I. Central Serous Chorioretinopathies: One hundred and nine patients with central serous retinopathy were an a lysed after treatment with AO Laser Photocoagulator. The patients in this study were mainly male (87%) between the ages of 30 and 40 years (81.5%). Involvement was exclusively unilateral (98.1 %), and fluorescein fundus angiography revealed leaking points in almost all cases (98.1%). Majority of patients (67.4%) recovered normal vision with one or two sittings of photocoagulation, each sitting composed of 6 to 8 energy pulses producing grade I lesion. During the course of this study normal vision is gained in 80.2% of patients. With the development of fluorescein fundus angiography the lesion of central serous retinopathy were found to be choroidal abnormalities associated serous leakage across Bruch's membrane. Burn is made by the light energy delivered to pigment epithlium. The burn results, through normal healing processes, in a scar, which seals off the communication across Bruch's membrane. This phenomenon constructs the basis of treatment of central serous retinopathy with photocoagulation. II. Diabetic Retinopathies: Diabetic retinopathy is rapidly becoming the prominent cause of blindness in the world. The striking change of retinopathy is in the venous side of retinal capillaries and their altered function leads to exudation, hemorrhage, formation of new vessels, and fibrosis over the retinal plane or into vitreous, resuJting ultimately into blindness. Of the 34 patients treated with AO Ruby Photocoagulator at Han Yang Uni. Hos., the response of the patients in pre-proliferative stage was excellent, all of them recovering vision above 0.8. The patients in proliferative stage, however, responded poorly to photocoagulation. It is learned in this study that the optimal time of photocoagulation is in the pre-proliferative stage. The photocoagulation of retinitis proliferans has some effect only in arresting or delaying the progress of retinal changes. III. Focal Choroiditis: Nonsuppurative intracular inflammation is caused by various etiology. Scrutinization such as serologic and skin test or x-ray finding is important for the diagnosis of uveitis but not so significant as the definitive clinical characteristics of specific forms of ocular inflammation. Focal choroiditis, sized less than 1/4 disk diameter, was coagulated with ruby laser. Four out of 6 patients recovered good vision, the lesion being replaced by a scar. The remaining two patients did not visit the hospital after one session of photocoagulation. It is emphasized by the author that the focal choroiditis is excellent indication to the laser photocoagulation. IV. Eales' Disease: Eales' disease is considered to be due to hypersensitivity to mostly tuberculo-antigen, clinically characterized by retinal perivenous exudate, neovascularization and vitreous hemorrhage. A boy has recovered his normal vision after 18 sessions of ruby laser photocoagulation. There have been no benificent effects where photocoagulation was discontinued after two or three sittings.
Angiography ; Blindness ; Bruch Membrane ; Burns ; Capillaries ; Central Serous Chorioretinopathy ; Choroid ; Choroiditis ; Cicatrix ; Diabetic Retinopathy ; Diagnosis ; Exudates and Transudates ; Fibrosis ; Fluorescein ; Hemorrhage ; Humans ; Hypersensitivity ; Inflammation ; Lasers, Solid-State* ; Light Coagulation* ; Male ; Retinal Diseases* ; Retinaldehyde* ; Retinitis ; Skin Tests ; Strikes, Employee ; Uveitis ; Vitreous Hemorrhage

Authors reviewed the clinical datas of 22 patients who were visited to Kyung Hee Medical Center from 1991 to 1994 for solitary macular hemorrhages. Solitary macular hemorrhge was defined as unilateral, solitary hemorrhge located in macular area with no associated retinal or choroidal diseases. Of these 22 patients, seven (31%) were male, 15(69%) were female. Seven had hemorrahges on their right eyes and 15 had it on their left eyes. Authors classified the solitary macular hemorrhages according to the location of hemorrhages and the size of hemorrhages. In the follow-up period, patients with preretinal and intraretinal hemorrhages had revealed a better final visual acuity than patients with subretinal hemorrhges. Also visual prognosis was more better in patients with small sized hemorrhges than the patients with the large sized homorrhages.
Choroid Diseases ; Female ; Follow-Up Studies ; Hemorrhage* ; Humans ; Male ; Prognosis ; Retinaldehyde ; Visual Acuity

Numerous eye diseases have been examined by means of time-amplitude ultrasonography for a period of more than ten years. A diagnostic ultrasonic examination is of great help in the following pathologic conditions: intraocular foreign body, retinal detachment, vitreous opacities, melanoma of the choroid, retrolental fibrorlasia, as well as in dermoid cysts and abscesses of the anterior orbit, etc. In my investigations, I have reeently also used the EKOLINE 20 ultrasonic equipment and frequencies of 6 to 11 Mc. Time-amplitude ultrasonography were performed on 7 cases (orbital tumor, 2 cases of intraocular foreign body, retinal detachment and vitreous hemorrhage, eale's disease, intraocular tumor and vitreous hemorrhage). In addition to a brief review of literature, Time-amplitude ultrasonography findings of 7 cases of ocular diseases have been reported.
Abscess ; Choroid ; Dermoid Cyst ; Eye Diseases ; Foreign Bodies ; Melanoma ; Orbit ; Retinal Detachment ; Ultrasonics ; Ultrasonography* ; Vitreous Hemorrhage

We present a case of acute subarachnoid hemorrhage in a 64-year-old male with sudden onset of left ophthalmoplegia. Cerebral angiography demonstrated a 10mm elongated aneurysmal sac which arose from the left internal carotid-anterior choroidal artery junction. The pterional approach was performed as an early surgery for aneurysm clipping. At operative field, the anterior choroidal artery aneurysm which directed posteromedially and compressed the origin of left oculomotor nerve was confirmed. And the blood blister like-aneurysm was also seen at the superolateral portion of the proximal bifurcation of the internal carotid-anterior choroidal artery. A large anterior choroidal artery aneurysm was clipped and the blood blister like-aneurysm was reinforced. No case report has been previously published describing a ruptured anterior choroidal artery aneurysm accomplished with third cranial nerve palsy. We reported a case of multiple aneurysms of anterior choroidal artery that caused ipsilateral oculomotor nerve palsy.
Aneurysm* ; Arteries* ; Blister ; Cerebral Angiography ; Choroid* ; Humans ; Male ; Middle Aged ; Oculomotor Nerve Diseases* ; Oculomotor Nerve* ; Ophthalmoplegia ; Paralysis ; Subarachnoid Hemorrhage

We present a case of acute subarachnoid hemorrhage in a 64-year-old male with sudden onset of left ophthalmoplegia. Cerebral angiography demonstrated a 10mm elongated aneurysmal sac which arose from the left internal carotid-anterior choroidal artery junction. The pterional approach was performed as an early surgery for aneurysm clipping. At operative field, the anterior choroidal artery aneurysm which directed posteromedially and compressed the origin of left oculomotor nerve was confirmed. And the blood blister like-aneurysm was also seen at the superolateral portion of the proximal bifurcation of the internal carotid-anterior choroidal artery. A large anterior choroidal artery aneurysm was clipped and the blood blister like-aneurysm was reinforced. No case report has been previously published describing a ruptured anterior choroidal artery aneurysm accomplished with third cranial nerve palsy. We reported a case of multiple aneurysms of anterior choroidal artery that caused ipsilateral oculomotor nerve palsy.
Aneurysm* ; Arteries* ; Blister ; Cerebral Angiography ; Choroid* ; Humans ; Male ; Middle Aged ; Oculomotor Nerve Diseases* ; Oculomotor Nerve* ; Ophthalmoplegia ; Paralysis ; Subarachnoid Hemorrhage

A very rare case of multiple primary intracranial tumors is reported. A 41-year-old female patient was referred for surgery with a cerebellopontine angle (CPA) tumor. Medical history and MRI study showed typical findings of a right acoustic neuroma with a hydrocephalus. Neurological, dermatological, and ocular examinations revealed no evidence of neurofibromatosis. During surgery, a red-colored cauliflower like mass was found in the right CPA. The roof of the fourth ventricle could be seen through the lateral recess after removal of the tumor. Another mass, a 1.5-cm sized schwannoma protruding through the right internal auditory meatus, was removed by the transmeatal approach. Although the tumor masses were in contact and compressed against each other, there was a clear demarcation between them. Histological examination confirmed that the first mass was a typical choroid plexus papilloma with fibrovascular core, and that the second was a schwannoma. The patient recovered without any new neurological deficit. Result of a Medline search indicated that this rare combination of multiple primary tumors has not been reported previously.
Adult ; Case Report ; Choroid Plexus Neoplasms/*pathology ; Female ; Human ; Magnetic Resonance Imaging ; Neoplasms, Multiple Primary/*pathology ; Neurilemmoma/*pathology ; Papilloma/*pathology ; Vestibulocochlear Nerve Diseases/*pathology

The preoptic area and anterior hypothalamus plays a pivotal role in body temperature regulation, and damage in this region causes hyperthermia. This hyperthermia is particularly troublesome because of the possibility that it may reflect an occult infectious process. We report a case of fever of unknown origin in a patient after removal of neoplasm involving the hypothalamus. A 29-year old man underwent craniotomy and removal of hypothalamic choroid meningioma. Seventy days after the removal of his tumor, his body temperature began to rise. But, there was no evidence of infection, inflammatory disease, metabolic disease, drug fever and recurred tumor. Repeated administration of antipyretic agent did not reduce body temperature. So, we considered that the elevated temperature had a central basis. The patient was treated with chlorpromazine in an attempt to lower his temperature. This drug reduced successfully his body temperature.
Adult ; Body Temperature ; Body Temperature Regulation ; Chlorpromazine ; Choroid ; Craniotomy ; Fever of Unknown Origin* ; Fever* ; Humans ; Hypothalamic Neoplasms* ; Hypothalamus ; Hypothalamus, Anterior ; Meningioma ; Metabolic Diseases ; Preoptic Area

OBJECTIVE: Surgical results for anterior choroidal artery (AChA) aneurysms have previously been reported as unsatisfactory due to inadvertent occlusion of the AChA, while the low incidence of AChA aneurysms hampers the accumulation of surgical experience. The authors reviewed their related surgical experience to document the ischemic complications and surgical outcomes. METHODS: Identification of the AChA at its origin by rigorous visual scrutiny, careful microdissection, and meticulous clip placement to avoid the AChA origin are all crucial surgical maneuvers. A retrospective review of a surgical series of 62 consecutive cases of an AChA aneurysm between 2004 and 2012 was performed. RESULTS: All patients, except for five (8.1%) with a small residual neck, showed complete aneurysm obliteration in postoperative angiographic evaluations. There was no incidence of procedure-related permanent AChA syndrome or oculomotor nerve palsy, while three (4.8%) patients suffered from transient AChA syndrome. The clinical outcomes [the 3-month modified Rankin Scale (mRS)] of the patients were related to their preoperative World Federation of Neurologic Surgeons (WFNS) grade. As regards the 3-month mRS, significant differences were found between patients with an unruptured aneurysm (WFNS grade 0; n=20), good-grade subarachnoid hemorrhage (WFNS grade 1-3; n=30), and poor-grade subarachnoid hemorrhage (WFNS grade 4-5; n=4). CONCLUSION: In surgical treatment of AChA aneurysms, a risk of AChA insufficiency can be minimized by taking every precaution to preserve the AChA patency and intraoperative monitoring. In addition, the surgical outcome is primarily determined by the preoperative clinical state.
Adenosine ; Aneurysm ; Arteries ; Cerebral Infarction ; Choroid ; Humans ; Incidence ; Intracranial Aneurysm ; Microdissection ; Monitoring, Intraoperative ; Neck ; Oculomotor Nerve Diseases ; Retrospective Studies ; Subarachnoid Hemorrhage ; Treatment Outcome

Tumors of the central nervous system are the second most frequent neoplasm in children. In a review of 43 children with brain tumor under the age of 16 evaluated at a pediatric and neurosurgical department at Severance Hospital Yonsei University during a 61/2 year period, following results were obtained. 1. All 43 cases were diagnosed by pathological examination as well as brain CT scan. The sex ratio of male and female was equal. The age distribution was highest between 13-14 year of age and 7% of them were under 1 year of age. 2. There was a small preponderance of infratentorial tumors (51%) over supratentoral tumors (49%). 3. Among 43 verified brain tumors by pathological examination, glioma represented 75%, of which astrocytoma was the commonest neoplasm being 19 cases (45%) and remainder were medulloblastoma 10 cases (23%), choroid plexus droglioma 2 cases (5%), ependymoma 1case (2%). The rest were craniopharyngioma 6 cases (14%), choroid plexus papilloma 1 case (2%), neuroblastoma 2 cases (5%), pineal teratoma 1 case (2%), melanotic neuroectodermal turmor 1 case (2%). 4. The most common symptom was headache occuring 63% of the patients followed by vomiting, motor weakness, visual disturbance, gait distrubance, mental disturbance and seizure in order of trequency. Neurological signs showed positive Babinski sign, papilledema, cerebellar sign, 6th nerve palsy and facial weakness. 5. Plain skull X-ray changes were noted in 26 out of the 43 cases (61%). Those were suture separation of skull noted 35% of tumors followed in frequency by increased digital marking, sella changes and calcification. 6. In brain CT scan studies, the most common abnormal finding was solid mass shadow followed by cystic mass shadow, solid and cystic mass shadow. After contrast infusion, diffuse enhancement was the most common features. 7. 27 cases were treated by operation only, 15 by operation and radiotherapy, 1 by operation, radiation and chemotherapy. 8. Progonsis of brain tumor was very poor. 5 of 43 cases died within 1 month of diagnosis, 1 year survival rate was 19%, and 2 year survival rate was 16%. The survival rate was better in the group of patients in whom total or subtotal resection combined with radiotherapy was performed. 53% of cases were not able to follow-up or discharged anainst advice without proper treatment.
Abducens Nerve Diseases ; Age Distribution ; Astrocytoma ; Brain Neoplasms* ; Brain* ; Central Nervous System ; Child* ; Choroid Plexus ; Craniopharyngioma ; Diagnosis ; Drug Therapy ; Ependymoma ; Female ; Follow-Up Studies ; Gait ; Glioma ; Headache ; Humans ; Infratentorial Neoplasms ; Male ; Medulloblastoma ; Neural Plate ; Neuroblastoma ; Papilledema ; Papilloma, Choroid Plexus ; Radiotherapy ; Reflex, Babinski ; Seizures ; Sex Ratio ; Skull ; Survival Rate ; Sutures ; Teratoma ; Tomography, X-Ray Computed ; Vomiting

Polyarteritis nodosa is a necrotizing vasculitis affecting medium and small-sized arteries throughout the body. Eye involvement is present in about 10% to 20% of patients, including chemosis, iritis, episcleritis, corneal ulcers, keratitiis, choroiditis, retinal detachment, extraocular muscle palsies, and hypertensive retinopathy. Rarely there have been reports of optic neuropathies and occasional central retinal artery occlusions. We experienced a patient with central retinal artery occlusion who had been diagnosed polyarteritis nodosa with mononeuritis multiplex.
Arteries ; Choroid ; Choroiditis ; Humans ; Hypertensive Retinopathy ; Iritis ; Mononeuropathies ; Optic Nerve Diseases ; Paralysis ; Polyarteritis Nodosa* ; Retinal Artery Occlusion* ; Retinal Artery* ; Retinal Detachment ; Scleritis ; Ulcer ; Vasculitis