Pub Date : 2024-03-15DOI: 10.3341/jkos.2024.65.3.257
Jun Chul Byun, Se Youp Lee, Soon Young Cho
Purpose: We report a diagnosis of Moyamoya disease based on brain magnetic resonance imaging (MRI) and brain magnetic resonance angiography (MRA) performed in a child diagnosed with morning glory syndrome.Case summary: A 6-year-old boy visited the hospital with a chief complaint of exodeviation of his left eye that started at 1 year of age. The corrected visual acuity was 20/30 in the right eye and 20/400 in the left. The Krimsky test showed exotropia of 35 prism diopters (PD) for near vision and 30 PD for distance. Fundus photography showed an enlarged optic disc with funnel-shaped excavation in the left eye. With a diagnosis of morning glory syndrome accompanied by exotropia, the patient underwent brain MRI and brain MRA. The patient had no neurological symptoms such as headache and muscle weakness. Moyamoya disease was diagnosed, as brain MRI and MRA showed tiny tortuous vessels forming collateral vessels from the lenticulostriatal arteries, left posterior cerebral artery, and left middle meningeal artery, which originated from the external carotid artery.Conclusions: Moyamoya disease can occur in children with morning glory disease. Brain MRI and MRA can help to diagnose Moyamoya disease. Caution is needed because transient ischemic attack, cerebral infarction, and cerebral hemorrhage may occur in patients with Moyamoya disease.
{"title":"A Case of Moyamoya Disease in Morning Glory Syndrome","authors":"Jun Chul Byun, Se Youp Lee, Soon Young Cho","doi":"10.3341/jkos.2024.65.3.257","DOIUrl":"https://doi.org/10.3341/jkos.2024.65.3.257","url":null,"abstract":"Purpose: We report a diagnosis of Moyamoya disease based on brain magnetic resonance imaging (MRI) and brain magnetic resonance angiography (MRA) performed in a child diagnosed with morning glory syndrome.Case summary: A 6-year-old boy visited the hospital with a chief complaint of exodeviation of his left eye that started at 1 year of age. The corrected visual acuity was 20/30 in the right eye and 20/400 in the left. The Krimsky test showed exotropia of 35 prism diopters (PD) for near vision and 30 PD for distance. Fundus photography showed an enlarged optic disc with funnel-shaped excavation in the left eye. With a diagnosis of morning glory syndrome accompanied by exotropia, the patient underwent brain MRI and brain MRA. The patient had no neurological symptoms such as headache and muscle weakness. Moyamoya disease was diagnosed, as brain MRI and MRA showed tiny tortuous vessels forming collateral vessels from the lenticulostriatal arteries, left posterior cerebral artery, and left middle meningeal artery, which originated from the external carotid artery.Conclusions: Moyamoya disease can occur in children with morning glory disease. Brain MRI and MRA can help to diagnose Moyamoya disease. Caution is needed because transient ischemic attack, cerebral infarction, and cerebral hemorrhage may occur in patients with Moyamoya disease.","PeriodicalId":504314,"journal":{"name":"Journal of the Korean Ophthalmological Society","volume":"20 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140240273","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 : 2024-03-15DOI: 10.3341/jkos.2024.65.3.241
Young-Ri Cho, M. Ahn, Nam-Chun Cho, I. You
Purpose: To report treatment failure of multidrug-resistant Acinetobacter baumannii keratitis in a patient wearing contact lenses for a long time.Case summary: A 48-year-old man using daytime soft lenses for 20 years was transferred due to decreased visual acuity and eye pain. Slit-lamp biomicroscopy showed a large corneal epithelial defect and stromal infiltration, but no hypopyon. Treatment was initiated with moxifloxacin, polyhexamethylene biguanide eye drops, and oral antibiotics. Corneal infiltration worsened, corneal scrapings and culture were performed. Gram staining showed Gram-positive bacteria, potassium hydroxide (KOH) hyphae-positive, and culture yielded Bacillus. He was hospitalized and vancomycin, voriconazole, and amphotericin B eye drops were administered. Oral antifungal agents were also prescribed. The corneal epithelial defect was restored from temporal side for a while, and then deteriorated with an endothelial plaque. Therefore, voriconazole and amphotericin B were injected intracamerally. All four repeated culture tests were negative. Despite total conjunctival flap, the patient complained of severe pain and eventually underwent evisceration. In the culture of intraocular contents, Acinetobacter baumannii, which is resistant to all drugs except minocycline, was detected.Conclusions: In patients wearing contact lens for a long time, not only mixed infection with acanthamoeba and fungi, but also gram-negative bacteria should be considered first, and multidrug-resistant Acinetobacter baumannii should also be considered.
目的：报告一名长期配戴隐形眼镜的患者耐多药鲍曼不动杆菌角膜炎治疗失败的病例。病例摘要：一名配戴日间软性镜片 20 年的 48 岁男子因视力下降和眼痛转院。裂隙灯生物显微镜检查显示角膜上皮大面积缺损和基质浸润，但未见眼睑下垂。开始使用莫西沙星、聚己亚胺双胍滴眼液和口服抗生素进行治疗。角膜浸润恶化，于是进行了角膜刮片和培养。革兰氏染色显示革兰氏阳性菌，氢氧化钾（KOH）菌丝阳性，培养结果为芽孢杆菌。他被送进了医院，并使用了万古霉素、伏立康唑和两性霉素 B 眼药水。医生还开了口服抗真菌药。角膜上皮缺损从颞侧恢复了一段时间，但随后恶化，出现了内皮斑块。因此，在角膜内注射了伏立康唑和两性霉素 B。四次重复培养检测结果均为阴性。尽管做了全结膜瓣，但患者仍抱怨剧烈疼痛，最终接受了切除手术。在眼内内容物的培养中，发现了鲍曼不动杆菌，该杆菌对米诺环素以外的所有药物都有耐药性：结论：对于长期佩戴隐形眼镜的患者，不仅应首先考虑棘阿米巴和真菌的混合感染，还应考虑革兰氏阴性菌的感染，同时还应考虑耐多药鲍曼不动杆菌的感染。
{"title":"Failed Treatment of Multidrug-resistant Acinetobacter Baumannii Keratitis Mistaken for a Mixed Infection","authors":"Young-Ri Cho, M. Ahn, Nam-Chun Cho, I. You","doi":"10.3341/jkos.2024.65.3.241","DOIUrl":"https://doi.org/10.3341/jkos.2024.65.3.241","url":null,"abstract":"Purpose: To report treatment failure of multidrug-resistant Acinetobacter baumannii keratitis in a patient wearing contact lenses for a long time.Case summary: A 48-year-old man using daytime soft lenses for 20 years was transferred due to decreased visual acuity and eye pain. Slit-lamp biomicroscopy showed a large corneal epithelial defect and stromal infiltration, but no hypopyon. Treatment was initiated with moxifloxacin, polyhexamethylene biguanide eye drops, and oral antibiotics. Corneal infiltration worsened, corneal scrapings and culture were performed. Gram staining showed Gram-positive bacteria, potassium hydroxide (KOH) hyphae-positive, and culture yielded Bacillus. He was hospitalized and vancomycin, voriconazole, and amphotericin B eye drops were administered. Oral antifungal agents were also prescribed. The corneal epithelial defect was restored from temporal side for a while, and then deteriorated with an endothelial plaque. Therefore, voriconazole and amphotericin B were injected intracamerally. All four repeated culture tests were negative. Despite total conjunctival flap, the patient complained of severe pain and eventually underwent evisceration. In the culture of intraocular contents, Acinetobacter baumannii, which is resistant to all drugs except minocycline, was detected.Conclusions: In patients wearing contact lens for a long time, not only mixed infection with acanthamoeba and fungi, but also gram-negative bacteria should be considered first, and multidrug-resistant Acinetobacter baumannii should also be considered.","PeriodicalId":504314,"journal":{"name":"Journal of the Korean Ophthalmological Society","volume":"3 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140241250","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 : 2024-03-15DOI: 10.3341/jkos.2024.65.3.226
Haryung Park, Seung Ah Chung
Purpose: To evaluate the effect of low-dose atropine on myopia control in children with a history of surgery for intermittent exotropia (IXT).Methods: We retrospectively reviewed the medical records of children who used 0.05% atropine for ≥ 1 year to control myopia progression. This group included 45 patients with a history of IXT surgery and 57 patients with no such history. The annual changes in spherical equivalent and axial length were compared 6 months before, 6 months after, and 1 year after atropine instillation between the IXT surgery group and myopia controls. In this comparison, the dominant eye was paired with the right eye and the non-dominant eye with the left eye. We also analyzed the difference between IXT surgery cases corrected within versus not within 10 prism diopters (PD) at the start of low-dose atropine treatment.Results: A total of 102 patients had an average of -3.81 ± 1.53 diopters (D) and used low-dose atropine for an average of 16.8 months from a mean age of 8.2 years. On average, the IXT surgery group underwent muscle surgery for 28.1 PD of IXT at 7.8 years. A year after instillation, the myopia progression rate was -0.52 ± 0.89 D/year and 0.27 ± 0.40 mm/year in the IXT surgery group compared to -0.47 ± 0.83 D/year and 0.31 ± 0.24 mm/year in the myopia control group with no significant differences. However, after 6 months of instillation, the dominant eye in the IXT surgery group exhibited a significantly faster myopia progression rate than the right eye in the myopia control group (-0.84 ± 1.61 D/year vs. -0.56 ± 0.80 D/year, p = 0.04; 0.27 ± 0.33 mm/year vs. 0.22 ± 0.21 mm/year, p = 0.02). No difference was found in the myopia control effect between corrected and uncorrected cases in the IXT surgery group.Conclusions: The effect of low-dose atropine on myopia control in children after IXT surgery was similar to that in myopia controls. However, it was less effective in the dominant eye during the early treatment period.
{"title":"Effect of Low-dose Atropine on Myopia Control in Children Operated for Intermittent Exotropia","authors":"Haryung Park, Seung Ah Chung","doi":"10.3341/jkos.2024.65.3.226","DOIUrl":"https://doi.org/10.3341/jkos.2024.65.3.226","url":null,"abstract":"Purpose: To evaluate the effect of low-dose atropine on myopia control in children with a history of surgery for intermittent exotropia (IXT).Methods: We retrospectively reviewed the medical records of children who used 0.05% atropine for ≥ 1 year to control myopia progression. This group included 45 patients with a history of IXT surgery and 57 patients with no such history. The annual changes in spherical equivalent and axial length were compared 6 months before, 6 months after, and 1 year after atropine instillation between the IXT surgery group and myopia controls. In this comparison, the dominant eye was paired with the right eye and the non-dominant eye with the left eye. We also analyzed the difference between IXT surgery cases corrected within versus not within 10 prism diopters (PD) at the start of low-dose atropine treatment.Results: A total of 102 patients had an average of -3.81 ± 1.53 diopters (D) and used low-dose atropine for an average of 16.8 months from a mean age of 8.2 years. On average, the IXT surgery group underwent muscle surgery for 28.1 PD of IXT at 7.8 years. A year after instillation, the myopia progression rate was -0.52 ± 0.89 D/year and 0.27 ± 0.40 mm/year in the IXT surgery group compared to -0.47 ± 0.83 D/year and 0.31 ± 0.24 mm/year in the myopia control group with no significant differences. However, after 6 months of instillation, the dominant eye in the IXT surgery group exhibited a significantly faster myopia progression rate than the right eye in the myopia control group (-0.84 ± 1.61 D/year vs. -0.56 ± 0.80 D/year, p = 0.04; 0.27 ± 0.33 mm/year vs. 0.22 ± 0.21 mm/year, p = 0.02). No difference was found in the myopia control effect between corrected and uncorrected cases in the IXT surgery group.Conclusions: The effect of low-dose atropine on myopia control in children after IXT surgery was similar to that in myopia controls. However, it was less effective in the dominant eye during the early treatment period.","PeriodicalId":504314,"journal":{"name":"Journal of the Korean Ophthalmological Society","volume":"2 35","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140241319","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 : 2024-03-15DOI: 10.3341/jkos.2024.65.3.194
A. Y. Lee, Sang-Mok Lee
Purpose: To investigate the effect of the postoperative spherical equivalent (SE) and astigmatism on the uncorrected near/distance visual acuity (UNVA/UDVA) in monofocal intraocular lens (IOL)-implanted pseudophakic eyes.Methods: Of the eyes that underwent successful cataract surgery and monofocal IOL implantation from January 2020 to September 2021 by a single surgeon, eyes with postoperative astigmatism ≤ 1.5 diopters (D) and -0.75 D ≤ SE < +0.25 D were included. Eyes implanted with a toric IOL or with a best corrected visual acuity under 20/25 were excluded. This was a cross-sectional study, and the correlation of SE/astigmatism and UNVA/UDVA at 1 month postoperatively was analyzed retrospectively. The eyes were divided into mini-myopia (-0.75 D ≤ SE < -0.25 D) and emmetropia (-0.25 D ≤ SE < 0.25 D) groups according to the SE.Results: This study included 118 eyes (86 patients). The UNVA was significantly better in the mini-myopia group than in the emmetropia group (p = 0.009), without a significant difference in UDVA (p = 0.412). Dividing the range into 0.5 D units according to the degree of astigmatism, no significant difference was observed in UNVA/UDVA between the mini-myopia and emmetropia groups in eyes with astigmatism ≤ 1.0 D. However, the mini-myopia group had a significantly better UNVA (p = 0.03), without a significant difference in UDVA (p = 0.879) in eyes with astigmatism > 1.0 D or ≤ 1.5 D.Conclusions: In non-toric monofocal IOL-implanted pseudophakic eyes with postoperative residual astigmatism of ≤ 1.5 D, especially in eyes with astigmatism > 1.0 D and ≤ 1.5 D, the mini-myopia group had a significantly better UNVA compared to the emmetropia group, without a significant difference in UDVA.
{"title":"Effect of Low Myopia on Near and Distance Vision in Astigmatic Pseudophakic Eyes","authors":"A. Y. Lee, Sang-Mok Lee","doi":"10.3341/jkos.2024.65.3.194","DOIUrl":"https://doi.org/10.3341/jkos.2024.65.3.194","url":null,"abstract":"Purpose: To investigate the effect of the postoperative spherical equivalent (SE) and astigmatism on the uncorrected near/distance visual acuity (UNVA/UDVA) in monofocal intraocular lens (IOL)-implanted pseudophakic eyes.Methods: Of the eyes that underwent successful cataract surgery and monofocal IOL implantation from January 2020 to September 2021 by a single surgeon, eyes with postoperative astigmatism ≤ 1.5 diopters (D) and -0.75 D ≤ SE < +0.25 D were included. Eyes implanted with a toric IOL or with a best corrected visual acuity under 20/25 were excluded. This was a cross-sectional study, and the correlation of SE/astigmatism and UNVA/UDVA at 1 month postoperatively was analyzed retrospectively. The eyes were divided into mini-myopia (-0.75 D ≤ SE < -0.25 D) and emmetropia (-0.25 D ≤ SE < 0.25 D) groups according to the SE.Results: This study included 118 eyes (86 patients). The UNVA was significantly better in the mini-myopia group than in the emmetropia group (p = 0.009), without a significant difference in UDVA (p = 0.412). Dividing the range into 0.5 D units according to the degree of astigmatism, no significant difference was observed in UNVA/UDVA between the mini-myopia and emmetropia groups in eyes with astigmatism ≤ 1.0 D. However, the mini-myopia group had a significantly better UNVA (p = 0.03), without a significant difference in UDVA (p = 0.879) in eyes with astigmatism > 1.0 D or ≤ 1.5 D.Conclusions: In non-toric monofocal IOL-implanted pseudophakic eyes with postoperative residual astigmatism of ≤ 1.5 D, especially in eyes with astigmatism > 1.0 D and ≤ 1.5 D, the mini-myopia group had a significantly better UNVA compared to the emmetropia group, without a significant difference in UDVA.","PeriodicalId":504314,"journal":{"name":"Journal of the Korean Ophthalmological Society","volume":"7 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140239471","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 : 2024-03-15DOI: 10.3341/jkos.2024.65.3.203
Ji Eon Kang, Hye Yeon Yoon, So-Hyang Chung, Hyun Seung Kim, Y. Byun
Purpose: To compare the short-term clinical outcomes (up to 3 months) after three different secondary intraocular lens (IOL) implantations in dislocated and aphakic eyes with insufficient capsular support.Methods: We retrospectively analyzed the medical records of 97 patients who underwent secondary IOL implantation (32 eyes with sutured scleral fixation, 21 with sutureless scleral fixation, and 44 with retropupillary IOL implantation) from March to December 2018. Uncorrected visual acuity (UCVA), and best-corrected visual acuity (BCVA), spherical equivalent (SE), prediction error (PE), mean absolute error (MAE), surgically induced astigmatism (SIA), ocular residual astigmatism (ORA), and complications in the three groups were assessed before and 1 week and 1 and 3 months after surgery.Results: All groups had an improved BCVA beginning 1 month after surgery. The pre- and postoperative SE (p = 0.857, p = 0.263, and p = 0.163) and PE (p = 0.479, p = 0.848, and p = 0.128) did not differ in the sutured scleral fixation, sutureless scleral fixation, and retropupillary IOL implantation groups, respectively; MAE differed significantly among the procedures 1 week after surgery (1.33 ± 1.25, 1.40 ± 1.54, and 0.85 ± 1.25, p = 0.044), but not 1 month after surgery (p = 0.965, p = 0.731). 3 months after surgery, there was no significant difference in SIA (p = 0.140) or ORA (p = 0.178) among the 3 groups. As a complication, intraocular pressure rise occurred more often in the sutured fixated group, while the retropupillary group had a higher dislocation rate.Conclusions: There was no significant difference in the SE, PE, MAE, SIA, ORA, or complications among the three procedures. Surgical skill is still required to minimize the chance of complications regardless of the implantation method.
{"title":"Comparison of Clinical Outcomes Among Sutured, Sutureless Scleral Fixation, and Retropupillary Fixation of Intraocular Lens","authors":"Ji Eon Kang, Hye Yeon Yoon, So-Hyang Chung, Hyun Seung Kim, Y. Byun","doi":"10.3341/jkos.2024.65.3.203","DOIUrl":"https://doi.org/10.3341/jkos.2024.65.3.203","url":null,"abstract":"Purpose: To compare the short-term clinical outcomes (up to 3 months) after three different secondary intraocular lens (IOL) implantations in dislocated and aphakic eyes with insufficient capsular support.Methods: We retrospectively analyzed the medical records of 97 patients who underwent secondary IOL implantation (32 eyes with sutured scleral fixation, 21 with sutureless scleral fixation, and 44 with retropupillary IOL implantation) from March to December 2018. Uncorrected visual acuity (UCVA), and best-corrected visual acuity (BCVA), spherical equivalent (SE), prediction error (PE), mean absolute error (MAE), surgically induced astigmatism (SIA), ocular residual astigmatism (ORA), and complications in the three groups were assessed before and 1 week and 1 and 3 months after surgery.Results: All groups had an improved BCVA beginning 1 month after surgery. The pre- and postoperative SE (p = 0.857, p = 0.263, and p = 0.163) and PE (p = 0.479, p = 0.848, and p = 0.128) did not differ in the sutured scleral fixation, sutureless scleral fixation, and retropupillary IOL implantation groups, respectively; MAE differed significantly among the procedures 1 week after surgery (1.33 ± 1.25, 1.40 ± 1.54, and 0.85 ± 1.25, p = 0.044), but not 1 month after surgery (p = 0.965, p = 0.731). 3 months after surgery, there was no significant difference in SIA (p = 0.140) or ORA (p = 0.178) among the 3 groups. As a complication, intraocular pressure rise occurred more often in the sutured fixated group, while the retropupillary group had a higher dislocation rate.Conclusions: There was no significant difference in the SE, PE, MAE, SIA, ORA, or complications among the three procedures. Surgical skill is still required to minimize the chance of complications regardless of the implantation method.","PeriodicalId":504314,"journal":{"name":"Journal of the Korean Ophthalmological Society","volume":"14 23","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140240498","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 : 2024-03-15DOI: 10.3341/jkos.2024.65.3.173
Ji Yoon Lee, Ji Sang Min, Jin Seok Choi, Eung Kweon Kim
Purpose: Granular corneal dystrophy type 1 (GCD1) is a genetic disorder characterized by grayish-white granular deposits in the corneal stroma, typically manifesting before age 10. The specific characteristics of GCD1 in the Korea population remain insufficiently described. This study investigated the morphological features of GCD1 corneas with confirmed genetic mutations in this population.Methods: Medical records of GCD1 patients with the R555W mutation confirmed through transforming growth factor β induced (TGFBI) gene testing on oral epithelium or blood samples from 2005-2022, were analyzed. Corneal photographs obtained using a slit lamp biomicroscope were also examined.Results: The study group included 11 males and 19 females with an average age of 35.7 years, ranging from 3-70 years. All participants were heterozygotes. In 28 individuals (56 eyes, representing 93.3% of the total), there were signs of corneal deposit detachments, known as “drop-off”, observed in patients aged 6 years and above. Surface deposits reemerged at the peripheral margin of previous locations and expanded toward the center. The number and shape of opacities significantly changed with age, showing cycles of deposition and shedding. There were variations in the severity of opacities within the same family, particularly with advancing age, and distinct opacities extending into deeper stromal layers.Conclusions: This study outlines the morphological characteristics of corneas in Korean GCD1 patients, based on corneal photograph analysis. These findings provide a basis for future comparative studies with GCD2 and may aid rapid clinical diagnosis based on clinical findings, prior to genetic testing confirmation.
{"title":"Morphological Characteristics of Granular Corneal Dystrophy Type 1 in the Korean Population","authors":"Ji Yoon Lee, Ji Sang Min, Jin Seok Choi, Eung Kweon Kim","doi":"10.3341/jkos.2024.65.3.173","DOIUrl":"https://doi.org/10.3341/jkos.2024.65.3.173","url":null,"abstract":"Purpose: Granular corneal dystrophy type 1 (GCD1) is a genetic disorder characterized by grayish-white granular deposits in the corneal stroma, typically manifesting before age 10. The specific characteristics of GCD1 in the Korea population remain insufficiently described. This study investigated the morphological features of GCD1 corneas with confirmed genetic mutations in this population.Methods: Medical records of GCD1 patients with the R555W mutation confirmed through transforming growth factor β induced (TGFBI) gene testing on oral epithelium or blood samples from 2005-2022, were analyzed. Corneal photographs obtained using a slit lamp biomicroscope were also examined.Results: The study group included 11 males and 19 females with an average age of 35.7 years, ranging from 3-70 years. All participants were heterozygotes. In 28 individuals (56 eyes, representing 93.3% of the total), there were signs of corneal deposit detachments, known as “drop-off”, observed in patients aged 6 years and above. Surface deposits reemerged at the peripheral margin of previous locations and expanded toward the center. The number and shape of opacities significantly changed with age, showing cycles of deposition and shedding. There were variations in the severity of opacities within the same family, particularly with advancing age, and distinct opacities extending into deeper stromal layers.Conclusions: This study outlines the morphological characteristics of corneas in Korean GCD1 patients, based on corneal photograph analysis. These findings provide a basis for future comparative studies with GCD2 and may aid rapid clinical diagnosis based on clinical findings, prior to genetic testing confirmation.","PeriodicalId":504314,"journal":{"name":"Journal of the Korean Ophthalmological Society","volume":"79 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140238154","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 : 2024-01-15DOI: 10.3341/jkos.2024.65.1.9
Jong Hoon Lee, Ja Young Moon, H. Yoon, K. Yoon
Purpose: We investigated the clinical effects of Siccafluid carbomer eye gel on the symptoms, tear film, and ocular surface in dry eye patients.Methods: Fifty-five patients with dry eye syndrome were also treated with carbomer eye gel for 6 months. The Dry Eye Questionnaire (DEQ-5), tear film breakup time (TBUT), Schirmer’s test, and ocular surface staining score were assessed during follow-up. Patients were classified into Sjögren’s syndrome and non-Sjögren’s syndrome groups and the effects of the carbomer eye drops in each group were analyzed.Results: Overall, the dry eye patients showed significant improvement in the total DEQ-5 score, frequency and intensity of dryness, and TBUT 6 months after treatment. In the non-Sjögren’s group, the total DEQ-5 score, intensity of dryness, and TBUT improved, while in the Sjögren’s group, the total DEQ-5 score, frequency and intensity of dryness, and TBUT improved. In both groups, patients with a shorter TBUT showed a significant improvement in the total DEQ-5 score.Conclusions: After 6 months of carbomer eye gel use in patients with dry eye syndrome, the symptoms of ocular dryness and tear film breakup time improved. In patients with dry eye syndrome who have a short TBUT, this can be an effective treatment for alleviating dry eye symptoms.
{"title":"Effects of Carbomer Eye Gels on the Ocular Surface in Dry Eye Patients","authors":"Jong Hoon Lee, Ja Young Moon, H. Yoon, K. Yoon","doi":"10.3341/jkos.2024.65.1.9","DOIUrl":"https://doi.org/10.3341/jkos.2024.65.1.9","url":null,"abstract":"Purpose: We investigated the clinical effects of Siccafluid carbomer eye gel on the symptoms, tear film, and ocular surface in dry eye patients.Methods: Fifty-five patients with dry eye syndrome were also treated with carbomer eye gel for 6 months. The Dry Eye Questionnaire (DEQ-5), tear film breakup time (TBUT), Schirmer’s test, and ocular surface staining score were assessed during follow-up. Patients were classified into Sjögren’s syndrome and non-Sjögren’s syndrome groups and the effects of the carbomer eye drops in each group were analyzed.Results: Overall, the dry eye patients showed significant improvement in the total DEQ-5 score, frequency and intensity of dryness, and TBUT 6 months after treatment. In the non-Sjögren’s group, the total DEQ-5 score, intensity of dryness, and TBUT improved, while in the Sjögren’s group, the total DEQ-5 score, frequency and intensity of dryness, and TBUT improved. In both groups, patients with a shorter TBUT showed a significant improvement in the total DEQ-5 score.Conclusions: After 6 months of carbomer eye gel use in patients with dry eye syndrome, the symptoms of ocular dryness and tear film breakup time improved. In patients with dry eye syndrome who have a short TBUT, this can be an effective treatment for alleviating dry eye symptoms.","PeriodicalId":504314,"journal":{"name":"Journal of the Korean Ophthalmological Society","volume":"23 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140507262","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 : 2023-11-15DOI: 10.3341/jkos.2023.64.11.1041
Jung Dong Kim, Junwon Lee, Jong Yun Yang, Eun Young Choi
Purpose: We present a modified, closed-loop scleral fixation technique. We inserted a 4-eyelet intraocular lens (IOL) into the anterior chamber prior to fixation. We investigated the clinical results.Methods: We retrospectively reviewed 39 eyes (39 patients) that underwent modified four-point scleral fixation of an inserted lens in our center from May 2019 to June 2022. The surgical procedure features conjunctival peritomy, 4-eyelet IOL insertion, eyeball penetration using a 9-0 polypropylene needle, eyelet placement using an ab externo technique to form a continuous loop, centering of the optic, and tying of a knot. We compared preoperative and 6-month postoperative changes in best-corrected visual acuity (BCVA), intraocular pressure, and refraction errors, and described postoperative complications.Results: The mean patient age was 62 years. The indications for surgery included complicated cataracts (20.5%), aphakia (20.5%), staged surgery for complicated cataract (12.8%), non-traumatic IOL dislocation (30.8%), traumatic IOL dislocation (12.8%), and crystalline lens dislocation (5.1%). The postoperative BCVA (0.40 logarithm of the minimum angle of resolution [logMAR]) was significantly better than the preoperative BCVA (0.69 logMAR) (p = 0.018). The postoperative spherical equivalent and the target diopter measurement were in high agreement (p = 0.002, intraclass correlation coefficient = 0.616). All of ocular hypertension (7.7%), hypotony (5.1%), bullous keratopathy (5.1%), and macular edema (5.1%) were noted, but 78% of the conditions improved with short-term medication. There was no re-dislocation of a fixated IOL.Conclusions: Our surgical technique simply and rapidly treats aphakia. Optic repositioning was easy, the IOL stability high, and the risk of complications during IOL fixation low.
{"title":"Closed-loop Scleral Fixation with 4-eyelet Intraocular Lens Implantation for Aphakia: Clinical Outcomes","authors":"Jung Dong Kim, Junwon Lee, Jong Yun Yang, Eun Young Choi","doi":"10.3341/jkos.2023.64.11.1041","DOIUrl":"https://doi.org/10.3341/jkos.2023.64.11.1041","url":null,"abstract":"Purpose: We present a modified, closed-loop scleral fixation technique. We inserted a 4-eyelet intraocular lens (IOL) into the anterior chamber prior to fixation. We investigated the clinical results.Methods: We retrospectively reviewed 39 eyes (39 patients) that underwent modified four-point scleral fixation of an inserted lens in our center from May 2019 to June 2022. The surgical procedure features conjunctival peritomy, 4-eyelet IOL insertion, eyeball penetration using a 9-0 polypropylene needle, eyelet placement using an ab externo technique to form a continuous loop, centering of the optic, and tying of a knot. We compared preoperative and 6-month postoperative changes in best-corrected visual acuity (BCVA), intraocular pressure, and refraction errors, and described postoperative complications.Results: The mean patient age was 62 years. The indications for surgery included complicated cataracts (20.5%), aphakia (20.5%), staged surgery for complicated cataract (12.8%), non-traumatic IOL dislocation (30.8%), traumatic IOL dislocation (12.8%), and crystalline lens dislocation (5.1%). The postoperative BCVA (0.40 logarithm of the minimum angle of resolution [logMAR]) was significantly better than the preoperative BCVA (0.69 logMAR) (p = 0.018). The postoperative spherical equivalent and the target diopter measurement were in high agreement (p = 0.002, intraclass correlation coefficient = 0.616). All of ocular hypertension (7.7%), hypotony (5.1%), bullous keratopathy (5.1%), and macular edema (5.1%) were noted, but 78% of the conditions improved with short-term medication. There was no re-dislocation of a fixated IOL.Conclusions: Our surgical technique simply and rapidly treats aphakia. Optic repositioning was easy, the IOL stability high, and the risk of complications during IOL fixation low.","PeriodicalId":504314,"journal":{"name":"Journal of the Korean Ophthalmological Society","volume":"C-25 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139272077","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 : 2023-11-15DOI: 10.3341/jkos.2023.64.11.1120
Hye Jin Lee, Jin Young Kim, Yu Min Kim, J. R. Do, D. Park, J. Shin, Yong Koo Kang
Purpose: We report a case of retinopathy related to bilateral hyperviscosity syndrome in a patient with Waldenström macroglobulinemia.Case summary: A 77-year-old male presented with reduced visual acuities of both eyes 2 months in duration. Fundus examination revealed extensive flame-shaped retinal hemorrhages and venous congestion. Optical coherence tomography (OCT) evidenced macular edema and OCT angiography (OCTA) indicated damage to the superficial and deep capillary plexi of retina and choriocapillaris and dilated large choroidal vessels. We diagnosed central retinal vein occlusion with macular edema and prescribed intravitreal bevacizumab and posterior subtenon triamcinolone injections, however, the edema did not improve. As retinopathy associated with hematological disease was thus suspected, we referred the patient to our department of hematology and oncology for further assessment. He was diagnosed with Waldenström macroglobulinemia. After initiation of chemotherapy, the retinal hemorrhage in and macular edema of both eyes decreased. After six chemotherapy cycles, the retinal hemorrhages resolved and the macular edema improved in both eyes. OCTA revealed that the choroidal vessel dilation also improved.Conclusions: In elderly patients presenting with central retinal vein occlusions and macular edema of both eyes, it is important to assess whether the retinopathy is associated with a hyperviscosity syndrome linked to a hematological disease.
{"title":"Hyperviscosity Syndrome-related Retinopathy in a Patient with Waldenström Macroglobulinemia","authors":"Hye Jin Lee, Jin Young Kim, Yu Min Kim, J. R. Do, D. Park, J. Shin, Yong Koo Kang","doi":"10.3341/jkos.2023.64.11.1120","DOIUrl":"https://doi.org/10.3341/jkos.2023.64.11.1120","url":null,"abstract":"Purpose: We report a case of retinopathy related to bilateral hyperviscosity syndrome in a patient with Waldenström macroglobulinemia.Case summary: A 77-year-old male presented with reduced visual acuities of both eyes 2 months in duration. Fundus examination revealed extensive flame-shaped retinal hemorrhages and venous congestion. Optical coherence tomography (OCT) evidenced macular edema and OCT angiography (OCTA) indicated damage to the superficial and deep capillary plexi of retina and choriocapillaris and dilated large choroidal vessels. We diagnosed central retinal vein occlusion with macular edema and prescribed intravitreal bevacizumab and posterior subtenon triamcinolone injections, however, the edema did not improve. As retinopathy associated with hematological disease was thus suspected, we referred the patient to our department of hematology and oncology for further assessment. He was diagnosed with Waldenström macroglobulinemia. After initiation of chemotherapy, the retinal hemorrhage in and macular edema of both eyes decreased. After six chemotherapy cycles, the retinal hemorrhages resolved and the macular edema improved in both eyes. OCTA revealed that the choroidal vessel dilation also improved.Conclusions: In elderly patients presenting with central retinal vein occlusions and macular edema of both eyes, it is important to assess whether the retinopathy is associated with a hyperviscosity syndrome linked to a hematological disease.","PeriodicalId":504314,"journal":{"name":"Journal of the Korean Ophthalmological Society","volume":"10 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139275478","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 : 2023-11-15DOI: 10.3341/jkos.2023.64.11.1109
Jeong Mun Choi, Mi Sun Kwon, Yong Koo Kang, Dai Woo Kim, Byeong Jae Son
Purpose: To report a case of orbital infarction syndrome in a patient with hemophagocytic lymphohistiocytosis (HLH).Case summary: A 70-year-old woman with diabetes mellitus and hypertension was referred to the Department of Ophthalmology for sudden-onset left upper eyelid ptosis after being diagnosed with HLH. After 3 days, the best corrected visual acuity in the right eye was 0.8, while there was no light perception in the left eye. In the left eye, the ocular motility examination showed limitations in all fields of gaze. On fundus examination, optic disc pallor, retinal hemorrhage, and narrowed retinal arteries were observed in the left eye. Fluorescein angiography showed no blood flow in the retinal arteries and veins in the left eye. On neck computed tomography angiography, the left distal internal carotid artery was narrowed. Orbit computed tomography showed exophthalmos and extraocular muscle hypertrophy in the left eye. Orbit magnetic resonance imaging confirmed optic nerve edema, enhancement of the optic nerve sheath, and high signal intensity of the intraocular fat in the left eye. Slit-lamp examination revealed ischemia of the anterior segment and ischemic necrosis of the eyelid in the left eye. The patient was diagnosed with orbital infarction syndrome.Conclusions: Several factors may lead to ischemia of the orbital tissues in patients with HLH, including coagulopathy, an increased incidence of blood clots, and inflammation in the orbit. It is necessary to consider the possibility of orbital infarction syndrome when HLH patients present with visual loss, ocular movement limitations, and anterior segment ischemia.
{"title":"A Case of Orbital Infarction Syndrome in a Patient with Hemophagocytic Lymphohistiocytosis","authors":"Jeong Mun Choi, Mi Sun Kwon, Yong Koo Kang, Dai Woo Kim, Byeong Jae Son","doi":"10.3341/jkos.2023.64.11.1109","DOIUrl":"https://doi.org/10.3341/jkos.2023.64.11.1109","url":null,"abstract":"Purpose: To report a case of orbital infarction syndrome in a patient with hemophagocytic lymphohistiocytosis (HLH).Case summary: A 70-year-old woman with diabetes mellitus and hypertension was referred to the Department of Ophthalmology for sudden-onset left upper eyelid ptosis after being diagnosed with HLH. After 3 days, the best corrected visual acuity in the right eye was 0.8, while there was no light perception in the left eye. In the left eye, the ocular motility examination showed limitations in all fields of gaze. On fundus examination, optic disc pallor, retinal hemorrhage, and narrowed retinal arteries were observed in the left eye. Fluorescein angiography showed no blood flow in the retinal arteries and veins in the left eye. On neck computed tomography angiography, the left distal internal carotid artery was narrowed. Orbit computed tomography showed exophthalmos and extraocular muscle hypertrophy in the left eye. Orbit magnetic resonance imaging confirmed optic nerve edema, enhancement of the optic nerve sheath, and high signal intensity of the intraocular fat in the left eye. Slit-lamp examination revealed ischemia of the anterior segment and ischemic necrosis of the eyelid in the left eye. The patient was diagnosed with orbital infarction syndrome.Conclusions: Several factors may lead to ischemia of the orbital tissues in patients with HLH, including coagulopathy, an increased incidence of blood clots, and inflammation in the orbit. It is necessary to consider the possibility of orbital infarction syndrome when HLH patients present with visual loss, ocular movement limitations, and anterior segment ischemia.","PeriodicalId":504314,"journal":{"name":"Journal of the Korean Ophthalmological Society","volume":"106 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139275880","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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