PURPOSE: To study the treatment outcomes in patients who were administered multiple intravitreal ganciclovir injections more than 10 times alone without systemic anti-cytomegalovirus therapy for cytomegalovirus retinitis. CASE SUMMARY: A 64-year-old man who underwent immunosuppressive therapy after thymectomy due to an invasive thymoma and pure red-cell aplasia, a 60-year-old woman who underwent chemotherapy after diagnosis of diffuse large B-cell lymphoma, a 49-year-old man with a history of bone marrow transplantation due to acute myeloid leukemia, a 29-year-old woman with dermatomyositis treated with oral steroids and cyclosporine, and a 47-year-old woman who received intravitreal dexamethasone implant injections, intravitreal and subtenon steroid injections due to Behcet's disease were diagnosed with cytomegalovirus retinitis. All patients showed systemic complications such as pancytopenia after systemic anti-cytomegalovirus therapy, and therefore, they were administered multiple intravitreal ganciclovir injections alone. Best-corrected visual acuities improved in all patients, except in one case, where viral lesions were observed in the fovea. Retinal hemorrhaging and infiltrative lesions decreased in all patients. No severe complication was observed during the injection and in the follow-up period. CONCLUSIONS: Multiple intravitreal ganciclovir injections alone can be used as a treatment modality for cytomegalovirus retinitis to avoid the systemic side effects of systemic anti-cytomegalovirus therapy.
Adult ; Bone Marrow Transplantation ; Cyclosporine ; Cytomegalovirus Retinitis* ; Cytomegalovirus* ; Dermatomyositis ; Dexamethasone ; Diagnosis ; Drug Therapy ; Female ; Follow-Up Studies ; Ganciclovir* ; Humans ; Intravitreal Injections ; Leukemia, Myeloid, Acute ; Lymphoma, B-Cell ; Middle Aged ; Pancytopenia ; Red-Cell Aplasia, Pure ; Retinaldehyde ; Steroids ; Thymectomy ; Thymoma ; Visual Acuity

We investigated the effect of experimentally induced anisometropia on binocular function. Unilateral myopia, hyperopia, or astigmatism(Axis 90degrees) was induced in eighteen adults with normal binocular function using softcontact lenses. Sensory status was assessed by measuring stereoacuity, Worth four dot test, and Bagolini lens test. Binocular function of all subjects decreased with increasing levels of anisometropia. In Worth four dot test, foveal suppression increased in proportion to the levels of anisometropia. Stereoacuity was similarly degraded by the induced anisometropia. Bagolinilens responses were normal in almost all subjects. Our study suggest that experimentally induced anisometropia cause significant abnormalities in binocular function in adults.
Adult ; Anisometropia* ; Humans ; Hyperopia ; Myopia ; Telescopes* ; Vision, Binocular*

SMAS(Superior Mesenteric Artery Syndrome) is a disease caused by a chronic obstruction of the duodenum(transverse portion), which is hardly detectable. However, it is known that when the superior mesenteric artery and abdominal aorta form a narrow angle, that the transverse portion of the duodenum is pressed down between the superior mesenteric artery and the abdominal aorta, and that this can lead to obstruction of the duodenum. Measuring this angle is a complicated job using conventional angiography, and results often turns out to be inaccurate. In addition, no attempt has been made to determine the value of this angle in Koreans. In this study, we conducted abdominal CT angiography using MIP(maximum intensity projection) on patients with no clinical evidence of SMAS in order to determine the angle at which the superior mesenteric artery branches from the abdominal aorta by using PC based software(Rapidia ver. 1.2) for the image reconstruction. Accordingly, we found that the mean angle between the abdominal aorta and the superior mesenteric artery was 50.05+/-15.87 degrees on average, and that the angle in men(53.64+/-16.57 degrees) is higher than in women(46.46+/-14.98 degrees). We hope that the angles determined by our study will serve as an important indicator for detecting SMAS.
Angiography ; Aorta, Abdominal* ; Duodenum ; Hope ; Humans ; Image Processing, Computer-Assisted* ; Mesenteric Arteries ; Mesenteric Artery, Superior* ; Superior Mesenteric Artery Syndrome ; Tomography, X-Ray Computed

SMAS(Superior Mesenteric Artery Syndrome) is a disease caused by a chronic obstruction of the duodenum(transverse portion), which is hardly detectable. However, it is known that when the superior mesenteric artery and abdominal aorta form a narrow angle, that the transverse portion of the duodenum is pressed down between the superior mesenteric artery and the abdominal aorta, and that this can lead to obstruction of the duodenum. Measuring this angle is a complicated job using conventional angiography, and results often turns out to be inaccurate. In addition, no attempt has been made to determine the value of this angle in Koreans. In this study, we conducted abdominal CT angiography using MIP(maximum intensity projection) on patients with no clinical evidence of SMAS in order to determine the angle at which the superior mesenteric artery branches from the abdominal aorta by using PC based software(Rapidia ver. 1.2) for the image reconstruction. Accordingly, we found that the mean angle between the abdominal aorta and the superior mesenteric artery was 50.05+/-15.87 degrees on average, and that the angle in men(53.64+/-16.57 degrees) is higher than in women(46.46+/-14.98 degrees). We hope that the angles determined by our study will serve as an important indicator for detecting SMAS.
Angiography ; Aorta, Abdominal* ; Duodenum ; Hope ; Humans ; Image Processing, Computer-Assisted* ; Mesenteric Arteries ; Mesenteric Artery, Superior* ; Superior Mesenteric Artery Syndrome ; Tomography, X-Ray Computed

We investigated the effects of panretinal photocoagulation (PRP)on macular microcirculation in diabetic retinopathy. PRP using argon blue green laser was performed in 23 eyes of 15 patients with early proliferative diabetic etinopathy and very severe nonproliferative diabetic retinopathy without significant macular edema. The changes in volume, flow, velocity of macular microcirculation were measured before PRP, 1 hour, 1 day, 1 week, and 1 month following PRP, using Heidelberg Retina Flowmeter(HRF). Mean volume, flow, velocity of macular microcirculation decreased to a maximal degree 1 hour following PRP, from 14.87+/-0.40, 387.45 +/-101.40, 1.40+/-0.28(before PRP)to 12.44+/-1.39, 347. 33+/-100.39, 1.27+/-0.34(p<0.05). From 1hour to 1 month after PRP, macular microcirculation gradually increased. However, throughout this period, all parameters of macular microcirculation remained lower than pre-PRP level(p<0.05). Our study suggests that panretinal photocoagulation reduces the macular microcirculation in diabetic retinopathy.
Argon ; Diabetic Retinopathy ; Humans ; Light Coagulation* ; Macular Edema ; Microcirculation* ; Retina ; Retinaldehyde*

PURPOSE: In the pathogenesis of proliferative vitreoretinopathy (PVR), retinal pigment epithelial (RPE) cells do not undergo apoptosis after separation from the basement membrane. In order to investigate the mechanism by which RPE cells resist apoptosis in PVR, the expression of focal adhesion kinase after cryotherapy was studied. METHODS: After lensectomy and vitrectomy was performed on rabbit eyes, a retinal tear was created. Cryotherapy was applied to the tear site one week after the tear creation. Rabbits were sacrificed at 1, 4 and 7 days after the tear formation and 30 minutes, 1, 4, 7, 9, 21 days after cryotherapy. Eyes were stained with anti-focal adhesion kinase (FAK) antibody. RESULTS: Expression of FAK increased after the tear formation and remained increased until 21days after cryotherapy. CONCLUSIONS: These data show that creation of a retinal tear and cryotherapy increases FAK expression and may contribute to resistance to apoptosis.
Apoptosis ; Basement Membrane ; Cryotherapy* ; Epithelial Cells* ; Focal Adhesion Protein-Tyrosine Kinases* ; Focal Adhesions* ; Phosphotransferases ; Rabbits ; Retinal Perforations ; Retinaldehyde* ; Vitrectomy ; Vitreoretinopathy, Proliferative

To investigate the correlation of peripapillary atrophy with optic disc dupping and disc hemorrhage in primary open angle glaucoma(POAG) patients, tomographic measurements were performed with Heidelberg Retina Tomograph(HRT, Heidelberg Engineering, Germany). We analyzed cup to disc area ratio(C/D ratio) and peripapillary atrophy to disc area ratio(P/D ratio) from 28 eyes of 14 POAG patients with peripapillary atrophy(Group A), only C/D ratio from 28 eyes of 14 POAG patients without peripapillary atrophy(Group B), and only P/D ratio from 28 eyes of non-glaucomatous subjects with peripapillary atrophy(Group C). Group A was subclassified into thos with disc hemorrhage (Group A-1) and those without dixd hemorrhage(Group A-2), and changes of visual field defects were also analyzed from each subgroup witn Humphrey automated perimetry (Allergan Humphrey, USA, C24-2) at the six-month follow-up. Cup to disc area ratio(0.54+/-0.160)in the Group A was signifcantly higher than that(0.406+/-0.130) in the Group B, and P/D ratio was higher in Group A(0.619+/-0.203) than in the Group C(0.484+/-0.130). P/D ratio was also higher in Group A-1(0.725+/-0.34) than in the Group A-2(0.605+/-0.273). There was no significant difference in mean deviation(M/D) and corrected pattern standard deviation(CPSD) between Group A-1 and Group A-2. The results led us to the conclusion that peripapillary atrophy had significant correlation with glaucomatous damage on optic disc and disc hemorrhage in glaucoma patients. Therefore more attention should be paid tod a glaucoma patient especially when he or she presents with peripapillary atrophy.
Atrophy* ; Follow-Up Studies ; Glaucoma ; Glaucoma, Open-Angle* ; Hemorrhage* ; Humans ; Retina ; Visual Field Tests ; Visual Fields

We evaluated the safety, stability, predictability and efficacy of photorefractive keratectomy (PRK) with Schwind excimer laser for one year. We performed one-step procedures on 114 eyes of 92 patients. They were divided into three groups according to their manifest refractive error (spherical equivalent): Group ! (<-5 D, 39 eyes) , Group I (-5. 01 to -8 D, 40 eyes) , or Group III (>-8.01 D, 35 eyes). One year after PRK, uncorrected visual acuity of 0.8 or better was achieved in 95% of eyes in group I, 97% of eyes in group I and 63% of eyes in group III. In the group I , 90% of eyes were within +/-1 D of attempted correction, as were 95% in group II and 63% in group III. Complications were corneal haze above grade 2(8.8%), temporarily increased intraocular pressure (18.4%), central island (14.9%), eccentric ablation more than 0. 5mm(34.2%) and halo (0.9%). We conclude that the Schwind excimer laser PRK appears to be 8 safe and relatively accurate procedure to correct low to moderate myopia, but long-term and more frequent follow-up is needed for high myopia.
Follow-Up Studies ; Humans ; Intraocular Pressure ; Lasers, Excimer ; Myopia ; Photorefractive Keratectomy ; Refractive Errors ; Visual Acuity

The authorsinvestigated the effects of UV-B and amniotic membrane graft about PRK induced inflammatory cell infiltration into corneal stroma, lipid peroxidation and keratocyte apoptosis. Total 20 white rabbits were divided into 5 groups; 1)mechanical epithelial removal, 2)epithelial removal and UV-B irradiation, 3)PRK only, 4) PRK and UV-B irradiation, 5)Amniotic membrane graft after PRK and UV-B irradiation. All corneas were harvested after 24hrs. H & E stain for PMNs infiltration, MDA immunohistochemical stain for lipid peroxidation and TUNEL stain for keratocyte apoptosis were performed. UV-B had little effect on infiltration of inflammatory cell into corneal stroma, lipid peroxidation and keratocyte apoptosis. Amniotic membrane suppressed infiltration of PMNs into corneal stroma, lipid peroxidation and keratocyte apoptosis. Environmental UV-B exposure should not be avoided after PRK. Amniotic membrane graft is beneficial to reduce keratocyte apoptosis and related corneal haze.
Amnion* ; Apoptosis* ; Cornea ; Corneal Stroma ; In Situ Nick-End Labeling ; Inflammation* ; Lipid Peroxidation* ; Membranes ; Rabbits ; Transplants

PURPOSE: To evaluate the factors associated with the recurrence of epiretinal membrane (ERM) after surgery for ERM METHODS: We reviewed patients' medical records who received vitrectomy for ERM. The preoperative findings, best postoperative and final visual acuity, and intraoperative findings of eyes with recurred ERM were compared with those of eyes without recurrence after removal of ERM. RESULTS: Recurrence of ERM was high in eyes with ERM associated with chronic uveitis, compared with the eyes with idiopathic ERM (p=0.030, Cox regression analysis). Neither the type of membrane nor incomplete membrane removal during pars plana vitrectomy was correlated with the recurrence of ERM. CONCLUSIONS: Considering the recurrence of ERM after surgical removal being high in eyes with chronic uveitis, close follow up is recommended in these patients.
Epiretinal Membrane* ; Follow-Up Studies ; Humans ; Medical Records ; Membranes ; Recurrence* ; Uveitis ; Visual Acuity ; Vitrectomy