PURPOSE: The authors report a case of optic nerve evulsion with literature review. METHOD: 15-year-old boy, who had optic nerve evulsion by tear of inferior rectus and medial rectus muscles, and hypotony by retinal and choroidal detachment RESULTS: we could preserve the eyeball with normal pressure by pars plana vitrectomy, endolaser photocoagulation and silicone oil injection
Adolescent ; Choroid ; Humans ; Light Coagulation ; Male ; Muscles ; Optic Nerve Injuries ; Optic Nerve* ; Retinaldehyde ; Silicone Oils ; Vitrectomy

Choroidal rupture is a common complication of contusion injuries of the eye. The data from 53 patients of choroidal ruptures attending SNUH for 6 years were analyzed. 1. There were more males than females and the peak age was twenties and thirties of age. 2. There was no statistical diffenence in frequency of left or right eye injuries. 3. The major(55%) chief complaint of the patients was visual disturbance. 4. The majority(36%) of the patients visited SNUH from 11 days to 1 month after the ocular trauma. 5. The major(34%) cause of ocular trauma was a blow by fist or foot. 6. Most(79%) of the corrected visual acuities on initial examination were 0.3 or less. 7. The majority(45%) of the choroidal ruptures were 1-2 disc diopter in length. 8. Most(75%) of the choroidal ruptures were single in number. 9. The majority(59%) of the choroidal ruptures were in the posterior pole and/or near the posterior pole and most(82%) of choroidal ruptures were located temporal to the optic disc. 10. The majority(72%) of the choroidal ruptures were associated with macular lesions, e.g., choroidal rupture, subretinal neovascular membrance, hemorrhage and degeneration, etc. 11. Fluorescein angiographic findings of choroidal ruptures were scleral staining(100%), subretinal pigment epithelial hemorrhage(37%), pigment hypertrophy(19%), subretinal hemorrhage(15%), and subretinal neovascular membrane(11%), etc. 12. In 15% of the choroidal ruptures, subretinal neovascular membrane developed.
Choroid* ; Contusions ; Eye Injuries ; Female ; Fluorescein ; Foot ; Hemorrhage ; Humans ; Male ; Membranes ; Rupture* ; Visual Acuity

A potent antiproliferative agent, Mitomcin-C, has been known to improve the surgical outcom of glaucomatous eyes with poor prognosis after filtering surgery. Twenty one eyes of 21 patients underwent trabeculectomy with Mitomyc-C. Overall success rate is 81%: 2 of 3 eyes with glaucoma after unsuccessful filtering surgery, 3 of 4 eyes with neovascular glaucoma, 2 of 3 eyes with secondary glaucoma, 1 of 2 eyes with aphakic glaucoma and all of 9 eyes with advanced glaucoma. Postoperative complications were prolonged conjuntival wound leakage in two eyes, conjuntibval wound leakage and corneo-lenticular touch in one eye, choroidal detachment in one eye, progression of cataract in one eye, hyphema in 3 eyes.
Cataract ; Choroid ; Filtering Surgery* ; Glaucoma* ; Glaucoma, Neovascular ; Humans ; Hyphema ; Mitomycin* ; Postoperative Complications ; Prognosis ; Trabeculectomy ; Wounds and Injuries

A potent antiproliferative agent, Mitomcin-C, has been known to improve the surgical outcom of glaucomatous eyes with poor prognosis after filtering surgery. Twenty one eyes of 21 patients underwent trabeculectomy with Mitomyc-C. Overall success rate is 81%: 2 of 3 eyes with glaucoma after unsuccessful filtering surgery, 3 of 4 eyes with neovascular glaucoma, 2 of 3 eyes with secondary glaucoma, 1 of 2 eyes with aphakic glaucoma and all of 9 eyes with advanced glaucoma. Postoperative complications were prolonged conjuntival wound leakage in two eyes, conjuntibval wound leakage and corneo-lenticular touch in one eye, choroidal detachment in one eye, progression of cataract in one eye, hyphema in 3 eyes.
Cataract ; Choroid ; Filtering Surgery* ; Glaucoma* ; Glaucoma, Neovascular ; Humans ; Hyphema ; Mitomycin* ; Postoperative Complications ; Prognosis ; Trabeculectomy ; Wounds and Injuries

The purpose of this study is to evaluate the influence of clinical factors on the development of postoperative hypotony, and also to determine whether the occurrence of hypotony has any effect on the outcome of trabeculectomy with intraoperative mitomycin C. The authors retrospectively reviewed the outcome in 160 eyes of 112 patients who underwent tight scleral flap trabeculectomy with releasable sutures. Mitomycin C with 0.25 or 0.5mg/ml was applied for 3 or 5 minutes between the Tenon's capsule and the sclera. The mean follow-up period was 16.5 +/- 11.5 months. Success of the trabeculectomy was defined as intraocular pressure (IOP) 6-21 mmHg with or without medications. Hypotony(IOP Anterior Chamber ; Cataract ; Choroid ; Follow-Up Studies ; Glaucoma ; Humans ; Incidence ; Intraocular Pressure ; Mitomycin* ; Postoperative Complications ; Retrospective Studies ; Sclera ; Sutures ; Tenon Capsule ; Trabeculectomy* ; Wounds and Injuries

Mitomycin C (MMC) is an antimetabolite, antibiotic which prevents the proliferation of fibroblast and fibrosis by inhibition of DNA-dependent RNA synthesis. It has been used to increase the success rate of filtering surgery. We performed trabeculectomy and peripheral iridectomy with 0.4 mg/ml MMC application for 3 minutes in poor prognostic glaucoma patient, 26 eyes of 24 patients from February 1992 to December 1994. The postoperative change of intraocular pressure (IOP) and complications were followed up from 3 to 30 months (mean 12.4 months). The preoperative and postoperative mean IOP after 24 months were 32.3 +/- 11.4 mmHg and 12.7 +/- 3.1 mmHg, respectively. The decrease rate of IOP was 60.7% and the success rate was 71.7%. The postoperative complications were 15 eyes including 5 eyes of shallow anterior chamber, 5 eyes of hyphema, 2 eyes of conjunctival wound leakage, one eye of bleb rupture, one eye of choroidal detachment, and one eye of cataract formation.
Anterior Chamber ; Blister ; Cataract ; Choroid ; Fibroblasts ; Fibrosis ; Filtering Surgery ; Glaucoma ; Humans ; Hyphema ; Intraocular Pressure ; Iridectomy ; Mitomycin* ; Postoperative Complications ; RNA ; Rupture ; Trabeculectomy* ; Wounds and Injuries

The use of intraoperative application of Mitomycin C at the filtration site has been known to improve the surgical outcome in glaucomatous eyes with high risk for failure of trabeculectomy. The author performed trabeculectomies with intraoperative Mitomycin C on 25 eyes of 20 patients with poor surgical prognosis to study the efficacy and safety of this technique in glaucomatous patients with high risk for failure of trabeculectomy. After the preparation of a scleral flap, 0.2mg/ml sulution of Mitomycin C was applied between Tenon's capsule and the sclera for 2 minutes. The exposed area was then irrigated with 200 ml of balanced salt solution. The follow-up period was from 1 to 7 months (mean 3.8 months). The mean preoperative intraocular pressure (IOP) was 38.6±6.6mmHg. The mean final postoperative IOP was 11.7±3.8mmHg. Twenty three (88%) of the 25 eyes were successfully controlled with the IOP of less than or equal to 20 mmHg wthout glaucoma medication. There were early postoperative complications of hyphema in 5 eyes (20%), shallow anterior chamber in 4 eyes(16%), punctate keratopathy in 3 eyes (12%), aqueous leaking from conjunctival wound in 2 eyes (8%), encapsulated bled in 1 eye (4%) and choroidal detachment in 1 eye (4%), and 4 eyes had long term hypotony lasting more than 2 months. Although Mitomycin C is simple to use and effective adjunct to trabeculectomy, further study will be needed to determine the mechanism of action, indication, dosage and optimal exposure time of Mitomycin C.
Anterior Chamber ; Choroid ; Filtration ; Follow-Up Studies ; Glaucoma ; Humans ; Hyphema ; Intraocular Pressure ; Mitomycin* ; Postoperative Complications ; Prognosis ; Sclera ; Tenon Capsule ; Trabeculectomy* ; Wounds and Injuries

In newoborn infants, we can find the retinal hemorrhage, hyphema, vitreous hemorrhage, cataract, iridodialysis, choroidal rupture, lens dislocation and the injuries to the conjunctiva and lid due to birth injury. We studied the frequency, influencing factors, shape and absorption period of retinal hemorrhages in newborn infants by the following method. The 152 newborn infants that were delivered at the obstetric department of S.C.H. college hospital from May 25th '80 to June 29th '80 are examined with direct ophthalmscope after instillation of 1% mydriacyl solution. Fundus eyamination was done within 24 hour after delivery, 3rd day, 2nd week, and 3rd week. 1) The retinal hemorrhage is seen in 19.1% of newborn infant. 2) Bilaterality is over 55%. 3) Frequency is higher in primipara than in multipara and higher in over 30 years old mother and vaccum deliveries. 4) The retinal hemorrhages are absorpted about 1/2 of cases within 3 days and almost within 3 weeks.
Absorption ; Adult ; Birth Injuries ; Cataract ; Choroid ; Conjunctiva ; Humans ; Hyphema ; Infant ; Infant, Newborn* ; Lens Subluxation ; Mothers ; Retinal Hemorrhage* ; Retinaldehyde* ; Rupture ; Vitreous Hemorrhage

Air-bags have received widespread support as an effective means of enhancing automotive safety, and they are becoming more common as standard automobile equipment on many cars. Although air-bag induced ocular injuries are rare, they present a serious concern because of the possibility of permanent damage or visual impairment. To date, most reports have investigated ocular injury from high velocity motor vehicle accidents and reports of ocular injury from low speed motor vehicle accidents have been rare. We describe a patient who sustained severe ocular injury, including periorbital fracture, hyphema, vitreous hemorrhage, and choroidal rupture of the macular area, due to an inflated air-bag in a low speed motor vehicle accident.
Accidents, Traffic ; Adult ; Air Bags/*adverse effects ; Choroid/*injuries ; Eye Injuries/*etiology ; Female ; Humans ; Hyphema/*etiology ; Orbital Fractures/*etiology/radiography ; Rupture ; Tomography, X-Ray Computed ; Vitreous Hemorrhage/*etiology/ultrasonography

In this study, expressions of aquaporin (AQP) 1, AQP4, endothelial nitric oxide synthase (eNOS), and vascular endothelial growth factor in blood-cerebrospinal fluid (CSF) barrier and blood-brain barrier (BBB) are examined in rat choroid plexus and peri-infarcted hippocampal formation (HF) following systemic hyponatremia (SH) and permanent middle cerebral artery occlusion (pMCAO). These events are thought to cause the development of hydrocephalic and vasogenic edemas. The importance of CSF overproduction and intact blood-CSF barrier during hydrocephalic edema formation is demonstrated by the high expression of AQP1 (329.86+/-10.2%, n=4 , P<0.01) and trapped plasma immunoglobulin G (IgG) in choroid plexus epithelium after 24 hours of SH. However, the increased eNOS expression in peri-infarcted HF (130+/-3%, n=4, P<0.01) and extravasation of plasma IgG into the extravascular compartment after 24 hours of pMCAO suggest that increased microvascular permeability, probably due to elevated levels of nitric oxide, leads to development of vasogenic brain edema via BBB breakdown. Based on these findings, the authors suggest that modulation of different protein expression, dependent on the type of brain edema, is required for primary (pMCAO) and secondary (SH) brain injuries to attenuate brain edema and neuronal degeneration.
Animals ; Aquaporin 1 ; Blood-Brain Barrier ; Brain Edema ; Brain Injuries ; Capillary Permeability ; Choroid Plexus ; Edema ; Epithelium ; Hippocampus ; Hyponatremia ; Immunoglobulin G ; Infarction, Middle Cerebral Artery ; Neurons ; Nitric Oxide ; Nitric Oxide Synthase Type III ; Plasma ; Proteins ; Rats ; Vascular Endothelial Growth Factor A