Amniotic Membrane Transplantation in the Management of Shield Ulcers of Vernal Keratoconjunctivitis

PURPOSE: Human amniotic membrane has been used to variable ocular surface disorder. We report a case of the usefulness of amniotic membrane transplantation (AMT) for vernal keratoconjunctivitis "Shield ulcer". METHODS: A 12-year-old male patient was diagnosed to have vernal keratoconjunctivitis "Shield ulcer" and treated with medical therapy for four weeks. But he showed severe itiching, foreign body sensation, decreased visual acuity and continued to corneoconjunctival lesion and then, Amniotic membrane transplantation with stromal side down was performed after debridement of the ulcer bed and therapeutic contact lens was applied. RESULTS: At tenth day after AMT, ulcer size was decreased and corneal state was generally improved with restoration of visual acuity. One month after, he has been comfortable with improved visual acuity, giant papillae of upper tarsal conjunctiva was nearly complete remission. CONCLUSIONS: AMT is an effective method for managing vernal keratoconjunctivitis "Shield ulcer", that are refractory to conventional medical treatment.

A Clinical Study of Serous Retinal Detachment in Pregnancy-induced Hypertension

PURPOSE: This study was designed to determine the clinical progression of serous retinal detachment(RD) due to hypertensive choroidopathy in toxemia of pregnancy. METHODS: We diagnosed 437 preeclampsia and eclampsia patients in 9, 689 consecutive deliveries at the Chunchon Sacred Heart Hospital from January 1996 to December 2000, and found 35 cases of serous RD among them. We retrospectively studied the incidence, clinical characteristics of the patients, location, and shape of retinal pigment epithelium (RPE) lesions. RESULTS: Among the 9, 689 pregnant women, there were 429 cases (4.4%) of preeclampsia and 8 (0.08%) of eclampsia. Serous RD occurred in 32 cases of preeclampsia (7.5%), and 3 of eclampsia (38%). In the preeclampsia cases, there were 26 cases (81%) of severe type, and 6 (19%) of mild type. The mean age of serous RD patients was 29.53yrs. Twenty-two cases (63%) in the 35 cases of serous RD were primipara patients, and 13 (37%) were multipara. Twenty-two cases (63%) in 35 the serous RD patients featured binocular involvement. Reattachment of retina was attained in all cases of serous RD, with a mean recovery interval of 18 days. CONCLUSIONS: Serous retinal detachment induced by toxemia of pregnancy can occur in mild preeclampsia patients. Reattachment of retina was attained in all serous RD cases. These study results will provide assurance for the treatment of serous retinal detachment patients.