Effect of Orthokeratologic Lenses on Myopic Progression in Childhood

PURPOSE: The present study assessed the influence of overnight orthokeratology (ortho-k) on the myopic progression in Korean children and analyzed factors affecting myopic progression. METHODS: The ortho-k group was comprised of 31 patients satisfying the inclusion criteria for ortho-k. In the ortho-k group, spherical equivalent refractive error (SER) was measured at baseline, and after 2 weeks, 6 and 12 months. The control group was comprised of 31 patients who were matched according to age, gender, and baseline SER of the ortho-k subjects. RESULTS: In the ortho-k group, the mean +/- SD changes in SER from 2 weeks to 6 months, 6 to 12 months, and 2 weeks to 12 months were -0.17 +/- 0.50 D, -0.04 +/- 0.76 D, and -0.21 +/- 0.78 D, respectively. In the control group, the changes in SER from baseline to 6 months, 6 to 12 months, and baseline to 12 months were -0.38 +/- 0.42 D, -0.44 +/- 0.38 D, and -0.82 +/- 0.68 D, respectively. Significant differences were found between changes in SER from 6 to 12 months and from baseline to 12 months (p or = -0.5 D with the group of SER change < -0.5 D, numeric values of white-to-white diameters of the 2 groups were different, and a significant correlation was found between the range of SER change and the white-to-white diameter (Pearson's r = -0.471, p = 0.008). CONCLUSIONS: Ortho-k is effective for slowing myopic progression. The smaller the white-to-white diameter, the slower the myopic progression could be.

Vitrectomy Combined with Intravitreal Triamcinolone Acetonide Injection and Macular Laser Photocoagulation for Nontractional Diabetic Macular Edema

PURPOSE: To evaluate the efficacy of vitrectomy combined with intravitreal injection of triamcinolone acetonide (IVTA) and macular laser photocoagulation for the treatment of nontractional diabetic macular edema (DME) refractory to anti-vascular endothelial growth factor (VEGF) therapy. METHODS: Twenty-eight eyes from 28 subjects who were diagnosed with nontractional DME refractory to three or more sequential anti-VEGF injections underwent sequential vitrectomy, IVTA, and macular laser photocoagulation. Changes in best-corrected visual acuity (BCVA) and central subfield thickness (CST) during the six months following vitrectomy were evaluated. Additionally, the CST and BCVA outcomes were compared with those of 26 eyes treated with the same triple therapy for nontractional DME refractory to conventional treatment, such as IVTA or macular laser photocoagulation, or both. RESULTS: The mean logarithm of the minimum angle of resolution BCVAs before and one, three, and six months after vitrectomy were 0.44 +/- 0.15, 0.36 +/- 0.18, 0.31 +/- 0.14, and 0.34 +/- 0.22, respectively. The mean CSTs were 433.3 +/- 77.9, 329.9 +/- 59.4, 307.2 +/- 60.2, and 310.1 +/- 80.1 microns, respectively. The values of both BCVA and CST at one, three, and six months were significantly improved from baseline (p < 0.05). The extent of CST reduction during the first month after triple therapy was greater in eyes refractory to conventional treatment than in eyes refractory to anti-VEGF (p = 0.012). CONCLUSIONS: Vitrectomy combined with IVTA and macular laser photocoagulation had a beneficial effect on both anatomical and functional outcomes in eyes with nontractional DME refractory to anti-VEGF therapy.

Who is more appropriate to do metabolic control of pregnancy complicated by diabetes?: Comparison of internist and obstetrician / 대한산부인과학회지

OBJECTIVE: To compared obstetric outcomes of pregnancies complicated by diabetes according to the managing department and to consider role of obstetrician and endocrinologist METHODS: A retrospective analysis of 72 pregnant women managed for diabetes during March 2004 to December 2006 was performed. Eighteen women had been managed by obstetricians (Group I) while 54 women had been managed by endocrinologists of internal medicine (Group II) during their pregnancies at Eulji Hospital. None of these patients had multiple pregnancies, abnormal karyotype, or other medical disorders other than diabetes. Pregnancy outcomes were compared between two groups. RESULTS: No difference was found with regard to the age, parity, BMI (body mass index), weight gain during the pregnancy, and the gestational weeks of delivery. There was also no difference in the blood glucose levels after 100 gm OGTT (oral glucose tolerance test) and HbA1C levels in two groups. The neonatal birth weight of group I (2.89+/-0.21 kg) was significantly lower than that of group II (3.38+/-0.08 kg, P=0.040). The 1 min APGAR score, which was corrected by weight through ANCOVA test, was also significantly lower in group I (7.11+/-0.51 vs 8.11+/-0.19, P=0.028). But There was no difference in 5 min APGAR score. The incidence of birth weight over 3.8kg was significantly higher in group II [37/54 (68.5%) vs 1/17 (5.6%), P=0.030]. Neonatal hypoglycemia was also higher in group II (37.0% vs 11.1%, P=0.043). Other neonatal and maternal complications associated with diabetes were not significantly different between two groups. CONCLUSIONS: In medical point of view, obstetrician can effectively manage diabetes during pregnancy as good as internist. Besides, the management by obstetricians may be more economic, less annoying, and can induce more compliance and motivation of the patients.