To evaluate the regional differences in the stereometric parameters of optic nerve head in primary open angle glaucoma, we retrieved rim area, disc area, cup volume/disc area, and maximum depth in 6 predefined segements using mean topography measured with Heidelberg Retina Tomograph. Eleven eyes from 11 primary open angle glaucoma patients, whose mean defect in Humphrey C30-2 visual field was -4.2 +/- 2.6dB and intraocular pressure was 18.7 +/- 3.2mmHg, were enrolled in this study. The values of rim area/disc area were significantly different between segments(p<0.05), and increased in the order of temporal. temporoinferior, temporosuperior, nasal nasosuperior, and nasoinferior segment. The values of cup volume/disc area were also significantly different between segments(p<0.05), and decreased in the order of temporoinferior, temporosuperior, temporal, nasosuperior, nasal, and nasoinferior segment. However, the values of maximum depth were not significantly different between segments. These results suggest that optic nerve head damage in primary open angle glaucoma may be different according to the region.
Glaucoma, Open-Angle* ; Humans ; Intraocular Pressure ; Optic Disk* ; Optic Nerve* ; Retina ; Visual Fields

Experimental melanin-induced uveitis[EMIU]was induced in Lewis rats to investigate the mechanisms of the tissue destruction and spontaneous turning off of the endogenous uveitis. The eyes were enucleated serially, and immunohistochemistry, TUNEL stains, and flow cytometry were performed. The major infiltrating inflammatory cells were CD4 T cells in the uveal tissue of EMIU. Apoptosis of these cells has occurred and progressed throughout the inflammatory period in EMIU eyes. Most TUNEL positive cells revealed CD4 positive. These results suggest that apoptotic cell death occurred primarily in the infiltrating inflammatory cells not in the tissue cells of the eye and the apoptosis of CD4 T cells may play a key role in the spontaneous turning off mechanism of intraocular inflammation in EMIU.
Animals ; Apoptosis* ; Cell Death ; Coloring Agents ; Flow Cytometry ; Immunohistochemistry ; In Situ Nick-End Labeling ; Inflammation ; Rats ; T-Lymphocytes ; Uveitis*

PURPOSE: To investigate the correlation between the severity of diabetic retinopathy and the responses of multifocal electroretinogram (mERG). METHODS: The amplitude and peak time of mERG was evaluated in a group of 88 diabetics and 20 control subjects. The severity of diabetic retinopathy was determined according to the ETDRS scale using color fundus photographs and fluorescein angiograms. RESULTS: The amplitudes of the summed mERG and the central seven hexagons were significantly lower in diabetic patients compared with control subjects, and the more severe the diabetic retinopathy was , the less the amplitude was (P<0.05). The peak times of the summed mERG and the central seven hexagons were significantly delayed in diabetic patients, and the peak time was increased in parallel with the severity of retinopathy (P<0.05). These significant correlations between mERG responses and the severity of diabetic retinopathy was maintained even after the exclusion of patients with diabetic macular edema. CONCLUSIONS: The macular function in diabetic patients is correlated with the grade of diabetic retinopathy, and mERG may have a clinical application in evaluating macular function in these patients.
Diabetic Retinopathy* ; Fluorescein ; Humans ; Macular Edema

PURPOSE: This study aimed to find out the difference in between the anatomic properties children with intermittent exotropia and children with orthophoria. METHODS: The intermittent exotropia group consisted of 35 patients who had an angle of deviation of more than 15 prisms. The control group consisted of 35 orthophoric children with comparable age and sex ratio. From the view of skull AP, we compared the diameter, interlateral wall distance, and intermedial wall distance of the orbital rim. Also we compared the intercanthal distance, interlateral canthal distance of eyelids, and interpupillary distance. RESULTS: The average values of interpupillary distance, intercanthal distance, and interlateral canthal distance of exotropic group were 54.23+/-1.85 mm, 34.75+/-1.66 mm, and 78.25+/-4.21 mm, respectively. Compared to those of control group, which were 53.59+/-1.21 mm, 33.56+/-1.54 mm, and 76.68+/-3.23 mm, respectively, there was no significant difference (P>0.05). The average values of the diameter, interlateral wall distance and the intermedial wall distance of the orbital rim were not significantly different between two groups (p>0.05). CONCLUSIONS: Our results showed that the anatomic properties including orbital rim size and orbital exodeviation did not seen to influence the development of intermittent exotropia.
Child ; Exotropia* ; Eyelids ; Humans ; Orbit ; Sex Ratio ; Skull

PURPOSE: To assess the clinical outcomes of cyclosporine treatment for noninfectious uveitis. METHODS: A retrospective review of medical records was completed for 182 noninfectious uveitis patients who were treated with cyclosporine between January 2001 and August 2010. Data was obtained relevant to demographic characteristics, anatomic classification, and laterality of uveitis, associated systemic disorder, dosage of cyclosporine and prednisolone, usage of other immunosuppressive drugs, visual acuity (VA), control of uveitic activity, and adverse effects during the cyclosporine use. RESULTS: Uveitic activity was controlled to a level of minimal inflammation in 89.0% and completely in 78.6% of patients by the median duration of 49 and 98 days, respectively. Prednisolone-sparing (dose < or =10 mg) control of inflammation equal to or less than the minimal activity was achieved in 75.3% of patients. VA was aggravated more than 0.2 logarithm of the minimum angle of resolution in 17.3% of eyes in spite of cyclosporine treatment for the mean follow-up of 698.4 days. Dose reduction and cessation of cyclosporine was required only in 3.3% and 9.3%, respectively, due to the intolerable toxicity, although 44.0% of patients experienced mild to moderate adverse effects. CONCLUSIONS: Cyclosporine combined with corticosteroids or other immunosuppressive drugs as needed is an effective treatment for noninfectious uveitis, thus minimizing the adverse effects of corticosteroids and other toxic drugs. However, careful monitoring for the toxicity of cyclosporine is needed, because a small group of patients cannot tolerate its toxicity.
Adolescent ; Adult ; Aged ; Cyclosporine/administration & dosage/*therapeutic use ; Female ; Humans ; Immunosuppressive Agents/administration & dosage/*therapeutic use ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Prednisolone/administration & dosage/therapeutic use ; Republic of Korea ; Retrospective Studies ; Treatment Outcome ; Uveitis/*drug therapy ; Visual Acuity

This is a report of an atypical case of progressive outer retinal necrosis (PORN) and the effect of highly active antiretroviral therapy (HAART) on the clinical course of viral retinitis in an acquired immunodeficiency syndrome (AIDS) patient. A 22-year-old male patient infected with human immunodeficiency virus (HIV) presented with unilaterally reduced visual acuity and a dense cataract. After cataract extraction, retinal lesions involving the peripheral and macular areas were found with perivascular sparing and the mud-cracked, characteristic appearance of PORN. He was diagnosed as having PORN based on clinical features and was given combined antiviral treatment. With concurrent HAART, the retinal lesions regressed, with the regression being accelerated by further treatment with intravenous acyclovir and ganciclovir. This case suggests that HAART may change the clinical course of PORN in AIDS patients by improving host immunity. PORN should be included in the differential diagnosis of acute unilateral cataract in AIDS patients.
AIDS-Related Opportunistic Infections/complications/*drug therapy ; Acyclovir/therapeutic use ; Adult ; *Antiretroviral Therapy, Highly Active ; Antiviral Agents/*therapeutic use ; Cataract/complications ; Disease Progression ; Drug Therapy, Combination ; Fluorescein Angiography ; Ganciclovir/therapeutic use ; Herpes Zoster Ophthalmicus/*drug therapy/etiology ; Humans ; Male ; Phacoemulsification ; Retinal Necrosis Syndrome, Acute/*drug therapy/etiology ; Visual Acuity

PURPOSE: To report one case of bilateral acute retinal necrosis (ARN) syndrome in the patient with acquired immunodeficiency syndrome (AIDS). METHODS: Bilateral retinal necrosis, occlusive vasculitis, vitreous opacity and inflammatory reaction in anterior chamber were noted in a 48-years old man with AIDS. RESULTS: The patient was diagnosed as bilateral ARN, but did not respond to intravenous acyclovir therapy. However, the patient was successfully treated with intravenous ganciclovir at a dosage of 5 mg/kg/day, which resulted in resolution of retinal lesion and improvement of visual acuity without complications such as retinal detachment. CONCLUSIONS: CMV retinitis, progressive outer retinal necrosis, ocular syphilis should be considered in the differential diagnosis of ARN syndrome in the AIDS patients and alternative treatment with ganciclovir should be considered promptly when the patient do not respond to acyclovir therapy.
Acquired Immunodeficiency Syndrome* ; Acyclovir ; Anterior Chamber ; Diagnosis, Differential ; Ganciclovir ; Humans ; Middle Aged ; Necrosis ; Retinal Detachment ; Retinal Necrosis Syndrome, Acute* ; Retinaldehyde ; Retinitis ; Syphilis ; Vasculitis ; Visual Acuity

PURPOSE: To investigate the clinical features of Korean patients with sarcoid uveitis. METHODS: The medical records of patients with endogenous uveitis who were recruited from the uveitis clinic at Seoul National University Hospital were reviewed. Sex, age at presentation, ocular symptoms and signs, treatment, complications, and the rate of recurrence were analyzed. RESULTS: Of 440 patients with endogenous uveitis, 31 (7.1%) with sarcoidosis were included. The mean age at onset was 54.5 years. Sarcoidosis patients with uveitis tended to be older than those without uveitis (44.1 years). Uveitis was the primary manifestation of sarcoidosis in 16 of 31 patients (51.6%). Anterior uveitis was the most common in terms of the anatomic location of inflammation (54.8%), and posterior involvement (38.7%) was not rare. Systemic corticosteroid therapy was administered to 28 patients (90.3%). Five patients (16.1%) received corticosteroids combined with immunosuppressive agents. CONCLUSIONS: Sarcoid uveitis is not a rare etiology of endogenous uveitis. Topical or systemic corticosteroids could control inflammation in most cases, but immunosuppressive agents are needed in a small percentage of patients. Steroids combined with immunosuppressive agents can prevent severe visual losses in such patients.
Adrenal Cortex Hormones ; Humans ; Immunosuppressive Agents ; Inflammation ; Medical Records ; Recurrence ; Sarcoidosis ; Steroids ; Uveitis ; Uveitis, Anterior

PURPOSE: To evaluate the expression of chemokine and chemokine receptors in the aqueous humor (AH) of patients with recurrent anterior uveitis (AU) in terms of HLA-B-27-association. METHODS: Patients with endogenous uveitis were recruited from the uveitis clinic at Seoul National University Hospital. AH and peripheral blood (PB) were obtained from each patient. The expression of chemokine receptors in T-cells from AH and PB was measured using flow cytometric analysis. Interleukin (IL)-8, interferon-gammainducible protein (IP)-10, and regulated-on-expression, normal T-cell expressed and secreted (RANTES) levels of PB and AH were measured. The expression of chemokine receptor and chemokine levels in PB and AH were compared between HLA-B27-associated AU and idiopathic AU patients. RESULTS: Seventeen patients with HLA-B27-associated AU, 14 patients with idiopathic AU and 5 healthy controls were included in this study. IL-8 and IP-10 levels of AH were shown to be increased more than in PB, and intraocular concentrations of IL-8 and IP-10 were higher in patients with HLA-B27-associated AU than in idiopathic AU patients. RANTES levels in AH were significantly lower than in PB for all groups. In all groups, the expression of chemokine receptor in AH increased more than in PB. CONCLUSIONS: The results from this study show chemokine may play an important role in inflammation in patients with AU. This implies that the chemokine environment may be different in terms of HLA-B-27-association.
Aqueous Humor ; Chemokine CCL5 ; Humans ; Inflammation ; Interleukin-8 ; Interleukins ; Receptors, Chemokine ; T-Lymphocytes ; Uveitis ; Uveitis, Anterior

The authors investigated macular circulation in a group of 27 patients(54 eyes) with diabetes melitus to evaluate the change of macular blood flow according to the grade of retinopathy, the status of glucose control and the duration of diabetes. Blood volume, flow and velocity on macular area were measured by Heidelberg Retinal Flowmeter(HRF, Heidelberg Engineering). Paticents with moderate or severe diabetic retinopathy showed a significant increase in macular blood flow than patients with less degree of diabetic retinopathy(502.45+/-223.58 AU vs, 355.19+/-123.84 AU, p=0.003). Both blood volume and velocity were also significantly increased in the patients with more advanced diabetic retinopathy. Macular blood flow was increased in the patients with higher fasting blood glucose, although the statistical significance was in borderline(473.12+/-238.57 AU vs, 362.14+/-103.22 AU, p=0.066). These results show that macular blood flow increases in the diabetic patients with more advanced diabetic retinopathy, suggesting that the increase in the macular blood flow may play a role in the development of diabetic macular microangiopathy.
Blood Glucose ; Blood Volume ; Diabetic Retinopathy ; Fasting ; Glucose ; Humans ; Retinaldehyde