PURPOSE: Choristomas represent congenital overgrowth of normal tissues in an abnormal location. The simultaneous presence of epibulbar choristoma and microphthalmos has rarely been reported. The authors report a case of extensive epibulbar choristoma associated with microphthalmos. CASE SUMMARY: A 9-day-old boy with the left eyeball absent from birth was referred to our clinic. A large cornea-like structure covered by keratinized membrane was observed inside the eyelid aperture, therefore buphthalmos or corneal staphyloma with microphthalmos was presumed. At the age of 2 months, a large mass of central conjunctival sac protruded through the left eyelid aperture. Manual reduction could not return the tissue to its original site and the mass immediately protruded again. At the age of 9 months, orbital magnetic resonance imaging showed the small presumed ocular tissue behind the large mass of fat signal in the central anterior orbit, therefore, extensive epibulbar choristoma associated with microphthalmos was diagnosed. At 12 months of age, partial excision of the protruding portion of the mass was performed. Based on pathologic examination, the mass was determined to be a choristoma and cosmetically acceptable appearance with prosthesis was maintained for 10 months after the surgery. CONCLUSIONS: Because there is no vision in extensive choristoma associated with microphthalmos, the treatment goal is cosmetic improvement. Conjunctivoplasty following partial mass excision for prosthesis wearing is a good treatment option.
Choristoma* ; Eyelids ; Humans ; Hydrophthalmos ; Lacrimal Apparatus ; Magnetic Resonance Imaging ; Male ; Membranes ; Microphthalmos* ; Orbit ; Parturition ; Prostheses and Implants

PURPOSE: To investigate the relationships between tear osmolarity and various parameters for ocular and systemic disease in primary Sjögren's syndrome. METHODS: The medical records of 53 patients with primary Sjögren's syndrome were reviewed. Tear osmolarity using a TearLab® (TearLab™ Corp., San Diego, CA, USA) osmometer as well as other dry eye parameters such as tear break-up time, ocular staining score (Sjögren's International Collaboration Clinical Alliance [SICCA] ocular staining score, SICCA score), Schirmer-I score, symptoms with Ocular Surface Disease Index (OSDI), and Visual Analog Scale (VAS) were obtained. Systemic laboratory data and medication history were also collected. The correlations between the parameters were analyzed using the Spearman's rank correlation test. RESULTS: 53 patients with a mean age of 54.1 ± 13.2 years and female predominance (96.23%) were enrolled. The majority of patients (28.3%) were receiving systemic therapy for severe Sjögren's syndrome. The tear osmolarity in Sjögren's syndrome patients was 307 ± 13.6 (mOsm/L). Higher tear osmolarity was associated with lower tear film break-up time (BUT) scores and with higher SICCA scores. Tear osmolarity and the Schirmer test results were not significantly related. Higher tear osmolarity was paradoxically associated with lower VAS scores and lower OSDI scores. Neither current medication nor the salivary gland focus score showed significant associations with tear osmolarity. Although tear osmolarity was not associated with the SSA-Ro or SSA-LA titer, serum immunoglobulin G (IgG) level and serum erythrocyte sedimentation rate (ESR) level showed positive correlations with tear osmolarity. CONCLUSIONS: Tear osmolarity is positively correlated with the severity of dry eye and was associated with lower symptom severity. The significant associations of tear osmolarity with IgG and ESR suggest that high tear osmolarity may be correlated with autoantibody load and the systemic inflammatory state.
Blood Sedimentation ; Cooperative Behavior ; Dry Eye Syndromes ; Female ; Humans ; Immunoglobulin G ; Medical Records ; Osmolar Concentration* ; Salivary Glands ; Tears* ; Visual Analog Scale

Purpose: To evaluate the agreement in ocular biometry outcomes measured by three different devices, the IOL Master 500, IOL Master 700, and Lenstar LS900, and compare the refractive outcomes after cataract surgery obtained using those three devices. Methods: Medical records of 178 eyes of 89 patients who underwent ocular biometry with the three devices were retrospectively reviewed, and 124 eyes met the inclusion criteria. Paired comparisons were performed for axial length (AL), mean keratometry (Km), and anterior chamber depth and quantified their agreement using Bland-Altman plots. Subgroup analyses were done according to the AL and the Km. Refractive outcomes were compared with respect to absolute prediction errors after cataract surgery in 54 eyes. Results: Among 124 eyes, 12, 3, and 5 eyes failed to be measured of AL by IOL Master 500, IOL Master 700 and Lenstar LS900, respectively. The AL measured by Lenstar LS900 was longer than that measured by IOL Master 500 and IOL Master 700 (p < 0.001, p = 0.002, respectively). Subgroup analysis revealed that these results were statistically significant only in long eyes (AL >25.5 mm). Km measured using the IOL Master 500 was steeper than that measured with the IOL Master 700 or Lenstar LS900 (p = 0.001,p < 0.001, respectively). anterior chamber depth measured by IOL Master 500 was shallower than that measured by IOL Master 700 or Lenstar LS900 (p < 0.001, p < 0.001, respectively). Ocular biometry measurements by the three devices showed high agreement with narrow 95% limits of agreement. Absolute prediction errors from the 3 devices showed no statistically significant differences after cataract surgery. Conclusions The IOL Master 700 and Lenstar LS900 demonstrated superior acquisition rates of biometric measurements compared with the IOL Master 500. Ocular biometry using the 3 different devices showed high agreement, although statistically significant differences were observed; however, since there was no difference in predicting the refractive outcomes, those differences are clinically negligible.

PURPOSE: To evaluate the protective effect of applying an ophthalmic viscosurgical device (OVD) to the ocular surface during cataract surgery and its ability to prevent dry eye syndrome. METHODS: Twenty-four patients aged 50 to 75 years who underwent cataract surgery at Seoul National University Bundang Hospital and agreed to participate in the study were included and divided into two groups: a study group who underwent cataract surgery after application of an OVD to the ocular surface, and a control group who underwent cataract surgery without application of an OVD. DisCoVisc was used as the OVD in the study group, while other factors including surgical techniques and administration of anesthetic agents were performed in both groups in the same manner. Indicators of dry eye syndrome including ocular staining score, tear break-up time, and tear osmolality were analyzed. Ocular surface disease index and a visual analog scale were analyzed for dry eye symptoms, and the amount of balanced salt solution used during surface irrigation and operation time were also analyzed. RESULTS: Significant improvement in the tear break-up time, corneal ocular staining score, and ocular surface disease index score in the study group compared with the control group one week after operation (by the Mann-Whitney test). Use of OVD was associated with longer operating time. CONCLUSIONS: OVD applied to the ocular surface during cataract surgery had a protective effect on the ocular surface one week after surgery.
Anesthetics ; Cataract Extraction ; Cataract ; Dry Eye Syndromes ; Humans ; Osmolar Concentration ; Seoul ; Tears ; Visual Analog Scale

Despite advancements in therapy for advanced gastric and gastroesophageal junction cancers, their prognosis remains dismal. Tumor angiogenesis plays a key role in cancer growth and metastasis, and recent studies indicate that pharmacologic blockade of angiogenesis is a promising approach to therapy. In this systematic review, we summarize current literature on the clinical benefit of anti-angiogenic agents in advanced gastric cancer. We conducted a systematic search of PubMed and conference proceedings including the American Society of Clinical Oncology, the European Society for Medical Oncology, and the European Cancer Congress. Included studies aimed to prospectively evaluate the efficacy and safety of anti-angiogenic agents in advanced gastric or gastroesophageal junction cancer. Each trial investigated at least one of the following endpoints: overall survival, progression-free survival/time to progression, and/or objective response rate. Our search yielded 139 publications. Forty-two met the predefined inclusion criteria. Included studies reported outcomes with apatinib, axitinib, bevacizumab, orantinib, pazopanib, ramucirumab, regorafenib, sorafenib, sunitinib, telatinib, and vandetanib. Second-line therapy with ramucirumab and third-line therapy with apatinib are the only anti-angiogenic agents so far shown to significantly improve survival of patients with advanced gastric cancer. Overall, agents that specifically target the vascular endothelial growth factor ligand or receptor have better safety profile compared to multi-target tyrosine kinase inhibitors.
Angiogenesis Inhibitors ; Bevacizumab ; Disease-Free Survival ; Esophagogastric Junction* ; Humans ; Medical Oncology ; Neoplasm Metastasis ; Prognosis ; Prospective Studies ; Protein-Tyrosine Kinases ; Stomach Neoplasms ; Vascular Endothelial Growth Factor A ; Vascular Endothelial Growth Factors