Self-Reported Findings of the Korean Intermittent Exotropia Multicenter Study Questionnaire.

PURPOSE: To determine subjective symptoms and medical history of patients with intermittent exotropia in a large study population. METHODS: The Korean Intermittent Exotropia Multicenter Study (KIEMS) is a nationwide, observational, cross-sectional, multicenter study conducted by the Korean Association for Pediatric Ophthalmology and Strabismus including 5,385 patients with intermittent exotropia. Subjective symptoms and medical history of patients with intermittent exotropia were extracted by a comprehensive survey based on a self-administered questionnaire according to the study protocol of the KIEMS. RESULTS: The mean age of symptom onset was 5.5 years. The most common symptom reported in patients with intermittent exotropia was photophobia (52.1%), followed by diplopia at near fixation (7.3%) and distance fixation (6.2%). Preterm birth was found in 8.8%, and 4.1% had perinatal complications. A family history of strabismus was present in 14.9%, and 5.5% of patients had a family member who underwent strabismus surgery. CONCLUSIONS: The KIEMS is one of the largest clinical studies on intermittent exotropia. Intermittent exotropia frequently caused photophobia and diplopia, and patients with a family history was not uncommon.

Relationship between high serum ferritin level and glaucoma in a South Korean population: the Kangbuk Samsung health study.

BACKGROUND/AIMS: To investigate the association between serum ferritin levels and glaucoma in a South Korean population. METHODS: This retrospective cross-sectional study included 164 029 subjects who underwent screening at Kangbuk Samsung Hospital Health Screening Center between August 2012 and July 2013. All subjects underwent a physical examination, answered sociodemographic and behavioural questions, and provided samples for laboratory analyses. A digital fundus photograph of both eyes was taken, and all photographs were reviewed by ophthalmologists. The ophthalmologists determined if an eye had glaucoma based on criteria set forth by the International Society of Geographical and Epidemiological Ophthalmology and the appearance of the retinal nerve fibre layer and optic disc. RESULTS: The mean serum ferritin level was 56.98 ng/mL in women and 223.82 ng/mL in men. After adjusting for age, serum iron, total iron-binding capacity (TIBC), transferrin saturation, white blood cell (WBC) count, high-sensitivity C-reactive protein (HsCRP) and total vitamin D level, males in the highest quartile for serum ferritin level had a higher OR for glaucoma than males in the lowest quartile (OR=1.176, 95% CI 1.030 to 1.342, p=0.016); we did not observe this relationship among women. Other markers of iron metabolism, such as iron level, transferrin saturation and TIBC, and inflammation measures, including WBC, HsCRP and total vitamin D, were not associated with glaucoma. CONCLUSIONS: High serum ferritin level was associated with a high risk of glaucoma in men, but not in women. Because serum ferritin is related to oxidative stress and inflammation, it might play a role in glaucoma development.

Clinical features of subepithelial layer irregularities of cornea.

PURPOSE: To illustrate surgical outcomes of subepithelial irregularities that were identified incidentally during laser refractive surgery. MATERIALS AND METHODS: The study group consisted of 406 patients who underwent 787 surface ablation refractive surgeries. Ophthalmologic evaluations were performed before each procedure and at 1, 3 and 6 months post-operatively. Subepithelial irregularities were evaluated by analyzing still photographs captured from video recordings. Sizes and locations were determined by a calibrated scale located at the major axis of the tracking system's reticle. RESULTS: Subepithelial irregularities were identified in 27 eyes during 787 surface ablation refractive surgeries. Most of the subepithelial irregularities did not show any abnormalities in the wavefront aberrometer. However, one case with diameter greater than 1.00 mm and one case of clustered multiple subepithelial irregularities with moderate size were corresponded significant coma (Z31) and increased higher order aberration (HOA) in the HOA gradient map. CONCLUSIONS: Corneal subepithelial irregularities may be related to problems that include significantly increased localized HOA and remaining permanent subepithelial opacity. Subepithelial irregularity should be considered even if the surface of the cornea is intact and there are no specific findings measured by corneal topography.

Effect of axial length on diurnal IOP in cataract patients without glaucoma.

PURPOSE: To evaluate the effect of ocular biometrics on intraocular pressure (IOP) and diurnal IOP fluctuation in nonglaucomatous subjects. METHODS: We examined 115 subjects from May to December 2007 in Kangbuk Samsung Hospital, Seoul, Korea. Intraocular pressure was measured with a Goldmann applanation tonometer in habitual positions every 2 hours from 9 am to 11 pm. Ocular biometric values including central corneal thickness, central corneal power, axial length, anterior chamber depth, and lens thickness were measured using an ultrasound biometer and keratometer and the refractive state was determined. RESULTS: Two hundred fourteen eyes of 115 patients were included in this study; the mean (±SD) IOP of all eyes was 12.33 (±2.55) mmHg. The mean (±SD) diurnal IOP fluctuation was 2.72 (±1.43) mmHg. Central corneal thickness was positively correlated with the mean IOP (Pearson correlation, r = 0.217, p = 0.002); however, there was no relationship between central corneal thickness and the diurnal IOP fluctuation. Axial length was not related to the mean IOP (Pearson correlation, r = 0.049, p = 0.476) and the diurnal IOP fluctuation (Pearson correlation, r = 0.058, p = 0.395). The mean IOP or diurnal IOP fluctuation was not related to any of the following values: central corneal power, anterior chamber depth, refractive error, lens thickness, or vitreous chamber depth. CONCLUSIONS: Central corneal thickness is significantly related to the IOP but may not affect diurnal IOP fluctuation. The axial length was not associated with IOP profiles in this study. Our results can contribute to a broader understanding of the effects of ocular biomechanical properties on the IOP profile.