The Effect of Atropine on Myopic Progression in Children

PURPOSE: To examine the effects of atropine therapy on myopic progression in myopic children. METHODS: Fifty myopic patients, aged from 7 to 14 years and less than -5 diopters, visited our clinic for correction of refractive error from August 2001, and were followed up for at least 1 year. Of these 50 patients, the atropine therapy group was 23 and the control group was 27. Right eye cycloplegic refraction and axial length changes of the two groups were compared and analyzed. RESULTS: There was a mean increase of myopia of 0.25+/-0.43 D/yr in the atropine therapy group and of 0.83+/-0.37 D/yr in the control group (P=0.000). There was a mean increase of axial length of 0.12+/-0.19 mm/yr in the atropine therapy group and 0.39+/-0.21 mm/yr in the control group (P=0.000). In refraction and axial length changes according to age, there was no statistically significant difference within the group, aged from 7 to 9 years. However, there was a statistically significant difference within the group, aged from 10 to 14 years. In refraction and axial length changes according to myopic grade, there were a statistically significant differences between the groups. CONCLUSIONS: Atropine therapy is effective in slowing the myopic progression in myopic children with refractive error less than -5 diopters.

A Case of Adjustable Surgery in Wall-eyed Bilateral Internuclear Ophthalmoplegia after Head Trauma

PURPOSE: Wall-eyed bilateral internuclear ophthalmoplegia (WEBINO) is a variation of bilateral internuclear ophthalmoplegia (Bilateral INO) that has profound exotropia in primary position. Head trauma is a rare cause in WEBINO. We report a case of WEBINO after head trauma which was not improved for 9 months and underwent extraocular muscle surgery with adjustable suture. METHODS: A 39-year-old man was referred to the department of ophthalmology for diplopia after head trauma from the department of neurosurgery. He was profoundly exotropic in the primary position and hads bilateral marked limitation of adduction with contralateral abducting nystagmus. There was no improvement even 9 months after the injury, so he underwent extraocular muscle surgery with adjustable suture. RESULTS: At postoperative 6 months, the patient showed orthophoria in the primary position and ocular motility was increased in adduction. There was no diplopia with a large area of binocular single vision in the primary position. CONCLUSIONS: Because of the disruption of normal ocular motor control in WEBINO, the effect of standard muscle surgery is unpredictable. Adjustable surgery is considerable as a useful technique because it is important in making accurate postoperative alignment, especially for diplopia.

The Effect of Vitrectomy and Arteriovenous Adventitial Sheathotomy for Branch Retinal Vein Occlusion

PURPOSE: We evaluated the effect of vitrectomy and arteriovenous adventitial sheathotomy for branch retinal vein occlusion (BRVO) according to operation timing and obstruction site. METHODS: We performed vitrectomy and arteriovenous adventitial sheathotomy in 14 eyes with BRVO. Patient selection criteria were foveal involvement of macular hemorrhage or macular edema and a best corrected visual acuity (BCVA) of 0.1 or less. We compared 7 eyes with symptom duration of 2 months or less (Group 1) and 7 eyes with symptom duration of more than 2 months (Group 2). We analyzed 7 eyes for which the obstruction site was 1 disc diameter (DD) or less from the disc margin (Group A) and 7 eyes of more than 1 DD (Group B). RESULTS: Seven of 14 eyes (50%) had visual improvement. Six eyes of Group 1 (86%) had visual improvement and Group 1 had better visual improvement than Group 2. There was a statistically significant difference between Groups 1 and 2 (p=0.029). Five eyes of Group A (71%) had visual improvement and Group A had better visual improvement than Group B. There was no statistically significant difference (p=0.286). CONCLUSIONS: In the case of foveal involvement of macular hemorrhage or macular edema and a BCVA of 0.1 or less, vitrectomy and arteriovenous adventitial sheathotomy are effective in early BRVO.

MICROSATELLITE INSTABILITY AND p53 GENE MUTATION IN ORAL SQUAMOUS CELL CARCINOMA

Germ-line mutations at DNA repair loci confer susceptibility to colon cancer in hereditary non-polypopsis colorectal cancer. Somatic loss of DNA mismatch repair gene has been reported in a large variety of other tumor types. Replication errors(RERs) judged by microsatellite instability(MSI) and its associated mutations have been recognized as an important mechanism in various tumor types. To investigate associations between MSI and oral squamous cell carcinoma, the frequency of MSI using 12 microsatellite markers were analyzed for the series of oral tumors. Of 17 tumors, 8 cases(47%) did not show instability at any of the 12 loci; 5(29%) showed instability at 2~3 loci; and 4(24%) showed instability above 4 loci. The 4 cases showing widespread MSI did not differ from those without evidence of instability in terms of age at diagnosis, degree of differentiation, metastasis to lymph node, tumor location or the presence of mutations in the p53 tumor suppressor gene. DCC and D17S 796 were the most frequently detected in MSI analysis. There were no correlation between smoking and MSI frequency, instead, smoking was suggested to increase the mutation rate of p53 and development of oral carcinomas.