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: 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

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*

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

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

To report the association of a unilateral serous macular detachment with severe postoperative pain. A 71-year-old woman presented with a sudden decrease in vision in the right eye, seven days after a total knee replacement arthroplasty. The patient's history was unremarkable except for a severe pain greater than the visual analog scale of 8 points for about 2 days after surgery. Retinal examination showed a well differentiated serous detachment that was about 3.5 disc diameter in size and located in the macular area. Fluorecein angiography and indocyanine green angiography showed delayed perfusion of the choriocapillaris without leakage points in the early phase and persistent hypofluorescence with pooling of dye in the subretinal space in the late phase. There was a spontaneous resolution of the serous detachment and the choroidal changes with residual pigment epithelial changes. Severe postoperative pain may influence the sympathetic activity and introduce an ischemic injury with a focal, choroidal vascular compromise and secondary dysfunction of overlying RPE cells in select patients.
Aged ; *Arthroplasty, Replacement, Knee ; Choroid/*blood supply ; Coloring Agents/diagnostic use ; Female ; Fluorescein Angiography ; Humans ; Indocyanine Green/diagnostic use ; Ischemia/diagnosis/*etiology ; Pain Measurement ; *Pain, Postoperative ; Retinal Detachment/diagnosis/*etiology ; Serum ; Vision Disorders/etiology

PURPOSE: To report a rare case of episcleritis as the only manifestation of neurosyphilis. CASE SUMMARY: A 40-year-old female was referred to the outpatient clinic because of right episcleritis that was unchanged during the month of treatment. Her headache persisted, and slit lamp examination showed tortuous congestion of engorged episcleral vessels with swelling in the superior-temporal region of the right eye, but fundus and radiological studies showed normal findings. Serological tests were reactive for venereal disease research laboratory test, treponema pallidum hemagglutination assay test, and fluorescent treponemal antibody absorption test. Under the suspicion of persistent syphilis infection, cerebrospinal fluid examination was performed, and the diagnosis of neurosyphilis with episcleritis was diagnosed. Treatment consisted of intravenous injections of 5 million IU penicillin G potassium every 4 hours for 14 days. The ocular inflammation resolved within the first week of treatment and did not recur. CONCLUSIONS: We report a case of intractable episcleritis that required examination for syphilitic infection using serological and CSF tests, and the appropriate antimicrobial therapy for syphilis with follow-up examinations.
Adult ; Ambulatory Care Facilities ; Cerebrospinal Fluid ; Diagnosis ; Estrogens, Conjugated (USP) ; Female ; Fluorescent Treponemal Antibody-Absorption Test ; Headache ; Hemagglutination ; Humans ; Inflammation ; Injections, Intravenous ; Neurosyphilis* ; Penicillin G ; Scleritis* ; Serologic Tests ; Sexually Transmitted Diseases ; Syphilis ; Treponema pallidum

PURPOSE: To determine whether there are significant differences between the retinal thicknesses of the macular area in eyes of healthy Koreans compared with normative data using OCT3 (version 4.0). METHODS: The study was performed in 111 eyes of 71 adults between the ages of 20 and 69 with corrected vision of 0.8 or greater and no systemic or ocular disease. The subject group was designed to have a similar age distribution to that of normative data. An OCT3 fast macular map was used to measure macular thickness. The results were further analyzed and compared with the normative data. RESULTS: The overall results from the subject group were similar to the normative data. However, the nasal parts of the outer ring were thicker than the normative data and the temporal parts of the outer ring were thinner (p<.0001). When each age group was compared, the thickness of the superior part of the inner ring and the nasal part of the inner and outer rings were thicker than the normative data in the age groups of twenties and thirties (p<.05). For the nasal parts of outer ring, the macula were thicker by OCT examination than the normative data in 25.2% of subjects, although they were clinically normal. CONCLUSIONS: Macular thickness in healthy Koreans was generally similar to the normative data of OCT3. However, a slight difference may exist and must be considered when measuring and interpreting macular thickness measurements.
Adult ; Age Distribution ; Eye ; Humans ; Retinaldehyde ; Tomography, Optical Coherence ; Vision, Ocular