Normal Value of Standard Electroretinography and Change with Age and Sex(II)-Results Using Burian-Allen Electrode and Comparison with Results Using EFG-jet Electrode-

Using Burian-Allen bipolar contact lens electrode, Authors examined the normal 120 eyes of 120 subjects(male 57, female 63), age ranged 7 to 83 years(mean 44.5 years), with the method which was same as the ISCEV standard. There was no statistically significant differences between the value obtained using Burian-Allen electrode and the value obtained using ERG-jet electrode(p>0.05). We expect that this data would be useful testing method to evaluate the retinal disease. And this data may provide new reference value in the study of electroretinogram.

The Morphological Study of the Ophthalmic Artery and the Central Retinal Artery for the Korean Adults

To study the morphological anatomy of ophthalmic artery and its branches in the Korean adults, the author dissected fifteen cadaver orbits, and reviewed fifty carotid angiograms and ten high resolution magnetic resonance images of orbit. In 8 of 15(53.3%) cadavers the ophthalmic artery arises at the upper medial circumference of the internal carotid artery in the cerebral portion of the intracranial cavity. The ophthalmic artery crosses over the optic verve in 21 of 25 cases(84.0%: Cadaver 11/15, Orbit MRI 10/10) and passes under the optic verve in 4 of 25 cases(16.0%: Cadaver 4/15, Orbit MRI(10/10). Average distance from its origin to its first branch was 21.9mm. The central retinal artery and medial posterior ciliary artery were identified its frist branch in 7 of 15 cases(46.7%). The tortuous central retinal artery courses forward inferior to the optic verve and mostly enters inferomedial side of the optic nerve in 9 of 15 cases(60.0%), penetrating into dural sheath at 13.0mm behind the globe. There were no significant difference in sexually or laterality(p>0.05). This result shares great deal of similarity with the previous reports(p>0.05).

Clinical Progressive Analysis of Serous Retinal detachment due to Hypertensive Choroidopathy in Toxemia of pregnancy

Hypertensive choroidopathy is seen in patients suffering from acute ypertension such as pregnancy-induced hypertension, renal disease, connective tissue disease, and accelerated essential hypertension, which can affect the visual acuity in many ways. Especially, retinal detachment is the most important factor in visual prognosis, so understanding its clinical course is important to the ophthalmologist. We diagnosed the 257 severe preeclampsia and eclampsia patinents at the Soonchunhyang University Hospital from January 1987 to Auguest 1996, and found 19 cases of serous retinal detachment. The fluorescein angiography showed delayed perfusion of the choriocapillaris in the earlyphase and marked pooling of dye in subretinal space in the late phase. The results of this study revealed that serous retinal detachment occured mostly binoculary (83.3%); the extent of the pathologic region ranged from 2.11DD to 7.2DD (mean 4.06DD); total bullous retinal detachment was found in one case; the duration of reattachment ranged from 8 to 43 days (mean 9.95days); and the recovery interval of visual acuity was between 21 to 35 days(average interval 18.5 days). Of 12 cases followed up 11 cases showed normal visual acuity, normal visual field and retinal reattachment without the macular degeneration.

A Case of Central Retinal Artery Occlusion after Intranasal Ethmoidectomy

The authors experienced a case of 54 years old female patient who had sudden loss of vision in her right eye following intranasal ethmoidectomy. The computer tomography of orbit showed that RMR muscle was entrapped to medial orbital wall and optic nerve was strained and deviated to medial wall. The fluorescein angiogram showed central retinal artery occlusion (CRAO) in that eye.

A Case of Central Retinal Artery Occlusion after Intranasal Ethmoidectomy

The authors experienced a case of 54 years old female patient who had sudden loss of vision in her right eye following intranasal ethmoidectomy. The computer tomography of orbit showed that RMR muscle was entrapped to medial orbital wall and optic nerve was strained and deviated to medial wall. The fluorescein angiogram showed central retinal artery occlusion (CRAO) in that eye.

Clinical Characteristics and Classifications of Retinal Vein Occlusion

Clinical evaluation was performed in 181 eyes of 173 patients with retinal vein occlusion in aspects of disease onset, visual acuity, age and sex distribution, associated systemic disorders, laser treatment and ocular complications. The age of onset ranged from 20 to 82 years old. Seventy five patients were male and 98 were female. Central retinal vein occlusion included 38 eyes(ischemic type; 16 eyes, non-ischemic type; 22 eyes), hemi-central retinal vein occlusion 15 eyes(ischemic type; 5 eyes, non-ischemic type; 10 eyes), and branch retinal vein occlusion 128 eyes(major branch type; 91 eyes, macular branch type: 37 eyes). Hypertension was the most common associated systemic disease for each retinal vein occlusion type. The causes of severe visual loss in retinal vein occlusive diseases were macular edema, anterior and posterior segment neovascularization, and vitreous hemorrhage.

A Case of Foster Kennedy Syndrome

The Foster Kennedy syndrome is ipsilateral optic disc atrophy and contralateral optic disc edema that is caused not only frontal lobe tumor but also another intracranial tumors and non tumorous conditions. In this case, suspected neurofibromatosis by the skin and ocular manifestations, there are glioblastoma multiforme in left temporoparietal lobe and undefined mass with bony destruction of the ipsilateral sphenoidal wing ridge. Authors asserted that ipsilateral optic atrophy was caused by direct compression of the undefined mass on sphenoidal wing ridge to the optic nerve and the contralateral disc edema was result from high intracranial pressure caused by glioblastoma multiforme.

A Case of Chronic Progressive External Ophthalmoplegia

Chronic progressive external ophthalmoplegia(CPEO) is rare syndrome, which is characterized by slowly progressive blepharoptosis, paralysis of extraocular muscle and has involvement of other organs, particularly the retina, heart, endocrine gland, and bony skeleton. Histological examination of muscle showes characteristic ragged red fibers. Electron microscopy reveals a number of abnormal mitochondria which contain paracrystalline inclusion bodies. We experienced a 50-year-old female with CPEO, that was pathologically proven by electron microscopy and bilateral levator levator advancements were given for ptosis.

Stereopsis in Child Amblyopes

The authors performed Titmus and TNO stereopsis tests in the group of children amblyopes aged from 3 to 11 year old in order to evaluate clinical usefulness of stereopsis in amblyopia and preschool vision screening. 36(72%) and 42(84%) amblyopes could not pass the Titmus 100 see and TNO 120 see each and if 6 amblyopes who had 0.8 or better vision were excluded, the sensitivity were 82%(36/44) and 95%(42/44). Each visions of amblyopic eyes gave the main influence to decide stereoacuity in the Titmus test(correlation coefficient=0.69) and all of the amblyopes who had 3 or more interocular acuity differences could not pass the TNO 120 sec. As a result Titmus test had too low sensitivity to use as the screening test but it was useful to evaluate the vision of amblyopiceye. TNO was sensitive to interocular acuity differences and the authors thought that TNO 120 see can be used in the screening.

Arteriovenous Crossing Patterns in the Normal Retina

The retinal blood bessels exit the optic disc and branch in a complex pattern to serve the metabolic need of the inner retina. As the vessels traverse the retina, the arteries and veins frequently cross one another. Recently, there has been renewed iterest in the orientation of the crossing retinal vessels at arteriovenous intersections, particularly as it relates to the risk of branch retinal vein occlusion. The authors studied standard fundus photographs of 30 subjects(60 eyes) who don't habve any retinal and systemic disorders. Arteriovenous crossings were analized for fundus location and relative orientation of the crossing vessels(vein-posterior or vein-anterior). In the superotemporal quadrant, A-V crossings were a greater number, distributed closer to the optic disc than the inferotemporal quadrant. Also a greater proportion of crossings was vein-posterior than the inferotemporal quadrant. These findings may explain the predilection for branch retinal vein occlusions to occur frequency in the superotemporal quadrant.

Familial Exudative Vitreoretinopathy Involving One Family

The familial exudative vitreoretinopathy is an autosomal dominantly inherited disease and shows abnormalities of the retina and vitreous. It affects both eyes in most cases, but the involvement is often asymmetric. Thus it is important to screen familial members carefully, since they may have only mild, nonprogressive changes in the retinal periphery. It is important to know family history of the disorder and history of prematurity or oxygen supplementation, since the clinical features are most similar to retinopathy of prematurity. The authors experienced three cases of familial exudative vitreoretinopathy in a 2-year-old girl with cryotherapy and her father and her brother with asymptomatic familial exudative vitreoretinopathy that has retinal vascular avascular zone of peripheral retina.

Pattern-VEP in Child Amblyopia

We assessed the potential clinical usefulness of pattern-visual evoked potentials (=PVEP) in the diagnosis of amblyopia. 15 children with bilateral amblyopia, 64 children with unilateral amblyopia and 11 children without amblyopia participated. After estimating of visual acuity for each eye. PVEP were also obtained. Of the 15 bilateral amblyopic children 12 (80%) showed abnormally lower amplitudes than normal children and amplitudes of the rest 3 patients were in normal range and their visual acuity were relatively upper range, 0.5-0.6. Of the 64 unilateral amblyopic children 4 of 9(44.4%) children who had 2 line difference of interocular visual acuity, 2 of 3(67.7%) children who had 3 line difference and all children except 1 who had 4 or more line difference(99.9%) showed abnormal interocular amplitude difference ratio(=IADR). As a result, bilateral and unilateral amblyopia can be identified by PVEP amplitude and IADR and abnormal IADR shows that interocular visual acuity differences is over 3-4 lines. We thought that PVEP could be used to find the amblyopic eye and monitor the effect of treatment in preverbal children also.

Histopathology of Multiple Lymphangiomas on The Supraorbital Area

The lymphangioma is a benign vascular tumor and, like hemangioma, represents a hamartomatous growths. The site of predilection include the head, neck. and axillae. Lymphangiomas tend to involve the bulbar conjunctiva as well as the eyelid and orbit. Histopathologieally three types of lymphangioma are encountered: demal, cavernous and cystit types. The clinical signs are proptosis, diffuse hematoma of eyelid and subconjunctival hemorrhage. Asymptomatic cases can be observed. The authors experienced a case of multiple lymphangiomas on the right supraorbital area in a 14-year-old man and reported light microscopic and electron microscopic findings of the lymphangioma.

Laser Interferometric Visual Acuity in Retinal Diseases

Laser interferometry is used to evaluate the retinal visual function in the eyes with media opacity. Although interferometric acuity was known to be useful to predict postoperative Snellen acuity following cataract extraction, the results are somewhat confusing in the eyes with retinal diseases. The author measured interferometric acuity in 43 eyes from 32 patients who were affected by retinal diseases involving macula and had clear ocular media. Average interferometric acuity was 0.47. Hahn's acuity was 0.46 and correlation index between two acuities was 0.64 meaning moderate degree of correlation. Interferometric acuities were better than Hahn's acuity in 23 eyes(53.5%) and worse in 12 eyes(27.9%). Our results suggest that in eyes with macular lesion, interferometric acuity is not sufficient to predict Hahn's acuity although it has some degree of correlation. Therefore, in order to predict the postoperative visual acuity in eyes with media opacity and probable macular lesion, it will be necessary to combine other useful modalities.

Anatomic Characteristics of Upper Eyelid Structures Important in Ptosis Surgery

Exact understanding of the upper eyelids is essential to the success of an anterior surgical approach for the correction of blepharoptosis. Therfore, we undertook this study using cadaver dissection, histologic sections, surgical observations, and review of MRI findings to gain a better understanding of the anatomical characteristics of the orbital septum and associated connective tissue structures which are important in ptosis surgery. The basic distinction of the upper eyelid structures between Oriental and Occidental is the relationship of the orbital septum and the levator aponeurosis. The orbital septum appears as a thick multilayered connective tissue originating just inside the superior orbital rim, but its inferior extension become thin progressively and blends with levator aponeurosis on an average of 1.6mm below the superior tarsal horder. Therefore the preaponeurotic fat is allowed to proceed to the anterior tarsal surface, resulting in a characteristic appearance of oriental eyelids. The levator aponeurosis maintains its thick and obvious structure continuously to the anterior tarsal surface near the lower margin of the upper lid. We resected levator aponeurosis with Muller's muscle which plays a important role in lid elevation for the correction of congenital htepharoptosis, and obtained excellent results.

The Change of Axial Length According to Age in the Eyeball of Premature infants by Ultrasonic Biometry

We measured the axial length according to age in the eyeball of premature infants who were born at our hospital. Our patients were 36 weeks old below in conceptual age, 38 eyes in 19 males, 28 eyes in 14 females. total 66 eyes in 33 premature infants. And we examined the axial length using the A-mode of the LTZ/SSW-48. 7MHz for 1 month at each weeks. The results were as follows: 1. The mean axial length was 16.56mm (15.40-17.80) at 1st week of life. 16.82mm (15.43-17.95) at 2nd week, 17.01mm(15.71-18.01) at 3rd week, 17.04mm (15.72-18.24) at 4th week. 2. The mean axial length of 1st week was 16.77mm in male, 16.34mm in female; at 2nd week, 16.91mm in male, 16.72mm in female; at 3rd week, 17.09mm in male, 16.90mm in female; at 4th week, 17.12mm in male, 16.96mm in female and they did not show significant difference between male and female premature infants.

Ophthalmic Complications After Paranasal Sinus Surgery

Various ophthalmic complications can occur after intranasal sinus surgery due to closed anatomic relation between orbit and paranasal sinuses. A study was undertaken to identify those patients with ophthalmic complication after intranasal sinus surgery. A consecutive series of 80 cases undergoing sinus surgery at department of ENT between Jan. 1992 and Jul. 1992 was studied prospectively. We recorded preoperative and postoperative best corrected visual acuity, intraocular pressure, exophthalmometric measurement, levator function, funding, lacrimal excretory function, extraocular muscle motility. Several patients were noticed a variety of ophthalmic problems after intranasal sinus surgery: 1 case of orbital hematoma and transient blepharoptosis, 2 cases of diplopia with limited duction, 4 cases of subcutaneous hemorrhage, tearing and blurring, 5 cases of conjunctival injection with chemosis, 7 cases of ocular discomfort, 42 cases of lid swelling. Orbital hematoma was treated with puncture and aspiration but other problems were recovered spontaneously within several days.

Effect of Cryotherapy for Retinopathy of Prematurity

Cryotherapy or photocoagulation is indicated for threshcld stage 3+ retinopathy of prematurity. Twenty-three infants with threshold stage 3+ retinopathy of prematurity were treated with cryotherapy and were analyzed from June 1988 10 December 1991. In patient with cryotherapy, mean gestational age was 30.0 weeks, mean birth weight was 1281gm, and mean number of cryoapplications was 45.4. 32 of 44 eyes (72.7%) had favorable outcomes, and 12 of 44 eyes (27.3%) had unfavorable outcomes.

Three Cases of Cytomegalovirus Retinitis in the Immunosuppressed Kidney Transplant Patients

Cytomegalovirus(CMV) infection in normal adults and children is usually asymptomatic. However, CMV represents a potent opportunistic pathogen in immunocompromised hosts, such as neonate, victims of acquired immune deficiency syndrome, organ transplant recipients, and patients receiving immunosuppressive chemotherapy, in whom the virus is capable of causing severe morbidity and mortality. We report three cases of CMV retinitis in the kedney transplat. patients who had been treated with immunosuppressants after transplant.

A Clinical Study of Paralytic Strabismus

A etiologic analysis of 94 cases of the paralysis of the third, fourth, and sixth cranial nerves was made. There were 42 cases(44.7%) of sixth nerve paralysis. 39 cases(41.5%) of third nerve paralysis. 5 cases(5.3%) of fourth nerve paralysis and 8 cases(8.5%) of multiple cranial nerve paralysis. The most common cause was head trauma(46 cases). Other etiologic factors were undetermined(23 cases), neoplasm(5 cases), vascular desease(6 case), aneurysm(5 cases) and others(9 cases). The recovery rates of sixth, third, and fourth cranial nerve paralysis were 52%, 41%, 20%, respectively.