Tangential vitreoretinal traction around fovea is known to be the principal cause in the pathogenesis of idiopathic macular holes. According to the recent study, the internal limiting membrane(ILM) may provide a scaffold for fibroblast proliferation and contraction, therefore play an important role in the enlargement of macular hole. We removed the ILM during macular hole surgery and assessed the anatomical and functional outcome of the macular hole surgery. Twelve consecutive patients with full-thickness macular hole were enrolled in this study. They were examed for best-corrected vision, fundus photography, fluorescein angiography, Humphrey automated perimetry, focal eletroretinogram, before and after surgery. After surgery, vision was improved in 8 eyes(67%), hole was closed in 10 eyes(83%). Macular thresholds on visual field was increased in 8 eyes and peripheral scotomas developed in 3 eyes postoperatively. The amplitude increased in 7 eyes and the implicit time decreased in 8 eyes on focal electroretinograms postoperatively. Out results suggested that the complete removal of ILM should be attempted to improve vision and to close holes during the full-thickness macular hole surgery.
Fibroblasts ; Fluorescein Angiography ; Humans ; Membranes* ; Photography ; Retinal Perforations* ; Scotoma ; Traction ; Visual Field Tests ; Visual Fields

PURPOSE: Optic disc harmatoma is usually seen in tuberous sclerosis patients, but, it may be seen in otherwise normal people. Visual acuity is usually not affected by this lesion. METHODS: We experienced a 40-year-old woman with optic disc hamartoma who presented with acute visual defect. With oral triamcinolone 48mg/day, her visions recovered to normal in 2 weeks. RESULTS: Her age, symptom, and course of disease supported the diagnosis of optic neuritis. CONCLUSION: We report this patient as a case of optic disc hamartoma combined with optic neuritis.
Adult ; Diagnosis ; Female ; Hamartoma* ; Humans ; Optic Neuritis* ; Triamcinolone ; Tuberous Sclerosis ; Visual Acuity

Recently, acute pseudomonas keratitis is reported to occur more frequently. If treatment is not adequate after the invasion of Pseudomonas into the cornea, corneal perforation ensues within 48 hours. Hence the rapid diagnosis and treatment is required, and the treatment mostly depends on the antibiotics. Pseudomonas keratitis induced in the rabbit cornea by inoculating Pseudomonas aeruginosa (lID 1210). Then the keratitis was treated with topical antibiotics available in Korea Chloramphenicol(R), Polyspectran(R), Tobra(R), Gentamicin(R), Tarivid(R). The effect of the antibiotics on Pseudomonas keratitis was evaluated clinically as well as bacteriologically and irritation of the antibiotics against the eye was also obsesved. 1. Polyspectran(R), tobra(R), gentamicin(R), tarivid(R) treated experimental Pseudomonas keratitis in the rabbit eyes but chloramphenicol(R) and saline did not inhibit the bacterial growth of the rabbit corneas. 2. Against the rabbit eyes, chloramphenicol(R) and polyspectran(R) were the most irritable aptibiotics, where as Gentamicin(R) and tarivid(R) were the moderate, and tobra(R) and saline were the least in the extent of irritation.
Anti-Bacterial Agents* ; Cornea ; Corneal Perforation ; Diagnosis ; Keratitis* ; Korea ; Pseudomonas aeruginosa ; Pseudomonas*

The latent nystagmus seems to be absent when both eyes are open, but on covering one eye, bilateral jerky nystagmus is evoked with the fast phase toward the uncovered eye. The confirmed diagnosis of latent nystagmus can be made with the aid of the Electro-oculography (EOG). On EOG recording, we experienced a case of latent nystagmus in light, which showed the characteristics of infantile nystagmus in darkness.
Darkness ; Diagnosis ; Electrooculography

PURPOSE: To evaluate the accuracy of postoperative refractive outcomes of combined phacovitrectomy for epiretinal membrane (ERM) in comparison to cataract surgery alone. MATERIALS AND METHODS: Thirty-nine eyes that underwent combined phacovitrectomy with intraocular lens (IOL) implantation for cataract and ERM (combined surgery group) and 39 eyes that received phacoemulsification for cataract (control group) were analyzed, retrospectively. The predicted preoperative refractive aim was compared with the results of postoperative refraction. RESULTS: In the combined surgery group, refractive prediction error by A-scan and IOLMaster were -0.305+/-0.717 diopters (D) and -0.356+/-0.639 D, respectively, compared to 0.215+/-0.541 and 0.077+/-0.529 in the control group, showing significantly more myopic change compared to the control group (p=0.001 and p=0.002, respectively). Within each group, there was no statistically significant difference in refractive prediction error between A-scan and IOLMaster (all p>0.05). IOL power calculation using adjusted A-scan measurement of axial length based on the macular thickness of the normal contralateral eye still resulted in significant postoperative refractive error (all p<0.05). Postoperative refraction calculated with adjusted axial length based on actual postoperative central foveal thickness change showed the closest value to the actual postoperative achieved refraction (p=0.599). CONCLUSION: Combined phacovitrectomy for ERM resulted in significantly more myopic shift of postoperative refraction, compared to the cataract surgery alone, for both A-scan and IOLMaster. To improve the accuracy of IOL power estimation in eyes with cataract and ERM, sequential surgery for ERM and cataract may need to be considered.
Aged ; Biometry/methods ; Case-Control Studies ; Cataract Extraction ; Epiretinal Membrane/*surgery ; Eye ; Female ; Humans ; *Lens Implantation, Intraocular ; *Lenses, Intraocular ; Male ; Optics and Photonics ; Phacoemulsification/*methods ; Postoperative Period ; Refraction, Ocular/physiology ; Retrospective Studies ; Treatment Outcome ; Vision Tests ; Visual Acuity ; Vitrectomy/*methods

A 5-year-old girl was diagnosed with neurofibromatosis type 2 (NF-2) due to multiple neurofibromas, cafe-au-lait spots, and schwannomas of the brain. During ophthalmologic evaluation, a posterior subcapsular cataract and a gray-green colored subretinal lesion were found in right eye. Fluorescein angiography (FA) revealed a combined hamartoma of the retina and retinal pigment epithelium (CHRRPE). At age 9, she underwent cataract surgery. At this time FA and spectral-domain optical coherence tomography (SD-OCT) were taken. The SD-OCT showed an elevated hyperreflective mass in the retina with prominent attenuation of the inner and outer retina, but minimal attenuation in the photoreceptor layers. The underlying retina appeared to be disorganized and thick (791 microm). This is the first case report of SD-OCT imaging of a CHRRPE associated with NF-2 in a pediatric patient. By using SD-OCT in this patient, we could obtain detailed tumor characteristics, and SD-OCT may be helpful in the diagnosis and management of CHRRPE.
Child, Preschool ; Diagnosis, Differential ; Female ; Hamartoma/complications/*diagnosis ; Humans ; Neurofibromatosis 2/*complications/diagnosis ; Retinal Diseases/complications/*diagnosis ; Retinal Pigment Epithelium/*pathology ; Tomography, Optical Coherence/*methods ; Visual Acuity

Metastatic tumor to the eye is the most common type of intraocular malignancy. The most common primary site of the intraocular metastatic tumor is the breast in women and the lung in men respectively and the choroid is by far the most common site for intraocular metastasis. We experienced a case of chroidal metastasis in a patient with pancreatic carcinoma which is not published in Korea. So, we review that case with the literatures related with metastatic pancreatic cancer to the choroid.
Breast ; Choroid* ; Female ; Humans ; Korea ; Lung ; Male ; Neoplasm Metastasis* ; Pancreatic Neoplasms

Metastatic tumor to the eye is the most common type of intraocular malignancy. The most common primary site of the intraocular metastatic tumor is the breast in women and the lung in men respectively and the choroid is by far the most common site for intraocular metastasis. We experienced a case of chroidal metastasis in a patient with pancreatic carcinoma which is not published in Korea. So, we review that case with the literatures related with metastatic pancreatic cancer to the choroid.
Breast ; Choroid* ; Female ; Humans ; Korea ; Lung ; Male ; Neoplasm Metastasis* ; Pancreatic Neoplasms

PURPOSE: To report a case of retinal detachment with a macular hole following photodynamic therapy (PDT) using verteporfin and intravtreal bevacizumab injection in the treatment of myopic choroidal neovasclarization (CNV). METHODS: A 58 -year-old woman was diagnosed with myopic CNV and treated with a combination of PDT with verteporfin and intravitreal bevacizumab injection that same day. She received the second injection of intravitreal bevacizumab four weeks after the initial treatment. RESULTS: The patient developed a sudden decline in vision one week after the second injection; and was subsequently diagnosed with retinal detachment associated with a macular hole. She underwent standard three-port pars plana vitrectomy with internal limiting membrane peeling, fluid-air exchange and silicone oil injection. The retina was still firmly attached at the patient's final follow-up visit. CONCLUSIONS: PDT and intravitreal bevacizumab injection used for the treatment of myopic CNV can be associated with retinal detachment with a macular hole. Patients need to be informed about this potential complication, and a higher index of suspicion may be warranted in patients who report sudden vision loss after the treatment.
Angiogenesis Inhibitors/administration & dosage/*adverse effects/therapeutic use ; Antibodies, Monoclonal/administration & dosage/*adverse effects/therapeutic use ; Choroidal Neovascularization/*drug therapy ; Female ; Humans ; Injections ; Middle Aged ; Photochemotherapy/*adverse effects ; Retinal Detachment/*etiology ; Retinal Perforations/*etiology ; Vitreous Body

PURPOSE: To evaluate the usefulness of OCT retinal mapping in determining the configuration of a vitreomacular adhesion and selecting a meridian for entry into the subhyaloid space in patients with vitreomacular traction syndrome. METHODS: Six consecutive patients (6 eyes) with vitreomacular traction syndrome underwent vitrectomy with peeling of posterior hyaloid. Ocular coherence tomography (OCT) retinal mapping was performed preoperatively. Access to the subhyaloid space was made by creating an opening with a 25 gauge needle at a location where the detached posterior hyaloid membrane was farthest from the retinal surface. The location was selected based on six preoperative meridional OCT scans. The posterior hyaloid was then gently peeled off in a circular fashion around the fovea with a micropick. Visual acuity and foveal thicknesses were measured before the operation and 3 months afterwards. RESULTS: After the operation, visual acuity improved and central macular thicknesses were reduced significantly in all six patients. The best corrected visual acuity improved from 0.4 to 0.75 with a mean increase by 3.5 lines on a Snellen chart 3 months after the operation. The mean foveal thickness was reduced from 406 micrometer to 241 micrometer. The restoration of foveal pit was observed in five patients. Neither intraoperative nor postoperative complications were observed during the follow up period. CONCLUSIONS: An OCT retinal mapping program is a valuable diagnostic tool in understanding the configuration of vitreomacular adhesion and planning the surgical approach for operating on vitreomacular traction syndrome.
Aged ; Eye Diseases/diagnosis/etiology/*surgery ; Female ; Humans ; Male ; Middle Aged ; Retinal Diseases/diagnosis/etiology/*surgery ; Syndrome ; Tissue Adhesions/etiology/surgery ; *Tomography, Optical Coherence ; Visual Acuity ; Vitrectomy/*methods ; Vitreous Body/pathology/*surgery ; Vitreous Detachment/complications