PURPOSE: To compare the anatomical and visual outcomes in idiopathic macular hole surgery with or without indocyanine green (ICG)-stained internal limiting membrane (ILM) peeling. METHODS: Thirty-six eyes of 36 patients who underwent idiopathic macular hole surgery were included. Follow-up period was longer than 6 months. In the initial 16 eyes, no ILM peeling was performed (non-ILM peeling group). The subsequent 20 eyes underwent surgery with ICG-stained ILM peeling (ILM peeling group). RESULTS: There were no significant differences in the age, sex, hole size, symptom duration and preoperative best-corrected visual acuity between the two groups. The anatomical closure rates were 95% (19/20eyes) and 75% (12/16eyes) in the ILM peeling and non-ILM peeling groups, respectively (Fisher's exact test, p=0.15). Visual improvement of two or more lines occurred in 35% (7/20eyes) in the ILM peeling group and 43.8% (7/16eyes) in the non-ILM peeling group (Chi-square test, p=0.59). CONCLUSIONS: ICG stained ILM peeling was not statistically significant for anatomic and functional success in idiopathic macular hole surgery. Further studies of the toxicity of ICG and the result of ILM peeling should be performed.
Follow-Up Studies ; Humans ; Indocyanine Green ; Membranes* ; Retinal Perforations* ; Visual Acuity

Multiple Evanescent White Dot Syndrome is a clinical disorder of unknown etiology that affects primarily the retinal pigment epithelium and photoreceptors, usually manifests with acute visual loss or blurred vision. The course of MEWDS is recoverable over several weeks. Characteristic ocular manifestations may include multiple white dots in the deep retina of posterior pole, granularity of the macula, optic disc edema, and vitreous cells. Fluorescein angiography shows small punctate areas of hyper-fluorescence at the level of the retinal pigment epithelium corresponding to the white dots and late fluorescein staining, fluorescein leakage from disc capillaries. We experienced a case of suspected Multiple Evanescent White Dot Syndrome with Ebstein-Barr virus infection and reviewed the available literatures regarding the disease entity.
Capillaries ; Edema ; Fluorescein ; Fluorescein Angiography ; Retina ; Retinal Pigment Epithelium

Branch retinal vein occlusion (BRVO) is the second most common form of retinal vascular diseases next to diabetic retinopathy. Several risk factors such as hypertension, diabetes mellitus, and hyperopia have been shown to be associated with BRVO. The pathogenesis of branch retinal vein occlusion has not been well understood. This study was conducted prospectively on 21 patients with BRVO and normal 21 patients as controls to assess the relationship of the axial length with the development of BRVO. Mean axial lengths of the affected and the fellow eyes in the branch retinal vein occlusion group were 22.69 +/-0.72 mmand 22.89 +/-0.67mm, respectively. The difference between mean axial lengths of the affected and the fellow eyes was not statistically significant (p=0.17). The mean axial length of control eyes was 23.22 +/-1.29 mm. The affected eyes in the BRVO group were 0.53 mmshorter than eyes in control group on the average, and the difference was statistically significant(p=0.04). This study suggests that shorter axial length could be a local risk factor in the pathogenesis of branch retinal vein occlusion.
Diabetes Mellitus ; Diabetic Retinopathy ; Humans ; Hyperopia ; Hypertension ; Prospective Studies ; Retinal Vein Occlusion* ; Retinal Vein* ; Retinaldehyde* ; Risk Factors ; Vascular Diseases

The authors studied retrospectively on the surgical results of modified Fasanella-Servat operation for blepharoptosis. The 58 patients underwent modified Fasanella-Servat operation for blepharoptosis and were followed for at least 6 months. We obtained 74.1% primary success rate in the 58 cases of blepharoptosis. The undercorrection, the most common complication, could be correctable by any other ptosis procedures such as levator resction. However, severe complications such as overcorrection and eyelid contour abnormalities were very rare. We also obtained good surgical results even in groups of moderate degree of ptosis and fair levator function which had not been indicated for Fasanella-Servat operation in general.
Blepharoptosis ; Eyelids ; Humans ; Retrospective Studies

PURPOSE: This study was undertaken to evaluate the clinical results of pars plana vitrectomy on posterior segment complications in posterior uveitis. METHODS: We reviewed the records of 20 eyes of 19 uveitis patients who were followed up for 6 months or more after vitrectomy. RESULTS: The mean follow-up period was 20 months. Final visual acuity improved in 10 eyes (50%), was maintained in 6 (30%), and decreased in 4 (20%). The mean improvement of vision was 1.6 lines (p=0.019). Detached retina was reattached in 8 (80%) among the 10 eyes with primary surgery. Postoperative complications were cataract (7 eyes), macular degeneration (2 eyes), retinal detachment (2 eyes), and recurrence (1 eye). CONCLUSIONS: These results suggest that pars plana vitrectomy may be a safe and effective treatment for posterior segment complications in posterior uveitis, but that early and complete vitrectomy should be considered for a better visual prognosis.
Cataract ; Follow-Up Studies ; Humans ; Macular Degeneration ; Postoperative Complications ; Prognosis ; Recurrence ; Retina ; Retinal Detachment ; Uveitis ; Uveitis, Posterior* ; Visual Acuity ; Vitrectomy*

Heterotopic pancreas (HP) is defined as pancreatic tissue lacking anatomic and vascular continuity with the main body of the pancreas. Most are asymptomatic, but can cause ulcer, bleeding, intussusception, and mechanical obstruction. Herein, we presented one case of HP presented as duodenal tumor causing duodenal obstruction. A 7-year-old girl visited the emergency room for abdominal pain with vomiting for 24 hours. Computed tomography and upper gastrointestinal series revealed a polypoid mass with short stalk in the 2nd portion of duodenum. We attempted an endoscopic removal. However, the lumen was nearly obstructed by the mass and the stalk was too broad and hard to excise. The mass was surgically removed via duodenotomy. It was confirmed as a HP with ductal and acini components (type 2 by Heinrich classification). Postoperatively, the patient has been well without any complication and recurrence.
Abdominal Pain ; Child ; Duodenal Neoplasms ; Duodenal Obstruction ; Duodenum ; Emergency Service, Hospital ; Female ; Hemorrhage ; Humans ; Intussusception ; Pancreas* ; Recurrence ; Ulcer ; Vomiting

PURPOSE: To investigate the effects of a delay in finger temperature recovery rate on the hand cold provocation test (HCPT) and a nocturnal dip greater than 10% (dipper) on the progression of glaucomatous visual field (VF) defects in open-angle glaucoma patients when the intraocular pressure (IOP) was well controlled lower than the target pressure. METHODS: 30 patients (58 eyes) with normal tension glaucoma (NTG) and 13 patients (24 eyes) with primary open angle glaucoma, and 12 normal controls (24 eyes) were retrospectively enrolled in this study. We performed HCPT, 24 hour ambulatory blood pressure monitoring (24-hr ABPM), Goldmann applanation tonometer measurements, and VF tests on all subjects. The delay in finger temperature recovery rate was defined as a delay longer than 15% of the mean finger temperature of normal controls over 2 intervals among 5, 10, 15, and 20 minutes after the immersion of cold water. We examined the relationships among the delay in finger temperature recovery rate, dipper, and the progression of glaucomatous VF defects. RESULTS: The finger temperature recovery rate in NTG patients was significantly delayed more than that of normal controls at 5, 10, and 15 minutes after the immersion. The delay in finger temperature recovery rate significantly correlated with dipper in NTG patients. Glaucomatous VF defects were significantly progressed in the presence of dipper in NTG patients. Delay in finger temperature recovery rate was significantly related to the progression of glaucomatous VF defects in NTG patients. In the binary logistic regression test, delay in finger temperature recovery rate was the only factor that was strongly related to the progression of glaucomatous visual field in NTG patients. CONCLUSIONS: When glaucomatous VF defects progressed despite the IOP being well controlled, 24-hr ABPM and HCPT for detecting vascular dysregulation might be helpful for diagnosis and treatment of glaucoma.
Blood Pressure Monitoring, Ambulatory ; Diagnosis ; Fingers* ; Glaucoma* ; Glaucoma, Open-Angle ; Hand ; Humans ; Immersion ; Intraocular Pressure ; Logistic Models ; Low Tension Glaucoma ; Retrospective Studies ; Visual Fields ; Water

PURPOSE: We report 2 cases of infectious endophthalmitis after intravireal triamcinolone acetonide injection which was successfully treated with early vitrectomy. METHODS: A 56 year old male patient with chronic cystoid macular edema of right eye and an 84 year old female patient with diabetic macular edema of right eye (pseudophakic) eye were treated with intravireal triamcinolone acetonide injection. Four days after the injection, both the patients complained of decreased visual acuity that had been developed 1 and 2 days prior respectively. Visual acuity was hand motion, inflammatory cells, flare, fibrins and hypopyon were found in the anterior chamber. Fundus was not visible due to vitreous opacity. RESULTS: The two patients were presumed to have infectious endophthalmitis. Anterior chamber irrigation, vitrectomy, intravitreal antibiotics injection, and vitreous culture were performed. Coagulase negative staphylococcus was detected from vitreous culture, Within 1 week of the follow-up procedures, the anterior chamber and vitreous inflammation were improved and visual acuity recovered to the level attained before intravireal triamcinolone acetonide injection. CONCLUSIONS: If after intravireal triamcinolone acetonide injection, there is severely decreased visual acuity, inflammation of the anterior chamber and vitreous, flare and fibrin are detected, infectious endophthalmitis must be suspected. If diagnosed early and treated with vitrectomy, a favorable visual prognosis is expected.
Aged, 80 and over ; Anterior Chamber ; Anti-Bacterial Agents ; Coagulase ; Endophthalmitis* ; Female ; Fibrin ; Follow-Up Studies ; Hand ; Humans ; Inflammation ; Intravitreal Injections* ; Macular Edema ; Male ; Middle Aged ; Prognosis ; Staphylococcus ; Triamcinolone Acetonide* ; Triamcinolone* ; Visual Acuity ; Vitrectomy

PURPOSE: To determine the preoperative factors of different types of diabetic macular edema (DME) classified using Optical Coherence Tomography (OCT) and to evaluate the short-term therapeutic effects and pattern changes of intravitreal triamcinolone acetonide injection (IVTA). METHODS: Seventy-seven eyes of 60 patients, who had been previously diagnosed with DME through fundoscopy and fluorescein angiography, were enrolled, and each patient was classified as one of three DME types according to his/her OCT features: Type 1, diffuse retinal thickening; Type 2, cystoid macular edema; and Type 3, serous macular detachment. We compared age, sex, the duration of diabetes mellitus (DM), and decreased visual acuity (VA). We analyzed VA, intraocular pressure (IOP), foveal thickness (FT), total macular volume (TMV), and pattern changes that occurred between pre-operation and 1 month post-operation. RESULTS: The duration of DM was short in Type 3 DME patients. There were no differences in age or the duration of decreased VA. Pre-operative VA was higher in Type 1 than in Type 2 or 3 patients. FT and TMV increased in thickness from Type 1 through Type 3. VA after IVTA improved in Types 2 and 3. FT and TMV after IVTA decreased in each type. However, the extent of the changes in Types 2 and 3 was greater than that in Type 1. Seventy-four percent of Type 2 and 83% of Type 3 changed to Type 1 after IVTA. CONCLUSIONS: This study found that there were differences in the therapeutic effect of IVTA among patients with different DME patterns. According to our results, the effectiveness of IVTA can be predicted, which we believe will help to objectively determine DME treatment.
Diabetes Mellitus ; Eye ; Fluorescein Angiography ; Humans ; Intraocular Pressure ; Macular Edema ; Retinaldehyde ; Tomography, Optical Coherence ; Triamcinolone ; Triamcinolone Acetonide ; Visual Acuity

PURPOSE: We report a case of post-traumatic hypotony retinopathy with cyclodialysis cleft treated by intravitreal gas injection. METHODS: A 38-year-old man presented with decreased visual acuity after blunt trauma to the left eye. Visual acuity of the left eye was 0.06 and intraocular pressure was 1 mmHg. No external wound was found. The anterior chamber showed a microscopic hyphema and, upon funduscopic examination, mild macular edema and striae were seen. The cyclodialysis was identified using gonioscopy. We treated the patient with intravitreal gas (perfluoropropane, C3F8) injection under topical anesthesia and tracked the outcome of this treatment. RESULTS: On the first postoperative day, intraocular pressure fell to the normal range. After 7 days the visual acuity improved to 1.0. During a follow-up period of 10 months, intraocular pressure and visual acuity remained in their normal range. CONCLUSIONS: Intravitreal gas injection offers a safe and effective method of treating hypotony retinopathy with cyclodialysis cleft.
Adult ; Anesthesia ; Anterior Chamber ; Follow-Up Studies ; Gonioscopy ; Humans ; Hyphema ; Intraocular Pressure ; Macular Edema ; Reference Values ; Visual Acuity ; Wounds and Injuries