to 1987 were reviewed retrospectively. At the time of diagnosis, the age-specific prevalence were greatest in the younger groups, with the rate for males being somewhat greater than that for females and the rate of bilateral involvement was greater than that of unilateral involvement. Of 126 eyes with. keratoconus, 76 achieved visual acuity of 0.3 or better with hard contact lens at the time of diagnosis. Thirty-nine received corneal graft and 38(97%) achieved visual acuity of 0.3 or better with correction. Keratoplasty can be delayed or avoided in many keratoconus patients by using contact lens, especially the specially designed lenses. Also keratoconus eyes often need contact lenses after keratoplasty.

A Statistical Study on the Corneal Diameter

We measured the horizontal and vertical diameter of the cornea, axial length and lens power in 314 patients who were admitted for cataract extraction. The data was analyzed by Minicomputer (honewel level 6 Model 57, U.S.A.) Cobal language. The results were as follows; 1) The average of the horizontal corneal diameter was 11.47 mm in the males and 11.17 mm in the females, and difference of the horizontal corneal diameter was 0.30 mm between both sexes. The average of the vertical corneal diameter was 10.80 mm in the males and 10.48 mm in the females and the difference of the vertical corneal diameter was 0.32 mm between both sexes. The horizontal and vertical corneal diameter in the males was loger than that of the females in adult. 2) The coeneal diameter was longest in the 41~50 years old group in male and 51~60 yaers old group in femele. The horizontal and vertical corneal diameter showed a tendency to decrease with age in adult. 3) We obtained significant changes statistically in that the cornea diameter showed atendency to increase as axial length increased in adult. 4) The corneal diameter was longest in the 15.01~16.00 Diopter group in lens power and the cornea diameter showed a tendency to decrease as lens power increased.