The Retinal Temperature Rise during Transpupillary Thermotherapy in Albino and Pigmented Rabbits

PURPOSE: we clinically measured the temperature rise in real time and analyzed the difference of albino rabbit and pigmented rabbit in use of the specially designed thermometer. METHODS: Specially designed thermometer was attached into the subretinal pigment epithealial and choroidal space through the suprachoroidal space in three pigment and three albino rabbits, with diode laser of 810 nm wave length, 3 mm spot size. We examined the retinal temperature according to laser irradiance power at each ten seconds during sixty seconds and the laser power setting was 200 mW, 300 mW, 400 mW in pigmeted rabbit and 300 mW, 600 mW, 800 mW in albino rabbit. We analyzed the results based on the measurements at least three times per each irradiance power. RESULTS: In albino rabbit, the maximal range of retinal temperature change was 1.2 degrees C and 1.7 degrees C in 300 mW and 600 mW, 14.1 degrees C in 800 mW power of 810 nm diode laser irradiance. In pigmented rabbit, the maximal range of retinal temperature change was 12.1 degrees C in 200 mW of laser irradiance power, 16.2 degrees C in 300 mW, 24.3 degrees C in 400 mW during sixty seconds in 810 nm diode laser. CONCLUSIONS: We investigated the ratinal temperature at transpupillary thermotherapy in 810 nm wavelength diode laser on rabbits. The difference of retinal temperature change was in accordance with the amount of chorioretinal melanin pigment. Therefore if the laser power setting used in caucasians would be attempted in orientals, it is the point to be considered during transpupillary thermotherapy.

Five Cases of Transpupillary Thermotherapy for Intraocular Tumors

PURPOSE: To evaluate the effects of transpupillary thermotherapy(TTT) for several intraocular tumor. METHODS: The 5 intraocular tumors (2 capillary hemangioma, 1 metastatic tumor, 1 retinal angioma, 1 melanocytoma) were treated with transpupillary thermotherapy. We compared preoperative visual acuity, size, fundus finding, ultrasonogram to postoperative data. RESULTS: The one capillary hemangioma and metastatic tumor were improved in fundus finding. The other tumors were not improved. The visual acuity of patient with metastatic tumor was improved from F.C/30cm to 0.15. CONCLUSIONS: Transpupillary thermotherapy was effective tool for intraocular tumors. We may need the guideline for treatment of intraocular tumor by using transpupillary thermotherapy.

The Clinical Results of Hemodilution Therapy for Retinal Vein Obstructive Disease

PURPOSE: To evaluate the clinical results of isovolemic hemodilution for central retinal vein occlusion and branch retinal vein occlusion patients. METHODS: We have done phlebotomy and then infused same volume of hydroxyethyl starch to 6 CRVO and 5 BRVO patients, and control group(5 CRVO, 9 BRVO) was observed. We have checked hematocrit the next day. If the hematocrit was reached to final target, we stopped the hemodilution therapy. Anterior segment examination, visual acuity, fundus photography, fluorescein angiography, laboratory test was done. and compare the preoperative value to postoperative result. RESULTS: The final visual acuity improved in 10 eyes undergoing isovolemic hemodilution and control group 12 eyes. In fluorescein angiography, Arm to retina time is about 19.03+/-10.86%, venous filling time is 14.80+/-8.57%. The average reduction of hemoglobin is 22.12+/-4.33%, hematocrit is 22.74+/-4.71%. In laboratroy test, platelet, triglyceride, phospholipid, CSR, HDL is reduced. CONCLUSIONS: The retinal blood flow was improved by hemodilution in CRVO and BRVO patients. But further investigation and long-term follow up result was needed in this study.

Two Cases of Enterococcus Fecalis Endophthalmitis

PURPOSE: We exprienced two cases of Endophthalmitis caused by Enterococcus fecalis in phacoemulsification and foldable IOL(intraocular lens) implantation. The endophthalmitis caused by Enterococcus fecalis is very rare disease. In Korea, no case has been reported. METHODS: The patient invited the hospital at each 1, 7 days after phacoemulsification and IOL implantation. We have done anterior chamber paracentesis. Enterococcus fecalis was founded in culture. We have done systemic IV antibiotics, fortified topical antibiotics, intravitreal antibiotics injection and pars plana vitrectomy at each 3, 7 day after symptom was appeared. RESULTS: The final visual acuity of one patient was 0.15, but the final visual acuity of the other patient was hand motion in 30cm. CONCLUSIONS: Visual prognosis of Enterococcus fecalis endophthalmitis is not good. Early vitrectomy is good in visual outcome than retard operation.

Laboratory Evaluation of Thrombophilic Factor in Retinal Vein Occlusive Disease

PURPOSE: To evaluate the significance of thrombophilic factors in retinal vein occlusive diseases. METHODS: Thirty-two patients with retinal vein occlusion (19 patients at the age of 55 or less, 13 patients at the age of 56 or more) underwent laboratory evaluation for CBC, lipid profile, VDRL/TPHA, homocysteine, protein C activity, protein S activity, lipoprotein (a), platelet aggregation test, Factor V Leiden, lupus anticoagulant, anticardiolipin antibody, fibrinogen, and antithrombin III. RESULTS: The abnormal laboratory findings (high homocysteine, hyperlipidemia, thrombocytosis, lipoprotein (a), high ESR, and decreased protein S activity) were found more often in patients of 55 years or less than those of 56 or more. CONCLUSIONS: The thrombophilic factors were more common positive findings at or less than 55 years. Thrombophilic factor tests are recommended in young patients with retinal vein occlusion.

Effect of Beta Blocker on MUC2, MUC5AC Expression of the Cultured Human Conjunctival Cell

PURPOSE: To evaluate the characteristics of MUC2, MUC5AC expression and the effect of beta-blocker on MUC2, MUC5AC expression in cultured human conjunctival cell. METHODS: Human conjunctival cell was cultured. After obtaining the monoclonality of conjunctival cells, secondary culture was done. Cultured conjunctival cell was treated with 0.2 nM timolol. Specimen was collected in 1, 3, 5, 10 days after the confluence of cultured conjunctival cells. To determine the effect of beta blocker, Periodic acid-Schiff (PAS) staining, immunohistochemistry, RT-PCR, and flowcytometry were performed. RESULTS: Goblet cell was found in cultures of conjunctival cell. MUC5AC was detected in RT-PCR, immunohistochemistry, and flowcytometry, but MUC2 was detected only in flowcytometry. Beta blocker didn't have significant effects on expression of MUC2 and MUC5AC in flowcytometry. CONCLUSIONS: MUC2 and MUC5AC were detected in cultured conjunctival cell. Beta blocker may not affect goblet cell. The other factor will be related to goblet cell suppressing the mucin in long standing antiglaucomatous medication.

Clinical Features of Corneal Erosion in Contact Lens Wearers

PURPOSE: To evaluate the clinical patterns of corneal erosion induced by contact lens wear and the relations of corneal complications to the duration of contact lens wear and the final wearing. METHODS: We have examined with slit lamp and questionnaire survey, 161 eyes of 105 patients with complication of contact lens wear who visited KyungHee Medical Center from January 2000 to June 2001. RESULTS: Majority of the corneal complication is diffuse punctate type that comprises 58.3%, corneal erosion 14.4%, corneal ulcer 3.1% and so on. Erosional grading and the final wearing time are not proportional to the clinical presentation. Extended-wear soft contact lens was used by 37.1% and RGP lens by 35.2%. Half of the symptoms starts shortly after the lens removal. Corneal ulcer has a significantly higher incidence in the long-duration of wearing group. CONCLUSIONS: The corneal complication is various as corneal erosion, corneal ulcer, and so forth. Consequently, it is quite necessary to give an intensive education to the contact lens wearers, especially in long-duration ones.

Incidence and Postoperative Visual Outcome of Terson's Syndrome

PURPOSE: The purpose of the study A was to determine the incidence of Terson's syndrome. The purpose of the study B was to assess the outcome of vitrectomy for Terson's syndrome. METHODS: In the study A, We have examined fundus by direct ophthalmoscope in 96 eyes of 62 persons with subarachnoid hemorrhage, subdural hemorrhage and epidural hemorrhage from March 2000 to June 2001. If we needed more examination, further evaluation was performed. In the study B. We have examined 8 eyes with Terson's syndrome retrospectively from 1997 to 2000. Visual outcome of operation was examined. RESULTS: A. The incidence of Terson's syndrome was 4.3% (4 eyes by 96eyes). Other ophthalmic findings were retinal hemorrhage (1 eye), central retinal artery occlusion (1 eye) and optic atrophy (1 eye). B. The final visual acuity was over 0.5 in 5 of 8 eyes and Visual acuity improved at a full cases postoperatively. CONCLUSIONS: The incidence of Terson's syndrome was 4.3%. The final visual acuity of Terson's syndrome was relatively good. Therefore, We must closely examine the fundus of patient with subarachoid hemorrhage, subdural hemorrhage and epidural hemorrhage patients. and We can also perform vitrectomy for vitreous hemorrhage, if Terson's syndrome is suspected.