Pub Date : 2023-06-15DOI: 10.3341/jkos.2023.64.6.550
J. Mun, Hyeon Gyu Choi, Kyoung Lae Kim, Y. Choi
Purpose: We report a case of neuroretinitis combined with external ophthalmoplegia in a patient who developed a cerebral venous sinus thrombosis after administration of a SARS-CoV-2 vaccine.Case summary: A 26-year-old woman who was on oral contraceptives was diagnosed with a cerebral venous sinus thrombosis 1 month after the first injection of a SARS-CoV-2 vaccine (BNT162b2, Pfizer-BioNTech). The levels of factors 8 and 9 were elevated on the blood test. The corrected visual acuities were 0.3 in both eyes. A complete limitation of abduction and esotropia were evident in the left eye. Both eyes exhibited optic disc swelling and hemorrhage and retinal nerve fiber layer swelling. Subretinal fluid was apparent in the right eye. Three weeks later, the optic disc swellings and hemorrhages had worsened and both eyes evidenced macular stars. After 10 months, the corrected visual acuities improved to 0.9 in both eyes. Ocular motor function and the esotropia also improved. However, the overall contraction of the visual field did not.Conclusions: SARS-CoV-2 vaccination can trigger cerebral venous sinus thrombosis, neuroretinitis, and external ophthalmoplegia. In patients with risk factors for such thrombosis, the possibility of ophthalmic complications should be considered after administration of a SARS-CoV-2 vaccine.
{"title":"Ocular Manifestations Associated with Cerebral Vein Sinus Thrombosis Developing after SARS-CoV-2 Vaccination","authors":"J. Mun, Hyeon Gyu Choi, Kyoung Lae Kim, Y. Choi","doi":"10.3341/jkos.2023.64.6.550","DOIUrl":"https://doi.org/10.3341/jkos.2023.64.6.550","url":null,"abstract":"Purpose: We report a case of neuroretinitis combined with external ophthalmoplegia in a patient who developed a cerebral venous sinus thrombosis after administration of a SARS-CoV-2 vaccine.Case summary: A 26-year-old woman who was on oral contraceptives was diagnosed with a cerebral venous sinus thrombosis 1 month after the first injection of a SARS-CoV-2 vaccine (BNT162b2, Pfizer-BioNTech). The levels of factors 8 and 9 were elevated on the blood test. The corrected visual acuities were 0.3 in both eyes. A complete limitation of abduction and esotropia were evident in the left eye. Both eyes exhibited optic disc swelling and hemorrhage and retinal nerve fiber layer swelling. Subretinal fluid was apparent in the right eye. Three weeks later, the optic disc swellings and hemorrhages had worsened and both eyes evidenced macular stars. After 10 months, the corrected visual acuities improved to 0.9 in both eyes. Ocular motor function and the esotropia also improved. However, the overall contraction of the visual field did not.Conclusions: SARS-CoV-2 vaccination can trigger cerebral venous sinus thrombosis, neuroretinitis, and external ophthalmoplegia. In patients with risk factors for such thrombosis, the possibility of ophthalmic complications should be considered after administration of a SARS-CoV-2 vaccine.","PeriodicalId":17341,"journal":{"name":"Journal of The Korean Ophthalmological Society","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42401685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-15DOI: 10.3341/jkos.2023.64.6.459
Sujin Yeo, K. Woo, Yoon-Duck Kim
Purpose: To report the efficacy of frontalis suspension using a silicone rod or preserved fascia lata for patients with blepharospasm who exhibit persistent symptoms and visual dysfunction unresponsive to botulinum injections.Methods: The clinical records of five patients (10 eyes) with essential blepharospasm who underwent frontalis suspension were reviewed. Patients who continued to report eyelid-opening difficulties despite prior administration of botulinum toxin were included.Results: The mean patient age was 60.2 years; and 40% of the patients were women. The frontalis was suspended using silicone rods (n = 3) or preserved fascia lata (n = 2). Blepharospasm frequency and severity were measured using the Jankovic Rating Scale (JRS). Compared with preoperative scores, the summed JRS scores decreased 1 week, 1 month, and 3 months after surgery. Postoperatively, two patients (40%) did not require further botulinum toxin injections. In three patients, the intervals between injections were increased after surgery. No patient experienced any significant complication.Conclusions: Frontalis suspension is safe and effective for patients with blepharospasm and apraxia of eyelid opening, who have not responded to botulinum toxin injections.
{"title":"Frontalis Suspension Surgery for Patients with Essential Blepharospasm Unresponsive to Botulinum Toxin Injections","authors":"Sujin Yeo, K. Woo, Yoon-Duck Kim","doi":"10.3341/jkos.2023.64.6.459","DOIUrl":"https://doi.org/10.3341/jkos.2023.64.6.459","url":null,"abstract":"Purpose: To report the efficacy of frontalis suspension using a silicone rod or preserved fascia lata for patients with blepharospasm who exhibit persistent symptoms and visual dysfunction unresponsive to botulinum injections.Methods: The clinical records of five patients (10 eyes) with essential blepharospasm who underwent frontalis suspension were reviewed. Patients who continued to report eyelid-opening difficulties despite prior administration of botulinum toxin were included.Results: The mean patient age was 60.2 years; and 40% of the patients were women. The frontalis was suspended using silicone rods (n = 3) or preserved fascia lata (n = 2). Blepharospasm frequency and severity were measured using the Jankovic Rating Scale (JRS). Compared with preoperative scores, the summed JRS scores decreased 1 week, 1 month, and 3 months after surgery. Postoperatively, two patients (40%) did not require further botulinum toxin injections. In three patients, the intervals between injections were increased after surgery. No patient experienced any significant complication.Conclusions: Frontalis suspension is safe and effective for patients with blepharospasm and apraxia of eyelid opening, who have not responded to botulinum toxin injections.","PeriodicalId":17341,"journal":{"name":"Journal of The Korean Ophthalmological Society","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44880807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-15DOI: 10.3341/jkos.2023.64.6.466
S. Choi, Jae Won Choi, W. Park
Purpose: We compared the clinical utilities of an amniotic contact lens and temporary amniotic membrane transplantation in patients with persistent corneal epithelial defects.Methods: Patients diagnosed with persistent corneal epithelial defects from November 2019 to July 2022 were randomly assigned to either lens placement for 2 weeks or temporary transplantation for 1 week, and the outcomes were retrospectively analyzed. The best-corrected visual acuity, corneal sensation, tear film break-up time, and corneal opacity were measured before and after the interventions. The treatment success rates, recurrences, and other complications were analyzed during the follow-up period.Results: We placed lenses in 32 patients (32 eyes) and 20 patients (20 eyes) underwent transplantation. In both groups, significant differences in best-corrected visual acuity, corneal sensation, tear film break-up time, and corneal opacity were apparent after intervention vs. before. None of the parameters showed any significant differences in terms of their rates of change.Conclusions: In patients with persistent corneal epithelial defects, amniotic contact lens placement is an effective outpatient procedure and is not inferior to temporary amniotic membrane transplantation.
{"title":"Comparison between Placement of an Amniotic Membrane Contact Lens and Temporary Amniotic Membrane Transplantation","authors":"S. Choi, Jae Won Choi, W. Park","doi":"10.3341/jkos.2023.64.6.466","DOIUrl":"https://doi.org/10.3341/jkos.2023.64.6.466","url":null,"abstract":"Purpose: We compared the clinical utilities of an amniotic contact lens and temporary amniotic membrane transplantation in patients with persistent corneal epithelial defects.Methods: Patients diagnosed with persistent corneal epithelial defects from November 2019 to July 2022 were randomly assigned to either lens placement for 2 weeks or temporary transplantation for 1 week, and the outcomes were retrospectively analyzed. The best-corrected visual acuity, corneal sensation, tear film break-up time, and corneal opacity were measured before and after the interventions. The treatment success rates, recurrences, and other complications were analyzed during the follow-up period.Results: We placed lenses in 32 patients (32 eyes) and 20 patients (20 eyes) underwent transplantation. In both groups, significant differences in best-corrected visual acuity, corneal sensation, tear film break-up time, and corneal opacity were apparent after intervention vs. before. None of the parameters showed any significant differences in terms of their rates of change.Conclusions: In patients with persistent corneal epithelial defects, amniotic contact lens placement is an effective outpatient procedure and is not inferior to temporary amniotic membrane transplantation.","PeriodicalId":17341,"journal":{"name":"Journal of The Korean Ophthalmological Society","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45905305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-15DOI: 10.3341/jkos.2023.64.6.490
Soyeon Jung, Hae-Un Shin, H. Chin
Purpose: To analyze the clinical features and visual prognosis of retinal vein occlusion (RVO) in patients under 50 years of age.Methods: A retrospective analysis of medical records of 36 patients under 50 years of age diagnosed with RVO from January 2016 to October 2021.Results: The mean age was 39.53 ± 9.98 years and 50%, 44.4%, and 5.6% had branch, central, and hemi-central RVO, respectively. Before the RVO diagnosis, systemic disease had been diagnosed in 38.9%. Further, 13.89% of the cases had a new systemic disease diagnosed after the diagnosis of RVO. Hypercholesterolemia was observed in 47.6%. The initial visual acuity (VA), best corrected visual acuity (BCVA), and central subfield thickness (CST) showed significant correlations with the final VA, BCVA, and CST.Conclusions: In patients with RVO under the age of 50 years, the initial VA and CST can be used as indicators to determine whether treatment is necessary by reflecting the final VA and CST. The initial VA and CST can also be used to predict the visual prognosis. Even at a young age, if complications occur, the visual prognosis of RVO may be poor, so an evaluation of the patient’s general condition is essential, especially the blood cholesterol level.
{"title":"Clinical Features and Visual Prognosis of Retinal Vein Occlusion in Those under 50 Years Old","authors":"Soyeon Jung, Hae-Un Shin, H. Chin","doi":"10.3341/jkos.2023.64.6.490","DOIUrl":"https://doi.org/10.3341/jkos.2023.64.6.490","url":null,"abstract":"Purpose: To analyze the clinical features and visual prognosis of retinal vein occlusion (RVO) in patients under 50 years of age.Methods: A retrospective analysis of medical records of 36 patients under 50 years of age diagnosed with RVO from January 2016 to October 2021.Results: The mean age was 39.53 ± 9.98 years and 50%, 44.4%, and 5.6% had branch, central, and hemi-central RVO, respectively. Before the RVO diagnosis, systemic disease had been diagnosed in 38.9%. Further, 13.89% of the cases had a new systemic disease diagnosed after the diagnosis of RVO. Hypercholesterolemia was observed in 47.6%. The initial visual acuity (VA), best corrected visual acuity (BCVA), and central subfield thickness (CST) showed significant correlations with the final VA, BCVA, and CST.Conclusions: In patients with RVO under the age of 50 years, the initial VA and CST can be used as indicators to determine whether treatment is necessary by reflecting the final VA and CST. The initial VA and CST can also be used to predict the visual prognosis. Even at a young age, if complications occur, the visual prognosis of RVO may be poor, so an evaluation of the patient’s general condition is essential, especially the blood cholesterol level.","PeriodicalId":17341,"journal":{"name":"Journal of The Korean Ophthalmological Society","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43203903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-15DOI: 10.3341/jkos.2023.64.6.514
Suji Yeo, Jong Min Kim
Purpose: To evaluate the clinical outcomes of myopic choroidal neovascularization (CNV) and atrophic and tractional changes according to the ATN (A: atrophy, T: traction, N: neovascularization) classification system.Methods: This was a retrospective review of the medical records of myopic CNV patients treated with intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections and followed up for at least 3 years. Atrophic and tractional components were graded according to the ATN system at baseline and the last visit.Results: The study included 21 eyes in 21 patients. The mean age was 52.29 ± 14.6 years, the mean follow-up duration was 57.65 ± 18.8 months, and the mean number of injections was 2.9 ± 1.9. Recurrence occurred in seven eyes (33.3%). Five patients (23.8%) developed myopic CNV in the contralateral eye. The mean initial and final logarithm of the minimum angle of resolution (logMAR) visual acuities were 0.44 ± 0.30 and 0.33 ± 0.39, respectively. Visual acuity was maintained or improved compared to baseline in 15 eyes (71.4%). Baseline visual acuity was significantly associated with the final visual acuity (p = 0.026). Based on the ATN classification system, the atrophic component progressed in four eyes (19.0%), while the tractional component improved in one eye (4.8%) and progressed in five eyes (23.8%).Conclusions: Intravitreal anti-VEGF injection therapy effectively preserved long-term vision in myopic CNV patients. Evaluation of the atrophic and tractional components should not be neglected during the follow-up.
{"title":"Long-term Outcomes of Myopic Choroidal Neovascularization and Retinal Changes according to ATN Classification","authors":"Suji Yeo, Jong Min Kim","doi":"10.3341/jkos.2023.64.6.514","DOIUrl":"https://doi.org/10.3341/jkos.2023.64.6.514","url":null,"abstract":"Purpose: To evaluate the clinical outcomes of myopic choroidal neovascularization (CNV) and atrophic and tractional changes according to the ATN (A: atrophy, T: traction, N: neovascularization) classification system.Methods: This was a retrospective review of the medical records of myopic CNV patients treated with intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections and followed up for at least 3 years. Atrophic and tractional components were graded according to the ATN system at baseline and the last visit.Results: The study included 21 eyes in 21 patients. The mean age was 52.29 ± 14.6 years, the mean follow-up duration was 57.65 ± 18.8 months, and the mean number of injections was 2.9 ± 1.9. Recurrence occurred in seven eyes (33.3%). Five patients (23.8%) developed myopic CNV in the contralateral eye. The mean initial and final logarithm of the minimum angle of resolution (logMAR) visual acuities were 0.44 ± 0.30 and 0.33 ± 0.39, respectively. Visual acuity was maintained or improved compared to baseline in 15 eyes (71.4%). Baseline visual acuity was significantly associated with the final visual acuity (p = 0.026). Based on the ATN classification system, the atrophic component progressed in four eyes (19.0%), while the tractional component improved in one eye (4.8%) and progressed in five eyes (23.8%).Conclusions: Intravitreal anti-VEGF injection therapy effectively preserved long-term vision in myopic CNV patients. Evaluation of the atrophic and tractional components should not be neglected during the follow-up.","PeriodicalId":17341,"journal":{"name":"Journal of The Korean Ophthalmological Society","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44961525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-15DOI: 10.3341/jkos.2023.64.6.473
Joonyoung Baeg, J. Han
Purpose: To compare the subfoveal choroidal thickness (SFCT) before and after scleral encircling (SE), with or without trans-pars plana vitrectomy (TPPV), in patients with monocular primary rhegmatogenous retinal detachment (RRD).Methods: We retrospectively analyzed patients who underwent SE for monocular primary RRD between January 2019 and June 2021 and underwent optical coherence tomography during follow-up. SFCT was measured independently at three regions before the surgery and 1, 2, 3, and 6 months after the surgery. The values were manually analyzed by two independent ophthalmologists.Results: Of the 33 eyes included in the study, 18 (54%) underwent SE alone, while 15 (46%) underwent SE with TPPV. SFCT gradually decreased after surgery in all patients (p < 0.05). The SFCT was significantly greater 6 months postoperatively in the SE alone group (260.51 ± 78.30 μm) compared to the SE with TPPV group (225.55 ± 75.24 μm) (p < 0.05). Macular detachment patients had significantly greater preoperative SFCTs (276.46 ± 20 μm) compared to others (223.93 ± 20 μm) (p < 0.05). Preoperative SFCT was significantly related to visual acuity (p < 0.05), while the remaining SFCT values did not have any significant effects.Conclusions: In primary RRD eyes, SFCT decreased over time after SE, more so when TPPV was also performed. Further studies are required to investigate the mechanism of SFCT change and its impact on RRD.
{"title":"Long-term Comparison of Choroidal Thickness between Scleral Encircling and Combined with Trans-pars Plana Vitrectomy in Retinal Detachment","authors":"Joonyoung Baeg, J. Han","doi":"10.3341/jkos.2023.64.6.473","DOIUrl":"https://doi.org/10.3341/jkos.2023.64.6.473","url":null,"abstract":"Purpose: To compare the subfoveal choroidal thickness (SFCT) before and after scleral encircling (SE), with or without trans-pars plana vitrectomy (TPPV), in patients with monocular primary rhegmatogenous retinal detachment (RRD).Methods: We retrospectively analyzed patients who underwent SE for monocular primary RRD between January 2019 and June 2021 and underwent optical coherence tomography during follow-up. SFCT was measured independently at three regions before the surgery and 1, 2, 3, and 6 months after the surgery. The values were manually analyzed by two independent ophthalmologists.Results: Of the 33 eyes included in the study, 18 (54%) underwent SE alone, while 15 (46%) underwent SE with TPPV. SFCT gradually decreased after surgery in all patients (p < 0.05). The SFCT was significantly greater 6 months postoperatively in the SE alone group (260.51 ± 78.30 μm) compared to the SE with TPPV group (225.55 ± 75.24 μm) (p < 0.05). Macular detachment patients had significantly greater preoperative SFCTs (276.46 ± 20 μm) compared to others (223.93 ± 20 μm) (p < 0.05). Preoperative SFCT was significantly related to visual acuity (p < 0.05), while the remaining SFCT values did not have any significant effects.Conclusions: In primary RRD eyes, SFCT decreased over time after SE, more so when TPPV was also performed. Further studies are required to investigate the mechanism of SFCT change and its impact on RRD.","PeriodicalId":17341,"journal":{"name":"Journal of The Korean Ophthalmological Society","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43125847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-15DOI: 10.3341/jkos.2023.64.6.507
I. Kim, S. Lee, H. Lee, Ho Ra, Jiwon Baek
Purpose: To compare the retinal and choroidal vessels of chronic alcoholics with non-alcoholics.Methods: This study included alcohol-associated liver disease (ALD) patients admitted between December 2020 and October 2021, along with age-matched controls. Retinal and choroidal vessel densities, measured using image binarization at the superficial capillary plexus (SCP), deep capillary plexus (DCP), choriocapillaris, and choroidal layers, were compared between ALD patients and controls. Correlations between clinical parameters and vessel densities in ALD patients were also analyzed.Results: Vessel densities at SCP, DCP, choriocapillaris, and choroidal layers were not significantly different between controls and ALD patients (p = 0.496, 0.988, 0.909, and 0.317, respectively). Platelet time and international normalized ratio (INR) were positively correlated with SCP density in ALD patients (r = 0.393 and 0.393; p = 0.015 and 0.015, respectively).Conclusions: ALD does not significantly affect vessel densities in the retina and choroid. The positive correlations of platelet time and INR with SCP may be related to vessel dilatation, but they require further investigation.
{"title":"A Study of Retinal and Choroidal Vessel Changes in Chronic Alcoholics","authors":"I. Kim, S. Lee, H. Lee, Ho Ra, Jiwon Baek","doi":"10.3341/jkos.2023.64.6.507","DOIUrl":"https://doi.org/10.3341/jkos.2023.64.6.507","url":null,"abstract":"Purpose: To compare the retinal and choroidal vessels of chronic alcoholics with non-alcoholics.Methods: This study included alcohol-associated liver disease (ALD) patients admitted between December 2020 and October 2021, along with age-matched controls. Retinal and choroidal vessel densities, measured using image binarization at the superficial capillary plexus (SCP), deep capillary plexus (DCP), choriocapillaris, and choroidal layers, were compared between ALD patients and controls. Correlations between clinical parameters and vessel densities in ALD patients were also analyzed.Results: Vessel densities at SCP, DCP, choriocapillaris, and choroidal layers were not significantly different between controls and ALD patients (p = 0.496, 0.988, 0.909, and 0.317, respectively). Platelet time and international normalized ratio (INR) were positively correlated with SCP density in ALD patients (r = 0.393 and 0.393; p = 0.015 and 0.015, respectively).Conclusions: ALD does not significantly affect vessel densities in the retina and choroid. The positive correlations of platelet time and INR with SCP may be related to vessel dilatation, but they require further investigation.","PeriodicalId":17341,"journal":{"name":"Journal of The Korean Ophthalmological Society","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46462905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-15DOI: 10.3341/jkos.2023.64.6.538
J. H. Suh, Tae Hwan Kim, J. Choi, I. Jun, Sang Il Cho, E. Kim
Purpose: A patient with heterozygous granular corneal dystrophy type 2 (GCD2) underwent phacoemulsification with multifocal intraocular lens insertion, and complained of visual discomfort. We investigated the cause of the discomfort and visual function in this case.Case summary: A 59-year-old woman with granular opacity had slit lamp photographs taken 5 years earlier. Two years later, she underwent phacoemulsification with multifocal intraocular lens (Trifocal AT Lisa tri toric 839MP®, Carl Zeiss Meditec AG, Inc., Jena, Germany) insertion in both eyes at a local clinic. She felt very uncomfortable after the surgery, but the granular and lattice opacities due to GCD2 of her corneas remained stationary for 5 years. Her visual acuity decreased from preoperatively (preoperative: right 0.5, left 0.6; last visit: right 0.3, left 0.4). Her contrast sensitivity was also decreased and the total higher order aberration was increased (right 1.590 μm, left 1.194 μm), compared to normal range.Conclusions: Multifocal intraocular lens insertion in cataract surgery can lead to severe declines in contrast sensitivity and visual acuity and increased higher-order aberration in a GCD2 patient. It may not be advisable to use multifocal intraocular lenses in a GCD2 patient.
目的：一名2型杂合颗粒性角膜营养不良（GCD2）患者接受了超声乳化白内障超声乳化多焦点人工晶状体植入术，并抱怨视觉不适。我们调查了这种情况下不适和视觉功能的原因。案例摘要：一名59岁的女性，颗粒不透明，5年前拍摄了裂隙灯照片。两年后，她在当地一家诊所接受了双眼多焦点人工晶状体超声乳化术（Trifocal AT Lisa tri-toric 839MP®，Carl Zeiss Meditec AG，股份有限公司，Jena，Germany）。手术后，她感到非常不舒服，但由于角膜GCD2导致的颗粒和晶格混浊在5年内保持静止。她的视力比术前下降（术前：右0.5，左0.6；最后一次就诊：右0.3，左0.4）。与正常范围相比，她的对比敏感度也下降，总高阶像差增加（右1.590μm，左1.194μm）。结论：白内障手术中的多焦点人工晶状体植入会导致GCD2患者的对比敏感度和视力严重下降，并增加高阶像差。在GCD2患者中使用多焦点人工晶状体可能是不可取的。
{"title":"Visual Function after Multifocal Intraocular Lens Insertion in a Heterozygous Granular Corneal Dystrophy Type 2 Patient: Case Report","authors":"J. H. Suh, Tae Hwan Kim, J. Choi, I. Jun, Sang Il Cho, E. Kim","doi":"10.3341/jkos.2023.64.6.538","DOIUrl":"https://doi.org/10.3341/jkos.2023.64.6.538","url":null,"abstract":"Purpose: A patient with heterozygous granular corneal dystrophy type 2 (GCD2) underwent phacoemulsification with multifocal intraocular lens insertion, and complained of visual discomfort. We investigated the cause of the discomfort and visual function in this case.Case summary: A 59-year-old woman with granular opacity had slit lamp photographs taken 5 years earlier. Two years later, she underwent phacoemulsification with multifocal intraocular lens (Trifocal AT Lisa tri toric 839MP®, Carl Zeiss Meditec AG, Inc., Jena, Germany) insertion in both eyes at a local clinic. She felt very uncomfortable after the surgery, but the granular and lattice opacities due to GCD2 of her corneas remained stationary for 5 years. Her visual acuity decreased from preoperatively (preoperative: right 0.5, left 0.6; last visit: right 0.3, left 0.4). Her contrast sensitivity was also decreased and the total higher order aberration was increased (right 1.590 μm, left 1.194 μm), compared to normal range.Conclusions: Multifocal intraocular lens insertion in cataract surgery can lead to severe declines in contrast sensitivity and visual acuity and increased higher-order aberration in a GCD2 patient. It may not be advisable to use multifocal intraocular lenses in a GCD2 patient.","PeriodicalId":17341,"journal":{"name":"Journal of The Korean Ophthalmological Society","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41979192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-15DOI: 10.3341/jkos.2023.64.6.498
Jeong Woo Heo, Y. Kwon
Purpose: The study investigated the results of direct surgical scleral depression using four ports and the chandelier lighting system in rhegmatogenous retinal detachment.Methods: Anatomical and functional success rates and complications were analyzed in 179 eyes diagnosed with rhegmatogenous retinal detachment that underwent primary vitrectomy using four ports at our hospital between March 2012 and February 2022.Results: A total of 168 (93.9%) eyes had anatomical success without reoperation while 11 (6.1%) developed recurrence. However, the final success rate was 100%. The best-corrected visual acuity improved significantly from logarithm of the minimum angle of resolution (logMAR) 1.03 ± 0.92 to logMAR 0.24 ± 0.39 after surgery (p < 0.001). Complications included a temporary increase in the intraocular pressure (n = 3, 1.7%), leakage through the scleral incision (n = 2, 1.1%), hyphema and vitreous hemorrhage (n = 10, 5.6%), and iatrogenic retinal break (n = 1, 0.6%), but these improved after treatment.Conclusions: Four-port vitrectomy for rhegmatogenous retinal detachment in which scleral depression is directly performed using the chandelier lighting system is a useful surgical method. It allows effective visualization of the peripheral retina regardless of the assistant’s proficiency which results in a more meticulous surgery. The anatomical and functional results of this technique were similar to the conventional technique.
{"title":"Four-port Vitrectomy in Rhegmatogenous Retinal Detachment","authors":"Jeong Woo Heo, Y. Kwon","doi":"10.3341/jkos.2023.64.6.498","DOIUrl":"https://doi.org/10.3341/jkos.2023.64.6.498","url":null,"abstract":"Purpose: The study investigated the results of direct surgical scleral depression using four ports and the chandelier lighting system in rhegmatogenous retinal detachment.Methods: Anatomical and functional success rates and complications were analyzed in 179 eyes diagnosed with rhegmatogenous retinal detachment that underwent primary vitrectomy using four ports at our hospital between March 2012 and February 2022.Results: A total of 168 (93.9%) eyes had anatomical success without reoperation while 11 (6.1%) developed recurrence. However, the final success rate was 100%. The best-corrected visual acuity improved significantly from logarithm of the minimum angle of resolution (logMAR) 1.03 ± 0.92 to logMAR 0.24 ± 0.39 after surgery (p < 0.001). Complications included a temporary increase in the intraocular pressure (n = 3, 1.7%), leakage through the scleral incision (n = 2, 1.1%), hyphema and vitreous hemorrhage (n = 10, 5.6%), and iatrogenic retinal break (n = 1, 0.6%), but these improved after treatment.Conclusions: Four-port vitrectomy for rhegmatogenous retinal detachment in which scleral depression is directly performed using the chandelier lighting system is a useful surgical method. It allows effective visualization of the peripheral retina regardless of the assistant’s proficiency which results in a more meticulous surgery. The anatomical and functional results of this technique were similar to the conventional technique.","PeriodicalId":17341,"journal":{"name":"Journal of The Korean Ophthalmological Society","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43527734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-15DOI: 10.3341/jkos.2023.64.6.532
Dongyoung Lee, Kyung-Ah Park
Purpose: To investigate the causes of isolated ocular motor nerve palsy in patients with a history of cancer.Methods: The charts of 30 patients with cancer diagnosed with isolated acquired third, fourth, and sixth cranial nerve palsies from March 2013 to December 2021 were retrospectively reviewed. Sex, age of onset, underlying disease and causes of cranial nerve palsy were analyzed.Results: Sixth cranial nerve palsy (n = 18, 60.0%) was the most common. Brain metastasis (n = 13, 43.3%) was the most common etiology, followed by microvascular causes (n = 11, 36.7%), radiation-induced neuropathy (n = 2, 6.7%), and undetermined (n = 4, 13.3%). Among the 13 patients with palsies due to brain metastasis, only one (7.7%) had been in complete remission for more than 1 year. Of the remaining 17 patients with other causes, seven (41.2%) had been in complete remission of a previously diagnosed cancer for more than 1 year.Conclusions: In patients with a history of cancer, cranial nerve palsy due to brain metastasis was the most common cause, and it was more likely if the primary cancer had not been in remission for more than 1 year. Brain magnetic resonance imaging should be performed as soon as possible to confirm brain metastasis and a differential diagnosis including various other causes is also important.
{"title":"Etiology of Isolated Third, Fourth, and Sixth Cranial Nerve Palsies with a Cancer History","authors":"Dongyoung Lee, Kyung-Ah Park","doi":"10.3341/jkos.2023.64.6.532","DOIUrl":"https://doi.org/10.3341/jkos.2023.64.6.532","url":null,"abstract":"Purpose: To investigate the causes of isolated ocular motor nerve palsy in patients with a history of cancer.Methods: The charts of 30 patients with cancer diagnosed with isolated acquired third, fourth, and sixth cranial nerve palsies from March 2013 to December 2021 were retrospectively reviewed. Sex, age of onset, underlying disease and causes of cranial nerve palsy were analyzed.Results: Sixth cranial nerve palsy (n = 18, 60.0%) was the most common. Brain metastasis (n = 13, 43.3%) was the most common etiology, followed by microvascular causes (n = 11, 36.7%), radiation-induced neuropathy (n = 2, 6.7%), and undetermined (n = 4, 13.3%). Among the 13 patients with palsies due to brain metastasis, only one (7.7%) had been in complete remission for more than 1 year. Of the remaining 17 patients with other causes, seven (41.2%) had been in complete remission of a previously diagnosed cancer for more than 1 year.Conclusions: In patients with a history of cancer, cranial nerve palsy due to brain metastasis was the most common cause, and it was more likely if the primary cancer had not been in remission for more than 1 year. Brain magnetic resonance imaging should be performed as soon as possible to confirm brain metastasis and a differential diagnosis including various other causes is also important.","PeriodicalId":17341,"journal":{"name":"Journal of The Korean Ophthalmological Society","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41716290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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