PURPOSE: To report a case of delayed sealing of full-thickness macular hole associated with diabetic retinopathy after vitrectomy with silicone oil tamponade. CASE SUMMARY: A 63-year-old woman visited our clinic complaining of decreased visual acuity in her left eye. Fundoscopy showed a full-thickness macular hole with vitreomacular traction in the left eye and bilateral proliferative diabetic retinopathy. The patient underwent uncomplicated phacoemulsification and pars plana vitrectomy with silicone oil tamponade because her vision in the contralateral eye was only light perception. She was unable to maintain a prone position postoperatively due to anterior chamber hyphema. At 1.5 months after surgery, vitreomacular traction was removed but the hole was not sealed as observed on optical coherence tomography. Approximately 3 months after vitrectomy, the macular hole was sealed with minimal subfoveal fluid. At 6 months after vitrectomy, the macular hole was closed completely with no subfoveal fluid.
Anterior Chamber ; Diabetic Retinopathy ; Eye ; Female ; Humans ; Hyphema ; Light ; Phacoemulsification ; Prone Position ; Retinal Perforations ; Silicone Oils ; Tomography, Optical Coherence ; Traction ; Vision, Ocular ; Visual Acuity ; Vitrectomy

PURPOSE: To evaluate the efficacy of internal limiting membrane (ILM) removal during vitrectomy in proliferative diabetic retinopathy (PDR) patients. METHODS: Seventy-four eyes of 74 PDR patients who underwent vitrectomy were enrolled. All patients had been followed for at least one year. Thirty-three patients who underwent vitrectomy without ILM peeling from January 2004 to February 2005 were assigned to Group A and 41 patients who underwent vitrectomy with ILM peeling from March 2005 to October 2005 were assigned to Group B. Visual acuity (LogMAR), central macular thickness measured by optical coherent tomography (OCT), and presence or absence of macular edema were compared between the two groups at six months and one year after surgery. RESULTS: Postoperative mean best corrective visual acuity (BCVA; LogMAR) were improved significantly in both groups at six months and one year after surgery. However, the overall amount of improvement in vision was not different between the two groups. The mean central forveal thickness in Group B was significantly thinner than in Group A at six months and one year after surgery. There was no difference between the two groups in macular edema incidence at that time. There were no serious complications in Group B by one year after surgery. CONCLUSIONS: There was no difference in visual acuity between the Group A and Group B However, the central forveal thickness measured by OCT was thinner in the ILM peeling group, and there were no serious complications in ILM peeling group. Routine ILM peeling during vitrectomy in PDR will help to maintain the structural stability of the macula postoperatively.
Diabetic Retinopathy ; Eye ; Humans ; Incidence ; Macular Edema ; Membranes ; Vision, Ocular ; Visual Acuity ; Vitrectomy

Objective: Despite the growing need for psychological programs for North Korean refugees, most psychological interventions for these people lack a verification study that tests their effectiveness. This study aims to evaluate the effectiveness of cognitive behavioral therapy (CBT) in North Korean refugees. Methods: Participants included 38 North Korean refugees, of whom 23 participated in simple relaxation and 15 participated in CBT. The Korean version of the Center for Epidemiologic Studies Depression Scale (CES-D), State-Trait Anxiety Inventory-State (STAI-S), and Impact of Event Scale-Revised were used to evaluate symptoms pre- and post-intervention. Results: Participants had a significant decrease in CES-D scores after treatment (p=0.037). The decrease in CES-D was larger in those who participated in the CBT compared to those in simple relaxation (p=0.023). The superior effects that CBT had on depressive symptoms over simple relaxation were particularly more prominent in those with severe depression (p=0.035). Participants with high levels of anxiety also showed significant decreases in STAI-S scores after treatment, regardless of which type of program they participated in (p=0.023). Conclusion This preliminary findings suggests that CBT is an effective psychiatric approach in treating depressive symptoms in North Korean refugees, especially for those with a higher degree of depressive symptom.