The Changes in Macular Thickness after Phacoemulsification in Patients with Non-diabetes and Nonproliferative Diabetic Retinopathy

PURPOSE: To compare the changes in macular thickeness between non-diabetic group and a mild or moderate nonproliferative diabetic retinopathy group after phacoemulsification. METHODS: This study consisted of 32 eyes of 22 patients who underwent phacoemulsification. The non-diabetic group included 20 eyes of 15 patients; the diabetic group (mild or moderate nonproliferative diabetic retinopathy) included 12 eyes of 7 patients. Macular thickness using optical coherence tomography (OCT) and corrected visual acuity were measured before surgery and 1 day, 1 week, 1 month, 2 months, 6 months and 12 months after surgery. RESULTS: In the non-diabetic group, the macular thickness increased by 2.8+/-4.2% at 1 week, 5.9+/-4.5% at 1 month, 4.8+/-3.8% at 2 months, 0.6+/-0.8% at 6 months, and -0.3+/-1.2% at 12 months after surgery, while it increased by 4.8+/-5.0% at 1 week, 11.1+/-5.2% at one month, 9.9+/-6.0% at two months, 8.1+/-4.6% at 6 months, 3.9+/-3.5% at 12 months in the diabetic group. The increased amount of macular thickness was significantly higher in the diabetic group than in the non-diabetic group at 1 month, 2 months, 6 months, and 12 months. Visual acuity was not significantly different between the diabetic and non-diabetic groups. In the non-diabetic group, 2 months after the operation, LogMAR below 0.02 (Snellen 0.95) were remained with best corrected visual acuity. Similarly to non-diabetic patients, diabetic patients needed 12 months to reach best corrected visual acuity. CONCLUSIONS: Macular thickness increased in both diabetic and non-diabetic groups after phacoemulsification, and the increased amount of macular thickness was significantly greater and lasted longer in the diabetic group compared with the non-diabetic group. In cases of mild or moderate nonproliferative diabetic retinopathy, macular thickness change due to cataract surgery did not influence visual acuity.

A Case of Remarkable Variation of Strabismic Angle in Thyroid Ophthalmopathy

PURPOSE: We report a patient with strabismus associated with thyroid ophthalmopathy whose condition changed remarkably for 6 years of a natural course. CASE SUMMARY: A 69-year-old woman with Graves' disease presented with diplopia in April 1999. On examination, she showed left hypotropia of 50 prism diopters (Delta) accompanied by supraduction limitation and lid lag in the left eye. She was diagnosed with strabismus associated with thyroid ophthalmopathy and was observed without any intervention. In October 2000, her left hypotropia decreased to 16Delta, and esotropia of 14Delta developed. Both eyes showed limitation of supraduction, and the left eye showed limitation of abduction. In December 2003, the esotropia increased to 35Delta, and the direction of vertical strabismus changed to 40Delta of right hypotropia. Supraduction limitation of the right eye and abduction restriction of both eyes increased, and infraduction limitation of the left eye developed. In April 2005, esotropia increased to 75Delta, and the amount of right hypotropia was 35Delta. The abduction limitation of both eyes increased. CONCLUSION: The natural course of strabismus associated with thyroid ophthalmopathy can show continuous and remarkable changes.

Bone Marrow Transplantation Retinopathy in a Patient with Acute Lymophocytic Leukemia Following Bone Marrow Transplantation

PURPOSE: To report a case in of a patient who developed bone marrow transplantation retinopathy at 18 months after receiving allograft bone marrow transplantation for acute lymphocytic leukemia. CASE SUMMARY: A 20-year-old male patient complained of a decrease in visual activity in his left eye 18 months after receiving a bone marrow transplantation for acute lymphocytic leukemia. The corrected visual activity was 1.0 for the right eye and 0.6 for the left. On fundus examination, both eyes showed cotton wool patches and dot hemorrhage, and the left eye showed macula edema. On fluorescein angiography, capillary nonperfusion was observed in the superior nasal area of the left eye. Four months after initial examination, the corrected visual activity of the left eye decreased to 0.3 and neovascularization was observed on fundus examination. On fluorescein angiography, capillary nonperfusion, neovascularization, and macular ischemia were observed. Laser photocoagulation was performed twice on the area with neovascularization and capillary nonperfusion. One year later, the corrected visual activity of the left eye recovered to 0.8. However, the area of macular ischemia on fluorescein angiography showed no change, and neovascularization and capillary nonperfusion were observed in new areas, which were treated with two additional laser photocoagulations.

Optical Coherence Tomography Findings in Three Cases of Albinism

PURPOSE: To report optical coherence tomography (OCT) findings in albinism. METHODS: Full ocular examinations, including OCT, were performed in one patient with ocular albinism and two patients with oculocutaneous albinism. RESULTS: OCT scans were unable to detect the foveal depression in these patients. A widespread thickening of the retina occurred throughout the entire fovea, which showed no difference from the surrounding macula. OCT scans also demonstrated probable scleral layer below the retinal pigment epithelial (RPE) layer. CONCLUSIONS: OCT scans of albinism patients confirmed foveal hypoplasia and increased transmission of incident light in the RPE layer.

Risk Factors Leading to Enucleation or Evisceration in Endophthalmitis

PURPOSE: To evaluate the risk factors associated with enucleation or evisceration in endophthalmitis patients. METHODS: The medical records of endophthalmitis cases from January 1995 to July 2006 were reviewed retrospectively. The cases were divided into 2 groups, the enucleation/evisceration group (36 eyes of 36 patients) who underwent enucleation or evisceration and the intraocular procedures group (61 eyes of 60 patients) who received intravitreal antibiotics injection and/or vitrectomy. We analyzed these cases with respect to age, sex, initial visual acuity, causes of endophthalmitis, systemic disease, and causative organisms. RESULTS: Older age (p=0.002), women (17/32, p=0.027), no light perception at presentation (33/37, p<0.001), endophthalmitis associated with corneal ulcer (25/25, p<0.001), and diabetes mellitus (14/20, p=0.001) were significantly associated with enucleation or evisceration. CONCLUSIONS: Older age, poor initial visual acuity, endophthalmitis associated with corneal ulcer, and diabetes mellitus were strongly associated with enucleation or evisceration. If any of these factors are present, more intensive treatments are warranted to prevent loss of the eye.