OBJECTIVE: To describe normal postoperative MR findings and MR findings of postoperative discitis in patients who underwent operation due to herniated intervertebral disc. MATERIALS AND METHODS: We retrospectively reviewed normal postoperative MR findings and MR findings of discitis in 30 patients(21-61yrs.) (13 cases dignosed as discitis and 17 cases as normal) who previonsly underwent laminectomy and discectomy, or bony fusion. We analyzed signal intensity of end plate and disc, end plate destruction, and enhancement of end plate and disc on T1- and T2-weighted images(WI) of 1.5T MRI. RESULTS: Among 14 out of 17 patients with no evidence of discitis, 7 patients showed high signal of the posterior portion of disc on T1- and T2-WI and 11 patients revealed enhancement at the same sites. In all 13 patients suspected of having discitis, end plate and disc showed low signal on T1-WI, high signal on T2-WI, heterogeneous enhancement, and irregular destruction of end plate. Meanwhile, 3 cases with no evidence of postoperative discitis clinically who underwent bony fusion showed similiar findings to those of the above 13 patients, except for homogeneous enhancement of end plate and vertebral body. CONCLUSION: The MR findings of postoperative discitis were low signal on T1-WI, high signal on T2-WI, and heterogeneous enhancement of and plate and disc, and destruction of end plate.
Discitis* ; Diskectomy ; Humans ; Intervertebral Disc* ; Laminectomy ; Magnetic Resonance Imaging ; Retrospective Studies

PURPOSE: To evaluate the course of the hypertensive phase (HP) after Ahmed glaucoma valve (AGV) implantation and the effects of digital ocular massage. METHODS: A total of 131 eyes of 131 patients, who underwent AGV implantation surgery, were studied retrospectively. HP was defined as an IOP (intraocular pressure) > or = 22 mm Hg within 6 months after surgery. Various clinical factors related to the occurrence of HP were analyzed. The HP group was compared to the non-HP group. Ocular massage was performed in patients showing acute elevation of IOP at a relatively early postoperative period, and the effects were compared with the non-massage group. The patients who received ocular massage were divided, based on its effects, and compared. RESULTS: HP developed in 62.6% of the patients after AGV surgery, and the success rate was significantly lower in the HP group. HP occurred more often in males and in patients with high IOP before surgery. HP developed in 82 eyes at 3.3 weeks after surgery in average. Ocular massage was performed in 30 eyes that showed acute IOP increase. The amount of IOP reduction, compared to 1 month after surgery, was greater in massage group than no massage group from 2 months to 3 years after surgery. Successful IOP control by ocular massage was observed in 14 eyes (46.7%), and the success rate was higher in these patients than the patients who showed no significant IOP reduction by ocular massage. But, the difference was not significant (p = 0.072). CONCLUSIONS: HP is related to the final outcome of surgery. Digital ocular massage can be used as an effective method to control HP and prevent further glaucomatous damage.
Eye ; Glaucoma ; Humans ; Male ; Massage ; Postoperative Period ; Retrospective Studies

PURPOSE: To report a case of bilateral optic neuropathy related with idiopathic hypertropic pachymeningitis. CASE SUMMARY: A 66-year old woman presented with acute visual loss that developed 6 days previously in the right eye and 3 days prior in the left eye. During the initial evaluation, her visual acuity was light perception in the right eye and counting fingers at 30 cm in the left eye. A relative afferent papillary defect (RAPD) was noted in the patient's right eye. On brain MRI, the duramater was thickened and enhanced by contrast. The erythrocyte Sedimentation Rate (ESR) and C-reactive protein (CRP) level were increased and myeloperoxidase-antineutrophil cytoplasmic antibody (MPO-ANCA) as positive. Other neurological and medical abnormalities were not found. Under the suspicion of bilateral optic neuropathy due to idiopathic hypertrophic pachymeningitis, the patient was treated with methylprednisolone pulse therapy. Two days after the treatment, the visual acuity was hand movements at 20 cm in the right eye and 0.6 in the left eye. Three months after the treatment, the visual acuity was counting fingers at 20 cm in the right eye, and 0.7 in the left eye. The right eye showed optic disc pallor and diffuse retinal nerve fiber layer (RNFL) defect. The left eye showed a suspicious RNFL defect, and was otherwise normal. CONCLUSIONS: The authors report a rare case of optic neuropathy related with idiopathic hypertrophic pachymeningitis. Idiopathic hypertrophic pachymeningitis should be considered as one of the various causes of optic neuropathy.
Blood Sedimentation ; Brain ; C-Reactive Protein ; Cytoplasm ; Eye ; Female ; Fingers ; Hand ; Humans ; Light ; Meningitis ; Methylprednisolone ; Nerve Fibers ; Optic Nerve Diseases ; Pallor ; Patient Rights ; Retinaldehyde ; Visual Acuity

OBJECTIVE: The purpose of this study was to describe the MR imaging appearance of the dural ligaments which is connected between the anterior dura mater and the posterior longitudinal ligament. MATERIALS AND METHODS: In 10 cadavers with formalin fixation, the dural ligaments were evaluated and photographed after removal of the posterior element of the spinal canal. MR studies of 12 patients who had distinct dural ligaments were evaluated. Spin-echo MR images were obtained on a 1. 5T unit. RESULTS: In seven of the ten cadavers, the midline dural ligament was observed; the lateral dural ligament was observed in 3 cadavers. On MR, the dural ligaments were imaged as thin lines of low signal intensity between the anterior dural margin and the posterior longitudinal ligament. Dural ligaments were well-visualized at the level of the lower lumbar spine which had a more prominent anterior epidural space than that of the upper level of the spine. Eight of 12 cases had well developed midline dural ligaments. Two cases showed distinct lateral dural ligaments and the remaining 2 cases had distinct midline and lateral dural ligaments. CONCLUSION: MR images of the dural ligament demonstrate a thin low signal line at the anterior epidural space.
Cadaver* ; Dura Mater ; Epidural Space ; Formaldehyde ; Humans ; Ligaments ; Longitudinal Ligaments ; Magnetic Resonance Imaging* ; Spinal Canal ; Spine

PURPOSE: To report the results of managing dislocated posterior chamber intraocular lenses (PC IOLs) by externalizing both haptics alternately through a single clear corneal incision. METHODS: The study included 10 eyes of 10 patients in which a dislocated PC IOL was managed with pars plana vitrectomy. With our modified method, both haptics were alternately externalized through a single clear corneal incision for suture knot placement and then reinserted. RESULTS: The dislocated PC IOLs were repositioned successfully in all 10 eyes, and the corrected visual acuity improved postoperatively in 9 eyes at a minimum follow-up of six months. Abnormal IOL position, IOL capture by the iris, or posterior synechia was not observed. Hypotony maculopathy occurred in one eye, but the macular folding disappeared and the visual acuity improved after adding one-bite suture. CONCLUSIONS: The technique we describe in this study is a simple and effective procedure for repositioning posteriorly dislocated PC IOLs with minimal intraocular manipulations and complications.
Dislocations ; Eye ; Follow-Up Studies ; Humans ; Iris ; Lenses, Intraocular ; Sutures ; Visual Acuity ; Vitrectomy

PURPOSE: To report the occurrence of central vein occlusion in an Eales disease patient. CASE SUMMARY: A 23-year-old man presented with decreased left eye visual acuity and was diagnosed with bilateral Eales disease after ophthalmic evaluations. The patient received laser photocoagulation and visual acuity in his left eye improved 1 month after treatment. He was followed up regularly for 3 years and had no specific eye problems. Subsequently, the patient visited our clinic because of visual disturbance in his right eye. The patient's visual acuity was 0.6 in his right eye, and 1.0 in his left eye. On right eye fundus examination, there were multiple flame shape hemorrhages and retinal vascular tortuosity was observed. Arteriovenous transit time was extended on fluorescein angiography. Therefore, the patient was diagnosed with central retinal vein occlusion and underwent an internal medical examination to reveal a possible systemic cause of the central retinal vein occlusion; however, there were no systemic problems. Macular edema was observed on optical coherence tomography and the patient received an intravitreal bevacizumab injection. Six months after treatment, the right eye visual acuity and macular edema improved. CONCLUSIONS: Reports of branched retinal vein occlusion on the peripheral retina are common in Eales disease patients. However, the authors experienced and report a case of central retinal vein occlusion occurring in Eales disease.
Antibodies, Monoclonal, Humanized ; Eye ; Fluorescein Angiography ; Hemorrhage ; Humans ; Light Coagulation ; Macular Edema ; Neovascularization, Pathologic ; Retina ; Retinal Vasculitis ; Retinal Vein ; Retinal Vein Occlusion ; Retinaldehyde ; Tomography, Optical Coherence ; Veins ; Visual Acuity ; Young Adult ; Bevacizumab

PURPOSE: We analyzed time series changes in cataract surgeries in Korea, and provide basic data to enhance the efficiency of medical services for cataract surgery. METHODS: Among cataract surgery statistics registered in the Korean National Health Insurance Cooperation from 2006 to 2012, we used data regarding the number of patients and operations and the number of patients and operations per 100,000 people. We analyzed various time series changes, including differences by sex and age. RESULTS: The total numbers of patients from 2006 to 2012 by year were 207,370; 228,170; 250,289; 268,548; 289,867; 308,111; and 302,182, respectively. The total numbers of operations from 2006 to 2012 by year were 272,920; 305,807; 338,332; 365,874; 398,338; 428,158; and 420,905, respectively. The number of patients and operations per 100,000 people were highest in men 80 to 84 years old and women 75 to 79 years old. Comparing the number of operations in 2006 and after, the patient age group with the highest increase rate changed from over 85 years old to 75–79 years old since 2010 in men and from over 85 years old to 50–54 years old since 2009 in women. For each year investigated, the number of operations performed was higher than the number of patients who received operations. CONCLUSIONS: Over the study period, the number of cataract surgeries increased, while the age of cataract patients decreased. Additionally, the number of cataract-related surgeries increased in relation to the number of patients.
Cataract Extraction ; Cataract* ; Epidemiology ; Female ; Humans ; Korea* ; Male ; National Health Programs

PURPOSE: To report polymicrobial keratitis involving Pseudomonas aeruginosa, Acinetobacter baumannii, and Ochrobactrum anthropi. CASE SUMMARY: A 53-year-old female complained of pain and secretion in her right eye, which started 6 weeks before her visit. She applied steroid ointment, which was received from the dermatologist, to her eyelid 7 days prior to her visit but this treatment worsened her symptoms. At the initial visit, the visual acuity of the right eye was light perception, and purulent secretions were observed. Using a slit lamp, severe conjunctival hyperemia, hypopyon, and a ring-shaped central corneal ulcer were observed. The anterior chamber and fundus were not observed due to corneal lesions but ultrasonography showed no intraocular inflammation. Infectious keratitis was suspected and cultured by corneal scraping. During the incubation period, 0.5% moxifloxacin, 2% voriconazole, and 1% cyclopentolate were administered. A total of 400 mg of moxifloxacin and 100 mg of doxycycline were given orally. In the primary culture, Pseudomonas aeruginosa and Acinetobacter baumannii were identified so 5% ceftazidime, which was sensitive for the antibiotic susceptibility results was further instilled. Thereafter, the keratitis improved but the keratitis again worsened while maintaining the topical treatment. A secondary culture was positive for Ochrobactrum anthropi. Treatment with 1.4% gentamicin, which was sensitive for the antibiotic susceptibility test was added and the keratitis improved. A conjunctival flap was performed because of the increased risk of perforation. CONCLUSIONS: We report polymicrobial keratitis involving Pseudomonas aeruginosa, Acinetobacter baumannii, and Ochrobactrum anthropi for the first time in the Republic of Korea.
Acinetobacter baumannii ; Acinetobacter ; Anterior Chamber ; Ceftazidime ; Corneal Ulcer ; Cyclopentolate ; Doxycycline ; Eyelids ; Female ; Gentamicins ; Humans ; Hyperemia ; Inflammation ; Keratitis ; Middle Aged ; Ochrobactrum anthropi ; Ochrobactrum ; Pseudomonas aeruginosa ; Pseudomonas ; Republic of Korea ; Slit Lamp ; Ultrasonography ; Visual Acuity ; Voriconazole

PURPOSE: To examine the results of macular hole surgery using pars plana vitrectomy (PPV), triamcinolone-assisted peeling of the internal limiting membrane (ILM), and intravitreous air in idiopathic stage 2 and 3 macular holes. METHODS: Thirteen eyes of 13 consecutive patients with idiopathic macular hole underwent a PPV with triamcinolone-assisted ILM peeling and intravitreous air tamponade. An air-fluid exchange was performed and the patient was asked to maintain a face-down position at home for 4 days. The follow-up period was 6 months or more in all cases. If a significant cataract was present before surgery, a combined phacoemulsification with posterior chamber lens implantation was performed at the time of the macular hole surgery. The closure of the macular hole was determined by biomicroscopy and Optical Coherence Tomography (OCT). RESULTS: The idiopathic macular hole was closed after the primary operation in all 13 patients. The postoperative visual acuities (0.1 to 0.9) significantly improved from the preoperative visual acuities (0.02 to 0.4) in all eyes. There was no recurrence of the macular hole and there were no adverse effects of the intraoperative use of triamcinolone and ILM peeling during the follow-up period. CONCLUSIONS: This study suggests that triamcinolone-assisted ILM peeling with intravitreous air may be an effective technique for stage 2 and 3 macular holes. This procedure could reduce the face-down position time and improve early visual rehabilitation by using air instead of long-acting gas tamponade.
Cataract ; Eye ; Follow-Up Studies ; Humans ; Membranes ; Phacoemulsification ; Recurrence ; Retinal Perforations ; Tomography, Optical Coherence ; Triamcinolone ; Visual Acuity ; Vitrectomy

Purpose: To determine the intraocular pressure (IOP) lowering effect and complications of Ahmed valve implantation (AGV) in patients who underwent cyclophotocoagulation (CPC). Methods: Patients who underwent AGV after CPC in group 1, those who underwent CPC after AGV in group 2, and patients who underwent repeated CPC in group 3 were included in this retrospective observational study. Changes in IOP, number of glaucoma eye drops, and best corrected visual acuity (BCVA) were analyzed before and 1 week, 1 month, 3 months, 6 months, and 12 months after surgery, and postoperative complications were analyzed. Results: Eight patients in group 1, 10 patients in group 2, and seven patients in group 3 were included in the analysis. Preoperative IOP was 45.6 ± 15.5, 29.3 ± 5.6, and 43.4 ± 14.4 mmHg in the three groups, respectively, and the number of glaucoma eye drops was 3.8 ± 0.7, 3.9 ± 0.3, and 3.7 ± 1.0 in the three groups, respectively. At 12 months postoperatively, IOP decreased significantly in all three groups compared to preoperatively (all p < 0.05), and the number of glaucoma eye drops was also significantly reduced (all p < 0.05). Among patients with preoperative BCVA of 0.02 decimal or higher, postoperative BCVA decreased in two patients in group 2 and one in group 3 (p = 0.380). Hypotony occurred in one patient in group 1 and two patients in group 3 (p = 0.383), and among them, one patient in group 1 and one patient in group 3 progressed to the phthisis (p = 0.940). Conclusions In patients whose IOP cannot be controlled after CPC, AGV is expected to be used as a relatively safe and effective treatment method for lowering IOP.