Central Serous Chorioretinopathy Occurring in Patients 50 years of Age and Older

PURPOSE: To assess the clinical characteristics of central serous chorioretinopathy in patients over 50 and be of help to diagnose it. METHODS: The medical records of 30 eyes of 24 patients diagnosed as central serous chorioretinopathy were reviewed retrospectively. We analyzed age, sex, visual acuity, and evaluated clinical features of fundus, characteristics of fluorescein angiography, indocyanine green angiography (ICGA), optical coherence tomography (OCT). RESULTS: The mean age was 55.4 years (50-69 years). 18 were male and 6 were female. Of the 30 eyes, 8 eyes were identified as classic central serous chorioretinopathy and 22 eyes were identified as chronic. On ICGA, 16 patients (76.2%) showed transient multifocal choroidal hyperpermeability bilaterally and 19 patients (90.5%) showed dilated choroidal vasculature bilaterally. Late hypofluorescence due to severe atrophy, hypertrophy, pigmentation, or small detachment of retinal pigment epithelium was noted in 22 eyes. On fellow eyes, retinal pigment epithelial degeneration was found in 15 eyes (79%). On OCT, serous retinal pigment epithelial detachment was noted in 10 eyes, serous retinal detachment in 25 eyes, and foveal thickening in 19 eyes. CONCLUSIONS: Central serous chorioretinopathy in patients over 50 was often associated with more degeneration of retinal pigment epithelium. ICGA and OCT are useful in diagnosing central serous chorioretinopathy in old ages.

Choroidal Neovascularization Characteristics and Its Size in Optical Coherence Tomography

The classification, size and activity of choroidal neovascularization (CNV) by optical coherence tomography (OCT) were compared with those obtained by fluorescein angiography (FA) and Indocyanine green angiography (ICG). This study included 32 patients (32 eyes) diagnosed as having CNV. The etiology of CNV was found to be age-related macular degeneration (AMD) or non-AMD. Patients were studied retrospectively by FA, ICG, and OCT. Of the 13 eyes with AMD, the boundary of the lesion could not be defined using FA in 7 patients. Among the 7 poorly defined CNV cases by FA, the identification of the boundary was possible in one case by OCT. The mean diameter of the classic well-defined lesions was 3500 +/- 421 micrometer by FA, 2624 +/- 1044 micrometer by ICG, and 1927 +/- 1272 micrometer by OCT. The size of the CNV by OCT was always smaller than by FA or ICG. Of the 19 eyes with Non-AMD, the boundary of the lesion could not be defined by FA in 5 patients. Among the 5 poorly defined cases by FA, the identification of the boundary was possible in 3 cases by OCT. The mean diameter of the well-defined CNV lesions was 2153 +/- 759 micrometer by FA, 1929 +/- 673 micrometer by ICG, and 1322 +/- 566 micrometer by OCT. Retinal thickness, which represents retinal edema, was found to be proportional to lesion size, although the relationship was not statistically significant. Regardless of CNV type, FA, ICG and OCT used in combination increase the specificity of diagnosis if their findings are compared.

Long-term Clinical Result and Patient Satisfaction after LASIK

PURPOSE: To evaluate the long-term clinical result and patient satisfaction after laser in situ keratomileusis. METHODS: This is a long term (over 3 years) retrospective analysis of 107 eyes (54 patients) that has undergone LASIK since February 1996. RESULTS: Mean preoperative Spherical Equivalent(SE) was -7.81 +/- 4.07D and mean postoperative SE was -0.88 +/- 1.74D at 1 week, -1.18 +/- 1.17D at 1 month, -1.32 +/- 1.71D at 3 month and -2.44 +/- 2.20D after 3 years. At the last visit, uncorrective visual acuity was 0.5 or better in 83.1% and 26.2% of manifest SE was within the +/- 1D. However, in high myopic group (>-10.D), it has decreased to 41.7% and 0% respectively. Myopic progression occurred also in reoperation cases, 81.3% had uncorrective visual acuity of 0.5 or better and 31.3% had manifest SE within +/- 1D at the last visit. In the survey of subjective satisfaction, 80.2% of patient was satisfied with the surgery, which has decreased to 46.2% after long term follow-up. CONCLUSIONS: In conclusion, the higher the preoperative SE, the more myopic regression has occurred (p0.05). The patient subjective satisfaction has significantly decreased after long term follow-up compared to immediate postoperative visit.

Morphological Study of a New Orbital Implant: Hydroxyapatite-Coated Porous Alumina in Rabbit

PURPOSE: We evaluated the morphologic change of the hydroxyapatite(HA)-coated porous alumina as a new orbital implant when it was used in rabbit. METHODS: After evisceration of 18 eyes of 18 New Zealand white rabbits, we implanted 12 mm-diameter-sized HA-coated porous alumina with different pore sizes; 300, 500, and 800 micrometer, and then the implants were extracted back to evaluate their morphologic change according to different time interval; 2, 4, and 12 weeks. RESULTS: Fibrovascularization was noted at periphery of the implant 2 weeks after implantation in all of the three groups, and to the center of the implant 4 and 12 weeks after implantation. This fibrova-scularization was most predominant in 500 micrometerpore-sized group compared to the rest two groups. CONCLUSIONS: HA-coated porous alumina showed similar appearance of fibrovascularization with relatively more affordable price and easy manufacture, compared to the other porous implants.

A Case of Stenotrophomonas Maltophilia Endophthalmitis after Cataract Operation

It has been reported that the cause of the bacterial endophthalmitis following cataract extraction and intraocular lens implantation was G(+) organisms in most cases. However, the endophthalmitis caused by G(-) organisms has worse prognosis than that by G(+)organisms. We experienced a case of Stenotrophomonas maltophilia endophthalmitis which has not yet been reported in Korea. A 77-year-old female presented with blurred vision, conjunctival injection and ocular pain 5 days after cataract extraction and intraocular lens implantation. Ocular findings such as corneal edema, hypopyon and thick posterior capsular opacity were consistent with infectious endophthalmitis. Culture of vitreous aspirate isolated Stenotrophomonas maltophilia 15 days after cataract extraction.