A Study on the Relation between Glaucoma and Quality of Life

PURPOSE: This study was performed to find the relation between glaucoma and the quality of life (QOL). METHODS: The questionnaire survey and ophthalmologic examination was made in 105 glaucoma patients under treatment at ophthalmology clinic of a university hospital and 120 normal persons who had undergone an routine health check-up from June 1st, 2000 and June 30th, 2001. The questionnaire was composed of general characteristics, health-related behavior and the short form-36 health survey for QOL. Using the t-test, analysis of variance (ANOVA), Pearson's correlation analysis and analysis of co-variance (ANCOVA), we examined the relationship between glaucoma and QOL. RESULTS: 1. By t-test or ANOVA various domains of QOL showed statistically significant difference by sex, age, coverage of medical insurance, family history of glaucoma, past history of systemic diseases, educational level, marital status, smoking and drinking status. Visual acuity showed significant positive correlation with QOL and horizontal and vertical cup-to-disk (C/D) ratio showed significant negative correlation with QOL. 2. By ANCOVA to find the association of glaucoma with QOL controlling other related characteristics of subjects, QOL of the glaucoma group showed lower than that of the normal group, but the differences were not statistically significant. CONCLUSIONS: QOL of glaucoma patients was lower than that of normal persons without glaucoma considering sex, age, health insurance system, family history of glaucoma, past history of systemic disease, educational level, marital status, smoking status, drinking status and visual acuity, so further study will be necessary to observe the change of QOL according to progression of glaucoma and treatment status.

The Changes of Tear Flow and Tear Film Stability after Antiglaucoma Drug Instillation

PURPOSE: To investigate the changes in tear flow and tear filim stability in patients with long-term instillation of antiglaucoma drug. METHODS AND OBJECTS: We measured Schirmer test score and tear film break-up time (BUT) in long-term antiglaucoma drug instilling 60 patients (120eyes) who had been diagnosed with open angle glaucoma and in randomly selected 60 normal subjects (120eyes) from March 2000 to February 2001 at Chosun University Hospital. Obtained results were retrospectively analyzed with the age progression and sex of subjects, duration of instillation, number and type of drugs to find out correlations between these factors. RESULTS: Average Schirmer test score and BUT were measured considerably lower in antiglaucomat drug instilled group compared to normal-subjects group (P0.05, ANOVA test). CONCLUSIONS: It should be predicted that the patients who had instilled antiglaucoma drug for a long time and who are also of old age may develop dry eye syndrome and eye surface problem. So special care should be taken with glaucoma treatment in such cases.

Bilateral Visual Field Defect Following Laser in Situ Keratomileusis(LASIK)

We report a 36-year-old male with the bilateral visual field defect following LASIK was observed. Preoperatively, patient had high myopia(right. -7.25 0.75x18, left. -7.5-0.5x12), normal intraocular pressure(IOP)(right/left: 16/14 mmHg), normal visual field(Humphrey 30-2 visual field)and revealed the tilted discs with symetric optic nerve head cupping(cup-to-disc ratio, 0.70), parapapillary atrophy. Bilateral LASIK keratorefractive surgery was on the same day and intraoperative complication was not noted. After the first operative visit day, examination revealed uncorreted visual acuity right 0.8 and left 0.6 but scotoma was reported. Three months later, Humphrey 30-2 visual field revealed a near-superior altitudinal defect in the right eye and nasal side visual field defect in the left eye. Best corrected visual acuity was 1.0 in the right eye, 0.8 in the left eye. Repeated visual fields over a 11-month period postoperatively showed stability of the defect, with IOP of 12 mmHg to 15 mmHg in each eye. We considered LASIK uses a microkeratome vaccum ring to make a corneal flap, transient elevation of IOP alters the microcirculation of optic nerve head and may have precipitated visual field defect.

A Case of Acute Fatty Liver of Pregnancy / 대한산부인과학회잡지

Acute fatty liver of pregnancy is a rare, clinically distinct cause of jaundice occuring during the third trimester of pregnancy, with maternal death as the usual outcome and first described in 1,940 by Sheehan, which may be characterized by nausea, vomiting, epigastric pain, jaundice and confirmed by liver biopsy. We have experienced a case of acute fatty liver at 38 weeks of gestation in 30 year-old primigravida woman and reproted with a brief review of related literatures.

Clinical Observation on Postoperative Endophthalmitis Following Cataract Surgery

Postoperative endophthalmitis following cataract surgery is rare but may influence the final visual outcome markedly. The authors reviewed the clinical records of 16 patients who had been treated with the diagnosis of endophthalmitis after cataract surgeries from March. 1992. to September, 1995. We analysised their final visual outcomes according to cultured microorganisms, durations of symptom onset after the surgeries, the methods of antibiotic administration and treatment methods with or without vitrectomies. Final visual accuities were 0.5 or better in 50% of all eyes, 0.15 or better in 75% and light perception or worse in 4 eyes(25%). Twelve(75%) of all eyes were cultured in positive. Five of twelve culture proven cases were Staphylococcus epidermidis and five were Pseudomonas aeruginosa. Each case of Xanthomonas maltophilia and fluorescens were cultured. All 5 cases infected by gram positive organisms had got visual accuity of 0.15 or better but 4 of 7 eyes infected by gram negative ones had got. We treated 9 patients with intravitreal, subconjunctival and systemic antibiotics but did 7 without systemic antibiotics. Six cases(85.7%) of these had got visual accuity of 0.15 or better but 6 cases(66.7%) of those had got. One of five patients who had undergone therapeutic vitrectomies had got visual outcome of 0.15 or better but all eleven without vitrectomy had got.

P100 Latency in Normal Persons by Pattern Reversal VEP and Flash VEP

The Flash Light Emitted Diode Flash Visual Evoked Potential(Flash VEP) is useful when patients are unable to cooperate sufficiently for a Pattern Reversal Visual Evoked Potential(RP-VEP). In order to evaluate the clinical utility of Flash VEP, we performed the PR-VEP and Flash VEP in 208 eyes of 104 normal persons. The average P100 latency(LaP100) was analyzed according to check size, age, sex, and the laterality of the eye. The LaP100 of PR-VEP stimulated with 8 X 8(120' X 96'), 16 X 16(60' X 48'), 32 X 32 (30' X 24') and 64 X 64(15' X 12') check size were 98.88 +/- 7.57msec(mean S.D msec) , 97.68 +/- 7.44msec, 96.31 +/- 7.21msec, 101.20 +/- 7.81msec, respectively. The LaP100 of PR-VEP stimulated with 32 X 32 check size at 3rd, 4th, 5th, 6th and 7th decades were 93.95 +/- 5.61msec, 94.70 +/- 7.71msec, 92.92 +/- 6.28msec, 97.78 +/- 6.24 msec, 102.79 +/- 5.27msec, respectively. The LaP100 of PR-VEP remained relatively stable until over 6th decade when it increased significantly (p0.05), and between male and female(p>0.05) in the LaP100 of both VEP. These results showed that LaP100 of PR-VEP changes according to the check size and patient's age. We should interprete the LaP100 of PR-VEP or Flash VEP after the processing of averaging its P100 according to the patient's.

A Case of Neuromyelitis Optica

Neuromyelitis optica(Devie's disease) is a demyelinating disorder of unknown etiology that is characterized by bilateral acute optic neuritis, associated with transverse myelitis. The authors experienced a case of Neuromyelitis optica in a 28 year old female who developed acute visual disturbance, sensory loss under the thoracic dermatome 8, and paraplegia, shortly after upper respiratory infection. Bilateral acute optic neuritis was noted with abnormal visually evoked potential. We confirmed this case by neurologic features, magnetic resonance imaging, and cerebrospinal fluid finding, and treated with Corticosteroid "pulse therapy".