1.Idiopathic Macular Hole Surgery with or without Indocyanine Green-Stained Internal Limiting Membrane Peeling.
Dong Heun NAM ; Sangjun HWANG ; Kuhl HUH
Journal of the Korean Ophthalmological Society 2004;45(7):1086-1091
PURPOSE: To compare the anatomical and visual outcomes in idiopathic macular hole surgery with or without indocyanine green (ICG)-stained internal limiting membrane (ILM) peeling. METHODS: Thirty-six eyes of 36 patients who underwent idiopathic macular hole surgery were included. Follow-up period was longer than 6 months. In the initial 16 eyes, no ILM peeling was performed (non-ILM peeling group). The subsequent 20 eyes underwent surgery with ICG-stained ILM peeling (ILM peeling group). RESULTS: There were no significant differences in the age, sex, hole size, symptom duration and preoperative best-corrected visual acuity between the two groups. The anatomical closure rates were 95% (19/20eyes) and 75% (12/16eyes) in the ILM peeling and non-ILM peeling groups, respectively (Fisher's exact test, p=0.15). Visual improvement of two or more lines occurred in 35% (7/20eyes) in the ILM peeling group and 43.8% (7/16eyes) in the non-ILM peeling group (Chi-square test, p=0.59). CONCLUSIONS: ICG stained ILM peeling was not statistically significant for anatomic and functional success in idiopathic macular hole surgery. Further studies of the toxicity of ICG and the result of ILM peeling should be performed.
Follow-Up Studies
;
Humans
;
Indocyanine Green
;
Membranes*
;
Retinal Perforations*
;
Visual Acuity
2.Color Doppler Imaging to Diagnose Ocular Disorders.
Yong Yeon KIM ; Kuhl HUH ; Tae Soo LEE
Journal of the Korean Ophthalmological Society 1999;40(1):261-266
Color Doppler imaging(CDI) facilitates the study of orbital vasculature by color encoding the Doppler frequency shifts of blood flow, superimposing this color on B-scan anatomic detail. In a patient with ocular ischemic syndrome, maximal systolic velocity of the ophthalmic artery in the ischemic eye was reduced markedly when compared with the contralateral control eye. CDI revealed no detectable blood flow velocities within the mass in cavernous hemangioma of the orbit. In a patient with carotid-cavernous fistula, CDI demonstrated a typical low-resistance blood flow pattern of the arterialized vein. Noninvasive CDI may be helpful diagnostic aid for disorders of the eye and orbit.
Blood Flow Velocity
;
Carotid-Cavernous Sinus Fistula
;
Fistula
;
Hemangioma, Cavernous
;
Humans
;
Ophthalmic Artery
;
Orbit
;
Veins
3.Effect of Mitomycin C on Glaucoma Filtering Surgery.
Journal of the Korean Ophthalmological Society 1986;27(6):1129-1138
The purpose of glaucoma filtering surgery is to maintain low intraocular pressure byoontinuous filtration of aqueous humor. Filtration failure commonly results from scarring at the surgical site. Fibroblast plays an important role in the scarring process. Mitomycin C and 5-fluorouracil are the antimetabolites capable of inhibiting fibroblast proliferation. In this animal experiment, the authors studied electron microscopically the effect of Mitomycin C and 5-fluorouracil on the fibroblast proliferation at the surgical site. Posterior sclerectomy was performed to 9 eyes of 9 normal rabbits. Postoperatively, 3 eyes recieved subconjunctival injection of Mitomycin C, 3 eyes 5-fluorouracil and 3 eyes normal saline as a control. Additional one eye of a rabbit was used for observation of normol fibroblast. Animals were killed two days, four days, six days following surgery at the time of 12 hours after the last injection. Globes were immediately removed and processed for transmission electron microscopic examination. The results were as follows; 1. Normal fibroblasts in episclera showed dilated cisternae of rough endoplasmic reticulum (RER). 2. Two days after operation, the fibroblasts were slightly activated. 3. Four days after operation, cytoplasmic organelles in fibroblasts were more activated. 4. Six days after operation, secreting forms of fibroblast were visible. The fibrillar materials of moderate electron density pooled in cisternae of RER, and the filamentous elements were in the periphery of the cytoplasm. 5. In Mitomycin C treated group, there was no remarkable change in the cytoplasmic organelles, but some dilation of RER was noted four days after operation. 6. In 5-fluorouracil treated group, there was the same feature as in Mitomycin C group, but milder. 7. Conclusively, Mitomycin C and 5-fluorouracil are considered effective on the inhibition of fibrogenesis with lowering of fibroblastic activity.
Animal Experimentation
;
Animals
;
Antimetabolites
;
Aqueous Humor
;
Cicatrix
;
Cytoplasm
;
Endoplasmic Reticulum, Rough
;
Fibroblasts
;
Filtering Surgery*
;
Filtration
;
Fluorouracil
;
Glaucoma*
;
Intraocular Pressure
;
Mitomycin*
;
Organelles
;
Rabbits
4.Mesectodermal Leiomyoma of the Ciliary Body.
Je Hyong BAE ; Kuhl HUH ; Tae Soo LEE
Journal of the Korean Ophthalmological Society 1995;36(10):1821-1826
A 12-year-old girl presented with a ciliary body mass that measured approximately 13 X 10 mm in size. The tumor was excised through cyclectomy. The light microscopic apprearance resembled neurogenic neoplasm such as neurofibroma or schwannoma. However, some tumor cells included fasciculus which is a characteristic feature of myogenic tumor. Immunohistochemistry assay and electron microscopic examination revealed smooth muscle nature including myofilaments with dense bodies and established the diagnosis as mesectodermal leiomyoma in the ciliary body. To our best knowledge, our patient is the youngest among the ciliary body leiomyoma cases ever reported.
Child
;
Ciliary Body*
;
Diagnosis
;
Female
;
Humans
;
Immunohistochemistry
;
Leiomyoma*
;
Muscle, Smooth
;
Myofibrils
;
Neurilemmoma
;
Neurofibroma
5.1 Case of Perivascular Retinitis in a Patient with Hodgkin's Disease.
Jae Hyun NOH ; Jong Wook HONG ; Kuhl HUH
Journal of the Korean Ophthalmological Society 1995;36(10):1810-1815
Although intraocular involvement in Hodgkin's disease is infrequent, there were reported iridocyclitis, exudative retinal detatchment, retinal hemorrhage, necrotizing retinitis, anterior and posterior uveitis, perivascular chorioretinitis. We report a 61 years old male patient with Hodgkin's disease who developed retinal lesion with decreased visual acuity in his right eye during a period of quiscence in his disease, 10 months since diagnosed. On first ophthalmic examination, best corrected vision of right eye was 0.6 and 1.0 on left eye. Fundus examination of the left eye was normal; however, the right eye revealed cotton wool patches, retinal edema, and intraretinal hemorrhage along the superior temporal venules. Fluorescein angiography showed blockage of choroidal flush in early phase and focal area of hyper fluorescence with perivascular leakage of dye in late phase. The results of TORCH test were negative, and the patient didn't have hypertension, diabetes mellitus, and bleeding tendency. Therefore we this case presumed perivascular retinitis associated with Hodgkin's disease.
Chorioretinitis
;
Choroid
;
Diabetes Mellitus
;
Fluorescein Angiography
;
Fluorescence
;
Hemorrhage
;
Hodgkin Disease*
;
Humans
;
Hypertension
;
Iridocyclitis
;
Male
;
Middle Aged
;
Papilledema
;
Retinal Hemorrhage
;
Retinaldehyde
;
Retinitis*
;
Uveitis, Posterior
;
Venules
;
Visual Acuity
;
Wool
6.Clinical Analysis of Vitrectomy for Complication of Proliferative Diabetic Retinopathy.
Journal of the Korean Ophthalmological Society 1996;37(7):1161-1167
To evaluate the postoperative prognostic factors of pars plana vitrectomy for the proliferative diabetic retinopathy, the authors studied retrospectively the surgical results of 65 eyes that have been followed over 6 months postoperatively. The surgical results were varied according to the indication. Seventy six percent of eyes with vitreous hemorrhage obtained final vision of 5/200 or better. Similar results were obtained in 73% of eyes with macular traction detachment, 47% of eyes with rhegmatogenous-traction detachment. Rhegmatogenous-traction detachment has less favorable outcome than vitreous hemorrhage and macular traction detachment. Factors associated with a favorable visual prognosis were as follows: (1) preoperative visual acuity of 5/200 or better, (2) the avoidance of performing lensectomy, (3) the avoidance of using intraocular gas bubbles, (4) the absence of preoperative retinal detachment. Thirteen eyes resulted in anatomic failure ; vitreous hemorrhage was the cause of failure in 4 eyes(31%) and anterior hyaloid fibrovascular proliferation in 3 eyes(23%), The causes of poor visual outcome included optic atrophy in 3 eyes, ischemic maculopathy in 2 eyes, submacular fibrosis in 1 eye and cataract in 1 eye.
Cataract
;
Diabetic Retinopathy*
;
Fibrosis
;
Hemorrhage
;
Optic Atrophy
;
Prognosis
;
Retinal Detachment
;
Retrospective Studies
;
Traction
;
Visual Acuity
;
Vitrectomy*
;
Vitreous Hemorrhage
7.A Case of Lacquer Crack Formation at the Site of Subretinal Bleeding in High Myopic Eye.
Journal of the Korean Ophthalmological Society 2000;41(1):268-271
Lacquer cracks represent the healed mechanical breaks of retinal pigment epithelium, Bruch's membrane, and choriocapillaris complex.The etiologic mechanism of new lacquer cracks in high myopia has not yet been elucidated. Recently, cases in which new lacquer cracks formed at the site of the previous subretinal bleeding have been reported and it has been postulated that the subretinal bleeding may be the precursor of lacquer cracks formation in high myopia.Herein, we present our patient who developed a new lacquer crack at the site of previous subretinal bleeding with a brief literatures review.
Bruch Membrane
;
Fluorescein Angiography
;
Hemorrhage*
;
Humans
;
Lacquer*
;
Myopia
;
Retinal Pigment Epithelium
8.Retnal Toxicty of Intravitreal Tissue Plasminogen Activator with C3F8 Injection in Rabbit Eyes.
Keun Soo KIM ; Kyuchul RHEE ; Kuhl HUH
Journal of the Korean Ophthalmological Society 2004;45(7):1181-1188
PURPOSE: To determine the concentration at which a mixed injection of tissue plasminogen activator (tPA) and C3F8 gas is toxic, we studied the histopathological changes in the rabbit retina. METHODS: Only tPA was injected into the right vitreous cavities of 18 normal pigmented rabbits at doses of 25 micro gram/0.1mL, 50 micro gram/0.1mL, and 100 micro gram/0.1mL, 6 rabbits per dosage. In the same rabbits, tPA and C3F8 (0.2cc) were simultaneously injected into the left vitreous cavities at doses of 25 micro gram/0.1mL, 50 micro gram/0.1mL, and 100 micro gram/0.1mL. All of the eyes were examined by slit lamp biomicroscopy and indirect ophthalmoscopy at 5, 10, and 15 days after the injection, and then they were enucleated for histopathological evaluation. RESULTS: Retinal pigmentary alterations were centered around the injection site 3 days postoperatively in the eyes receiving doses of 50 micro gram/0.1mL or greater. On light microscopy(LM), the involved areas showed vacuolization in the photoreceptor elements and the inner nuclear layer(INL) at a dose of 25 micro gram/0.1mL at postoperative 5 days and the vacuolar changes disappeared at postoperative 15 days. But at doses of 50 micro gram/0.1mL or greater, loss, contracture, and vacuolization of the photoreceptor outer segment (POS) and vacuolization of INL were noted at postoperative 15 days. On LM, at a dose of 25 micro gram/0.1mL, the involved areas showed vacuolization in POS and mitochondrial swelling of the photoreceptor inner segment (PIS) at postoperative 5 days. The mitochondrial swelling of PIS disappeared at postoperative 15 days. However, at doses of 50 micro gram/0.1mL or greater, loss and contracture of POS and mitochondrial swelling of PIS were noted at postoperative 15 days. The retinal damage from simultaneous injection of tPA and C3F8 at doses of 25, and 50 micro gram/0.1mL was equal to or less than that of only tPA injection, whereas at a doses of 100 micro gram/0.1mL the damage was greater. CONCLUSIONS: At doses of 50 micro gram/0.1mL or greater, irreVersible retinal toxicity was noted histopathologically in rabbit eyes. At doses of 25, and 50 micro gram/0.1mL, the degree of retianl damage did not seem to be affected by whether C3F8 was injected concomitantly or not.
Contracture
;
Mitochondrial Swelling
;
Ophthalmoscopy
;
Rabbits
;
Retina
;
Retinaldehyde
;
Tissue Plasminogen Activator*
9.The Effect of Axial Length on Branch Retinal Vein Occlusion.
Dong Heun NAM ; Jeong Kyu LEE ; Kuhl HUH
Journal of the Korean Ophthalmological Society 1999;40(8):2212-2217
Branch retinal vein occlusion (BRVO) is the second most common form of retinal vascular diseases next to diabetic retinopathy. Several risk factors such as hypertension, diabetes mellitus, and hyperopia have been shown to be associated with BRVO. The pathogenesis of branch retinal vein occlusion has not been well understood. This study was conducted prospectively on 21 patients with BRVO and normal 21 patients as controls to assess the relationship of the axial length with the development of BRVO. Mean axial lengths of the affected and the fellow eyes in the branch retinal vein occlusion group were 22.69 +/-0.72 mmand 22.89 +/-0.67mm, respectively. The difference between mean axial lengths of the affected and the fellow eyes was not statistically significant (p=0.17). The mean axial length of control eyes was 23.22 +/-1.29 mm. The affected eyes in the BRVO group were 0.53 mmshorter than eyes in control group on the average, and the difference was statistically significant(p=0.04). This study suggests that shorter axial length could be a local risk factor in the pathogenesis of branch retinal vein occlusion.
Diabetes Mellitus
;
Diabetic Retinopathy
;
Humans
;
Hyperopia
;
Hypertension
;
Prospective Studies
;
Retinal Vein Occlusion*
;
Retinal Vein*
;
Retinaldehyde*
;
Risk Factors
;
Vascular Diseases
10.Eales Disease Accompanied with Branch Retinal Vein Occlusion.
Joong Bin AHN ; Yong Yeon KIM ; Kuhl HUH
Journal of the Korean Ophthalmological Society 1995;36(4):658-663
Eales disease is an uncommon idiopathic vasoproliferative retinal disease that primarily affects the peripheral retina. We experienced a 17-year-old male patient who was referred to our clinic because of retinal hemorrhage at the superior temporal quadrant of his left eye. After excluding other causes of branch retinal vein occlusion with medical evaluation, the primary branch retinal vein occlusion was diagnosed. During the follow-up period, retinal vasculitis developed in the peripheral retina of his both eyes along with rapid development of the neovascularization in the left eye. Eales disease was diagnosed. In spite of scattered laser photocoagulation, vitreous hemorrhage eventually occurred, requiring pars plana vitrectomy. We emphasize the occurrence of the branch retinal vein occlusion in young patient with Eales disease.
Adolescent
;
Follow-Up Studies
;
Humans
;
Light Coagulation
;
Male
;
Retina
;
Retinal Diseases
;
Retinal Hemorrhage
;
Retinal Vasculitis
;
Retinal Vein Occlusion*
;
Retinal Vein*
;
Retinaldehyde*
;
Vitrectomy
;
Vitreous Hemorrhage