A Case of Visual Loss and Ophthalmoplegia Following Injection of Hyaluronic Acid into the Glabella

PURPOSE: To report a case of sudden unilateral visual loss and total external ophthalmoplegia combined with multifocal brain infarction following injection of hyaluronic acid (Restylane; Q-Med AB, Uppsala, Sweden) into the glabella area. CASE SUMMARY: A 25-year-old woman was referred for sudden unilateral visual loss and blepharoptosis. Visual acuity was no light perception in the right eye and 0.15 in the left eye. The best corrected visual acuity was no light perception in the right eye and 1.0 in the left eye. The right pupil was dilated and a relative afferent pupillary defect was detected. The patient showed blepharoptosis and total external ophthalmoplegia on the right side. Fundus examination revealed central retinal artery occlusion and pale disc in the right eye. The patient had developed skin necrosis and a surrounding reddish reticular pattern on her face around the glabella. She was injected with hyaluronic acid for 5 times into the glabella area. Fluorescein angiography of the right eye revealed markedly prolonged choroidal filling around the optic disc with no retinal arterial filling. Brain MRI showed multifocal punctuate acute infarction in both frontal lobes. After 2 months, ophthalmoplegia improved partially although her right eye vision did not, and 15 PD right exotropia was observed. CONCLUSIONS: Although most complications of dermal fillers are mild and transient, severe and persistent adverse effects can occur including tissue necrosis, retinal artery occlusion, and brain infarction. Therefore cosmetic procedures should be carefully performed when administering periocular dermal filler injection. A prompt consultation with an ophthalmologist is recommended when there is evidence of visual problems after injection.

Comparison of Serum Homocysteine, Vitamin B12, Vitamin B6 and Folate Levels in Different Glaucoma Types

PURPOSE: To compare the levels of serum homocysteine, vitamin B12, vitamin B6 and folate in patients with normal-tension glaucoma, pseudoexfoliation glaucoma and high-tension glaucoma. METHODS: Thirty-two healthy subjects, 35 patients with normal-tension glaucoma, 22 patients with pseudoexfoliation glaucoma and 31 patients with high-tension glaucoma were included in the present study. Fasting venous samples were collected from all the participants. The levels of serum homocysteine, vitamin B12, vitamin B6 and folate were measured. One-way analysis of variance was used for the comparison of homocysteine, vitamin B12, vitamin B6 and folate levels among the 4 groups. RESULTS: The mean homocysteine levels in the pseudoexfoliation glaucoma and high-tension glaucoma group were 17.91 +/- 5.11 and 17.60 +/- 3.89 micromol/l, respectively, which were significantly higher than that of the control group (p = 0.014, p = 0.013, respectively). The mean vitamin B6 levels in the pseudoexfoliation glaucoma and high-tension glaucoma group were 17.67 +/- 14.32 and 17.00 +/- 10.58 nmol/l, respectively, which were significantly lower than that of the control group (p = 0.026, p = 0.008, respectively). CONCLUSIONS: Hyperhomocysteinemia may play a role as a risk factor in the development or progression of pseudoexfoliation glaucoma and high-tension glaucoma.

Clinical Features for Patients Presenting with Diplopia

PURPOSE: To evaluate the clinical features, causes and outcomes of patients with diplopia. METHODS: All patients presenting with diplopia from October 2010 to March 2012 and followed up for more than 3 months were retrospectively investigated. RESULTS: During the study period, 59 patients with diplopia were identified. There were 42 males and 17 females with an average age of 50 years. Binocular diplopia accounted for 54 cases (92%) and 5 cases (8%) had monocular diplopia. Cranial nerve palsies were the most common cause of binocular diplopia (28 cases, 52%). Within the cranial nerve palsies group, 14 cases (50%) were accompanied by hypertension or diabetes mellitus. Binocular diplopia spontaneously resolved in 35 cases (65%) by 3 months rising to 41 cases (76%) by 7 months. Thirteen (93%) out of 14 cases of cranial nerve palsies with hypertension or diabetes resolved spontaneously by 3 months. CONCLUSIONS: Binocular diplopia was caused most commonly by cranial nerve palsy and resolved after 3 months in 65% of patients. A spontaneous recovery from diplopia was observed after 3 months in 93% of patients with cranial nerve palsies and microvascular disease such as hypertension or diabetes. Therefore, the initial observation without additional treatment would be sufficient in these patients.

Age-Related Changes in the Thickness of the Lamina Cribrosa Measured by Spectral Domain OCT

PURPOSE: To measure the lamina cribrosa thickness (LCT) in vivo of healthy people and to determine any association between the LCT and age or sex. METHODS: We evaluated 100 eyes of 100 healthy volunteers. Forty eyes were selected and divided into 2 specific age groups (38-49 and 78-89 years) and the differences were assessed with respect to age and sex. Each participant underwent a complete eye examination and the LCT was evaluated with spectral domain optical coherence tomography (OCT) using enhanced depth imaging (EDI) mode. RESULTS: Eighty-seven eyes were considered for the measurement and analysis of the LCT and 13 eyes were excluded because of an unclear image for identifying the LCT. The mean age was 55.0 +/- 19.5 years. The mean LCT in healthy volunteers was 231.3 +/- 41.6 microm (range, 152.5 - 327.5 microm) and a negative relationship was found between LCT and age (LCT = -1.614 x age + 320.191 microm, 95% CI for slope -1.91 to -1.32, r2 = 0.572, p < 0.001). Regarding differences related to sex, males had relatively thicker LCT than females, irrespective of age, although not statistically significant (p = 0.623). CONCLUSIONS: The present study results showed a decrease in human LCT with increasing age. Therefore, a decreasing LCT with an increasing age could be considered a strong risk factor for the development of glaucoma. In addition, measuring the LCT may help to understand the disease prognosis.

Intraocular Pressure and Ocular Biometry Change of Healthy Eyes in Postural Variation

PURPOSE: To investigate intraocular pressure (IOP) and ocular biometry change according to the posture change in healthy eyes. METHODS: Forty eight eyes of 48 healthy young subjects were enrolled. IOP, central anterior chamber depth (cACD), and axial length were measured after keeping each position for 10 minutes (upright, sitting, supine, and prone positions) by using the TonoPen(R) and A-scan ultrasonography. RESULTS: Mean IOP was 19.68 +/- 2.15 mm Hg in prone position, 17.19 +/- 1.33 mm Hg in supine position, 16.49 +/- 1.76 mm Hg in sitting position, and 15.33 +/- 1.34 mm Hg in upright position. Difference among the positions was statistically significant (p < 0.01). Mean cACD was 3.68 +/- 0.35 mm in upright position, 3.63 +/- 0.32 mm in supine position, 3.59 +/- 0.34 mm in sitting position, and 3.47 +/- 0.30 mm in prone position. Difference among the positions was statistically significant (p < 0.01) except for the difference between supine and sitting position. Linear regression analysis revealed that cACD was significantly associated with IOP in prone position (R2 = 0.139, p < 0.01). CONCLUSIONS: There was a significant change in IOP and cACD according to the posture change. cACD was significantly associated with IOP only in prone position.

The Effect of Hemodialysis on Intraocular Pressure, Retinal Nerve Fiber Layer Thickness and Corneal Thickness

PURPOSE: To compare the intraocular pressure (IOP), retinal nerve fiber layer (RNFL) thickness and central corneal thickness (CCT) in healthy individuals and patients with chronic renal failure (CRF) undergoing hemodialysis, and to evaluate the changes in each parameter before and after hemodialysis in patients with CRF. METHODS: Thirty-six eyes of 36 patients with CRF undergoing hemodialysis were included in the hemodialysis group and 54 eyes of 54 healthy subjects were recruited as the control group. All subjects underwent a complete eye examination, including best-corrected visual acuity (BCVA), slit lamp examination, dilated funduscopic examination, gonioscopy, automated perimetry, IOP measurement, corneal pachymetry, and evaluation of RNFL thickness. In the hemodialysis group, IOP, RNFL thickness, and CCT were measured again within 1 hour of hemodialysis. RESULTS: Age, sex, BCVA, cup-to-disc ratio, IOP, and CCT were not statistically different between the 2 groups. The RNFL of the hemodialysis group was statistically significantly thinner than the control group (p < 0.001). The IOP decreased from 16.52 +/- 2.95 mm Hg to 14.88 +/- 2.03 mm Hg after hemodialysis (1.63 +/- 3.27 mm Hg; p = 0.005). The changes in RNFL thickness and CCT were not statistically significant (p = 0.148, p = 0.352). CONCLUSIONS: In CRF patients with hemodialysis, RNFLs were thinner in the control group and hemodialysis induced significant IOP reduction. The results from the present study should be considered for the proper evaluation of ocular disorders in CRF patients with hemodialysis.

Contrast Sensitivity and Color Vision Comparison Between Clear and Yellow-Tinted Intraocular Lens in Diabetic Retinopathy

PURPOSE: To compare contrast sensitivity and color vision after implantation of a clear intraocular lens (IOL) and a yellow-tinted IOL in diabetic retinopathy patients. METHODS: In the 50 eyes of 25 diabetic patients with non-proliferative diabetic retinopathy, clear IOLs were implanted in 25 eyes, and yellow-tinted IOLs were implanted in 25 fellow eyes. Three months after the surgery, contrast sensitivity function was measured with a vision contrast test system, and color discrimination was tested using the Farnsworth Munsell 100-hue test. RESULTS: Eyes implanted with yellow-tinted IOLs had significant differences in contrast sensitivity values compared to those of fellow eyes implanted with clear IOLs in both the moderate diabetic retinopathy group (6.0 cycles per degree) and the severe diabetic retinopathy group (throughout all spatial frequencies except 12.0 cycles per degree). The yellow-tinted IOL did not modify chromatic discrimination compared with that of the clear IOL. In the blue-yellow axis error score, however, there were significant differences between the clear IOL and the yellow-tinted IOL. CONCLUSIONS: With progressing diabetic retinopathy, the yellow-tinted IOL provided better contrast sensitivity than the clear IOL. The yellow-tinted IOL improved color vision in the blue-yellow chromatic axis without causing chromatic discrimination defects.

Comparison and Repeatability of Anterior Segment Parameters Obtained by Galilei and Slit-lamp Optical Coherence Tomography

PURPOSE: To evaluate the repeatability and comparability of anterior chamber depth (ACD) and central corneal thickness (CCT) measurements obtained by Galilei dual Scheimpflug analyzer (Ziemer, Port, Switzerland) and slit-lamp optical coherence tomography (SL-OCT; Heidelberg Engineering, Dossenheim, Germany). METHODS: ACD and CCT were measured by Galilei and SL-OCT in 68 eyes of 68 healthy young subjects. Each measurement was performed 3 times by a single examiner, and the repeatability of 3 consecutive measurements was analyzed. ACD and CCT measurements were compared between the 2 devices. RESULTS: Both Galilei and SL-OCT showed high repeatability (ICCs > or = 0.994) for ACD and CCT measurements. The mean ACD and CCT measured by Galilei were greater than SL-OCT measurements by 0.11 +/- 0.09 mm and 14.01 +/- 7.38 microm, respectively. The 95% limit of agreement values for ACD and CCT measurements were 0.36 mm, 27.66 microm, respectively, and were highly correlated (correlation coefficients > or = 0.89, p < 0.001). CONCLUSIONS: Although the repeatability of each device was high, ACD and CCT obtained by Galilei and SL-OCT were significantly different. These differences should be considered when interpreting ACD and CCT measurements obtained by the 2 devices.

A Case of Acute Fibrin Pupillary Block Diagnosed by Ultrasonic Biomicroscopy

PURPOSE: To report a case of fibrin pupillary block diagnosed by ultrasonic biomicroscopy (UBM) and treated by argon-neodymium:YAG (Nd:YAG) laser in a patient with uveitis. CASE SUMMARY: A 56-year-old man visited the hospital for decreasing visual acuity and a sudden onset of pain in the right eye. Best corrected visual acuity was 0.02 in the right eye and 1.0 in the left eye. Intraocular pressure (IOP) was 48 mm Hg in the right eye and 18 mm Hg in the left eye. Slit-lamp examination revealed diffuse corneal stromal edema with Descemet's folds and uniform shallowing of the anterior chamber, with 360 degrees of peripheral iridocorneal touch in the right eye. A fibrin membrane was present across the pupil. UBM showed a fibrin membrane across the pupil, uniform shallowing of the anterior chamber, and peripheral angle closure. The lens was displaced posteriorly. A sequential Nd:YAG laser membranectomy was performed that same day, with immediate deepening of the anterior chamber and normalization of the IOP. CONCLUSIONS: UBM can play an invaluable role in the diagnosis of fibrin pupillary block by showing the presence of a fibrin pupillary membrane, accumulation of aqueous in the posterior chamber, and a clear separation between the iris and the lens. Nd:YAG laser membranectomy can be performed effectively in a fibrin pupillary block.

Comparison Between Retinal Nerve Fiber Layer Change and Visual Field Change in Normal Tension Glaucoma

PURPOSE: To evaluate longitudinal changes in retinal nerve fiber layer thickness (RNFL) and visual field in patients with normal tension glaucoma (NTG). METHODS: Thirty eyes of 30 NTG patients and 30 eyes of 30 normal control subjects were enrolled in the present study. RNFL thickness was measured using optical coherence tomography (OCT), and visual field tests were performed using a Humphrey visual field analyzer at baseline and 23.3 +/- 15.3 months later. Changes in RNFL thickness at each clock-hour segment and visual field sensitivities were analyzed. The rates of change in RNFL thickness were also calculated. RESULTS: Significant differences in RNFL thickness were observed between NTG patients and normal control subjects at the 5, 6, 7 and 12 o'clock positions at baseline (p < 0.001). At follow-up, the RNFL thickness change was not significant for normal control subjects, although it was significant for NTG patients at the 4, 5, 6, 7, 11 and 12 o'clock positions (p < 0.001). Visual field parameters did not change significantly in the normal control subjects or NTG patients. The reduction rates of RNFL thickness were 0.38 microm/month for the NTG patients and 0.11 microm/month for the normal control group, displaying a 3.5-fold faster reduction rate for NTG patients. CONCLUSIONS: The NTG group showed greater reductions in RNFL thickness in the upper and lower sectors over time; however, the visual field parameters did not change significantly. The results suggest that progression of glaucoma can be detected in an earlier stage using OCT than can be detected using a visual field test.

Changes in Anterior Segment Biometry by Laser Iridotomy in Eye With Shallow Anterior Chamber

PURPOSE: To identify the impact of the presence of peripheral anterior synechia (PAS) on the depth of the anterior segment in patients with a shallow anterior chamber after laser iridotomy (LI) by analyzing changes in the anterior segment biometry using ultrasound biomicroscopy (UBM). METHODS: Twenty eyes of 20 patients with PAS and shallow anterior chamber, and another 20 eyes of 20 patients with shallow anterior chamber without PAS were studied. The changes in the anterior segment biometry for each group of patients were examined using gonioscopy and UBM before and after the LI. RESULTS: The central corneal thicknesses and scleral thicknesses of the two groups did not show significant differences (p > 0.05). The anterior chamber depths, anterior chamber angles, trabecular meshwork-iris distances, and angle-opening distances 500 increased significantly after the peripheral LI (p < 0.05) in both groups. However, the difference in the increases in the anterior segment biometries between the two groups was not statistically significant. CONCLUSIONS: LI can increase the depth of the anterior chamber regardless of the presence of PAS.

A Case of Acute Angle-Closure Glaucoma in a Nanophthalmos Patient

PURPOSE: To present a case of acute angle-closure glaucoma in a nanophthalmos patient. CASE SUMMARY: A 28-year-old woman visited the hospital for a sudden pain in the left eye, she had a small orbital bone and narrow palpebral fissurea in both eyes. Her intraocular pressure (IOP) was 58 mmHg in the left eye. The slit lamp examination showed shallow anterior chambers in both eyes, and the gonioscopic examination showed a closed angle in the left eye. The diameters of the corneas were 11 mm , and the axial lengths were 19.7 mm in the right eye and 19.6 mm in the left eye. The depths of the anterior chambers were 1.51 mm in the right eye and 1.82 mm in the left eye. The disease was diagnosed as acute angle-closure glaucoma in the left eye of the patient with nanophthalmos, and thus the IOP of the left eye was lowered using ophthalmic drugs and medications. Laser iridotomy was performed on both eyes. CONCLUSIONS: For around a year of follow-up after laser iridotomy, complications such as the rise of intraocular pressure and choroidal effusion were not observed. This suggests that laser iridotomy can be an effective treatment for acute angle-closure glaucoma accompanying nanophthalmos.

Quality of Life in Patients With Restless Legs Syndrome in Korea: Comparison With Other Chronic Diseases

BACKGROUND: We studied the quality of life (QOL) of patients with restless legs syndrome (RLS) and compared it to that of normal controls and patients with hypertension or diabetes in Korea. METHODS: We developed a Korean version of the Johns Hopkins RLS QOL questionnaire by translating this into Korean and then back into English to check its accuracy. In total, 250 RLS patients were included in this study. The scores of RLS patients were compared with those of 215 normal controls, 196 patients with hypertension, and 185 diabetics. All subjects completed the questionnaires, including the Korean versions of the Short Form 36, Johns Hopkins RLS QOL, Pittsburgh Sleep Quality Index, and the Beck Depression Inventory. The associations between the severity of RLS and the QOL scores were examined using Pearson correlations. RESULTS: The QOL scores were lower in subjects with RLS than in the normal controls and the patients with hypertension or diabetes. More severe RLS symptoms were associated with a lower QOL score. Correlation analysis revealed a significant negative correlation between the severity of RLS symptoms and QOL score (r=-0.702, p<0.001). However, neither the gender of the RLS subjects nor the age at symptom onset (early or late onset) affected the QOL score. The factors most related to QOL score in RLS patients were depression and sleep quality. CONCLUSIONS: We found that Koreans with RLS have a considerably diminished QOL, with this being worse than in Korean subjects with diabetes or hypertension. These findings are comparable with studies conducted in Western countries.

The Reliability and Validity of the Korean Versions of the International Restless Legs Scale and the Restless Legs Syndrome Quality of Life Questionnaire

BACKGROUND: The International Restless Legs Scale (IRLS) and the Restless Legs Syndrome Quality of Life questionnaire (RLSQoL) are valid and reliable tools for assessing RLS severity and the impact of RLS on daily life in Western countries. The purpose of this study was to validate the Korean versions of these questionnaires in Korean RLS patients. METHODS: We developed the Korean versions of the IRLS and the RLSQoL. In total, 250 Korean primary RLS patients were included in this study. These questionnaires were used for the initial interview and a subsequent retest approximately 1 month later. The findings were compared with those obtained using the Clinical Global Impression, Short Form 36 Health Survey, and other instruments. The percentage agreement and Cronbach's alpha were calculated for each question, and the validity coefficients were estimated from these statistics. RESULTS: The scores for the Korean versions of the IRLS (range: 0-40) and the RLSQoL (range 0-100) proved reliably consistent (Cronbach's alpha=0.96 and 0.92, respectively) and had good test-retest reliability (intraclass correlation coefficient=0.61-0.85 and 0.61-0.89, respectively). The Korean version of the RLSQoL could be used to distinguish between groups with none, mild, moderate, severe, and very severe symptoms (F=66.10, P<0.0001). The two questionnaires proved to have high reliability and validity coefficients. CONCLUSIONS: The Korean versions of the IRLS and the RLSQoL are valid and reliable tools for assessing RLS severity and the impact of RLS on the daily life of Korean RLS patients.

Correlation Between Central Corneal Thickness and Retinal Nerve Fiber Layer Thickness in Normal Tension Glaucoma

PURPOSE: To investigate the correlation between central corneal thickness (CCT) and peripapillary retinal nerve fiber layer (RNFL) thickness in the eyes of patients with normal tension glaucoma (NTG) at the initial examination and to examine the difference in the degrees of damage of RNFL thickness depending on the CCT. METHODS: Fifty-one eyes of 36 patients with NTG were included in the study, and 51 eyes of 30 people without the disease were used as a control group. CCT and peripapillary RNFL thickness were measured in each eye by ultrasonic pachymetry and optical coherence tomography(OCT), respectively. Patients from the normal NTG group who underwent OCT more than three times inthree years were identically assigned to two groups based on CCT: thin ( or = 553.6 micrometer). Thus, a comparison of the changes in the thickness of retinal nerve fiber layer was performed between the two groups. RESULTS: Patients with NTG showed a significant positive correlation between CCT and the mean peripapillary RNFL thickness at the initial examination (R=0.68, p0.05) CONCLUSIONS: At the time of initial diagnosis of NTG, there was a significant correlation between the thickness of CCT and RNFL. Howeverthere was no significant correlation between the thickness of CCT and the progression of the damage of RNFL.

Correlation Between Macular, Retinal Nerve Fiber Layer Thickness, and Visual Field in Open Angle Glaucoma

PURPOSE: This study was performed to evaluate the macular and peripapillary retinal nerve fiber layer (RNFL) thickness and to evaluate their association with glaucomatous visual field change. METHODS: Forty normal eyes of 24 subjects, 30 ocular hypertension eyes of 15 patients, 30 pre-perimetric glaucoma eyes of 18 patients and 90 open angle glaucoma eyes of 59 patients. The macularand peripapillary RNFL thickness were measured by the optical coherence tomography (Stratus OCT(TM) model 3000, Carl Zeiss Meditec) and visual field tests were performed by the Humphrey's automated perimetry. RESULTS: There was a significant decrease of both the macular (p<0.05) and peripapillary RNFL thickness (p<0.001) in the open angle glaucoma group compared with the normal group. In 190 eyes, statistically significant positive relationship was demonstrated between mean deviation (MD) and all areas of peripapillary RNFL thickness (p<0.001) as well as between MD and all areas of macular thickness except the fovea, central ring (p<0.01). CONCLUSIONS: The macular and peripapillary RNFL thickness were significantly decreased and the findings indicated a significant association with the visual field change in open angle glaucoma eyes.

The Prevalences of Anxiety and Depressive Disorders in Patients of Pediatric Sleep Disorders / 대한소아신경학회지

PURPOSE: Sleep disorder is common in childhood and adolescence with prevalence of 27-62%, and the patients could have trouble with their daily life due to fatigue and headache; and it can also cause developmental disability, learning disorder, anxiety disorder, and depressive disorder. We studied the prevalence of anxiety and depressive disorder in childhood and adolescence with sleep disorder. METHODS: We studied 34 cases of patients under twenty-year-old who took a sleep polysomnography test at Sleep Center of Keimyung University Dongsan Medical Center and who could answer sleep survey questionnaires; and we used testing methods of Questionnaire for insomnia, Epworth sleepness scale, Hospital Anxiety Depression Scale, and Back Depression Inventory. We studied sleep disorder as two categories of sleep apnea and other sleep disorders and also the relationships of sleep and anxiety and depressive disorder with chi-square test. RESULTS: 29.4% of sleep disorder patients had anxiety disorder, and 47.1% depressive disorder. Considering the two categories of sleep disorder, anxiety disorder was significantly higher(P<0.005) in sleep apnea group with 43.5% than in other sleep disorder group with 9.1%. Depressive disorder was also significantly higher(P<0.05) in sleep apnea group with 65.6% than in other sleep disorder group with 36.4%. CONCLUSION: The patients with sleep disorder also had a tendency of having mood disorder, with prevalence of 29.4% of anxiety disorder and 47.1% of depressive disorder; especially in the group of sleep apnea, mood disorders was significantly higher than other sleep disorder group, which means more aggressive diagnosis and treatment are needed for the combined condition of sleep and mood disorder.

The Possibility of Fluid Contamination Within Syringes in Case of Experimental Needle Contamination

PURPOSE: The present study examined the risk of intraocular infection only in cases where the injection needle was replaced when the injection needle was contaminated before intraocular injection. METHODS: Staphylococcus aureus and Staphylococcus epidermidis were cultured and smeared on the end of 30 syringe needles containing 0.1 mL normal saline. After removing only the injection needle, the normal saline in the syringes was injected onto blood agar plates and cultured. RESULTS: The culture results were positive in 21 out of 30 samples in the group smeared with Staphylococcus aureus, and in 25 out of 30 samples in the group smeared with Staphylococcus epidermidis. CONCLUSIONS: When the injection needle is contaminated, the replacement of the needle does not eliminate the possibility of intraocular infection.

The Possibility of Fluid Contamination Within Syringes in Case of Experimental Needle Contamination

PURPOSE: The present study examined the risk of intraocular infection only in cases where the injection needle was replaced when the injection needle was contaminated before intraocular injection. METHODS: Staphylococcus aureus and Staphylococcus epidermidis were cultured and smeared on the end of 30 syringe needles containing 0.1 mL normal saline. After removing only the injection needle, the normal saline in the syringes was injected onto blood agar plates and cultured. RESULTS: The culture results were positive in 21 out of 30 samples in the group smeared with Staphylococcus aureus, and in 25 out of 30 samples in the group smeared with Staphylococcus epidermidis. CONCLUSIONS: When the injection needle is contaminated, the replacement of the needle does not eliminate the possibility of intraocular infection.

Correlation Between Disc Size and Retinal Nerve Fiber Layer Thickness in Normal Tension Glaucoma

PURPOSE: To investigate the correlation between optic disc size and retinal nerve fiber layer (RNFL) thickness in healthy subjects and patients with normal tension glaucoma (NTG). METHODS: Optical coherence tomography was performed on 50 eyes of 50 healthy subjects and on 50 eyes of 50 NTG patients. RESULTS: The optic disc size showed a significant correlation with the RNFL thickness in healthy subjects and in patients with NTG. Significant correlations were observed between the optic disc size and the ratio of superior-to-total RNFL thickness (r=-0.283, p=0.049) and the ratio of nasal to total RNFL thickness (r=0.403, p=0.004) in healthy subjects. In patients with NTG, significant correlations were observed between the optic disc size and the ratio of superior to total RNFL thickness (r=-0.314, p=0.029) and the ratio of inferior to total RNFL thickness (r=-0.302, p=0.034). CONCLUSIONS: RNFL thickness increased significantly with an increase in optic disc size in both healthy subjects and NTG patients. The correlation between optic disc size and the ratios of each quadrant to the total RNFL thickness showed a different pattern between healthy subjects and NTG patients.