Comparison of Retinal Nerve Fiber Layer Thickness in Early Normal-Tension Glaucoma and Early Primary Open-Angle Glaucoma

PURPOSE: To investigate the comparison of retinal nerve fiber layer (RNFL) thickness parameters measured by optical coherence tomography (Stratus OCT 3000TM) and visual field indices in early normal-tension glaucoma (NTG) and early primary open-angle glaucoma (POAG). METHODS: Sixty-one early normal-tension glaucomatous eyes, 21 early primary open-angle glaucomatous eyes and 34 healthy control eyes were enrolled in this cross-sectional study. Each subject received a visual field test (Humphrey C30-2) and the fast RNFL thickness algorithm test by OCT. The correlations between RNFL thickness and visual field indices were analyzed. The sensitivity and specificity for the detection of early glaucoma were determined with the area under the receiver operating characteristics curve (AUROC). RESULTS: All RNFL thickness values except for the temporal quadrant RNFL thickness were significantly decreased in the early NTG and POAG groups (p<0.05). In early POAG, the average and superior quadrant RNFL thicknesses were significantly thinner than in the early NTG group. Significant correlations were observed between the PSD and the average and superior quadrant RNFL thicknesses in the early NTG and POAG groups (p<0.05). The average RNFL thickness for early glaucoma had the widest AUROC among all of the parameters. CONCLUSIONS: In the early NTG group with visual field defects similar to those of early POAG, RNFL defects measured by OCT were less severe, particularly in the average and superior quadrant RNFLs.

The Efficacy of Intravitreal Bevacizumab in the Treatment of Macular Edema

PURPOSE: To investigate the efficacy in best corrected visual acuity (BCVA) and central macularthickness after intravitreal bevacizumab injection in patients with macular edema. METHODS: Patients with macular edema due to branch retinal vein occlusion, central retinal vein occlusion, and diabetic retinopathy received intravitreal injection of bevacizumab (2.5 mg/0.1cc). Complete ophthalmic examinations including best corrected visual acuity and optical coherence tomography (OCT) were performed at baseline and follow-up visits for 6 months. RESULTS: In macular edema secondary to branch retinal vein occlusion, the mean BCVA improved from logMAR 0.62+/-0.30 at baseline to logMAR 0.43+/-0.37 at 1 month, 0.34+/-0.40 at 3 months and 0.38+/-0.37 at 6 months (p<0.05). The mean central macular thickness decreased from 451.2+/-118.9 micrometer at baseline to 280.3+/-124.6 micrometer at 1 month, 345.8+/-157.1 micrometer at 3 months and 312.9+/-174.4 micrometer at 6 months (p<0.05). In macular edema secondary to central retinal vein occlusion and diabetic retinopathy, visual improvement and macular thickness reduction were not statistically significant. CONCLUSIONS: Intravitreal bevacizumab injection appears to be more effective for macular edema due to branch retinal vein occlusion than macular edema secondary to central retinal vein occlusion and diabetic retinopathy.

The Efficacy of Intravitreal Bevacizumab in the Treatment of Macular Edema

PURPOSE: To investigate the efficacy in best corrected visual acuity (BCVA) and central macularthickness after intravitreal bevacizumab injection in patients with macular edema. METHODS: Patients with macular edema due to branch retinal vein occlusion, central retinal vein occlusion, and diabetic retinopathy received intravitreal injection of bevacizumab (2.5 mg/0.1cc). Complete ophthalmic examinations including best corrected visual acuity and optical coherence tomography (OCT) were performed at baseline and follow-up visits for 6 months. RESULTS: In macular edema secondary to branch retinal vein occlusion, the mean BCVA improved from logMAR 0.62+/-0.30 at baseline to logMAR 0.43+/-0.37 at 1 month, 0.34+/-0.40 at 3 months and 0.38+/-0.37 at 6 months (p<0.05). The mean central macular thickness decreased from 451.2+/-118.9 micrometer at baseline to 280.3+/-124.6 micrometer at 1 month, 345.8+/-157.1 micrometer at 3 months and 312.9+/-174.4 micrometer at 6 months (p<0.05). In macular edema secondary to central retinal vein occlusion and diabetic retinopathy, visual improvement and macular thickness reduction were not statistically significant. CONCLUSIONS: Intravitreal bevacizumab injection appears to be more effective for macular edema due to branch retinal vein occlusion than macular edema secondary to central retinal vein occlusion and diabetic retinopathy.

The Efficacy of Intravitreal Gatifloxacin in Experimental S. epidermidis Endophthalmitis

PURPOSE: To compare the efficacy of intravitreal gatifloxacin with intravitreal vancomycin in the treatment of Staphylococcus epidermidis endophthalmitis in a rabbit model. METHODS: Albino rabbits (n=30), infected with an intravitreal inoculum of S. epidermidis (10(5) colony forming unit/0.1 mL), were divided into 6 groups (n=5). Groups I and IV received 200 microgram/0.1 mL of intravitreal gatifloxacin, and groups II and V were injected 1000 microgram/0.1 mL of vancomycin intravitreally. Intravitreal balanced salt solutions (untreated control) were given to Groups III and VI. Intravitreal antibiotic therapy commenced 24 hours after bacterial inoculation. The bactericidal efficacy was determined by electroretinography (ERG), clinical grading, bacterial culture of vitreous aspirates and histopathologic grading. ERGs and clinical gradings were performed only for groups I, II, and III and bacterial cultures were done only for groups IV, V, and VI. RESULTS: Eyes in the gatifloxacin groups showed similar appearance to those in the vancomycin treated groups clinically, histologically, and functionally as proved with ERG. All aspirates from the gatifloxacin and vancomycin groups were culture negative at 5 days after bacterial inoculation, whereas all eyes in the untreated control group were culture positive. CONCLUSIONS: This study demonstrated that intravitreal injection of 200 microgram /0.1mL gatifloxacin appeared to be equally effective compared to intravitreal 1000 microgram /0.1 mL vancomycin in the treatment of S. epidermidis endophthalmitis. If proven safe and efficacious after further study in humans, intravitreal injection of gatifloxacin could be considered an effective alternative to vancomycin for the treatment of S. epidermidis endophthalmitis.

A Case of Intestinal Obstruction Caused by Strangulated Femoral Hernia Accompanying Soft Tissue Necrosis / 대한소화기학회지

Intestinal obstruction involves a partial or complete blockage of the bowel which results in the failure of intestinal contents to pass through. The mechanical causes of obstruction may include the followings: hernias, postoperative adhesions or scar tissue, impacted feces, gallstones, tumors, granulomatous processes, intussusception, volvulus, foreign bodies, and etc. Hernias are the third leading cause of intestinal obstruction by 10% approximately. However, most hernias are the cases with abdominal wall, inguinal or internal hernia. Femoral, obturator, lumbar, or sciatic hernia as the cause of obsturction is rare. Furthermore, the cases accompanying soft tissue necrosis are seldomly reported. Herein, we report a case of intestinal obstruction caused by strangulated femoral hernia accompanying soft tissue necrosis in a 78-years-old female patient.

Appendiceal Intussusception Caused by the Mucocele of the Appendix

Mucocele of the appendix is basically a cystic dilatation of the appendix distal to an obstruction of the appendiceal lumen. It develops in unusual situations in which the distal lumen does not contain enough bacteria to initiate appendicitis when obstruction develops. The continuing mucous secretion causes gradual distention of the appendix and thinning of the wall until mucous secretion stops. The changes after the sudden blocking of the lumen of the appendix depend on the amount and character of the content distal to the obstruction. If the lumen is empty, the appendix distends with mucus to form a mucocele. Here we report a case which we experienced a 68-years-old female patient whose vermiform appendix had mucoceles with appendiceal intussusception.