PURPOSE: Vogt-Koyanagi-Harada syndrome is more common in adults than in children. We report a atypical case of Vogt-Koyanagi-Harada syndrome like white dot syndromes in a 7-year-old child. METHODS: A 7-year-old child visited with complaints of decreased binocular visual acuity. Under ophthalmologic examination, anterior uveitis and optic neuropathy were found. But there was no other retinal lesion. After high-dose intravenous corticosteroids pulse therapy, yellow pigment lesions like white dot syndromes developed in peripheral retina and enlarged without serous retinal detachment. RESULTS: In 5 months after high-dose intravenous corticosteroids pulse therapy, anterior inflammation was decreased and visual acuity was 0.8 in both eyes. But depigmented retinal lesions were increased and sunset glow occurred. Alopecia and poliosis of hair were found. Human leukocyte antigen typings revealed HLA-DR4 antigen.
Adrenal Cortex Hormones ; Adult ; Alopecia ; Child* ; Hair ; HLA-DR4 Antigen ; Humans ; Inflammation ; Leukocytes ; Male* ; Optic Nerve Diseases ; Retina ; Retinal Detachment ; Retinaldehyde ; Telescopes ; Uveitis, Anterior ; Uveomeningoencephalitic Syndrome* ; Visual Acuity

PURPOSE: Cerebral malaria is caused by Plasmodium falciparum. The reports about cerebral malaria are very rare because Korea is not endemic area of P. falciparum. Additionally, macular hemorrhage and decreased vision associated with cerebral malaria was not reported ever in Korea, we report one case of cerebral malaria associated with retinal hemorrhage on macular area and review of literature. METHODS: Ophthalmology was consulted with about 19-year-old woman in cerebral malaria, tropical endemic disease caused by Plasmodium falciparum, with decresed visual acuity. RESULTS: 1250 mg/day of Mefloquine was injected into patient for cerebral malaria for 18 days. After awareness, the patient complained of decreased visual acuity in left eye, then the best corrected visual acuity(BCVA) in left eye was 20/800, BCVA in right eye was 20/20, retinal hemorrhage and Roth's spot were found on fundus examination in left eye, and finding in fluorescein angiography was not specific. After 8 months, retinal hemorrhage in left eye was absorbed, but BCVA in left eye was not changed.
Endemic Diseases ; Female ; Fluorescein Angiography ; Hemorrhage ; Humans ; Korea ; Malaria, Cerebral* ; Mefloquine ; Ophthalmology ; Plasmodium falciparum ; Retinal Hemorrhage* ; Retinaldehyde* ; Visual Acuity ; Young Adult

PURPOSE: Various studies on amniotic membrane transplantation for ocular surface reconstruction have been reported. To investigate the effect of human amniotic membrane transplantation on corneal fungal ulcer, we reviewed the records of four fungal ulcer patients. METHODS: Human amniotic membranes were transplanted to the diseased corneas under topical anesthesia within 12 hours. RESULTS: After the mean observation period of 8.5 months, cornea was stabilized in all eyes. No aggravation or rejection were observed. Secondary penetrating keratoplasty was performed in 2 cases. CONCLUSION: Amniotic membrane transplantation may be effective to promote corneal wound healing in refractory fungal ulcer and considered as a useful treatment prior to corneal transplantation.
Amnion* ; Anesthesia ; Cornea ; Corneal Transplantation ; Humans* ; Keratoplasty, Penetrating ; Ulcer* ; Wound Healing

PURPOSE: To compare retinal layer thickness and chorioretinal vascular density (VD) between acute and chronic branch retinal vein occlusion (BRVO). METHODS: This study included patients with BRVO. The VD of the superficial capillary plexus (VDs), the VD of the deep capillary plexus (VDd), and VD of the choriocapillaris were obtained using optical coherence tomography angiography. Acute and chronic BRVO data were compared to assess differences between the involved and uninvolved areas. RESULTS: We included 17 eyes with acute BRVO and 23 eyes with chronic BRVO. The VDs in the involved area were not significantly different between the involved area and in the uninvolved area in acute BRVO (p = 0.551). However, the difference was significant in chronic BRVO (p = 0.013). The VDd in the involved area was lower than in the uninvolved area in both acute and chronic BRVO (p = 0.020, p = 0.003, respectively). In addition, the VD of the choriocapillaris values did not differ significantly between acute and chronic BRVO, or between involved and uninvolved areas. The VDs in the involved area in chronic BRVO were lower than in acute BRVO (p = 0.047), and the VDd did not differ between acute and chronic BRVO in all areas. CONCLUSIONS: Vascular impaired patterns in the retinal layer differed between acute and chronic BRVO. These results may suggest that vascular change and remodeling develops differently in acute and chronic phases in BRVO.
Angiography ; Capillaries ; Humans ; Retinal Vein Occlusion ; Retinal Vein ; Retinaldehyde ; Tomography, Optical Coherence

PURPOSE: To evaluate the diurnal variation of macular thickness in eyes with diabetic macular edema. METHODS: We measured macular thickness using optical coherence tomography in 33 eyes with diabetic macular edema and 33 normal control eyes at 7 am, 11 am, 2 pm, and 5 pm. We investigated the correlation between macular thickness change and several factors such as sex, duration of diabetes mellitus, presence of hypertension, HbA1c, creatinine clearance, blood urea nitrogen, serum creatinine, blood sugar, blood pressure, severity of diabetic retinopathy, and whether PRP was done or not. RESULTS: Retinal thickness in 3.45 mm macular area was the thickest at 7 am and then decreased over the day to be thinnest at 5 pm (p Blood Glucose ; Blood Pressure ; Blood Urea Nitrogen ; Creatinine ; Diabetes Mellitus ; Diabetic Retinopathy ; Hypertension ; Macular Edema* ; Retinaldehyde ; Tomography, Optical Coherence

PURPOSE: To evaluate long-term visual outcome of arteriovenous adventitial sheathotomy in BRVO-induced macular edema. METHODS: The visual outcomes of 8 patients following vitrectomy with arteriovenous adventitial sheathotomy for BVO-induced macular edema (surgery group) were retrospectively evaluated. The three-year post-operative visual acuity of the surgery group was compared with that of the conservatively managed controls. RESULTS: All patients were followed for a minimum of 36 months. Mean BCVA (logMAR) in the surgery group changed from 1.10+/-0.34 to 1.19+/-0.70 and to 0.80+/-0.36 at 12 and 36 months, respectively (p=0.959 at 12 months, p=0.018 at 36 months). In the control group, visual acuity improved from 1.15+/-0.43 to 0.43+/-0.44 and to 0.43+/-0.39 at 12 and 36 months, respectively (p=0.015 at 12 months, at p=0.003 at 36 months). A strong trend toward better visual acuity at 12 months and final examination was observed for controls. (surgery vs. control group, p=0.052 at 12 months, p=0.066 at 36 months). CONCLUSIONS: Considering the favorable natural course of BVO and the unproven effect of reperfusion on macular edema, surgical efficacy of arteriovenous adventitial sheathotomy requires further evaluation.
Aged ; Connective Tissue/*surgery ; Decompression, Surgical/methods ; Female ; Humans ; Macular Edema/etiology/physiopathology/*surgery ; Male ; Middle Aged ; Retinal Artery ; Retinal Vein ; Retinal Vein Occlusion/complications/physiopathology/*surgery ; Retrospective Studies ; Treatment Outcome ; Visual Acuity/*physiology ; Vitrectomy/*methods

PURPOSE: To evaluate the influence of peripapillary atrophy on the progress of diabetic retinopathy. METHODS: Interval between the diagnosis of diabetes and the onset of diabetic retinopathy was compared between 77 eyes of 50 patients with peripapillary atrophy and 253 eyes of 172 patients without peripapillary atrophy who visited the Korea university ophthalmology department between January 2002 and May 2002, No one had glaucoma or high myopia. Pepipapillary atrophy was classified by severity and compared. RESULTS: Time to the onset of nonproliferative diabetic retinopathy was longer in the patients with peripapillary atrophy (13.7 years) than the patients without peripapillary atrophy (11.2 years) (p Atrophy* ; Diabetic Retinopathy* ; Diagnosis ; Glaucoma ; Humans ; Korea ; Myopia ; Ophthalmology

PURPOSE: To investigate systemic factors associated with central serous chorioretinopathy (CSC). METHODS: We retrospectively reviewed the medical records of 113 Korean patients who were diagnosed with CSC and who underwent history taking with a specialized questionnaire for CSC. They were matched for age and gender at a ratio of 1 : 3 to 339 normal controls. Normal controls were consecutively selected from a database at the Health Promotion Center. General characteristics and medical histories were compared between the two groups. The statistical analyses used included independent t-test, Mann-Whitney test, Fisher's exact test, and multivariate logistic regression analysis. RESULTS: There were 90 men and 23 women in the CSC group, and the male-female ratio for both groups was 3.9 : 1. The mean age of the patients was 45.6 years. In multivariate analysis, hypertension (odds ratio [OR], 2.327; 95% confidence interval [CI], 1.349-4.013), use of medicinal plants (OR, 2.198; 95% CI, 1.193-4.049), sleep disturbances (OR, 1.732; 95% CI, 1.096-2.739), and snoring (OR, 1.727; 95% CI, 1.058-2.820) were strongly associated with CSC. CONCLUSIONS: Hypertension, sleep disturbance, snoring, and medicinal plant use were identified as factors associated with CSC. Expanded history taking, including systemic factors and culture-specific behavior related to stress or fatigue such as use of medicinal plants, will be helpful in identifying Korean patients at an increased risk for CSC.
Asian Continental Ancestry Group ; Case-Control Studies ; Central Serous Chorioretinopathy/*epidemiology/*etiology ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Questionnaires ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Factors ; Statistics, Nonparametric

PURPOSE: The relationship between central serous chorioretinopathy associated with retinal macrovessel remains controversial due to its rareness. We report a case of central serous chorioretinopathy diagnosed by spectral domain optical coherence tomography (SD-OCT) in a patient with a retinal macrovessel that improved spontaneously. CASE SUMMARY: A 36-year-old healthy male patient visited our clinic complaining of blurred vision in his left eye. Fundus examination of the left eye revealed central serous chorioretinopathy with retinal macrovessel in the macular area. Fundus fluorescent angiography showed an ink blot-shaped leakage, which was not clearly distinguishable due to a retinal macrovessel. Serous retinal detachment under the neurosensory retina was identified on OCT. A small pigment epithelial detachment was observed and considered as a leaking point. However, no visible exudates appeared to be leaking around the retinal macrovessel. CONCLUSIONS: Central serous chorioretinopathy with a retinal macrovessel in a Korean patient was evaluated by SD-OCT. When compared with typical cases, no differences were observed in this case and no significant associations between central serous chorioretinopathy and retinal macrovessel were shown.
Angiography ; Central Serous Chorioretinopathy ; Exudates and Transudates ; Eye ; Humans ; Ink ; Male ; Retina ; Retinal Detachment ; Retinaldehyde ; Tomography, Optical Coherence ; Vision, Ocular

PURPOSE: To evaluate the long-term effects of reduced-fluence photodynamic therapy (RF-PDT) combined with intravitreal anti-vascular endothelial growth factor (anti-VEGF) for polypoidal choroidal vasculopathy (PCV). METHODS: Twenty-two eyes of 21 patients with PCV that were followed up for more than 24 months after RF-PDT and anti-VEGF combination therapy were retrospectively reviewed. The patients received intravitreal anti-VEGF (bevacizumab 1.25 mg, ranibizumab 0.5 mg, or aflibercept 2.0 mg) within 7 days of PDT. Patients were retreated with either RF-PDT and anti-VEGF injection, or with only anti-VEGF injection, as indicated. The main outcome measures were best-corrected visual acuity (BCVA) and central foveal thickness (CFT), which were measured before and after combination therapy. RESULTS: During follow-up, the mean logMAR BCVA significantly improved from 0.75 at baseline to 0.54 at 12 months and 0.52 at 24 months (p=0.009 and p=0.032, respectively). The mean CFT significantly decreased from 409.8 µm at baseline to 234.1 µm at 12 months and 245.9 µm at 24 months (p<0.001 and p=0.001, respectively). In 20 eyes (90.9%), the BCVA remained stable or improved. CONCLUSIONS: The efficacy of this combination therapy for 24 months resulted in stabilized vision and anatomical improvement. RF-PDT combined with intravitreal anti-VEGF injection could be an effective treatment modality for patients with PCV.
Choroid* ; Endothelial Growth Factors* ; Follow-Up Studies ; Humans ; Outcome Assessment (Health Care) ; Photochemotherapy* ; Ranibizumab ; Retrospective Studies ; Vascular Endothelial Growth Factor A ; Visual Acuity