PURPOSE: To evaluate the factors influencing the effect of the intravitreal bevacizumab injection in patients with central serous chorioretinopathy. METHODS: We performed a retrospective review of the medical records of 54 patients (56 eyes) who had been symptomatic for more than 3 months with central serous chorioretinopathy (CSC), who had undergone intravitreal bevacizumab injection and been on regular follow-up for at least 6 months. RESULTS: Responders were 34 eyes (60.7%) and non-responders were 22 eyes (39.3%). The leaking points of the non-responder group were multiple and located more centrally than that of the responder group on fluorescein angiography (FA) (p = 0.01, p = 0.044). In addition, non-responder group showed cystoid macular edema on optical coherence tomography (OCT) as compared with responder group (p = 0.042). CONCLUSIONS: CSC with multiple, centrally located leaks on FA or cystoid macular edema on OCT was ineffective or recurrent with intravitreal bevacizumab injection.
Central Serous Chorioretinopathy* ; Fluorescein Angiography ; Follow-Up Studies ; Humans ; Macular Edema ; Medical Records ; Retrospective Studies ; Tomography, Optical Coherence ; Bevacizumab

PURPOSE: To evaluate the characteristics of choroidal nevus using the enhanced depth imaging spectral domain optical coherence tomography (EDI SD-OCT), with a comparison to the B scan ultrasound (BUS) findings. METHODS: Medical records of 124 eyes of 124 choroidal nevus patients were reviewed retrospectively. All patients underwent fundus photography (FP), EDI SD-OCT, and BUS. RESULTS: Of 124 eyes with choroidal nevus examined by EDI SD-OCT, 43 eyes (35%) displayed good images to study. The most common EDI-OCT imaging features included choroidal shadowing, choriocapillary thinning, retinal pigment epithelial changes, and overlying subretinal fluid. The mean nevus thickness was 817 microm (120-1850 microm) by EDI-OCT compared 1295 microm (780-2400 microm) by BUS. The mean difference in the tumor thickness between two techniques was 475 microm (27-1319 microm) (p < 0.05). CONCLUSIONS: These results have suggested that imaging of choroidal nevus with EDI-OCT shows superior measurement of its characteristics compared with ultrasonography. The clinical utility of this modality is emerging. EDI-OCT is useful in distinguishing suspicious nevi from other chorioretinal lesions, detecting tumor re-growth along the treatment margin, and demonstrating retinal or choroid tumor location.
Choroid* ; Humans ; Medical Records ; Nevus* ; Photography ; Retinaldehyde ; Retrospective Studies ; Shadowing (Histology) ; Subretinal Fluid ; Tomography, Optical Coherence* ; Ultrasonography*

PURPOSE: The histiogenesis of retinoblastoma, the most common intraocular malignancy of childhood, has been investigated from the early times. But in spite of this effort, its origin has been controversial. This study was performed to investigated the cell of origin for retinoblastoma using enzyme histomchemistry for carbonic anhydrase. METHODS: We obtained enucleated eye that was diagnosed as retinoblastoma and its section was stained for hematoxylin-eosin for diagnosis of retinoblastoma. We used enzyme histomchemistry for carbonic anhydrase distinguishing Muller's cells, red-and green-sensistive cones from neuro-retinal cells. RESULTS: They were disagnosed as relatively well-differentiated retinoblastoma by hematoxylin-eosin staining and composed of tumor cells with numerous rosette. Neither numeric nor morphologic changes of Muller cells that are suspected of malignant features in enzyme histochemistry for carbonic anhydrase was found. CONCLUSIONS: The cells of retinoblastoma were originated from the two layers, inner nuclear and ganglion cell layer. The enzyme histochemistry for carbonic anhydrase is the one of the useful methods to investigate the origin of retinoblastoma although more cases is needed to assess.
Carbonic Anhydrase I ; Carbonic Anhydrases ; Diagnosis ; Ependymoglial Cells ; Ganglion Cysts ; Retinoblastoma*

Carbonic anhydrase, an enzyme catalysing the reversible hydration of carbon dioxide, is present in the Muller cells.Because the enzyme is not present in other uroretinal cells in the retina, it can be used as a marker for Muller cells.Carbonic anhydrase activity was demonstrated bnzymehistochemically in human and rabbit Muller cells to know a relation of metabolic functions and carbonic anhydrase activity.Human retinas were obtained from donor eyes.The eyes were enucleated immediately after death forenzymatic activity. In human retina, heavy staining was found in the inner nuclear layer and nerve fiber layer, moderate staining in the outer nuclear layer and weak or no staining in the plexiform layers.In rabbit retina, heavy staining was found in the nerve fiber layer and nuclear layers and weak reaction in the two plexiform layers. These findings suggest that Muller cells may participate in CO2 homeostasis mechanism of carbonic anhydrase in the retina.
Carbon Dioxide ; Carbon* ; Carbonic Anhydrases ; Ependymoglial Cells ; Homeostasis ; Humans ; Metabolism ; Nerve Fibers ; Retina ; Tissue Donors

PURPOSE: Vascular cells may not be the only cells affected by diabetes in the retina. In particular, b-wave abnormalities of the electroretinogram in diabetic patients with absentor minimal microangiopathy have suggested to possible dysfunction of Muller cells. METHODS: This study was performed to investigate the morphological changes of Muller cell in human diabetic retinopathy. Thirteen human retinas were obtained from donor eyes. These eyes were enucleated immediately after death. Five eyes were used as normal controls without specific medical history. Eight eyes were obtained from diabetes patients and four eyes of them had diabetic retinopathy in gross finding. RESULTS: In normal control group, Muller cells were observed in nerve fiber layer and inner nuclear layer of the retina. The Muller cells were found to have stained strong positive reaction and polygonal pattern. In the group of diabetic history without diabetic retinopathy, Muller cells had similar pattern with control group. But, in diabetic retinopathy, Muller cells had lightly positive pattern in inner nuclear layer and nuclei were oval, compared with polygonal shape in normal retina. CONCLUSIONS: These findings suggested that Muller cells might have functional and morphological changes in diabetic retinopathy, and these changes can induce the diabetic microvascular abnormalities.
Carbonic Anhydrases ; Diabetic Retinopathy* ; Ependymoglial Cells ; Humans* ; Nerve Fibers ; Retina ; Tissue Donors

PURPOSE: To report a case of focal choroidal excavation associated with central serous chorioretinopathy. CASE SUMMARY: A 48-year-old female presented with a 20-year history of visual disturbance. Focal choroidal excavation with neurosensory retinal detachment was detected in the right eye on optical coherence tomography. Fluorescein angiography showed hyperfluorescene in the area of excavation and multiple focal hyperfluorescences in the perimacular area. Vertically linear hyperfluorescene line was detected in the excavated area caused by retinal pigment epithelial atrophy. Based on the 2 diagnostic findings, we diagnosed a focal choroidal excavation with central serous chorioretinopathy. No progression was detected for 2 months.
Atrophy ; Central Serous Chorioretinopathy* ; Choroid* ; Female ; Fluorescein Angiography ; Humans ; Middle Aged ; Retinal Detachment ; Retinaldehyde ; Tomography, Optical Coherence

PURPOSE: To review the management of posterior segment metallic intraocular foreign bodies (IOFB) and to compare the use of an external approach using a large electromagnet and an internal approach using vitrectomy and its tools for their removal. METHODS: A retrospective review was performed on 49 eyes of 49 patients who underwent surgical removal of metallic IOFBs with either an internal or an external approach at a single institution between January 2003 and December 2006. We divided 49 eyes into two groups based on the type of approach: 26 external (n=26) and 23 internal (n=23). Visual acuity and the presence of any complications occurring with the two approaches were the main outcome measures studied. RESULTS: Thirty of 49 eyes (61%) showed improvements in visual acuity. When we compared patients treated with an external versus an internal approach, we found no statistically significant difference in regard to visual outcome. Preoperative vitreous hemorrhage and endophthalmitis were more common in the internal approach group. A trend toward a higher rate of reoperation was more common in the external approach group, but they were not statistically significant. Postoperative complications found to be significantly different between the two groups were the rate of postoperative endophthalmitis and retinal detachment, which were more common in the external approach group. CONCLUSIONS: Surgical removal of metallic IOFBs results in significant visual improvement regardless of the approach method. The internal approach by vitrectomy is recommended as the first choice in preoperative conditions such as severe cataracts, vitreous hemorrhage and endophthalmitis, as well as in groups at high risk for postoperative endophalmitis and retinal detachment.
Cataract ; Endophthalmitis ; Eye ; Foreign Bodies ; Humans ; Magnets ; Outcome Assessment (Health Care) ; Postoperative Complications ; Reoperation ; Retinal Detachment ; Retrospective Studies ; Visual Acuity ; Vitrectomy ; Vitreous Hemorrhage

PURPOSE: Blood vessels within the retina are surrounded by Muller cells, and it is known that Muller cells may be related with the pathogenesis of diabetic retinopathy based on this histologic structure. Argon laser photocoagulation is routinely performed in the treatment of diabetic retinopathy by inhibiting neovascularization and edema, but its mechanism remains unclear. Muller cell changes were demonstrated utilizing carbonic anhydrase immunohistochemical staining to know a relation between argon laser photocoagulation and the effect of Muller cells in the rabbit retina. METHODS: Author used 16 rabbit retinas which were obtained from 8 rabbits. Exposure time and spot size were kept 0.15 second and 500 microgram. 150~350 mW of power intensity was needed to produce moderate degree coagulation in rabbit retina. RESULTS: We observed retina and its histological changes at 1 week, 2 weeks, 3 weeks and 4 weeks after photocoagulation by using carbonic anhydrase staining. The differences in the morphological changes in Muller cells and retina layers were observed between moderate and severe degree coagulation. With severe degree coagulation, the loss of all the retinal layers was observed. On the other hand, with moderate degree coagulation, proliferated pigment epithelial cells and chorioretinal adhesion were observed with loss of photoreceptor and outer nuclear layer. Muller cells were observed by carbonic anhydrase staining with proliferated Muller cells with increased nuclei and proliferated process. CONCLUSIONS: These findings suggest that Muller cells might be important in the scar formation by argon laser photocoagulation and that the proliferaration of Muller cells play a certain role in the therapeutic mechanism.
Argon* ; Blood Vessels ; Carbonic Anhydrases ; Cicatrix ; Diabetic Retinopathy ; Edema ; Ependymoglial Cells ; Epithelial Cells ; Hand ; Light Coagulation* ; Rabbits ; Retina ; Retinaldehyde

PURPOSE: To evaluate the efficacy and safety of the combination of cataract surgery and intravitreal bevacizumab injection in patients with cataract and diabetic macular edema. METHODS: Patients received an intravitreal injection of bevacizumab(1.25 mg) combined with phacoemulsification and implantation of a posterior chamber intraocular lens. Best corrected visual acuity (BCVA, LogMAR) and, central macular thickness (CMT) were measured using OCT at baseline and at one week, one, three, and six months after surgery, and adverse events were recorded. RESULTS: The mean baseline LogMAR BCVA was 0.84+/-0.50 and mean CMT was 337.1+/-57.50 micrometer. At one week, one, three, and six months after surgery, the mean BCVAs were 0.52+/-0.40, 0.51+/-0.42, 0.52+/-0.34, and 0.46+/-0.37, and the mean CMTs were 356.4+/-86.44 micrometer, 338.8+/-138.4 micrometer, 349.0+/-122.9 micrometer, and 334.2+/-100.4 micrometer, respectively. No adverse events associated with cataract surgery or intravitreal bevacizumab injection were observed. CONCLUSIONS: The short-term results from the present study suggest the combination of cataract surgery and intravitreal bevacizumab injection are safe and effective for the prevention of macular edema aggravation for one month, but has little effect on prevention of macular edema aggravation three months after surgery for diabetic macular edema patients.
Antibodies, Monoclonal, Humanized ; Cataract ; Humans ; Intravitreal Injections ; Lenses, Intraocular ; Macular Edema ; Phacoemulsification ; Visual Acuity ; Bevacizumab

PURPOSE: To identify the clinical manifestations and risk factors for poor visual outcome, as well as antibiotic susceptibility of isolates in bacterial keratitis. METHODS: A total of 128 eyes in 128 patients with bacterial keratitis, who were diagnosed by smears and cultures from January 2000 to December 2007 were reviewed retrospectively. Sex, age, previous ocular disease, trauma history, pre-treatment duration, previous ocular surgery, clinical manifestation, causative bacteria, pre- and post-treatment visual acuity, and treatment results were evaluated. An initial univariate and multivariate logistic regression analysis was performed to identify and select the main prognostic factors. The antibiotic susceptibility was evaluated in 2 consecutive 4-year periods. RESULTS: The mean age of the 128 patients was 59.0+/-18.2 years; 67 (52.3%) patients were male. The most common risk factor was ocular trauma (40.6%). The most prevalent isolate was coagulase-negative Staphylococcus (43.7%). Large size (p < 0.001) and previous ocular disease (p < 0.001) were significant prognostic factors in the multivariate logistic regression model. Resistance of cefazolin and aminoglycoside antibiotics that were commonly used as a combination therapy increased over the 8 years, but there was no significant difference in the 2 time periods tested (all p > 0.05). Among the fluoroquinolone antibiotics, susceptibility of ciprofloxacin was 75.7%. CONCLUSIONS: In patients with bacterial keratitis, a large ulcer size and the presence of previous ocular disease were risk factors for poor visual outcome. Gentamicin, cefazolin, and ciprofloxacin should be avoided as primary monotherapy for bacterial keratitis.
Anti-Bacterial Agents ; Bacteria ; Cefazolin ; Ciprofloxacin ; Eye ; Gentamicins ; Humans ; Keratitis ; Logistic Models ; Male ; Retrospective Studies ; Risk Factors ; Staphylococcus ; Ulcer ; Visual Acuity