Short-term Efficacy and Safety of Intravitreal Brolucizumab Injection for Treatment-Naive Exudate Age-related Macular Degeneration: A Multicenter Study.

PURPOSE: To compare short-term efficacy and safety of intravitreal brolucizumab injection with aflibercept in treatment-naive neovascular age-related macular degeneration (nAMD) patients. METHODS: A total of 59 eyes from 59 treatment-naive nAMD patients in three hospitals were retrospectively reviewed. Of which, 27 patients underwent intravitreal brolucizumab injections and 32 received aflibercept. After monthly consecutive three injections, best-corrected visual acuity (BCVA; in logarithm of minimal angle of resolution [logMAR]), central macular thickness (CMT), dry macula achievement rate, and intraocular inflammation (IOI) incidence were compared. RESULTS: After loading-phase treatment, BCVA was significantly increased from 0.48 ± 0.30 logMAR at baseline to 0.33 ± 0.21 logMAR at 3 months in the brolucizumab group (p = 0.002) and 0.40 ± 0.39 logMAR at baseline to 0.33 ± 0.36 logMAR at 3 months in the aflibercept group (p = 0.007). But there was no significant difference in BCVA improvement at 3 months between the two groups. CMT significantly decreased from 429.67 ± 250.59 µm at baseline to 210.67 ± 93.53 µm at 3 months in the brolucizumab group and from 346.69 ± 159.09 µm to 234.52 ± 83.42 µm in the aflibercept group (both p < 0.001). The amount of CMT reduction was significantly greater in the brolucizumab group after 3 months (p = 0.036). In typical AMD eyes, brolucizumab showed similar BCVA improvement but better CMT reduction at 3 months (p = 0.018). Dry macula achievement rate was not significantly different between the two groups. One IOI was observed in the brolucizumab group. CONCLUSIONS: Intravitreal injections of brolucizumab and aflibercept showed similar anatomical and functional outcomes. But CMT reduction was greater in the brolucizumab group. One IOI was identified, which was tolerable for topical agents. These results suggest that brolucizumab could be a novel first line treatment option for treating naive nAMD patients.

Refractory Dry Eye Syndrome after Transconjunctival Excision of the Palpebral Lobe of the Lacrimal Gland.

The aim of the present study was to report two cases of refractory dry eye syndrome (DES) after transconjunctival excision of the palpebral lobe of the lacrimal gland. A 25-year-old female patient with a chief complaint of a palpable mass in both upper eyelids visited our medical center. Preoperative orbital computer tomography showed high-attenuation lesions in both lacrimal glands. Incisional biopsy of the lacrimal gland palpebral lobe via transconjunctival incision was performed in January 2019. At 1 month after the biopsy, a lack of tears and persistent corneal erosions were found in both eyes. Artificial tears, punctal occlusion, autologous serum eye drops, and therapeutic contact lenses were applied in an attempt to control the dry eye symptoms. The patient continues to suffer from intractable DES at 2.5 years after the procedure. The second case involved a 52-year-old female patient who visited our medical center with a chief complaint of a palpable mass in both upper eyelids. Bilateral orbital tumors were diagnosed with preoperative magnetic resonance imaging. An incisional biopsy of the lacrimal gland was performed. Immunoglobulin G4-related dacryoadenitis was confirmed through lacrimal palpebral lobe incisional biopsy. Intractable DES and corneal erosion of her left eye persisted thereafter. A transconjunctival incision is an effective approach for minimizing postoperative scars and is suitable for the biopsy of tumors that are visible through the conjunctiva. After a biopsy of the palpebral lobe of the main lacrimal glands, the secretion of reflex tears decreases due to damage to the secreting ducts of the main lacrimal glands. However, total tear secretion can be maintained by basal tear secretion from the accessory lacrimal glands. In this report, we describe two cases of refractory DES due to decreased total tear secretion, although only the palpebral lobes of the main lacrimal glands were biopsied.

Combined Vitrectomy With Macular Buckling In High Myopic Eyes With Macular Hole Retinal Detachment: A Pilot Study Of A Novel Snail-Tipped Exoplant.

PURPOSE: To evaluate the efficacy of a novel snail-tipped exoplant for macular buckling combined with vitrectomy in high myopic eyes with macular hole retinal detachment. PATIENT AND METHODS: A novel exoplant was simply prepared with a 5 × 3 mm silicone sponge strengthened in the center with a malleable titanium plate. One end was bent to make a rolled tip like a snail shell to be placed under the macula. Combined vitrectomy with macular buckling using this exoplant was performed in eight consecutive cases. The long arm of the exoplant was manipulated manually to fit the curvature of the eyeball and the length was trimmed appropriately after scleral suturing of the exoplant. RESULTS: Retinal reattachment was achieved in all cases (100%) and macular hole closure was confirmed in 6 eyes (75%). The mean best-corrected visual acuity improved from 1.53 ± 0.73 LogMAR preoperatively to 1.14 ± 0.59 LogMAR to postoperatively (p = 0.063). The mean pre- and postoperative AL was 28.44 ± 1.86 mm and 27.60 ± 1.83 mm, respectively (p = 0.016). The mean follow-up period was 15.4 months and no buckle-related complications such as diplopia, infection or exposure of the exoplant were noticed during the period. CONCLUSION: This exoplant could easily be prepared with readily available materials in the operating room and it was well tolerated with favorable anatomic results in high myopic eyes. Further studies of increased number of patients with long-term follow-up will be necessary.

Ultra-wide-field angiography findings in acute Vogt-Koyanagi-Harada disease.

BACKGROUND/AIMS: To investigate the prevalence of abnormal central and peripheral ultra-wide-field (UWF) angiography findings, and their association with clinical features in acute Vogt-Koyanagi-Harada (VKH) disease. METHODS: This retrospective, observational study included 26 eyes of 13 treatment-naïve patients with acute VKH disease who underwent UWF fluorescein angiography (FA). Sixteen eyes of eight patients also underwent UWF indocyanine green angiography (ICGA). A circle simulating the central 75° field was used to divide the acquired image into the central fundus area (CFA) and peripheral fundus area (PFA), in which the presence of six previously reported abnormal angiographic findings were analysed. Correlations between abnormal angiography findings in FA and clinical features were also investigated. RESULTS: All eyes demonstrated more than one abnormal angiographic finding in both the CFA and PFA. UWF FA revealed three abnormal findings in the CFA versus the PFA: focal leakage (92.3% vs 76.9%); pooling with a dark rim (84.6% vs 53.8%); and retinal vascular leakage (0% vs 46.2%). UWF ICGA revealed three abnormal findings in the CFA versus the PFA: hypofluorescent dark dots (100% vs 100%); diffusely leaking fuzzy choroidal vessels (93.8% vs 75.0%); and late hypofluorescent patches (81.3% vs 31.3%). Pooling with a dark rim and retinal vascular leakage in the PFA were significantly associated with low initial visual acuity (p=0.03) and subfoveal choroidal thickness change ratio (p=0.04), respectively. CONCLUSION: Abnormal UWF angiography findings were frequently detected in the CFA and PFA. Such findings may be useful in evaluation and monitoring of VKH disease.

FACTORS ASSOCIATED WITH VISUAL OUTCOME AFTER MACULA-OFF RHEGMATOGENOUS RETINAL DETACHMENT SURGERY.

PURPOSE: To evaluate preoperative factors influencing the visual outcome and postoperative factors associated with the changes in visual acuity, after reattachment surgery to treat macula-off rhegmatogenous retinal detachment. METHODS: A total of 180 eyes of 180 patients who underwent reattachment surgery to treat macula-off rhegmatogenous retinal detachment, and who were followed up for more than 12 months, were reviewed retrospectively. Preoperative and postoperative characteristics, including optical coherence tomography findings, were comprehensively analyzed using univariate and multivariate models to evaluate preoperative factors influencing best-corrected visual acuity 12 months after macula-off rhegmatogenous retinal detachment surgery and postoperative factors associated with changes in best-corrected visual acuity after surgery. RESULTS: Preoperatively, the extent of detachment (P = 0.037), macula-off duration (P < 0.001), and integrity of the external limiting membrane (ß = 0.163; P = 0.002) were significantly associated with postoperative visual prognosis. Six factors were associated with changes in visual acuity after surgery: disruption of ellipsoid zone integrity (ß = 0.167; P < 0.001), the Henle's fiber layer and the outer nuclear layer (HFL + ONL)/photoreceptor layer ratio (ß = 0.199; P < 0.001), the photoreceptor outer segment length (ß = -0.020; P < 0.001), the photoreceptor inner segment length/photoreceptor outer segment length ratio (ß = 0.047; P = 0.005), the ratio of photoreceptor layer thickness between the RD eye and fellow eye (ß = -0.126; P = 0.018), and the photoreceptor outer segment length ratio between the RD eye and fellow eye (ß = -0.425; P < 0.001). CONCLUSION: Preoperative factors associated with the visual outcome after macula-off rhegmatogenous retinal detachment surgery were the extent of detachment, macula-off duration, and external limiting membrane integrity. Postoperatively, predictive factors were the outer retinal microstructures, particularly the photoreceptor outer segment layer.

A comparison of responses to intravitreal bevacizumab, ranibizumab, or aflibercept injections for neovascular age-related macular degeneration.

PURPOSE: To compare the responses of intravitreal injections of bevacizumab, ranibizumab, or aflibercept for the treatment of neovascular age-related macular degeneration (nAMD). METHODS: This retrospective study examined 232 eyes of 232 patients who received intravitreal anti-vascular endothelial growth factor (VEGF) injections due to treatment-naïve nAMD. All patients, who were followed-up for at least 1 year, were treated with intravitreal injections monthly until 3 months, and then as needed. We evaluated the effects of intravitreal injections for treatment of nAMD using the central macular thickness (CMT), subretinal fluid (SRF), pigment epithelial detachment (PED) size, and best-corrected visual acuity (BCVA). RESULTS: CMT, SRF, PED size, and BCVA (LogMAR) were significantly decreased after treatment with all three anti-VEGF agents. Overall, the bevacizumab, ranibizumab, and aflibercept treatments showed no significant differences in their responses. However, the aflibercept injections decreased PED size more quickly than bevacizumab injections (P = 0.034). CONCLUSIONS: Bevacizumab, ranibizumab, and aflibercept injections are effective treatments for nAMD and have similar responses, although the number of injections of aflibercept was fewer than other anti-VEGF agents. In addition, aflibercept injections may be a better choice than other anti-VEGF agents for cases of severe increases in PED height.

Bariatric surgery is associated with less progression of diabetic retinopathy: A systematic review and meta-analysis.

BACKGROUND: The impact of bariatric surgery on diabetic retinopathy (DR) remains underexplored, and conflicting results have been reported. OBJECTIVE: To clarify the impact of bariatric surgery on DR. SETTING: A systematic review and meta-analysis. University Hospital, Korea. METHODS: A comprehensive database search was performed across PubMed, Embase, Web of Science, and the Cochrane Library from inception to August 2016. Eligible studies included retrospective or prospective studies reporting changes in DR severity as primary or secondary outcomes after bariatric surgery. A random-effects model was used to calculate pooled odds ratios (ORs) and 95% confidence intervals (CIs) for progression of DR. RESULTS: Twelve studies composed of 876 patients who underwent bariatric surgery were selected for this systematic review. The pooled ORs showed less DR progression in patients with bariatric surgery than in those with medical treatment alone (OR, .47; 95% CI, .22-.99). The postoperative progression odds were not significantly different between patients with and without DR at baseline (OR, 1.04; 95% CI, .35-3.11). Another meta-analysis investigating the effects of surgery depending on pre-existing sight-threatening DR showed no significant difference (OR, 1.88; 95% CI, .29-12.25) with borderline heterogeneity (I2 = 48%). Remission of diabetes could not prevent the development or progression of DR after surgery. CONCLUSIONS: Bariatric surgery has beneficial effects on DR progression compared with medical treatment alone, but there is currently insufficient evidence to assess the effects on DR regression. The progression odds were not significantly different between patients with and without DR preoperatively.

The effect of dexmedetomidine sedation on patient and surgeon satisfaction during retinal surgery under sub-tenon's anesthesia: a randomized controlled trial.

BACKGROUND: The purpose of this study was to evaluate the effect of intraoperative dexmedetomidine sedation on patient's and surgeon's satisfaction during retinal surgery under sub-tenon's anesthesia. METHODS: Forty-four patients scheduled for elective retinal surgery under sub-tenon's anesthesia were enrolled in this randomized controlled trial. The patients were divided into Dexmedetomidine (n = 22) and Control (n = 22) groups. Intravenous dexmedetomidine or 0.9% saline via infusion pump were administered continuously to the dexmedetomidine or control group, respectively. Ramsay sedation scale with a target level of 3-4 was used to assess adequacy of sedation. Perioperative pain, hemodynamic and respiratory data were collected, while satisfaction from patients and surgeon were assessed post-surgery using a 5-point satisfaction scale. RESULTS: Patient and surgeon satisfaction was higher in the dexmedetomidine group (P < 0.001, P = 0.002, respectively). The pain associated with sub-tenon's anesthesia and peripheral vitrectomy was lesser in the dexmedetomidine group than in the control group (P = 0.020). There was significant reduction of heart rate in the dexmedetomidine group (P = 0.001), but only one patient needed treatment with atropine. There was no respiratory effect on both groups. CONCLUSIONS: Dexmedetomidine sedation during retinal surgery improved satisfaction from both patient and surgeon without respiratory complication. It is a safe and preferable choice of sedation for retinal surgery.

Ocular Manifestations of Acquired Immunodeficiency Syndrome.

PURPOSE: To investigate the patterns and risk factors of the ocular manifestations of acquired immunodeficiency syndrome (AIDS) and their correlation with CD4+ count in the era of highly active antiretroviral therapy (HAART). METHODS: This retrospective study examined 127 AIDS patients who presented to Soonchunhyang University Hospital. Data were collected from patient interviews, clinical examinations, and laboratory investigations. Ophthalmologic examinations included the best-corrected visual acuity, intraocular pressure, anterior segment and adnexal examination, and dilated fundus examination. RESULTS: Of the 127 patients with AIDS, 118 were on HAART and 9 were not. The mean CD4+ count was 266.7 ± 209.1 cells/µL. There were ocular manifestations in 61 patients (48.0%). The incidence of anterior segment manifestations was higher than posterior segment manifestations at 28.3% and 19.7%, respectively. The mean CD4+ count was significantly (p < 0.05) lower in the patients with posterior versus anterior segment ocular manifestations. The most common ocular manifestation was retinal microvasculopathy (15.0%), followed by keratoconjunctivitis sicca (14.2%), conjunctival microvasculopathy (9.4%), cytomegalovirus retinitis (3.1%), herpes zoster ophthalmicus (2.4%), and blepharitis (1.6%). Retinal microvasculopathy and cytomegalovirus retinitis were common in patients with CD4+ counts <200 cells/µL, while keratoconjunctivitis sicca and conjunctival microvasculopathy were common in patients with CD4+ counts of 200 to 499 cells/µL. There was a significant (p < 0.05) association between ocular manifestation and CD4+ count or age. CONCLUSIONS: The introduction of HAART has changed the landscape of ocular presentations in patients with AIDS. In this study, anterior segment and external ocular manifestations occurred more frequently than posterior segment manifestations. Also, the mean CD4+ count was significantly lower in patients with posterior segment ocular manifestations versus anterior segment ocular manifestations. We found that CD4+ count and age >35 years were independent risk factors for developing ocular manifestations.

Adjunctive effect of intravitreal bevacizumab prior to lens-sparing vitrectomy in aggressive posterior retinopathy of prematurity: a case report.

BACKGROUND: Intravitreal injection of bevacizumab in retinopathy of prematurity has shown satisfactory results without any systemic complications. However, increased fibrosis and tissue contraction are reported as adverse effects in some cases. CASE: A premature girl, born at 29 weeks + 4 days of gestation, had bilateral aggressive posterior retinopathy of prematurity (APROP) on her first screening at 3 weeks of age. She received extensive, near confluent, laser ablation of the avascular retina and off-label intravitreal bevacizumab (0.75 mg) injection OU. The right eye showed a slight regression, but a localized tractional membrane was noted OS. After another intravitreal bevacizumab injection in each eye, the left eye underwent lens-sparing vitrectomy (LSV) because of contraction of the proliferative membrane leading to a dome-shaped tractional retinal detachment (TRD). OBSERVATIONS: At 6-week follow-up, the left eye showed complete retinal reattachment. Both eyes showed prompt resolution of vascular engorgement with anterior progression of the peripheral retinal vasculature. CONCLUSIONS: Intravitreal bevacizumab is safe and effective as a treatment of APROP. In some cases tissue contraction may occur, but because TRD is localized to the posterior pole, effective LSV can be performed.

Improving intraocular lens power prediction in combined phacoemulsification and vitrectomy in eyes with macular oedema.

PURPOSE: To report the accuracy of intraocular lens (IOL) power estimation in eyes that have undergone phacovitrectomy for retinal diseases with accompanying macular oedema. METHODS: A retrospective study was conducted in 23 eyes of 23 patients at Soonchunhyang University Hospital, Seoul, Korea. The relationship between preoperative planned refraction and postoperative achieved refraction was evaluated by simple linear regression analysis. Pre- and postoperative macular thicknesses were measured using optical coherence tomography (OCT). The estimated IOL power of the ultrasound axial length (AL) and the adjusted AL (increased amount of macular thickness added to ultrasound AL) were compared using a paired t-test. RESULTS: The pre- and postoperative refractions were -0.28 ± 0.14 dioptres (D) and -0.74 ± 0.48 D, respectively (P = 0.000). The postoperative refraction showed better correlation with the target refraction of the implanted IOL calculated with the adjusted AL (R = 0.608, P = 0.002) compared with the original planned refraction (R = 0.142, P = 0.518). The IOL power calculated with the adjusted AL was 0.59 ± 0.56 D less than the original IOL power (P = 0.000). CONCLUSION: Postoperative myopic shift can be corrected by adding the amount of macular thickness measured on OCT to the ultrasound AL, or by simply implanting an IOL 0.50 D less than the IOL targeted for emmetropia.

Surface calcification of hydrophilic acrylic intraocular lens related to inflammatory membrane formation after combined vitrectomy and cataract surgery.

UNLABELLED: Two patients complained of blurred vision approximately 6 months after having combined vitrectomy and phacoemulsification with implantation of a C-flex 570C hydrophilic acrylic intraocular lens (IOL). Multiple granules were noted on the anterior surface of the IOLs in both patients. Intraocular lens exchange was performed in both eyes, and the explanted IOLs were sent for histopathological analysis. Scanning electron microscopy confirmed the presence of cracks and granules on the IOL surfaces and energy-dispersive x-ray spectroscopy demonstrated calcium deposition. Based on the calcification pattern on the anterior surface of the IOLs, 2 additional cases of opacification were identified under slitlamp examination. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.

Transscleral fixation by injector implantation of a foldable intraocular lens.

Scleral fixation of a foldable intraocular lens (IOL) was performed in 17 eyes of 17 patients using a new small incision technique with injector implantation. All eyes were implanted with a hydrophobic acrylic three-piece IOL, either with phacoemulsification surgery or secondarily. No cases of intraoperative or postoperative complications were observed. The operation time required for scleral fixation only was less than 30 minutes in all cases. Scleral fixation of foldable IOLs using a self-sealing tunnel incision and injector technique minimizes intraoperative hypotony and related complications such as suprachoroidal hemorrhage. Furthermore, this technique saves surgery time and the sutureless technique used for most patients can reduce postoperative astigmatism.

Anterior segment measurements using Pentacam and Orbscan II 1 to 5 years after refractive surgery.

PURPOSE: To compare anterior segment measurements between Pentacam and Orbscan II after laser surface ablation. METHODS: Corneal thickness, anterior elevation, posterior elevation, and anterior chamber depth more than 1 year after laser refractive surgery were measured using Pentacam and Orbscan II in 51 eyes that underwent laser epithelial keratomileusis (LASEK) and 21 eyes that underwent photorefractive keratectomy (PRK). As controls, the same comparisons were made in 52 unoperated eyes. RESULTS: Mean follow-up was 28.2 months in the LASEK group and 49.9 months in the PRK group. Mean corneal thickness using Pentacam was thicker than that using Orbscan by 10.4 microm in unoperated eyes, 22.6 microm in LASEK eyes, and 11.0 microm in PRK eyes, but the two devices showed good correlation in all groups. Mean anterior elevation was highly correlated between the two devices with 2.1-microm differences in LASEK eyes, but posterior elevation showed no correlation with significant discrepancies. Mean anterior chamber depth was 0.12-to 0.14-microm thicker with Pentacam than with Orbscan, and highly correlated in all groups. CONCLUSIONS: Pentacam and Orbscan showed good correlations in corneal thickness, anterior elevation, and anterior chamber depth despite some differences in mean values. The two devices, however, showed no correlation in posterior elevation measurements, a difference that was greater in the postoperative groups.

Stability of the posterior corneal surface after laser surface ablation for myopia.

PURPOSE: The purpose of this study was to evaluate changes in the posterior corneal surface before and after laser surface ablation using the Pentacam. METHODS: Thirty consecutive myopic eyes having laser surface ablation (14 photorefractive keratectomies, 16 laser-assisted subepithelial keratectomies) were evaluated preoperatively and postoperatively with the Pentacam. Changes in the posterior corneal curvature, posterior elevation, and anterior chamber depth were measured. RESULTS: The 30 eyes had a mean correction of -4.50 D (range, -2.12 to -8.0) and a mean ablation depth of 58.4 microm (range, 21-106 microm). The change in mean posterior corneal curvature was -0.02 +/- 0.07 mm in the central 4-mm zone (P = 0.106) and the mean posterior displacement was 0.47 +/- 4.23 microm (P = 0.551). The mean change in the anterior chamber depth was -0.06 +/- 0.08 mm (P < 0.001). The amount of forward shift of the posterior corneal surface had no correlation with the residual corneal thickness and ablation depth. CONCLUSIONS: There was no significant change in the posterior corneal surface after laser surface ablation.

Intraocular lens exchange with removal of the optic only.

PURPOSE: To evaluate the clinical outcomes of intraocular lens (IOL) exchange in patients with an opacified ACRL-C160 intraocular lens (IOL) using an optic-only removal technique. SETTING: Department of Ophthalmology, Soonchunhyang University Hospital, Seoul, Korea. METHODS: The study comprised eyes with previous phacoemulsification and implantation of a single-piece hydrophilic acrylic IOL in the capsular bag and subsequent development of severe late opacification of the IOL. In all eyes, the IOL optic was explanted; any haptic with firm adhesions was left in the capsular bag. This was followed by placement of a new IOL. The perioperative complications were evaluated, and the best corrected visual acuity (BCVA) before surgery and after surgery was compared. RESULTS: Twenty-three eyes of 20 patients were evaluated. Uneventful IOL exchange and placement of a new IOL in the bag was achieved in 9 eyes (39.1%) and in the sulcus in 13 eyes (56.5%), with posterior capsule rupture in 2 eyes (8.7%). One eye (4.3%) developed zonular dehiscence, and scleral IOL fixation was performed. The mean BCVA was 0.64 +/- 0.35 logMAR before IOL exchange and 0.24 +/- 0.20 logMAR after IOL exchange. During 41 months of follow-up, 1 eye (4.3%) each was affected by recurrent anterior uveitis and delayed zonular dehiscence. The final mean BCVA was 0.38 +/- 0.40 logMAR. There was no corneal decompensation or infectious keratitis. CONCLUSION: The optic-only removal technique was a safe and helpful procedure that allowed recovery of visual acuity because it decreased the intraoperative complication of zonular dehiscence.

Sudden unilateral visual loss after autologous fat injection into the nasolabial fold.

A 27-year-old female presented with sudden visual loss of her right eye after receiving an autologous fat injection into the right nasolabial fold. Fundus examination of the right eye showed multiple whitish patchy lesions with macular edema. Fluorescein angiogram showed deterioration of choroidal circulation with patchy choroidal filling and arm-to-retina circulation time and retinal arteriovenous passage time were delayed to 30 seconds and 20 seconds, respectively. There was no response in flash visual evoked potential (VEP). High dose steroid therapy (methylprednisolone 1 g/day/i.v.) was done and about 2 weeks later, the disc edema subsided and retinal arteriovenous passage time of fluorescein angiogram was normalized but there was no improvement in visual acuity. Absence of a cherry red spot, deterioration of choroidal circulation with patchy choroidal fillings seen in fluorescein angiogram, and no response in flash VEP suggests multiple choroidal infarction due to perfusion defect of the short posterior ciliary artery. The autologous fat injected is thought to have entered the dorsal nasal artery and the retrograde migration of the emboli to the ophthalmic artery might have caused the multiple occlusions of the short posterior ciliary artery.

Effects of Structural and Functional Characteristics of Social Network on Social Adjustment in People With Mental Illness / 신경정신의학

OBJECTIVES: The purpose of this study was to investigate effects of structural and functional characteristics of social network on social adjustment in people with mental illness. METHODS: 236 members of the people with mental illness who were enrolled in day hospital, community mental health center and social rehabilitation center participated in the survey. RESULTS: Of structural and functional characteristics of social network, the influenced factors on social adjustment were network size of professional, social support (family, friend and professional) and conflict with professional. When controlling socio-demographic and disorder characteristics, this regression model affected significantly on social adjustment but the power of influence reduced slightly. CONCLUSION: In order to improve the social adjustment of people with mental illness, it is necessary for social network to provide them with more emotional and social resources. Especially, it is important for mental health professionals to build active partnership with the people with mental illness as consumer. For people with mental illness, the economic stability through guaranteed income such as disability benefits, and occupational rehabilitation is very important.