Impact of cardiovascular comorbidity on increased neutrophil-lymphocyte ratio in pseudoexfoliation syndrome.

BACKGROUND: The purpose of this study was to compare neutrophil-to-lymphocyte ratios (NLRs) of patients with pseudoexfoliation syndrome (PEX) according to the presence of cardiovascular disease (CVD) with those without CVD as controls. METHODS: A total of 197 participants (97 patients with PEX and 100 participants without PEX regarded as the control group) were included in this retrospective study. The PEX group was divided into 2 subgroups, PEX with CVD (group 1) and PEX without CVD (group 2). NLRs were then compared to those of the control group. RESULTS: The incidence of CVD was significantly (P = .015) higher in the PEX group than in the control group. NLR was significantly higher in the group 1 and group 2 compared with that of the control group (P = .048 and P = .002, respectively). In the PEX group, group 1 showed higher NLR than group 2 (P = .023). CONCLUSION: Although the PEX group showed a higher incidence of CVD, the NLR was higher in the PEX group regardless of cardiovascular comorbidity than that in the control group.

Association of Polymorphisms at the SIX1/SIX6 Locus With Normal Tension Glaucoma in a Korean Population.

PRCIS: We demonstrated that SIX1/SIX6 locus polymorphism (rs10483727 and rs33912345) was significantly associated with a genetic susceptibility to NTG in a Korean population. More studies are needed to investigate whether the SIX1/SIX6 locus is associated with NTG among various ethnic populations. PURPOSE: Several previous studies have reported that the relevance of the SIX1/SIX6 locus to open angle glaucoma (OAG) in various ethnic populations. However, definitions of OAG patients were different among those studies. The relevance of the SIX1/SIX6 locus to normal tension glaucoma (NTG) in a Korean population remains uncertain. Therefore, the purpose of this study was to investigate the relationship of the SIX1/SIX6 locus with NTG in a Korean cohort. METHOD: Patients with NTG and ethnically matched healthy controls were recruited from eye clinics in Korea (210 cases and 117 controls). Four polymorphisms (rs33912345, rs12436579, rs2179970, and rs10483727) of the SIX1/SIX6 locus were genotyped for 327 subjects using a TaqMan single nucleotide polymorphism genotyping assay. RESULTS: The rs33912345 polymorphism was significantly correlated with NTG in the recessive model [odds ratio (OR): 0.265; 95% confidence interval (CI): 0.078-0.898, P =0.033], but not in the allelic and dominant models (both P >0.05). The SNP rs10483727 was significantly associated with NTG in the allelic model (OR: 0.674; 95% CI: 0.464-0.979, P =0.038) and the recessive model (OR: 0.187; 95% CI: 0.058-0.602, P =0.005). Genetic association analysis of SNP rs12436579 and rs2179970 revealed no significant difference in genotype distribution between NTG cases and controls in the allelic, dominant, or recessive models (all P >0.05). CONCLUSION: The current study found that SIX1-SIX6 locus rs10483727 and rs33912345 polymorphisms were significantly associated with NTG risk in the Korean population.

Lack of association between SIX1/SIX6 locus polymorphisms and pseudoexfoliation syndrome in a population from the Republic of Korea.

Previous studies have reported the association of the SIX1/SIX6 locus with open-angle glaucoma in various ethnic populations. However, the relevance of the SIX1/SIX6 locus to pseudoexfoliation syndrome (XFS) appears uncertain at present. Thus, we investigated the relationship between polymorphisms in the SIX1/SIX6 locus and XFS in a Korean XFS cohort. A total of 246 participants comprising 167 unrelated Korean patients with XFS and 79 ethnically matched control subjects were recruited. Four polymorphisms of the SIX1/SIX6 locus (rs33912345, rs12436579, rs2179970, and rs10483727) were genotyped using a TaqMan® allelic discrimination assay. Genotypic and allelic associations were analyzed using logistic regression. The minor allele frequency (MAF) of rs33912345 was found to be 0.287 and 0.247 in the XFS cases and controls, respectively, and the MAF of rs12436579 was found to be 0.383 and 0.361 in the XFS cases and control subjects, respectively. The MAF of rs2179970 was found to be 0.090 and 0.095 in the XFS cases and control subjects, respectively, and the MAF of rs10483727 was found to be 0.293 and 0.253 in the XFS cases and control subjects, respectively. Genetic association analysis of 4 SIX1/SIX6 locus single nucleotide polymorphisms (SNPs) revealed no significant difference in genotype distribution between the XFS cases and control subjects in the allelic, dominant, or recessive models (all, P > .05). The current study suggested that SIX1/SIX6 locus polymorphisms (rs33912345, rs12436579, rs2179970, and rs10483727) may not be associated with a genetic susceptibility to XFS in a Korean cohort.

Comparison between distance and near visual acuity in amblyopes.

To compare distant visual acuity (DVA) and near visual acuity (NVA) in amblyopia and evaluate if NVA can be used to diagnose amblyopia.A retrospective study was performed on 73 patients diagnosed with amblyopia based on DVA, by measuring their NVA and comparing the DVA and NVA. The NVA was measured by Snellen chart at 30 cm and the DVA was measured by Dr Hahn vision test chart at 5m. The patients' age, type of amblyopia, spherical equivalent, the difference between spherical equivalent and the fellow eye spherical equivalent spherical, and prism diopter (PD) were evaluated and their relationship with the difference between the DVA and NVA was analyzed.The NVA was significantly better than the DVA in amblyopia (P = .000). The difference between the DVA and NVA was not significantly related to the type of amblyopia (P = .600) or the patients' age(P = .351). Also, the difference between the DVA and NVA was not significantly affected by the spherical equivalent (P = .425) or the difference between spherical equivalent and the fellow eye spherical equivalent (P = .212) in anisometropia amblyopia, and also not by the PD (P = .882) in strabismus amblyopia.In amblyopes, the NVA was better than the DVA before amblyopia treatment. The difference between the DVA and NVA was not affected by age, type of amblyopia, spherical equivalent, the difference between spherical equivalent and the fellow eye spherical equivalent spherical, or PD. Therefore, it should be taken into consideration that NVA could underestimate the severity of amblyopia and affect the accuracy at diagnosing amblyopia.

Lack of correlation between S1 RNA binding domain 1 SNP rs3213787/rs11884064 and normal-tension glaucoma in a population from the Republic of Korea.

Previous studies have reported the association of the S1 RNA binding domain 1 (SRBD1) gene with open-angle glaucoma in various ethnic populations. However, in those studies, the definition of the patients differed, as did the results. Therefore, the relevance of the SRBD1 gene to normal tension glaucoma (NTG) appears uncertain at present. Thus, we investigated the relationship between the SRBD1 gene and NTG in a Korean NTG cohort.In total, 159 unrelated Korean patients with NTG and 103 Korean control subjects were recruited. Thus, a total of 262 participants were analyzed for SRBD1 (rs3213787 and rs11884064) gene polymorphisms.The minor allele frequency of rs3213787 was found to be 0.13 and 0.19 in NTG cases and controls, respectively. The genetic association analysis of SNP rs3213787 revealed no significant difference in genotype distribution between NTG cases and controls in allelic (odds ratio [OR] = 0.634, P = .063), dominant (OR = 0.589, P = .066) or recessive models (OR = 0.639, P = .7716). The minor allele frequency of rs11884064 was found to be 0.24 and 0.25 in NTG cases and controls, respectively. For rs11884064, no significant difference in genotype distribution was observed between NTG cases and controls in allelic (OR = 0.938, P = .755), dominant (OR = 0.927, P = .798) or recessive models (OR = 0.920, P = 1.000).The current study suggested that SRBD1 gene polymorphisms (rs3213787 and rs11884064) may not be associated with genetic susceptibility to NTG in a Korean cohort.

Lack of Correlation between ASB10 and Normal-tension Glaucoma in a Population from the Republic of Korea.

Purpose: Ankyrin repeats and suppressor of cytokine signaling box-containing protein 10 (ASB10) was identified as a novel gene for glaucoma. Since then, there have been reports on the association of ASB10 with glaucoma in various ethnic populations. In these studies, patients with different glaucoma types were included. Thus, we investigated the relationship between ASB10 and NTG in a Korean cohort.Methods: Whole-exome sequencing was performed to identify the ASB10 variants in one patient with a strong NTG family history. A total of 263 participants, comprising 157 NTG patients and 106 control subjects, were analyzed for ASB10 gene single nucleotide polymorphisms (SNPs).Results: Nine variants of the ASB10 gene were identified using whole-exome sequencing analysis, including four exonic SNPs. Of the exonic variants, three were known polymorphisms (rs3800791, rs2253592, and rs77615410), and one was newly reported (rs552803353). A nonsynonymous variant, rs552803353 was predicted as functionally damaging using PolyPhen-2. The exonic SNPs were compared against gene sequences of the control group in the NTG cohort. However, the minor allele frequency (MAF) of rs552803353 was found to be 0.029 and 0.038 in NTG cases and control subjects, respectively. The MAF of rs3800791 was found to be 0.096 and 0.118 in NTG cases and control subjects, respectively, and the MAF of rs77615410 was found to be 0.220 and 0.245 in NTG cases and control subjects, respectively, which were higher than those reported by previous studies. Genetic association analysis of four ASB10 SNPs revealed no significant difference in genotype distribution between NTG cases and control subjects in allelic, dominant, or recessive models (all, P > .05).Conclusions: The present study indicated that the MAFs of ASB10 gene polymorphisms showed a large difference among various ethnic groups, and that ASB10 gene polymorphisms may not be associated with genetic susceptibility to NTG in a Korean cohort.

Association of HK2 and NCK2 with normal-tension glaucoma in a population from the Republic of Korea.

BACKGROUND: Previous studies have reported the association of HK2 and NCK2 genes with normal-tension glaucoma (NTG) in Japan, but there has been no follow-up study in other countries, so the relevance of these genes to NTG appears uncertain at present. Thus, we investigated the relationship between the HK2 and NCK2 genes and NTG in a Korean NTG cohort. METHODS: In total, 154 unrelated Korean patients with NTG and 101 normal Korean controls were recruited. Thus, a total of 255 participants were analyzed for NCK2 (rs2033008) and HK2 (rs678350) gene polymorphisms. RESULTS: The minor allele frequency (MAF) of rs678350 was significantly higher in NTG patients (MAF = 0.32) than in controls (MAF = 0.23) (OR, 1.586; 95% CI, 1.058 to 2.375; P = 0.028). This trend was more significant in the dominant model (OR, 1.908; 95% CI, 1.144 to 3.180; P = 0.015). When we performed logistic regression analysis to adjust for age, both the allelic and dominant models were still statistically significant. No significant difference was observed in rs2033008 allele or genotype frequencies between the NTG patients and control subjects. CONCLUSIONS: The current study suggested that HK2 gene polymorphism may contribute to the genetic susceptibility to NTG.

Neurofibromatosis type 1 with tarsal conjunctiva thickening: A case report.

RATIONALE: We report a rare case of neurofibroma in the form of tarsal conjunctival thickening of the eyelid in patients with neurofibromatosis type 1 (NF1), common ocular complications of which are Lisch nodules, choroidal nodules, and optic nerve glioma. PATIENT CONCERNS: A 46-year-old female patient was diagnosed with neurofibroma after biopsy and removal of 2 lumbar level intradural masses 15 years ago. She was being monitored without recurrence. When the patient visited our hospital, multiple iris Lisch nodules were found in both her eyes with ill-defined, diffuse thickening in the upper eyelid tarsal conjunctiva of the right eye. DIAGNOSIS: Neurofibroma was diagnosed by incisional biopsy and immunohistochemistry of the tarsal conjunctiva. INTERVENTIONS: The patient of the present case did not undergo any additional surgical treatment because tarsal conjunctiva thickening caused little functional problem. OUTCOMES: The patient has only been regularly examined for changes in size of neurofibroma, and there was no change in size over a 12-month period. LESSONS: Neurofibroma should be considered as a differential diagnosis if a patient diagnosed with NF1 shows tarsal conjunctiva thickening.

Platycodon grandiflorum-derived saponin attenuates the eccentric exercise-induced muscle damage.

Platycodon grandiflorum contains triterpenoid saponins, such as platycodin D and platyconic acid A, and acts as a multifold nutritious compound. Our previous research demonstrated that Platycodon grandiflorum-derived saponin (PS) improves high-fat diet-induced non-alcoholic steatohepatitis and inhibits osteoclast differentiation. The pivotal effects of PS on inflammatory mechanism were suppressed NF-κB and matrix metalloproteinase (MMPs). However, the effects of PS on skeletal muscle damage remain unknown. Therefore, we investigated whether PS protects against eccentric exercise-induced muscle damage. A significant reduction in eccentric exercise-induced muscle damage area and muscle damage related to the level of NF-κB p65 by PS was associated with the downregulation of ERK/p38/SMAD signaling. Eccentric exercise caused muscle damage by increasing the serum lactate dehydrogenase (LDH), creatinine kinase (CK) and C-related protein level. The serum LDH, CK and C-related protein level was significantly lower in the PS supplementation group compared with the control group. Moreover, PS was inhibited MMP-1, MMP-2 and MMP-9. PS protects against eccentric exercise-induced muscle damage. Together, these results provide a novel perspective on the biological function of PS against muscle damage.

Sudden bilateral vision loss as the sole manifestation of posterior reversible encephalopathy syndrome from acute uremia: Clinical case report.

RATIONALE: Posterior reversible encephalopathy syndrome (PRES) is a cliniconeuroradiological entity associated with vasogenic edema. Symptoms may include headache, seizures, altered mental status, and visual impairment. Patients with PRES generally present with neurological deficits. PATIENT CONCERNS: Here, we report an unusual case of a 42-year-old man who presented with sudden bilateral vision loss without any other neurologic symptoms. DIAGNOSES: He was diagnosed with PRES secondary to acute uremia. INTERVENTIONS AND OUTCOMES: Our patient experienced a dramatic improvement in visual acuity, blood chemistry values, and magnetic resonance imaging findings following repeated hemodialysis. LESSONS: Sudden bilateral vision loss may be the sole manifestation of PRES, particularly in patient with risk factors for PRES. Awareness of this variation of the clinical symptoms of PRES is important to facilitate its recognition.

Comparison of Nd: YAG capsulotomy rate between 1-piece and 3-piece acrylic intraocular lenses: A STROBE-compliant article.

The aim of the study is to compare Nd:YAG capsulotomy rate between acrylic 1- and 3-piece intraocular lenses. Among 924 eyes of 762 patients who received cataract surgery, we selected the 303 patients (404 eyes) implanted with an SN60WF 1-piece intraocular lens (Alcon, Fort Worth, TX) or a YA-60BBR 3-piece intraocular lens (Hoya Co., Tokyo, Japan). For intraindividual comparison, we enrolled the 17 patients implanted with an SN60WF in 1 eye and a YA-60BBR in the contralateral eye. We compared Nd:YAG capsulotomy rate between acrylic 1- and 3-piece intraocular lenses 24 months after the operation. Of the 404 eyes in this study, Nd:YAG capsulotomy was performed in 20 of 268 eyes (7.5%) in the SN60WF 1-piece intraocular lens group and 24 of 136 eyes (17.6%) in the YA-60BBR 3-piece intraocular lens group; the difference was statistically significant (P = .002). Among the 17 patients (34 eyes) who were implanted with 2 different inraocular lenses, Nd:YAG capsulotomy was performed in only 2 eyes (12%) in the SN60WF group and 9 eyes (53%) in the YA-60BBR group; the difference was statistically significant (P = .020).The authors found a significantly greater incidence of Nd:YAG capsulotomy in eyes who received 3-piece lenses compared with those who received 1-piece lenses.

Late emergence of macular sparing in a stroke patient: Clinical Case Report.

RATIONALE: Occlusive cerebrovascular disease is the most common cause of homonymous hemianopia (HH) with macular sparing. PATIENT CONCERNS: A 61-year-old man came to our ophthalmology clinic complaining of right-side hemianopia. Ophthalmic examination, visual field (VF) examination, and brain magnetic resonance imaging (MRI) were performed. DIAGNOSES: He had right HH without macular sparing on the initial VF test. And brain MRI 6 days after the visual symptoms began revealed a left occipital infarction. INTERVENTIONS AND OUTCOMES: Thirty-seven days after the onset, his follow-up 24-2 VF examination showed HH with bilateral macular sparing, which was not apparent in the initial VF examination. About 4 months after the stroke, his central 10-2 VF examination also showed HH with bilateral macular sparing. LESSONS: We report a case of HH with a dramatic improvement in central vision several days after an occipital infarction. To our knowledge, this is the first case to show macular sparing developing after several days.

Evaluation of socioeconomic status as a risk factor of pterygium using the Korean National Health and Nutrition Examination Survey 2010 to 2011: A STROBE-compliant article.

Pterygium is a common conjunctival disorder. The socioeconomic risk factors of pterygium have not been systematically evaluated in Korea. The study investigated risk factors of pterygium considering socioeconomic status.Participants were 9839 adults aged 19 to 74 years, who underwent ophthalmic slit-lamp examinations as part of the Korean National Health and Nutrition Examination Survey 2010 to 2011. Pterygium was diagnosed as a growth of fibrovascular tissue over the cornea. The socioeconomic risk factors were analyzed in association with the presence of pterygium. Multiple logistic regression analysis was used to evaluate the odds ratios for differences in socioeconomic status.The presence of pterygium was associated with diabetes mellitus, hypertension, metabolic syndrome, and sun exposure time (>5 h/d). The blood level of 25-hydroxyvitamin D was higher in the pterygium group than in the control group, but both groups were deficient in 25-hydroxyvitamin D compared with the normal reference level. Pterygium was almost 3 times as frequent among persons who worked outdoors, such as skilled agricultural, forestry, and fishery workers, than among those who worked indoors (odds ratio 3.061, 95% confidence interval 1.946-4.813). Low educational status and longer working hours were also significantly associated with pterygium.This study used a nationwide population-based survey conducted by the Korean Centers for Disease Control and Prevention to reveal that pterygium is associated with low socioeconomic status. Efforts should be made to reduce the risk of pterygium by changing modifiable risk factors, especially among people with low socioeconomic status.

Saponins from the roots of Platycodon grandiflorum ameliorate high fat diet-induced non-alcoholic steatohepatitis.

Platycodon grandiflorum has been healthy effects due to its various nutritious compounds and is considered as a functional food. Platycodon grandiflorum root-derived saponins (CKS) have been reported to show a variety of effects including anti-inflammatory and anti-oxidative activity. Although CKS have been studied on various bioactivities, the inhibitory effect of CKS on non-alcoholic steatohepatitis (NASH) is not examined. In this study, the inhibitory effects on HFD-induced NASH by CKS were determined. CKS suppressed HFD-induced hepatic lipid peroxidation level, collagen deposition, pro-fibrogenic and pro-inflammatory cytokines expression. CKS treatment suppressed HFD-induced COX-2 expression via inhibition of NF-κB p65 nuclear translocation and IκBα degradation. CKS treatment restored HFD-reduced Nrf2-mediated antioxidant enzymes expression. Furthermore, CKS treatment reinstated HFD-reduced peroxisomal proliferator-activated receptor alpha (PPARα)-regulated acyl-coA oxidase and carnitine-palmitoyl-coA transferase-1 expression. These findings suggest that CKS reduces HFD-induced NASH by up-regulation of Nrf2-mediated anti-oxidant enzymes and PPARα-regulated fatty acid oxidation.

Platycodin D Inhibits Osteoclastogenesis by Repressing the NFATc1 and MAPK Signaling Pathway.

Platycodon grandiflorum root-derived saponins (Changkil saponins, CKS) are reported to have many pharmacological activities. In our latest research, CKS was proven to have a significant osteogenic effect. However, the detail molecular mechanism of CKS on osteoclastic differentiation has not been fully investigated. Administration of CKS considerably reduced OVX-induced bone loss, and ameliorated the reduction in plasma levels of alkaline phosphatase, calcium, and phosphorus observed in OVX mice. CKS also repressed the deterioration of bone trabecular microarchitecture. Interestingly, platycodin D, the most abundant and major pharmacological constituent of triterpenoid CKS, inhibited receptor activator of NF-κB ligand (RANKL)-induced activation of NF-κB, and ERK and p38 MAPK, ultimately repressing osteoclast differentiation. OVX-induced bone turnover was attenuated by CKS, possibly via repression of osteoclast differentiation by platycodin D, the active component of CKS. Platycodin D can be regarded as an antiosteoporotic candidate for treatment of osteoporosis diseases. J. Cell. Biochem. 118: 860-868, 2017. © 2016 Wiley Periodicals, Inc.

A comparison of the Plusoptix S09 with an autorefractometer of noncycloplegics and cycloplegics in children.

The aim of the study is to compare outcome measures of refractive error obtained using the Plusoptix S09 photorefractor and an autorefractometer of noncycloplegics and cycloplegics in children.We reviewed the medical records of 40 patients (77 eyes) who were classified using 2 methods. The patients were first assigned to 2 groups consisting of 11 eyes with ≥+3.0 D and 66 eyes with <+3.0 D, and then to 2 groups of 12 and 65 eyes with cycloplegic and noncycloplegic refraction of spherical powers ≥+2.0 D and <+2.0 D, respectively. We compared the outcome measures of refractive error using the Plusoptix S09 photorefractor and an autorefractometer of noncycloplegics and cycloplegics.There was no statistically significant difference between the Plusoptix S09 photorefractor and cycloplegic autorefractometer in the spherical power and spherical equivalent. In contrast, there was a statistically significant difference between the Plusoptix S09 photorefractor and noncycloplegic autorefractometer (P < 0.001). There was a statistically significant difference between the spherical equivalent of the Plusoptix S09 photorefractor and cycloplegic autorefractometer in children with hyperopia ≥+3.0D and with cycloplegic and noncycloplegic refraction of spherical power ≥+2.0 D. We also found a significant difference between the outcomes of the Plusoptix S09 photorefractor and cycloplegic autorefractometer in the spherical power and spherical equivalent for children with hyperopia ≥+3.0 D.The refractive error of the Plusoptix S09 photorefractor was similar to that of the cycloplegic autorefractometer, in contrast to the noncycloplegic autorefractometer. However, the Plusoptix S09 photorefractor is an inaccurate tool to estimate the refractive errors of children with moderate hyperopia.

Effect of Cataract Opacity Type and Glaucoma Severity on Visual Field Index.

PURPOSE: To determine the effect of cataract opacity type and glaucoma severity on the visual field index (VFI). METHODS: A total of 152 eyes of 152 patients were analyzed. Patients with glaucoma, previous evaluation with the Swedish Interactive Threshold Algorithm-standard 24-2 VFs, visually significant cataracts, and VFs before surgery were included in this study. Cataract opacity was classified as cortical, nuclear sclerotic, or posterior subcapsular. The patients underwent phacoemulsification cataract extraction surgery. A postoperative VF test was done within 10 months of the previous VF. Glaucoma severity was classified by the postoperative mean deviation (MD) value. Changes in MD, pattern standard deviation (PSD), and VFI value before and after surgery were compared according to cataract opacity and glaucoma severity. RESULTS: The mean age at cataract surgery was 72 ± 10 years. The MD, PSD, and VFI values were less influenced by nuclear sclerotic cataract opacity. In patients with early glaucoma (MD > -6), particularly with cortical cataract opacity, MD, PSD, and VFI improved after cataract extraction (p < 0.05). Cataract opacity could make interpreting the VF indices more difficult in patients with early glaucoma. VFI was a reliable index that was less affected by cataract extraction, except in patients with early glaucoma (MD > -6) and cortical cataract opacity. CONCLUSIONS: Existing cataract opacity and the type of cataract opacity may affect the VF test results. Therefore, both glaucoma severity and the type of cataract opacity should be considered when interpreting VF results.

Clinical features of posterior microphthalmos associated with papillomacular fold and high hyperopia.

BACKGROUND: The aim was to evaluate the characteristic clinical features of posterior microphthalmos. METHODS: Medical records of four patients (eight eyes) between the ages of three and 31 years with posterior microphthalmos were reviewed retrospectively. Thorough ocular examinations were performed, including visual acuity, intraocular pressure, ocular alignment, axial length, cycloplegic refraction, slitlamp biomicroscopy of the anterior segment and fundus and spectral-domain optical coherent tomography (SD-OCT). RESULTS: All subjects had presented with high hyperopia (+11.0 to +15.75 D) and retinal papillomacular folds in both eyes. They also had reduced bilateral axial length (15.55-18.61 mm), with foreshortening of the posterior segment and a relatively normal anterior segment. Papillomacular retinal folds involving the inner retinal layers and sparing the outer retinal layers, along with the absence of foveal depression, were confirmed by macular SD-OCT. In three patients, we found esodeviations associated with posterior microphthalmos and one of these required strabismic surgery. Concomitant optic nerve hypoplasia and a newly-developed neurosensory retinal detachment were found in one patient. CONCLUSION: Posterior microphthalmos is a developmental arrest of ocular growth. In addition to high hyperopia and retinal papillomacular folds, various types of esotropia, optic disc hypoplasia and neurosensory retinal detachment may accompany posterior microphthalmos. In particular, children with posterior microphthalmos require early appropriate management of the high refractive error and resultant esotropia.

Comparison of Postoperative Exodrift after First Unilateral and Second Contralateral Lateral Rectus Recession in Recurrent Exotropia.

PURPOSE: To compare postoperative exodrift of the first unilateral lateral rectus (ULR) muscle recession with the exodrift of the second contralateral ULR muscle recession in patients with recurrent small-angle exotropia (XT). METHODS: We evaluated the results of a second ULR muscle recession in 19 patients with recurrent XT with deviation angles under 25 prism diopter (PD), following a first procedure of ULR muscle recession for small-angle XT. Recession of the lateral rectus muscle ranged from 8 to 9 mm. The postoperative motor alignment and degree of exodrift were investigated after the first ULR muscle recession and the second ULR muscle recession in the same patients. RESULTS: Observed differences in postoperative ocular alignment between the first ULR muscle recession and the second ULR muscle recession were statistically significant at follow-up periods of six months (7.84 ± 4.43 vs. 3.89 ± 3.47 PD), one year (9.58 ± 4.97 vs. 5.21 ± 4.94 PD), and at a final follow-up (21.11 ± 2.98 vs. 7.52 ± 4.06 PD) after surgery (p = 0.006, 0.013, and 0.000). Postoperative exodrift was statistically different between the first and second ULR muscle recessions at three to six months (2.89 ±3.75 vs. 0.63 ± 3.45 PD) and one year to final follow-up (11.52 ± 5.50 vs. 2.32 ± 3.53 PD) (p = 0.034 and 0.000). All of the first ULR muscle recession patients showed XT with deviation angles of more than 15 PD at the final follow-up. Regardless, the surgical success rate (<8 PD) after the second ULR recession was 63.16% (12 patients) among the total amount of patients with recurrent XT. CONCLUSIONS: This study shows that changes in exodrift after a second ULR muscle recession are less than changes after the first URL muscle recession among patients with recurrent XT. A second ULR muscle recession may be a useful surgery for small-angle XT patients with deviation angles of 25 PD or less after a first ULR muscle recession.

Retinopathy of prematurity in Korean infants with birthweight greater than 1500†g.

OBJECTIVE: To determine the incidence and clinical features of, and risk factors for, retinopathy of prematurity (ROP) in Korean infants with birthweight (BW) >1500 g. METHODS: A total of 201 consecutive infants with BW >1500 g from January 2009 to December 2013 were included. The location and maximal stage of retinopathy observed were recorded for each infant. The associated systemic and maternal risk factors in infants with mild or absent ROP were compared with those in infants with treatment-requiring ROP. RESULTS: The total incidence of ROP was 11.94% and that of treatment-requiring ROP was 3.98%. Two patients with gestational age (GA) >32 weeks and BW >1500 g had treatment-requiring ROP. 15 eyes from eight infants with type I ROP required laser photocoagulation. The mean BWs and GAs in the treatment-requiring ROP group were significantly lower than those in the no or mild ROP group. Total duration of oxygen supplementation, surfactant usage, respiratory distress syndrome, bronchopulmonary dysplasia, antibiotic use for more than 14 days and the number of ROP-associated risk factors significantly increased the likelihood of treatment-requiring ROP (p=0.002, p=0.008, p=0.008, p=0.000, p=0.015, and p=0.004, respectively). CONCLUSION: Our study confirmed that treatment-requiring ROP does occur in infants with BW >1500 g. To avoid overlooking infants with vision-threatening ROP, an evaluation of the data from larger BW preterm infants is advisable so that screening guidelines in neonatal care units may be refined.