Iridocorneal Endothelial Syndrome with Features of Posterior Polymorphous Corneal Dystrophy

PURPOSE: To report a case of iridocorneal endothelial syndrome, which overlapped with some of the features of posterior polymorphous corneal dystrophy. CASE SUMMARY: A 61-year-old female presented with tearing pain and blurred vision in her left eye, which was aggravated in the morning. The symptom started approximately 1 year prior to her visit. At the initial visit, the visual acuities were 1.0 in both eyes and the intraocular pressures were normal. On slit-lamp examination, a single pair of horizontal parallel lines was observed at the central corneal endothelial layer in the right eye. In contrast, multiple pairs of oblique parallel lines were observed in the left eye. The lines of the lesions were more prominent and wavier in the left eye than those of the right eye. The overlying cornea was clear, and the corneal thicknesses were in the normal range in both eyes. Using a gonioscopic examination, localized peripheral anterior synechiae were observed only in the left eye. The pupil and iris were normal in both eyes. On specular microscopic examination, the corneal endothelial cell size in the right eye increased and the corneal endothelial density decreased to 668 cells/mm². In the left eye, multiple abnormal endothelial cells with dark-light reversal were observed. In conclusion, the patient was subsequently diagnosed with iridocorneal syndrome, rather than posterior polymorphous corneal dystrophy. CONCLUSIONS: Posterior polymorphous corneal dystrophy and iridocorneal endothelial syndrome may present with many similarities. Therefore, in cases of uncertain diagnosis, an understanding of the clinical features is important for proper diagnosis.

The Correlation between Tear Matrix Metalloproteinase-9 Concentration and Clinical Findings in Dry Eye Disease

PURPOSE@#To investigate the correlation between the matrix metalloproteinase-9 (MMP-9) concentration, and subjective symptoms and objective signs in dry eye patients.@*METHODS@#We retrospectively reviewed the medical records of 134 eyes of 67 patients who were diagnosed with dry eye disease. The results of tear MMP-9, which were conducted at a care testing facility, were defined as negative (N), equivocal (E), weak positive (W), positive (P) or strong positive (S). Using three methods with different classification ranges, MMP-9 results were classified into a negative group or positive group. The objective signs of dry eye disease, including tear break-up time (TBUT), tear volume measured by Schirmer's test, degree of corneal erosion estimated by the Oxford stain score (OSS), and ocular surface disease index (OSDI) as the subjective symptom, were recorded. The differences of indices were compared between the negative and positive groups.@*RESULTS@#There was no significant difference of the TBUT, Schirmer's test, or OSS between the MMP-9 negative and positive groups. Also, the percentage of females was significantly higher in the negative group compared with the positive group regardless of the classification methods (all, p < 0.05). When the MMP-9N alone was classified as a negative group, the OSDI score was significantly higher in the positive group when compared to that of the negative group (p = 0.009).@*CONCLUSIONS@#The measurement of MMP-9 in patients with dry eye disease may be helpful in predicting subjective symptoms of dry eye disease.

Inadvertent Intralenticular Dexamethasone Implant for Diabetic Macular Edema Unresponsive to Bevacizumab

PURPOSE: To report a case of inadvertent intralenticular slow-release dexamthasone implant (Ozurdex(R), Allergan Inc., Irvine, CA, USA) for diabetic macular edema unresponsive to bevacizumab. CASE SUMMARY: A 71-year-old woman presented with proliferative diabetic retinopathy. During follow-up, diabetic macular edema developed in both eyes and did not improve with intravitreal bevacizumab injections. For refractory diabetic macular edema, slow-release dexamthasone implant (Ozurdex(R)) was to be injected at the vitreous cavity of her left eye, but it was inadvertently injected into the crystalline lens. The patient was followed closely for 10 months. Diabetic macular edema completely resolved 1 month after the injection and did not recur during follow-up. There were no severe complications except mild cataract formation. Best-corrected visual acuity for the left eye improved from 0.1 to 0.2. The Ozurdex(R) implant slightly decreased after 10 months, but was still observed in the crystalline lens. CONCLUSIONS: The inadvertent intralenticular dexamthasone implant was a rare complication but effective for diabetic macular edema.

Comparison of Choroidal Thickness in Patients with Diabetes by Spectral-domain Optical Coherence Tomography

PURPOSE: To evaluate choroidal thickness in diabetes patients using spectral-domain optical coherence tomography. METHODS: We examined 203 eyes of 203 diabetic participants and 48 eyes of 48 healthy controls. The choroidal thickness at the foveal lesion was measured by enhanced-depth imaging optical coherence tomography. The participants were grouped according to diabetic retinopathy grade: no diabetic change, mild-to-moderate or severe non-proliferative, or proliferative diabetic retinopathy. The study parameters included history, age, axial length, intraocular pressure, central retinal thickness, fasting glucose, and blood pressure. RESULTS: The subfoveal choroidal thickness was thinner in eyes with non-proliferative or proliferative diabetic retinopathy than in normal eyes (p < 0.01). However, there was no difference between eyes with non-proliferative and proliferative diabetic retinopathy or between eyes with no diabetic change and the controls. Eyes exhibiting macular edema showed no significant difference in choroidal thickness compared with eyes having normal macular contours. CONCLUSIONS: The central choroid is thinner when eyes show diabetic changes on the retina. However, the presence of diabetic macular edema or proliferative change is not associated with more pronounced choroidal thinning.

Parenting Stress and Support System in Parents of Child Neuropsychiatric Outpatients / 신경정신의학

OBJECTIVES: Parents of child neuropsychiatic patients may have many stresses due to their children's illness. Characteristics and severity of diseases will influence to the stresses of parents. The authors investigated various factors and parents' social support having an effect on the parenting stress. METHODS: Children and parents in outpatients interviewed and completed measures assessing children's problem behaviors, parenting stress, general social support, and support related to parenting by Child Behavior Checklist, Parenting Stress Index, Medical Outcomes Study's Social Support Scale, and Parenting Support Scale. RESULTS: We could not find the differences in the total scores of CBCL, Social Support Scale, and Parenting Stress Index among major diagnostic groups. In the same diagnosis, no difference of parenting stress was found according to general social support. Parenting stress highly correlated with severity of problem behaviors measured by CBCL. CONCLUSION: Severity of problem behaviors perceived by parents most predicted parenting stress. Parenting stress correlated with support to parenting, but not with general social support. Managing of children's problem behaviors is the most immediate and effective method to diminish the parental stress of child neuropsychiatric patients.

A study on the prevalence of malocclusion in 2,378 Yonsei university students / 대한치과교정학회지

Since malocclusion affects a large segment of the population, it is by definition a public health problem. The etiology ana treatment of malocclusions have been studied by clinicians; however epidemioloic aspect of tile problem have been neglected. This study was undertaken using Angle's classification to obtain and to evaluate epidemiologic data on the prevalence of malocclusion in a group of 2,378 Yonsei University students, 17 to 23 years of age. All freshmen were selected, except for those students receiving orthodontic treatment and those few with too many missing teeth which prohibits classification by Angle's method. The following results were obtained: 1) Almost 91% of students had malocclusion of the teeth severe enough to require correction. 2) There was a statistically significant difference in malocclusion between males and females(93.66% malocclusion in males, 79.13% malocclusioa in females). 3) Crowding was most pravalent in class I malocclusion. 4) There appeared to be a specific association between the number of lost first molars and Angle's classification. 5) In this study, more class II, Div.2 malocclusion appeared than in Massier's and Frankel's study of Caucasians, which used similar criteria. Class III malocclusion was more prevalent than normal occlusion in the Korean students studied, but in Caucasians' normal occlusion was more prevalent.