PURPOSE: To assess whether a 4 mg/0.05 ml intravitreal triamcinolone acetonide injection can reduce the IOP elevation compared to conventional 4 mg/0.1 ml injection. METHODS: A retrospective case study was performed in 48 patients (48 eyes) who received intravitreal triamcinolone acetonide injection and who had a minimum follow-up time of six months. Patients were randomly assigned to receive 4 mg/0.1 ml or 4 mg/0.05 ml (24 patients in each group). RESULTS: Before injection, mean IOP was 13.8+/-2.2 mmHg and 13.9+/-2.4 mmHg in the 0.1 ml and 0.05 ml group. The difference in IOP elevation between the two groups was statistically significant immediately after injection (P=0.000), one hour after injection (P=0.001), and one day after injection (P=0.000). After injection, the central macular thickness decreased significantly the of two groups. The difference of the central macular thickness decrease between both groups was not statistically significant. CONCLUSIONS: An intravitreal triamcinolone acetonide 4 mg/0.05 ml injection will more quickly reduce the IOP elevation in the early phase compared to 4 mg/0.1 ml injection, while providing a similar effect on the change of central macular thickness.
Follow-Up Studies ; Humans ; Intraocular Pressure ; Retrospective Studies ; Triamcinolone ; Triamcinolone Acetonide

No abstract available.
Hepatitis A Antibodies* ; Hepatitis* ; Immunoglobulin M*

PURPOSE: To report a rare case of choroidal metastasis from renal cell carcinoma. CASE SUMMARY: A 61-year-old man visited our clinic with the chief complaint of decreased vision in the right eye. Three years earlier, he underwent right nephrectomy due to renal cell carcinoma. Best corrected visual acuity was 0.2 in the right eye and 1.0 in the left eye. Fundoscopic examination of the right eye revealed a yellowish, dome-shaped elevated choroidal mass with serous retinal detachment, measuring 5.0 x 4.0 disc diameter and located lateral to the macular area. Systemic evaluations showed multiple lung and brain metastases. A diagnosis of choroidal metastasis from renal cell carcinoma was made for the right eye, and the patient received local treatments with oral sorafenib therapy, composed of subtenon triamcinolone injection and intravitreal ranibizumab injection. Tumor progression continued, and visual acuity declined to hand motion. Enucleation was recommended, but the patient refused and is on a regular follow-up after transpupillary thermotherapy. CONCLUSIONS: Ocular manifestation may be the initial presenting sign of a recurrent tumor, and an extensive systemic evaluation for metastatic malignancy should be performed. The present example showed a rare case of choroidal metastasis from renal cell carcinoma.
Antibodies, Monoclonal, Humanized ; Brain ; Carcinoma, Renal Cell ; Choroid ; Eye ; Follow-Up Studies ; Hand ; Humans ; Lung ; Middle Aged ; Neoplasm Metastasis ; Nephrectomy ; Niacinamide ; Phenylurea Compounds ; Retinal Detachment ; Triamcinolone ; Vision, Ocular ; Visual Acuity ; Ranibizumab

PURPOSE: To evaluate long-term effects and usefulness of combined intravitreal injection of bevacizumab and panretinal photocoagulation (PRP) in patients with high-risk proliferative diabetic retinopathy. METHODS: The authors retrospectively reviewed the records of 40 patients (40 eyes) with high-risk proliferative diabetic retinopathy who had been treated with PRP alone (laser treatment group, n=20) or intravitreal bevacizumab before PRP (combined treatment group, n=20). Changes in best corrected visual acuity (BCVA), central macular thickness (CMT) and the total area of leakage from active new vessels (NVs) were compared between the groups at one, three, and six months and at one year post-treatment. RESULTS: In the combined treatment group, CMT decreased significantly at one month (p=0.021), and the areas of active NVs decreased significantly at one month (p=0.001) and three months (p=0.014) compared to those of the laser treatment group. However, there were no differences between the two groups after three months. In the combined treatment group, elevated intraocular pressures were found in three cases after one month, and there were vitreous hemorrhages in two cases after three months. CONCLUSIONS: The combined treatment showed significant early improvements in BCVA, CMT, and NVs regression for up to three months. However, long-term follow-up and additional treatment was necessary in the patients with persistent or recurred NVs and macular edema after three months.
Antibodies, Monoclonal, Humanized ; Diabetic Retinopathy ; Follow-Up Studies ; Humans ; Intraocular Pressure ; Intravitreal Injections ; Light Coagulation ; Macular Edema ; Retrospective Studies ; Visual Acuity ; Vitreous Hemorrhage ; Bevacizumab

PURPOSE: To evaluate the safety and effects of intracameral triamcinolone acetonide injection in rabbit corneas. METHODS: Triamcinolone acetonide in the amounts of 0.5, 1, and 2 mg was injected into the anterior chamber of rabbit eyes, and intraocular pressure, corneal thickness, and endothelial cell counts were evaluated on days 1, 3, 7, 14, and 28. Twenty-eight days after triamcinolone acetonide injection, the eyes were enucleated and examined after TUNEL staining. RESULTS: No statistically significant differences were found among control, 0.5, and 1 mg triamcinolone-injected eyes in central corneal thickness, endothelial cell density, pleomorphism, and polymegathism. There was no difference between 2 mg triamcinolone-injected eyes and control eyes for corneal thickness and cell density, but there were statistically significant differences between these two groups for pleomorphism (p<0.05) and polymegathism (p<0.05). CONCLUSIONS: The results of this study suggested that intracameral injections of 0.5~1 mg of triamcinolone acetonide are beneficial and cause no toxic effects on corneas.
Anterior Chamber ; Cell Count ; Cornea ; Endothelial Cells ; Eye ; In Situ Nick-End Labeling ; Intraocular Pressure ; Rabbits ; Triamcinolone ; Triamcinolone Acetonide

PURPOSE: To evaluate the cause of dark arcuate striae observed in infrared photographs in idiopathic epiretinal membrane (ERM) and macular hole patients after internal limiting membrane (ILM) peeling. METHODS: Forty patients (41 eyes) of idiopathic ERM and macular hole who underwent trans pars plana vitrectomy with ILM peeling and gas tamponade were included in the present study. The best corrected visual acuity (BCVA) was recorded at preoperative and postoperative 6 months. Infrared (IR) photography with spectral domain optical coherence tomography (SD-OCT) were obtained at preoperative and postoperative 1 week, 1 month, 3 months, and 6 months. When abnormal findings were visible on IR photographs, additional SD-OCT was performed at the corresponding sites. RESULTS: Of 40 patients, 4 patients demonstrated dark striae extending from the optic nerve to near macular area in IR photographs at 1 week postoperatively. SD-OCT images of the dark striae region revealed the swelling of retinal nerve fiber layer (RNFL). At postoperative 6 months, however, RNFL swelling previously observed subsided in all 4 cases, while temporal retinal thinning and dimples were observed in 3 cases. The preoperative and postoperative BCVA did not show any statistical difference between the patients with the RNFL swelling and the patients without the swelling. CONCLUSIONS: Swelling of RNFL may occur in idiopathic ERM and macular hole patients after pars plana vitrectomy and ILM peeling, which may present as dark striae in IR photographs.
Epiretinal Membrane ; Humans ; Membranes* ; Nerve Fibers* ; Optic Nerve ; Photography ; Retinal Perforations ; Retinaldehyde* ; Tomography, Optical Coherence ; Visual Acuity ; Vitrectomy

Unilateral acute idiopathic maculopathy is a rare, self limiting disorder that affects healthy young adults with sudden, severe loss of central vision. We diagnosed bilateral acute idiopathic maculopathy in a 17-year-old man who experienced sudden, rapidly progressive central visual loss following a flu-like illness and report this case with a review of the literatures.
Adolescent ; Humans ; Young Adult

PURPOSE: To investigate weather an administrated inhibitor (disintegrin) of angiogenic factors inhibits the development of laser-induced experimental choroidal neovascularization (CNV) in rat model. METHODS: Experimental CNV was induced by red argon laser photocoagulation in the eyes of 10 Brown Norway rats. The rats were divided into two groups, the disintegrin (flavoridin)-treated group and control group. Fundus photography and fluorescein angiography were performed to identify late leakage after two weeks of laser photocoagulation. Three days after fluorescein angiography, the expression of vascular endothelial growth factor (VEGF) was identified by immunohistochemical stain. RESULTS: CNV-related fluorescein leakage appeared in forty-four (18 in the flavoridin-treated group, 26 in the control group) of 64 laser spots delivered to the 10 eyes that were tested at two weeks post-treatment. Expression of VEGF on laser-induced CNV lesions was reduced in the flavoridin-treated group. CONCLUSIONS: The results of this study suggest that disintegrin is an inhibitor of ocular angiogenesis; disintegrin reduced CNV in laser-induced experimental model. We expect that disintegrin may have a potent effect in age-related macular degeneration.
Angiogenesis Inducing Agents ; Animals ; Argon ; Choroidal Neovascularization ; Fluorescein ; Fluorescein Angiography ; Light Coagulation* ; Macular Degeneration ; Models, Animal ; Models, Theoretical ; Norway ; Photography ; Rats ; Retina* ; Vascular Endothelial Growth Factor A ; Weather

PURPOSE: We report two cases of Cohen syndrome associated with ophthalmologic findings, which is the first such report from Korea. METHODS: A 14-year-old boy and a 13-year-old girl, a brother and sister, who had visited the department of pediatrics for evaluation of developmental disorders was transferred to the department of ophthalmology due to evidence of nyctalopia and decreased visual acuity. There, refraction, ultrasonography, and fundus examinations were performed. RESULTS: The children had high myopia, and refractive astigmatism. Bull's eye maculopathy with a pale disc was found on the fundus examination. There were characteristic facial appearances including wave-shaped, down-slanting palpebral fissures and short philtrum. They also had grimacing expressions upon smiling. Neutropenia was identified in the female patient. CONCLUSIONS: Cohen syndrome should be suspected and considered in the differential diagnosis of patients with high myopia, nyctalopia, and decreased visual acuity.
Adolescent ; Astigmatism ; Child ; Diagnosis, Differential ; Female ; Humans ; Korea ; Lip ; Male ; Myopia ; Neutropenia ; Night Blindness ; Ophthalmology ; Pediatrics ; Siblings ; Smiling ; Ultrasonography ; Visual Acuity

Congenital renal arteriovenous malformation is a rare lesion. Nephrectomy or partial nephrectomy is a well-known treatment and as alternative method, transcatheter embolization therapy has been developed. We report a case of congenital arteriovenous malformation manifested by intermittent right flank pain and gross hematuria with blood clots, cured by means of transcatheter embolization therapy during angiographic study with polyvinyl alcohol foam (IVALON).
Arteriovenous Malformations* ; Flank Pain ; Hematuria ; Kidney ; Nephrectomy ; Polyvinyl Alcohol