Protein C and Protein S as a Risk Factor for Retinal Vein Occlusion

PURPOSE: The authors evaluated the possibility of protein C and protein S as risk factors for retinal vein occlusion (RVO). METHODS: We evaluated the medical histories and performed laboratory tests, including protein C and protein S, in patients who were diagnosed with RVO by fundus examination and fluorescein angiography. The same data were obtained from a healthy control group. We analyzed mean activity and the ratio of patients with decreased levels of protein C or protein S. RESULTS: Forty-seven patients with RVO in this study consisted of 14 with central retinal vein occlusion (CRVO) and 33 with branch retinal vein occlusion (BRVO). Sixteen normal subjects were also enrolled in this study as controls. There are no cases that presented decreased protein C activity. However, there was a statistically significant difference in the number of cases with protein S deficiency between the patients and the control group (p<0.05). CONCLUSIONS: Deficiency of anticoagulant proteins, especially protein S, may be a risk factor of retinal vein occlusion. Examination of the coagulation system may be useful in the systemic evaluation of RVO patients.

The Result of Full Tendon Transposition in Paralyzed Strabismus

Nine patient with paralyzed strabismus of large deviation(Seven patients with lateral rectus or medial rectus muscle palsy and two patients with double elevator palsy) had full tendon transposition procedure. If remained strabismus was large postoperatively, recession of anatagonist of paralyzed muscle and botulinum toxin infection was performed respectively. Five patients achieved single binocular vision within central 10 degree of visual field. And six patients achieved less than 10 prism diopter of deviation in primary position. Our method compares favorably with previously descrived transposition procedure for muscle palsy in terms of the amount of correction and the extent of the window of single binocular vision with low risk of anterior ischemia syndrome.

Difference of the Accuracy between Autorefration and Subjective Refraction in Photorefractive Keratectomy(PRK) and LASIK-Treated Eyes

Authors decided to test whether differences occurred in automated and subjective refraction in untreated, PRK, and LASIK-treated eyes. Ninety six eyes of 50 patients(96 eyes) who underwent PRK(57 eyes) or LASIK(39 eyes) for myopia and myopic astigmatism were routinely autorefracted with the CANON RK-3 before subjective refraction was done, using several parameters. This two procedures were done preoperation and 3 months after operation. In comparing the postoperative(PRK, LASIK) results, automated refraction showed more myopia and higher cylinder power, without significant difference in refractive axis, than those of subjective measurement. The difference of cylinder power were found in the cases of large ablation depth(above 100micrometer), high degree of eccentric ablation(above 0.25 mm), LASIK operation. The significant differences of cylinder power and axis were found in the cases of high degree of eccentric ablation(above 0.25 mm). So we recommend the method of subjective refraction before PRK and LASIK operation instead of using automated refraction. Postoperatvely, we also should evaluate the postoperative status of the patient by subjective refraction. And we should decide the amount of ablation in case of retreatment by subjective refraction, instead of autorefraction. We have to be cautious of evaluating the automated refraction results after operation, especially in cases of large ablation depth, high degree of eccentric ablation, and LASIK.

The Additive Effect of Trusopt to Beta-blockers in the Treatment of Glaucoma Patients

Intraocular pressure(IOP) and side effects of adding Trusopt to beta blockers was studied in 39 eyes of 22 glaucoma patients that was inadequately controlled with beta blockers alone. Routine eye examination and IOP measurement were performed before the additive therapy. Trusopt eye drops were topically applied three times a day with previously used three kinds of beta blockers. IOP was measured at 1 week, 1 month, and 3 month after the combined therapy. Mean IOP was 18.1+/-5.2mmHg before combined therapy; 15.3+/-4.0mmHg after 1week, 15.2+/-3.2mmHg after 1 month and 15.0+/-3.4mmHg after 3 month of therapy. Side effects of combined therapy were bitter taste(20.5%), burning sensation(9.6%) redness(5.1%), discomfort(5.1%), and ocular pain(5.1%). These results indicate that adding Trusopt in patients treated with beta blockers cause a further reduction of IOP that may prove to be clinically useful in glaucoma therapy.