The Influence of Demographic Characteristics on the Qualitative Signs of Glaucomatous Optic Disc

PURPOSE: To evaluate the influence of age, gender, and refractive error on the qualitative signs of glaucomatous optic nerve damage in normal eyes. METHODS: We evaluated color optic disc photographs for the presence or absence of 10 qualitative signs: rim shape alteration (alteration of ISN'T rule), thinnest rim width outside the temporal sector, rim notch, optic disc hemorrhage, baring of circumlinear vessel, bayonetting of vessel, nasalization of vessel, abnormally large peripapillary atrophy, abnormal form of peripapillary atrophy, and zone beta in 181 eyes of 181 normal subjects. The influence of age, gender, and refractive error on each qualitative sign was analysed by multiple logistic regression. RESULTS: Refractive error was related to zone beta (odds ratio=2.29, 95% confidence interval [CI]=1.21~4.33, p=0.009) and the frequency of zone beta was higher in myopic eyes. Age was weakly associated with abnormally large peripapillary atrophy (odds ratio=1.03, 95% CI=1.01~1.06, p=0.02). Gender, on the other hand, had no influence on qualitative signs. CONCLUSIONS: Our findings indicate that the qualitative signs of glaucomatous optic nerve damage were not affected by age, gender, and refractive error, except for zone beta and abnormally large peripapillary atrophy. Myopia was related to zone beta, and age was related to abnormally large peripapillary atrophy in normal eyes.

Comparison of Glaucomatous Optic Nerve Damage in Primary Angle-Closure Glaucoma with and without Acute Attack

PURPOSE: To compare the glaucomatous optic nerve damage in primary angle-closure glaucoma (PACG) with acute attack (acute PACG; AACG) and PACG without acute attack (chronic PACG; CACG). METHODS: The study subjects were 84 normal individuals, 130 AACG patients, and 86 CACG patients. Color optic disc photographs were evaluated for the presence or absence of 10 qualitative signs to differentiate between normal and glaucomatous optic discs. RESULTS: Abnormally shaped rim width (alteration of ISN'T rule), bared circumlinear vessel, vessel bayonetting, rim width narrower than the temporal sector, and zone beta (nasal and superotemporal sectors) were detected more frequently in the CACG group than in the AACG group (P< 0.05). The most accurate qualitative sign was abnormally shaped rim width in both groups. The specificity and sensitivity of abnormally shaped rim width were 71.4% and 60.8% for AACG, and 71.4% and 81.4% for CACG, respectively. CONCLUSIONS: The optic disc damage is greater in CACG than in AACG.

Hypertensive Optic Neuropathy Related to Chorioretinal Lesions

PURPOSE: To investigate the relationship between chorioretinal lesions and papilledema in patients with hypertensive optic neuropathy. METHODS: We analyzed the angiographic findings of 142 patients (284 eyes) who had been diagnosed with hypertensive chorioretinal disease in the ophthalmic outpatient department of our hospital, from March 2001 to December 2003. We classified hypertensive ocular disorders to either the optic disc edema group or the non-optic disc edema group. RESULTS: There were 34 patients with hypertensive optic neuropathy. With an analysis of color photo and angiographic findings, a significant correlation of optic disc edema was seen in Elschnig's spot, prominent watershed zone, and retinal hemorrhage. CONCLUSIONS: Hypertensive optic neuropathy was significantly related to retinal hemorrhage, Elschnig's spot, and prominent watershed zone. We should carefully observe the patients who have these lesions.

The Effect of Postoperative Intranasal Steroid in Endonasal Dacryocystorhinostomy

PURPOSE: Endonasal dacryocystorhinostomy (DCR) has been performed commonly in patients with chronic epiphora due to nasolacrimal duct obstruction. The most frequent cause of DCR failure is obstruction of the osteotomy site due to inflammation and granuloma. We used postoperative nasal steroid spray to suppress inflammation, and growth of granuloma, and to increase the success rate. METHODS: Between November 2002 and August 2003, 48 patients (55 eyes) underwent endonasal DCR in Hanyang University Guri Hospital. The patients were classified into two groups: those who took nasal steroid spray and those who did not. RESULTS: Thirteen cases showed recurrent epiphora. The total success rate of endonasal DCR was 76.4% (42/55). The success rate of the steroid group at 83.9% (26/31), was higher than that of the non-steroid group at 66.7% (16/24), but the difference was not statistically significant (P=0.20, x2 test). CONCLUSIONS: The nasal steroid spray failed to increase the patency rates in endonasal DCR.

Radiologic Diagnostic Criteria of Sphincter of Oddi Dysfunction: Analysis of Five Cases Confirmed by Biliary Manometry

PURPOSE: Biliary dyskinesia was considered as a wastebasket of quasi-biliary disease which could not be clearly explained under the basis of morphologic pathology. This entity was a source of confusion because of misconception and poor understanding. Recent introduction of biliary manometric technique enlightened some of these disorders. We evaluated the cholangiographic morphology of these disorders to clarify and to characterize the some characteristic findings, subsequently in order to help the diagnosis. MATERIALS AND METHODS: Five cases were confirmed by this technique as sphincter of Oddi dysfunction for last 13 months. All patients were female and age range was 53 to 75 years old. All patients were suffered from intermittent and recurrent biliary type pain. RESULTS: ERCP showed five common findings. The common bile duct was dilated over 12ram in all patients. Different from recurrent pyogenic cholangiohepatitis, intrahepatic ducts were proportionally dilated as extrahepatic ducts, in four patients and they branched normally and ductal wall was smooth. Transient or persistent meniscus sign was observed in four patients. All patients showed delayed emptying of contrast media from the common bile duct into the duodenum. Following IV injection of cholecystokinin, persistent meniscus disappeared and contrast media inflowed into the duodenum. CONCLUSION: Identification of all or some characteristic cholangiographic findings may eliminate a cumbersome and painful biliary manometric test for the diagnosis of sphincter of Oddi dysfunction.

Clustered microcalcifications on mammogram: Loss of microcalcifications during tissue processing? radiologic-pathologic correlation

Mammography is the only examination capable of depicting malignant calcifications in breast. In some instances calcifications evident in mammogram and specimen mammograms are not observed in the histologic specimen. Therefore, wer retrospectively analyzed 27 cases in which hook-guided wire localization and biopsy had been performed to determine if microcalcifications were lost during histopathologic processing. Calcium was apparently lost during preparation of the block in about 7% of the cases and after slide preparation in about 11%, for a total possible loss of 18%. The authors recommend a protocol for avoiding these loss that involves performance of a more comprehensive examination of histologic sections by the pathologist and radiographic reexamination of paraffin-embedded tissue blocks with subsequent step sectioning by the pathologist.