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Purpose@#To evaluate the changes in peripapillary retinal nerve fiber layer (pRNFL) thickness and macular ganglion cell-inner plexiform layer (mGC-IPL) thickness measured by swept source optical coherence tomography (SS-OCT) following cataract surgery in patients with glaucoma. @*Methods@#We included 42 glaucoma eyes and 42 case-matched normal eyes that underwent cataract surgery without complications. One matching set included one glaucoma eye and one case-matched normal eye. The age, sex, and cataract subtype scores were similar for each group. Before and within 3 months of surgery, we measured the pRNFL thickness and mGCIPL thickness by SS-OCT. @*Results@#Following cataract surgery, the image quality (IQ) of SS-OCT improved in both groups. The thickness of the pRNFL and mGC-IPL increased in the mean values and all areas, except for pRNFL from 1 to 4 o’clock in the glaucoma group and at 1 o’clock in the normal group. Posterior subcapsular cataract was related to the change in IQ following surgery. The glaucoma and normal group showed greater pRNFL thickness change due to lesser preoperative pRNFL thickness. Furthermore, the mGC-IPL thickness change was greater in the glaucoma group because of lesser preoperative mGC-IPL thickness. By contrast, the normal group demonstrated greater mGC-IPL thickness change due to higher cortical cataract scores. @*Conclusions@#Cataracts caused the deterioration of the IQ in SS-OCT, thereby resulting in an undermeasurement of the pRNFL and mGC-IPL thickness. Preoperative pRNFL and mGC-IPL were negatively associated with postoperative pRNFL and mGCIPL thickness change in the glaucoma and normal groups. Therefore, ophthalmologists should particularly consider the effect of cataract while diagnosing glaucoma using SS-OCT.
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Purpose@#To evaluate the results of treatment according to the method of intravitreal injection of bevacizumab for macular edema due to branch retinal vein occlusion (BRVO). @*Methods@#The clinical records of macular edema patients were analyzed retrospectively for a total of 62 eyes of 62 patients who were injected with bevacizumab into the vitreous as the first treatment for BRVO. Best-corrected visual acuity (BCVA), the findings of spectral-domain optical coherence tomography before and after injection, and prognosis-related factors were evaluated for 21 eyes that received the initial three monthly loading treatments and the 41 eyes that did not. @*Results@#Significant improvement in BCVA was observed in the group having received the initial three injections compared with the group who did not receive the injections at 3, 6, and 12 months (p = 0.025, p = 0.019, and p = 0.008, respectively). The central macular thickness (CMT) showed greater improvement in the initial three injections group than the group without at 6 months (p = 0.034). Multivariate regression showed that the duration from the onset, the three loadings, BCVA, disorganization of the retinal inner layer (DRIL), and choroidal thickness were predictors related to visual gain (p = 0.044, p = 0.047, p = 0.004, p = 0.045, and p = 0.034, respectively). Age, three loadings, BCVA, and DRIL were predictors related to final visual acuity (p = 0.045, p = 0.046, p = 0.002, and p = 0.034, respectively). Duration from the onset, CMT, and choroidal thickness were predictors related to CMT improvement (p = 0.042, p = 0.009, and p = 0.015, respectively). @*Conclusions@#In macular edema of BRVO, the initial three monthly intravitreal injections of bevacizumab provided superior treatment outcomes regarding short-term functional and anatomical improvements and long-term functional improvement, compared with methods that did not treat with the initial three monthly injections.
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Purpose@#This study investigated the 1-year outcomes of a treat-and-extend regimen of ranibizumab for exudative age-related macular degeneration and examined the clinical results when drug treatment was changed within the same period. @*Methods@#This retrospective analysis included 32 eyes first diagnosed with wet age-related macular degeneration and treated for more than 1 year with a treat-and-extend regimen of ranibizumab, as well as 24 eyes treated by changing from ranibizumab to aflibercept within the same period. The injection number, maximum injection interval, change in central retinal thickness, and best-corrected visual acuity were assessed in all eyes. @*Results@#In 32 eyes that received a treat-and-extend regimen of ranibizumab, the mean best-corrected visual acuity improved from 59.46 ± 15.13 to 68.00 ± 12.48 at 12 months (p < 0.0001). The mean central retinal thickness decreased from 409 ± 141 μm to 273 ± 89 μm at 12 months (p < 0.0001). The average number of injections per year was 7.2 ± 0.85. One complication related to the 12 months of injections was a tear in the retinal pigment epithelium; no systemic complications were observed. Of 24 eyes that underwent a change in medication, the rate of maintenance or improvement in initial visual acuity was 83% (10 eyes). The central retinal thickness was initially 371.58 ± 109.96 μm, but improved to 290.33 ± 58.66 μm in 12 eyes that received three injections of aflibercept. @*Conclusions@#At 1 year, good outcomes were obtained using treat-and-extend ranibizumab for exudative age-related macular degeneration. When the treatment was changed to aflibercept within the same period, vision was often maintained and short-term anatomical improvement was evident.
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Purpose@#To report a case of acute angle-closure attack resulting from hemorrhagic retinal detachment after a double retinal pigment epithelium (RPE) tear in exudative age-related macular degeneration (AMD) with large pigment epithelial detachment (PED).Case summary: A 66-year-old female visited with a complaint of poor vision in left eye, which began 1 month prior. She was diagnosed with exudative AMD with a large PED using optical coherence tomography and indocyanine green angiography. Intravitreal aflibercept injection was performed. The RPE tear occurred at 2 weeks after the intravitreal anti-vascular endothelial growth factor injection for AMD, after which the range of the RPE tear expanded and included the macular area at 4 weeks after the second injection. At 3 months after the third injection, massive submacular hemorrhage occurred; aflibercept injection was repeated. At 3 days after the fourth injection, the patient’s intraocular pressure (IOP) was 60 mmHg, and massive hemorrhagic serous retinal detachment and anterior movement of the lens with total angle closure were observed. Therefore, we performed a sclerotomy; a large amount of dark blood and subretinal fluid was drained. The IOP decreased, and the retinal detachment improved somewhat. The patient was kept under observation for careful monitoring of her condition. @*Conclusions@#It is very rare to experience a double RPE rupture after intravitreal anti-vascular endothelial growth factor injection in AMD. We report on our experience and treatment of acute angle-closure attack. The IOP increased due to hemorrhagic retinal detachment after a double RPE tear over the treatment course.
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Purpose@#To evaluate the results of treatment according to the method of intravitreal injection of bevacizumab for macular edema due to branch retinal vein occlusion (BRVO). @*Methods@#The clinical records of macular edema patients were analyzed retrospectively for a total of 62 eyes of 62 patients who were injected with bevacizumab into the vitreous as the first treatment for BRVO. Best-corrected visual acuity (BCVA), the findings of spectral-domain optical coherence tomography before and after injection, and prognosis-related factors were evaluated for 21 eyes that received the initial three monthly loading treatments and the 41 eyes that did not. @*Results@#Significant improvement in BCVA was observed in the group having received the initial three injections compared with the group who did not receive the injections at 3, 6, and 12 months (p = 0.025, p = 0.019, and p = 0.008, respectively). The central macular thickness (CMT) showed greater improvement in the initial three injections group than the group without at 6 months (p = 0.034). Multivariate regression showed that the duration from the onset, the three loadings, BCVA, disorganization of the retinal inner layer (DRIL), and choroidal thickness were predictors related to visual gain (p = 0.044, p = 0.047, p = 0.004, p = 0.045, and p = 0.034, respectively). Age, three loadings, BCVA, and DRIL were predictors related to final visual acuity (p = 0.045, p = 0.046, p = 0.002, and p = 0.034, respectively). Duration from the onset, CMT, and choroidal thickness were predictors related to CMT improvement (p = 0.042, p = 0.009, and p = 0.015, respectively). @*Conclusions@#In macular edema of BRVO, the initial three monthly intravitreal injections of bevacizumab provided superior treatment outcomes regarding short-term functional and anatomical improvements and long-term functional improvement, compared with methods that did not treat with the initial three monthly injections.
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Purpose@#This study investigated the 1-year outcomes of a treat-and-extend regimen of ranibizumab for exudative age-related macular degeneration and examined the clinical results when drug treatment was changed within the same period. @*Methods@#This retrospective analysis included 32 eyes first diagnosed with wet age-related macular degeneration and treated for more than 1 year with a treat-and-extend regimen of ranibizumab, as well as 24 eyes treated by changing from ranibizumab to aflibercept within the same period. The injection number, maximum injection interval, change in central retinal thickness, and best-corrected visual acuity were assessed in all eyes. @*Results@#In 32 eyes that received a treat-and-extend regimen of ranibizumab, the mean best-corrected visual acuity improved from 59.46 ± 15.13 to 68.00 ± 12.48 at 12 months (p < 0.0001). The mean central retinal thickness decreased from 409 ± 141 μm to 273 ± 89 μm at 12 months (p < 0.0001). The average number of injections per year was 7.2 ± 0.85. One complication related to the 12 months of injections was a tear in the retinal pigment epithelium; no systemic complications were observed. Of 24 eyes that underwent a change in medication, the rate of maintenance or improvement in initial visual acuity was 83% (10 eyes). The central retinal thickness was initially 371.58 ± 109.96 μm, but improved to 290.33 ± 58.66 μm in 12 eyes that received three injections of aflibercept. @*Conclusions@#At 1 year, good outcomes were obtained using treat-and-extend ranibizumab for exudative age-related macular degeneration. When the treatment was changed to aflibercept within the same period, vision was often maintained and short-term anatomical improvement was evident.
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Purpose@#To report a case of acute angle-closure attack resulting from hemorrhagic retinal detachment after a double retinal pigment epithelium (RPE) tear in exudative age-related macular degeneration (AMD) with large pigment epithelial detachment (PED).Case summary: A 66-year-old female visited with a complaint of poor vision in left eye, which began 1 month prior. She was diagnosed with exudative AMD with a large PED using optical coherence tomography and indocyanine green angiography. Intravitreal aflibercept injection was performed. The RPE tear occurred at 2 weeks after the intravitreal anti-vascular endothelial growth factor injection for AMD, after which the range of the RPE tear expanded and included the macular area at 4 weeks after the second injection. At 3 months after the third injection, massive submacular hemorrhage occurred; aflibercept injection was repeated. At 3 days after the fourth injection, the patient’s intraocular pressure (IOP) was 60 mmHg, and massive hemorrhagic serous retinal detachment and anterior movement of the lens with total angle closure were observed. Therefore, we performed a sclerotomy; a large amount of dark blood and subretinal fluid was drained. The IOP decreased, and the retinal detachment improved somewhat. The patient was kept under observation for careful monitoring of her condition. @*Conclusions@#It is very rare to experience a double RPE rupture after intravitreal anti-vascular endothelial growth factor injection in AMD. We report on our experience and treatment of acute angle-closure attack. The IOP increased due to hemorrhagic retinal detachment after a double RPE tear over the treatment course.
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Purpose@#To investigate the bacterial culture, clinical characteristics, and prognosis associated with infectious endophthalmitis in western Gyeongsangnam-do. @*Methods@#This study was a retrospective review of the medical records of 98 eyes that presented with infectious endophthalmitis from 2010 to 2019. All patients were analyzed for the type of causative bacteria, treatment method, and the visual prognosis. @*Results@#The bacterial cultures (n = 98 eyes) revealed bacterial growth in 67 eyes (68.4%). The most commonly isolated causative microorganism was Gram-positive Staphylococcus epidermidis (14.3%). As a result of analyzing the best corrected visual acuity (VA) based on 1.0 (logMAR), baseline VA was worse than counting fingers, and whether pars plana vitrectomy was undertaken showed a difference in the final visual acuity (p < 0.001, p = 0.021). @*Conclusions@#Exogenous endophthalmitis occurs frequently after cataract surgery, and S. epidermidis is the most common causative agent, but a good visual prognosis resulted. Liver abscess was a common extraocular source of endogenous endophthalmitis and Klebsiella pneumonia was the most common causative agent for a poor visual prognosis.
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Purpose@#To investigate the bacterial culture, clinical characteristics, and prognosis associated with infectious endophthalmitis in western Gyeongsangnam-do. @*Methods@#This study was a retrospective review of the medical records of 98 eyes that presented with infectious endophthalmitis from 2010 to 2019. All patients were analyzed for the type of causative bacteria, treatment method, and the visual prognosis. @*Results@#The bacterial cultures (n = 98 eyes) revealed bacterial growth in 67 eyes (68.4%). The most commonly isolated causative microorganism was Gram-positive Staphylococcus epidermidis (14.3%). As a result of analyzing the best corrected visual acuity (VA) based on 1.0 (logMAR), baseline VA was worse than counting fingers, and whether pars plana vitrectomy was undertaken showed a difference in the final visual acuity (p < 0.001, p = 0.021). @*Conclusions@#Exogenous endophthalmitis occurs frequently after cataract surgery, and S. epidermidis is the most common causative agent, but a good visual prognosis resulted. Liver abscess was a common extraocular source of endogenous endophthalmitis and Klebsiella pneumonia was the most common causative agent for a poor visual prognosis.
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BACKGROUND: Dry eye is a common disease, and coffee is a popular beverage that is heavily consumed in Korea and worldwide. We examined the correlation between coffee consumption and dry eye.METHODS: This study was performed using data from the 5th Korean National Health and Nutrition Examination Survey, which was a cross-sectional study of the Korean population conducted from 24 months. We included adults aged ≥19 years who underwent ophthalmologic examination and excluded those who had comorbid conditions with dry eye. The subjects were divided into dry eye and control groups. The dry eye group consisted of those who had been clinically diagnosed with dry eye. A multiple logistic regression analysis was conducted to determine the correlation between coffee consumption and dry eye.RESULTS: An inverse correlation was found between coffee consumption and dry eye in the group that consumed 3 cups of coffee a day (P=0.001). However, after multivariate adjustment, the statistical significance of the correlation disappeared (P=0.283).CONCLUSION: Consumption of 3 cups of coffee a day in comparison to non-consumption group was negatively correlated with dry eye in an univariate analysis model, but the correlation was not statistically significant after adjusting for age, sex, body mass index, smoking, binge drinking, sun exposure time and history of eye surgery.
Subject(s)
Adult , Humans , Beverages , Binge Drinking , Body Mass Index , Coffee , Cross-Sectional Studies , Dry Eye Syndromes , Korea , Logistic Models , Nutrition Surveys , Smoke , Smoking , Solar SystemABSTRACT
PURPOSE: A case of frosted branch angiitis in Kikuchi-Fujimoto disease is reported. CASE SUMMARY: A 33-year-old male complained of a sudden decrease in visual acuity that developed in both eyes 5 days prior. He suffered from a headache, chills, myalgia, and flank pain 1 week before. The initial best-corrected visual acuity (BCVA) was 0.1 in the right eye and 0.2 in the left eye. On slit lamp examination, no inflammatory finding was observed in the anterior chamber and vitreous body of both eyes. On fundus examination, a diffuse vascular sheathing-like frosted branch was found in the retinal vessels, and retinal hemorrhage was observed. Fluorescein angiography showed staining and leakage of dye along the vascular sheathing. Serological findings were negative, showing no evidence of an autoimmune disease or viral infection. Neck ultrasonography revealed non-tender left cervical lymph node enlargement >1 cm in diameter. Ultrasound-guided fine needle aspiration cytology showed findings compatible with Kikuchi-Fujimoto disease, including necrotic changes and pronounced karyorrhexis, plus histiocyte and lymphocyte infiltration without neutrophils. We started systemic steroid therapy. One month after treatment, the BCVA of both eyes improved to 1.0. CONCLUSIONS: In patients with frosted branch angiitis, systemic disease such as Kikuchi-Fujimoto disease should be considered.
Subject(s)
Adult , Humans , Male , Anterior Chamber , Autoimmune Diseases , Biopsy, Fine-Needle , Chills , Flank Pain , Fluorescein Angiography , Headache , Histiocytes , Histiocytic Necrotizing Lymphadenitis , Lymph Nodes , Lymphocytes , Myalgia , Neck , Neutrophils , Retinal Hemorrhage , Retinal Vessels , Slit Lamp , Ultrasonography , Vasculitis , Visual Acuity , Vitreous BodyABSTRACT
PURPOSE: To report one case involving Thelazia callipaeda subconjunctival infestation. CASE SUMMARY: A 52-year-old man came in with left eye discomfort that started about a month prior to hospital visit. Slit lamp examination identified a live white translucent parasite about 10 mm in length and about 0.3 mm in width moving under the lower left eye subconjunctiva. No other abnormal findings were found in the front or fundus. An incision of about 5 mm in the conjunctiva where the parasite was located was carried out, and after opening the area, the parasite was slowly pulled out using a clamp. Then, the bottom of the conjunctiva was washed with normal saline. Further, five additional parasites were found in the conjunctival sac and were removed. The parasite was identified as Thelazia callipaeda, and through outpatient follow-up for 1 month after removal, additional parasites were not found. CONCLUSION: The authors report this case of intraocular Thelazia callipaeda infestation because it is not known to be common; however, the authors witnessed a number of parasites in the conjunctival fornix, as well as Thelazia callipaeda in the subconjuctiva.
Subject(s)
Humans , Middle Aged , Conjunctiva , Follow-Up Studies , Lacrimal Apparatus , Outpatients , Parasites , Slit Lamp , ThelazioideaABSTRACT
PURPOSE: To determine whether retinal nerve fiber layer (RNFL), macula and macular ganglion cell layer (mGCL)-inner plexiform layer (IPL) thickness differ in the amblyopic and normal fellow eyes of unilateral amblyopic patients using spectral domain optical coherence tomography (SD-OCT). METHODS: 80 patients with 160 eyes were included in this study; the distribution of patients was 17 patients with strabismic amblyopia, 17 patients with strabismic non-amblyopia, 23 patients with anisometropic amblyopia, and 23 patients with anisometropic non-amblyopia. Macular, RNFL, and mGCL-IPL thickness were obtained by SD-OCT, and the interocular thickness differences of each group were analyzed. After treatment, the changes of OCT parameters were evaluated in amblyopic patients. RESULTS: Average macular, average RNFL, and average mGCL-IPL thickness of amblyopic eyes were thicker than for normal fellow eyes in amblyopic patients (40 patients total; p < 0.001, p < 0.001, p = 0.002, respectively). In 23 patients with anisometropic amblyopia, average macular, average RNFL, and average mGCL-IPL thickness of amblyopic eyes were thicker than the normal fellow eye (p = 0.008, p < 0.001, p = 0.002). In the 17 patients with strabismic amblyopia, average macular and average RNFL thickness of amblyopic eyes were thicker than the normal fellow eye (p=0.016, p < 0.006, respectively). No interocular thickness differences were observed in the control groups. Interocular differences between amblyopic and normal eyes remained unchanged after the amblyopic eyes were treated. CONCLUSIONS: Average RNFL and average mGCL-IPL thickness of amblyopic eyes were thicker than normal fellow eyes, but no differences were observed for macular in amblyopic patients. There was no change in the OCT parameter in amblyopic eyes after treatment.
Subject(s)
Humans , Amblyopia , Ganglion Cysts , Nerve Fibers , Retinaldehyde , Tomography, Optical CoherenceABSTRACT
PURPOSE: To analyze the clinical aspects of consecutive esotropia after intermittent exotropia reoperation and study the prognosis and associated risk factors. METHODS: The present study included 34 patients with intermittent exotropia who underwent reoperation; incidence rate, risk factors, treatment methods and prognosis of the postoperative consecutive esotropia were analyzed. RESULTS: Of the 34 patients, 12 developed consecutive esotropia that persisted longer than a month after the reoperation; a higher incidence rate was observed in patients with esodeviation greater than 16 prism diopter (PD) on postoperative day 1 and in patients who received unilateral lateral muscle recession and medial muscle resection during the operation (p < 0.05). Conversely, factors such as age, deviation angle, refractive power, anisometropia, lateral incomitance and oblique muscle dysfunction prior to the reoperation did not affect the incidence of consecutive esotropia. The patients who developed consecutive esotropia received conservative treatments such as alternative occlusion therapy and fresnel prism wearing; 10 of 12 patients showed significant clinical improvements. CONCLUSIONS: Consecutive esotropia frequently occurs after intermittent exotropia reoperation if the patient had esodeviation greater than 16 PD on postoperative day 1 or received unilateral lateral muscle recession and medial muscle resection. The conservative treatments of the consecutive esotropia showed good clinical response and improved prognosis.