Clinical Features of the Fellow Eyes of Children with Unilateral Facial Port-Wine Stains and Ipsilateral Glaucoma

Purpose@#To investigate the clinical features of non-affected fellow eyes in patients with unilateral facial port-wine stain (PWS) and ipsilateral secondary glaucoma. @*Methods@#We performed a retrospective analysis of the medical records of 35 patients with unilateral facial PWS glaucoma and those of controls (35 subjects without both facial PWS and glaucoma) between September 1996 and May 2020. We noted patients’ age at the glaucoma diagnosis (for unilateral facial PWS glaucoma patients) or at the initial examination (for controls), cup-to-disc ratio (CDR), and intraocular pressure (IOP). We compared the clinical features between the glaucoma-free eyes in patients with unilateral facial PWS glaucoma and the controls. @*Results@#The mean age at the glaucoma diagnosis for unilateral facial PWS glaucoma patients was 0.56 ± 0.99 years (range, 0.08-4). The mean IOP of the glaucoma-free eyes was 16.68 ± 5.73 mmHg (range, 9-22.9), and the mean CDR was 0.37 ± 0.14 (range, 0.15-0.80) at glaucoma diagnosis. The mean IOP of the glaucoma-free eyes was 14.14 ± 6.29 mmHg (range, 8.1-26.7), and the mean CDR was 0.37 ± 0.12 (range, 0.26-0.82) at final examination. When comparing glaucoma-free eyes of the unilateral facial PWS glaucoma patients with the control group (mean age, 11.2 ± 7.4 years), the mean CDR was significantly greater (0.37 ± 0.12 vs. 0.30 ± 0.08; p = 0.014) but there was no significant difference in the mean IOP (14.14 ± 6.29 mmHg vs. 14.57 ± 2.49 mmHg; p = 0.712). @*Conclusions@#The glaucoma-free eyes of unilateral facial PWS glaucoma patients showed greater CDR compared to the non-facial PWS and non-glaucoma controls. Additional longitudinal studies are needed to investigate the clinical course of those eyes, whether the risk of developing glaucoma is increased.

Comparison of Clinical Outcomes between Swept-source Optical Coherence Tomography Biometer and Partial Coherence Interferometer

Purpose@#To compare the ocular biometry and postoperative refractive outcomes using two devices; the swept-source opticalcoherence tomography biometer (Argos) versus the partial coherence interferometer (IOL Master®500, Carl Zeiss Meditec AG,Jena, Germany). @*Methods@#The axial length (AL), anterior chamber depth (ACD) and keratometry (K) in 221 cataract eyes were measured withArgos and IOL Master®500. One month after surgery, refraction of the respective eyes was conducted and the mean absoluteerror (MAE) calculated for analysis of the refractive outcomes. @*Results@#Measurement was not possible in 13 eyes with the IOL Master®500 but was possible with Argos. Measurement was notpossible in one eye with either biometer. Agreement in measured ocular biometry between the two devices by intraclass correlationcoefficient (ICC) and Bland-Altman plot (ICC AXL = 0.999, ACD = 0.975, K = 0.978) was excellent. The AL and ACD measuredwith Argos were significantly longer than measured with IOL Master®500 (p= 0.005, p= 0.000). The MAE showed no significantdifference between the Argos and IOL Master®500 (p= 0.087). @*Conclusions@#The measurement of ocular biometry was better in Argos than in IOL Master®500. The accuracy of the intraocularlens power calculations of Argos was clinically acceptable and compatible with a conventional device.

The Effect of Epiretinal Membrane on Dexamethasone Implant for Branch Retinal Vein Occlusion Macular Edema

PURPOSE: To evaluate the effect of epiretinal membrane (ERM) on the outcomes of intravitreal dexamethasone implant (Ozurdex®, Allergan, Irvine, CA, USA) treatment for macular edema (ME) secondary to branch retinal vein occlusion (BRVO). METHODS: Thirty eyes of 30 patients who received Ozurdex treatment for ME secondary to BRVO, and were followed-up for at least 6 months were retrospectively reviewed. Patients were divided into two groups based on the presence (ERM [+] or absence ERM [−]) of ERM at baseline. The best-corrected visual acuity (BCVA), central foveal thickness (CFT), recurrence of ME, and retreatment rate were evaluated at baseline, 1, 3, and 6 months after Ozurdex injection. RESULTS: Ten eyes of 30 eyes (33%) showed ERM at baseline. While the mean CFT was significantly reduced at 1 month after Ozurdex injection, it began to increase gradually thereafter in both groups. The ERM (+) group showed a significantly higher mean CFT than the corresponding values of the ERM (−) group at 1 (p = 0.022) and 6 months (p = 0.001) after Ozurdex injection. However, no significant difference was found in the BCVA between the two groups at every visit. The proportion of eyes with ME was significantly higher in the ERM (+) group (90%) than that in the ERM (−) group (35%) at 6 months after Ozurdex injection (p = 0.009). There were no significant differences between the two groups in the percentage of retreatment, time to retreatment, and type of materials used for retreatment. CONCLUSIONS: In patients with ME secondary to BRVO, the treatment effect of Ozurdex was low and the duration of treatment was short when ERM was concurrently present. However, the presence of ERM did not significantly affect visual outcomes after treatment with Ozurdex.

A Case of Orbital Apex Syndrome with Central Retinal Artery and Vein Occlusion Following Trauma

PURPOSE: To report a case of orbital apex syndrome (OAS) combined with central retinal artery occlusion (CRAO) and central retinal vein occlusion (CRVO) following blunt trauma. CASE SUMMARY: A 4-year-old female visited the hospital following a traffic accident. She was admitted because of multiple fractures of the skull and pneumocephalus. On day 5, she was referred to us with decreased visual acuity in her right eye. Her initial visual acuity was hand motions in the right eye and 0.8 in the left eye. The right eye showed a dilated pupil, ptosis, and total ophthalmoplegia, and the left eye showed limited abduction. A fundus examination revealed multiple retinal hemorrhages, tortuous veins, and an edematous white retina with a cherry-red spot in the right eye. Brain magnetic resonance imaging revealed an entrapped right optic nerve because of bony fragments in the orbital apex. The patient was diagnosed with OAS accompanied by CRAO and CRVO in the right eye, and with traumatic abducens nerve palsy in the left eye. After 6 months, the visual acuity was hand motions, and the fundus examination showed absorbed retinal hemorrhages, pale discs, and general retinal thinning of the right eye. Ptosis of the right eye and extraocular muscle movement of both eyes were improved. CONCLUSIONS: Combined CRAO and CRVO following trauma is very rare and is even more rarely associated with OAS. It is important for clinicians to be aware of the potential for central retinal vessel occlusions and OAS in cases of blunt ocular trauma.

Distribution of Diseases Causing Liver Function Test Abnormality in Children and Natural Recovery Time of the Abnormal Liver Function

Although liver function test abnormality is frequently noted in children, there is no report about the distribution of the etiology and natural recovery time of the abnormal liver function. From March 2005 to February 2014, clinical information was retrospectively collected from 559 children who had abnormal liver function and were hospitalized or visited the outpatient clinic at the Jeju National University Hospital. The etiology of abnormal liver function was classified into groups and the natural recovery time of abnormal liver function was analyzed. The etiological groups of 559 patients included 'nonspecific hepatitis' in 42 (7.5%), 'infection' in 323 (57.8%), 'rheumatologic and autoimmune' in 66 (11.8%), 'nonalcoholic fatty liver disease' in 57 (10.2%), 'anatomic' in 12 (2.1%), 'toxic' in 13 (2.1%), 'metabolic' in 8 (1.4%), 'hematologic' in 7 (1.3%), 'hemodynamic' in 4 (0.7%), and 'others' in 27 (4.8%). Among the 'infection' group (57.8%), the 'viral infection in the respiratory tract' subgroup, which had 111 patients (19.8%), was the most common. The natural recovery time of the abnormal liver function was 27 days (median) in 'nonspecific hepatitis', 13 days (median) in 'viral respiratory tract disease', 16 days (median) in 'viral gastroenteritis', 42 days (median) in 'viral febrile illness", and 7 days (median) in "Kawasaki disease". The information on the natural recovery time of abnormal liver function may help the physician to perform good clinical consultation for patients and their parents.