Multiple Subretinal and Intraretinal Hemorrhages as a First Sign of Infective Endocarditis

PURPOSE: To report a patient with multiple subretinal and intraretinal hemorrhages in the absence of retinal/choroidal lesions, diagnosed with infective endocarditis (IE). CASE SUMMARY: We describe the case of a 44-year-old male with an acute decrease of vision in his right eye. Ophthalmic evaluation revealed multiple subretinal and intraretinal hemorrhages, but no choroidal or other retinal lesions. A systemic examination revealed a pansystolic murmur and blood cultures with echocardiography were suggestive of IE. CONCLUSIONS: Thorough systemic evaluations are important when patients present with subretinal and intraretinal hemorrhages in the absence of other retinal/choroidal lesions.

Efficacy of Primary Intravitreal Ranibizumab Injection for Treatment of Type 1 Retinopathy of Prematurity

PURPOSE: To evaluate the effectiveness and safety of primary intravitreal ranibizumab injection as a treatment for retinopathy of prematurity. METHODS: Retrospective analysis of the medical records of patients diagnosed with retinopathy of prematurity and treated with intravitreal ranibizumab injection from January 1, 2013 to January 1, 2016 was performed. We complied with the standards for ‘prethresold, type 1’ established by the Early Treatment of Retinopathy of Prematurity study for intravitreal ranibizumab injection. The follow-up period after injection was at least 9 months. Patients who received additional treatment such as laser photocoagulation or intravitreal injection without reactivation of retinopathy of prematurity were excluded. RESULTS: A total of 21 patients (39 eyes) were included in this study. Nine (16 eyes) were male and 12 (23 eyes) were female. The average duration between treatment decision and intravitreal ranibizumab injection was 2.1 ± 1.5 days. Complete regression of the plus sign occurred 18.2 ± 9.1days after injection. One eye with reactivation was treated with panretinal laser photocoagulation while four other eyes with reactivation were treated with intravitreal bevacizumab injection. There were 87.1% (34/39) eyes that underwent primary intravitreal ranibizumab injection with stable results without any reactivation. There were no systemic complications related to intravitreal ranibizumab injection. CONCLUSIONS: Primary intravitreal ranibizumab injection as a treatment for retinopathy of prematurity showed good efficacy and safety. However, thorough evaluation is needed after primary intravitreal ranibizumab injection due to the potential for reactivation. Long-term monitoring is needed after intravitreal ranibizumab injection.

Comparison of Inner Retinal Thickness between the Fellow Eyes of Unilateral Branch Retinal Vein Occlusion and Normal Control

PURPOSE: The purpose of this study was to compare inner retinal thickness and retinal nerve fiber layer (RNFL) thickness between fellow eyes with unilateral branch retinal vein occlusion (BRVO) and normal control eyes. METHODS: Retrospective cross-sectional study including 59 patients diagnosed with unilateral BRVO and 51 control subjects. Using spectral domain optical coherence tomography, we investigated the average, 4 quadrant, and 12 clock-hour RNFL thicknesses and the average, minimum, superior, superonasal, superotemporal, inferior, inferonasal, and inferotemporal thicknesses of the ganglion cell-inner plexiform layer (GCIPL) layer. RESULTS: Patients with unilateral BRVO had a higher incidence of hypertension. In the fellow eyes of the unilateral BRVO patients, 7 and 11 o'clock RNFL thicknesses were significantly thinner than for the control eyes. There was no significant difference in the GCIPL thickness between the two groups CONCLUSIONS: The RNFL thickness of the fellow eyes of the unilateral BRVO patients showed significant decreases in the 7 and 11 o'clock sectors (p=0.005, 0.017, respectively), whereas there was no significant difference in the GCIPL thickness between the two groups. In the RNFL thickness analysis, the 7 and 11 o'clock sectors were found to be dominant locations of decreased RNFL thickness for the open angle glaucoma. Further, glaucomatous change should be carefully monitored in the fellow eyes of unilateral BRVO patients.

The Development of Health Risk Appraisal at the Worksite / 대한산업의학회지

Health Risk Appraisal(HRA) is usually defined as a process by which we expect of individual's chances of death or acquiring specific diseases within a defined period of time. The concept of worksite as an area of health maintenance and promotion is newly developing. Our movement for health promotion of employees has been increasingly known in the worksite. The aim of this study is to develop health risk appraisal tools about health promotion at the worksite for employees. We performed this study by two steps: one step was to develop a HRA questionnaire of worksites in Korea, another was to evaluate the reliability of the questionnaire. For developing HRA questionnaire, we reviewed scientific examples at first, and then weighted the score by delphi. To evaluate the reliability of developed questionnaire, we carried out survey by test-retest method. A total of 131 employees completed HRA questionnaire on two times. The results are as follows. The total score of health risk in unhealthy workers was higher than that of healthy workers. The range of test-retest reliability of responses to the questionnaire was 0.57-0.94. Therefore it seems that this questionnaire was very suitable to assess the health behavior of workers. In conclusion, the developed HRA questionnaire can be used as a tool for evaluating health behavior and for providing health counseling materials.