A first male patient with age of 30 in Vietnam had typical clinical symptoms and histopathological features of the primary gelatinous Drop-like dystrophy. This was the first time the research on the genetic mutation affirmed the hereditary of the disease. The combination of surgery with the open amniotic transplantation was new method of the treatment.
diagnosis ; therapeutics ; Corneal Diseases

PURPOSE: To unveil the etiology, pathogenic mechanism and the clinical significance of the corneal iron line through various clinical aspects of the corneal iron line. METHODS: This study included 45 eyes of 39 patients who visited the Department of Ophthalmology in Chungnam National University Hospital between April 2011 and March 2014. Anterior segment of the eye was photographed during the diagnostic process. The medical history of the patient was investigated and corneal topography was performed to discover the relationship between the position of the corneal iron line and the curvature of the corneal surface. RESULTS: The corneal iron line was identified in various corneal diseases such as herpetic stromal keratitis and; corneal ulcer. The average age of patients was 57.8 years. Corneal topography was performed in 12 patients and a connection was found between the curvature of the corneal surface and the position of corneal iron line at 75%. During the research period, corneal disease progressed and associated corneal iron line became clearer in 2 eyes. However, there was no repositioning or new appearance in different areas. The corneal iron line was not associated with visual acuity and the shape varied in accordance with the accompanying corneal disorder. The location where the tears repeatedly accumulate was associated with corneal surface. CONCLUSIONS: Based on the occurrence location and the shape of the corneal iron line, we could understand that the occurrence of corneal iron line is associated with the past and current corneal surface irregularities, which verified the validity of the tear pooling hypothesis. Therefore, this result can aid in establishing the diagnosis and treatment plan when the corneal iron line is discovered during clinical practice.
Chungcheongnam-do ; Corneal Diseases ; Corneal Topography ; Corneal Ulcer ; Diagnosis ; Humans ; Iron* ; Keratitis ; Ophthalmology ; Tears ; Visual Acuity

PURPOSE: To unveil the etiology, pathogenic mechanism and the clinical significance of the corneal iron line through various clinical aspects of the corneal iron line. METHODS: This study included 45 eyes of 39 patients who visited the Department of Ophthalmology in Chungnam National University Hospital between April 2011 and March 2014. Anterior segment of the eye was photographed during the diagnostic process. The medical history of the patient was investigated and corneal topography was performed to discover the relationship between the position of the corneal iron line and the curvature of the corneal surface. RESULTS: The corneal iron line was identified in various corneal diseases such as herpetic stromal keratitis and; corneal ulcer. The average age of patients was 57.8 years. Corneal topography was performed in 12 patients and a connection was found between the curvature of the corneal surface and the position of corneal iron line at 75%. During the research period, corneal disease progressed and associated corneal iron line became clearer in 2 eyes. However, there was no repositioning or new appearance in different areas. The corneal iron line was not associated with visual acuity and the shape varied in accordance with the accompanying corneal disorder. The location where the tears repeatedly accumulate was associated with corneal surface. CONCLUSIONS: Based on the occurrence location and the shape of the corneal iron line, we could understand that the occurrence of corneal iron line is associated with the past and current corneal surface irregularities, which verified the validity of the tear pooling hypothesis. Therefore, this result can aid in establishing the diagnosis and treatment plan when the corneal iron line is discovered during clinical practice.
Chungcheongnam-do ; Corneal Diseases ; Corneal Topography ; Corneal Ulcer ; Diagnosis ; Humans ; Iron* ; Keratitis ; Ophthalmology ; Tears ; Visual Acuity

PURPOSE: Although a confocal microscopy has been largely used, there has been no domestic report concerning the normal structure of rabbit and human cornea by confocal microscope. In this study, we investigated confocal microscopic morphology of normal cornea of rabbit and human. MEHTODS: Using confocal microscope (ConfoScan 2.0, Fortune Technology, Italy), cross-sectioned corneal images of the corneal epithelium, Bowman's layer, stromal layer (anterior, middle, and posterior keratocyte), Descemet 's membrane, and endothelium were examined in vivo. RESULTS: In normal rabbit corneas, the superficial epithelium was polygonal and Bowman's layer was wrinkled. The stromal keratocyte nuclei was elliptical anteriorly and was with less cellularity posteriorly. The endothelium of rabbit was uniform, hexagonal in shape and had highly reflective cell borders. In human corneas, the superficial epithelium had highly reflective nuclei and regular wing cell or subepithelial nerve plexus was visible. Bowman's layer was fold-like structure. The shape of anterior and middle keratocyte nuclei were polygonal, but posterior keratocyte was oval shape. Also the nerve plexus of middle stromal layer was visible and the nucleus of endothelial cell was reflective hexagonal shape. CONCLUSIONS: The normal corneal morphological findings were studied by confocal microscopy. These data might provide the useful informations for the diagnosis of corneal disease.
Cornea ; Corneal Diseases ; Diagnosis ; Endothelial Cells ; Endothelium ; Epithelium ; Epithelium, Corneal ; Humans* ; Membranes ; Microscopy, Confocal

PURPOSE: To evaluate the current status of pathological report in the accurate diagnosis of recipient cornea following penetrating keratoplasty. METHODS: We performed a chart review of the hospital records of 174 patients (191 eyes) who had received keratoplasty in between January, 1994 and March, 2002. RESULTS: Pathologists described pathological diagnoses in 64 cases (33.5%). Pathological diagnosis seemed to be made according to patients' clinical diagnosis. Pathologists described the same disease in various forms. Special staining was used in 9 cases (4.71%). CONCLUSIONS: In most cases, pathologists described pathological findings without a definite diagnosis. We suggest a new form of pathological report for better description of corneal disease. There should be a system for active interchange between ophthalmologists and pathologists.
Cornea ; Corneal Diseases ; Corneal Transplantation ; Diagnosis* ; Hospital Records ; Humans ; Keratoplasty, Penetrating* ; Pathology

PURPOSE: To evaluate the risk factors for cataract formation and cataract extraction after penetrating keratoplasty to determine whether a combined surgery should be performed. METHODS: Variables from 189 phakic eyes that underwent penetrating keratoplasty from April 1992 to November 2004 were analyzed for the possibility of cataract extraction after penetrating keratoplasty according to sex, age, diagnosis, accompanied glaucoma, preoperative vision and steroid use. The mean interval between penetrating keratoplasty and cataract extraction was also studied. RESULTS: Cataract extraction was performed in 27 eyes (14.3%) and the mean interval between keratoplasty and cataract extraction was 24.5 months. Age was determined to be the most important independent risk factor for cataract extraction (p=0.0009) associated glaucoma also shown to be a risk factor (p=0.0011). Sex and corneal disease before keratoplasty were not shown to be risk factors. In the mean interval cataract extraction following penetrating keratoplasty, no statistically significant difference was found according to age, sex and diagnosis. Posterior subcapsular cataract was predominant (55.6%) and the mean visual acuity improved from 0.10 to 0.42. CONCLUSIONS: The likelihood of cataract formation and cataract extraction subsequent to penetrating keratoplasty increased with age and associated glaucoma. The results from this study can help surgeons to determine whether combined surgery should be performed and help them to counsel patients on the risk of cataract formation.
Cataract Extraction ; Cataract* ; Corneal Diseases ; Corneal Transplantation ; Diagnosis ; Glaucoma ; Humans ; Keratoplasty, Penetrating* ; Risk Factors ; Visual Acuity

Rheumatic diseases are associated various extra-articular manifestations, such as eye, nerve, pericardium, and pleura. The anterior part of the eye has distinguished anatomic structure resembling synovial joints, thus it is a common site of ocular manifestation in rheumatic disease. These changes include sicca syndrome, peripheral ulcerative keratitis, episcleritis, scleritis, and iritis. Some of these findings may be the clues for the diagnosis of the rheumatic diseases, and some ocular manifestations may represent the activity or prognosis of the rheumatic diseases. These ocular complications may leads to severe visual loss. It is crucial to rule out underlying systemic diagnosis in rheumatic disease associated ocular diseases, and when diagnosed, the coordination of the rheumatologist with the ophthalmologist in the treatment is imperative.
Corneal Ulcer ; Diagnosis ; Eye Diseases* ; Iritis ; Joints ; Pericardium ; Pleura ; Prognosis ; Rheumatic Diseases* ; Scleritis ; Sjogren's Syndrome

Adult ; Corneal Diseases ; diagnosis ; etiology ; Humans ; Male ; Multiple Myeloma ; complications ; diagnosis

Herpes simplex virus keratits(HSK) is one of the most common external eye diseases that cause corneal blindness, Therefore early diagnosis and proper treatment of HSK are essential. However it is frequently misdiagnosed because it shows non-specific corneal lesion than other infectious corneal disease. And also diagnosis of HSK mostly rely on clinical examination and patient history. We evaluated suspicious HSK patients by indirect immunofluofluorescent(IF) antibody test and analyzed its efficacy in the early diagnosis of HSK. Among 47 patients(47 eyes), 37 patients were suspicious heretic keratitis and others not. Dendritic keratitis patients existed in 17 out of 37 patients and they were evaluated with virus culture and indirect IF test. The result of indirect IF test was confirmed under the immunofluorescent microscope and for virus culture the specimens were inoculated on Vero cells(monkey kidney cells). The positive results of indirect IF test was 28 out of 37 suspicious HSK patients and 1 out of 10 non-suspicious HSK patients. Dendritic HSK patients showed IF positive in 15 out of 17 patients(82.3%). Sensitivity of indirect IF test in suspicious HSK patients was 75.7%(2837) and 88.2%(15/17) in dendritic HSK patients. Indirect IF test was all positive(14/14) in dendritic HSK patients that showed culture positive. From these results, indirect IF test has a high sensitivity in early diagnosis of HSK and might be ussful as a rapid diagnostic tool in HSK patients.
Blindness ; Corneal Diseases ; Diagnosis ; Early Diagnosis ; Eye Diseases ; Herpes Simplex* ; Humans ; Keratitis ; Keratitis, Dendritic ; Keratitis, Herpetic* ; Kidney ; Simplexvirus

Herpes simplex virus keratits(HSK) is one of the most common external eye diseases that cause corneal blindness, Therefore early diagnosis and proper treatment of HSK are essential. However it is frequently misdiagnosed because it shows non-specific corneal lesion than other infectious corneal disease. And also diagnosis of HSK mostly rely on clinical examination and patient history. We evaluated suspicious HSK patients by indirect immunofluofluorescent(IF) antibody test and analyzed its efficacy in the early diagnosis of HSK. Among 47 patients(47 eyes), 37 patients were suspicious heretic keratitis and others not. Dendritic keratitis patients existed in 17 out of 37 patients and they were evaluated with virus culture and indirect IF test. The result of indirect IF test was confirmed under the immunofluorescent microscope and for virus culture the specimens were inoculated on Vero cells(monkey kidney cells). The positive results of indirect IF test was 28 out of 37 suspicious HSK patients and 1 out of 10 non-suspicious HSK patients. Dendritic HSK patients showed IF positive in 15 out of 17 patients(82.3%). Sensitivity of indirect IF test in suspicious HSK patients was 75.7%(2837) and 88.2%(15/17) in dendritic HSK patients. Indirect IF test was all positive(14/14) in dendritic HSK patients that showed culture positive. From these results, indirect IF test has a high sensitivity in early diagnosis of HSK and might be ussful as a rapid diagnostic tool in HSK patients.
Blindness ; Corneal Diseases ; Diagnosis ; Early Diagnosis ; Eye Diseases ; Herpes Simplex* ; Humans ; Keratitis ; Keratitis, Dendritic ; Keratitis, Herpetic* ; Kidney ; Simplexvirus