PURPOSE: To evaluate the short-term efficacy of intravitreal triamcinolone (IVTA) injection for the treatment of macular edema secondary to branch retinal vein occlusion (BRVO) refractory to intravitreal bevacizumab injections. METHODS: This retrospective, observational study included 23 eyes of 23 patients with macular edema secondary to BRVO. The patients with macular edema unresponsive to 2 or more consecutive monthly intravitreal bevacizumab injections were treated with IVTA. Best-corrected visual acuity (BCVA) and central foveal thickness (CFT) based on optical coherence tomography were evaluated before IVTA and 1 month and 3 months after IVTA injections. RESULTS: All patients were previously treated with 3.4 ± 1.2 intravitreal bevacizumab injections. The IVTA injection was performed at 4.3 ± 1.7 weeks after the last bevacizumab injection. The logarithm of the minimal angle of resolution (log MAR) BCVA was also decreased from 0.61 ± 0.45 to 0.52 ± 0.35 after 1 month and to 0.58 ± 0.37 after 3 months of IVTA, although without statistical significance (p = 0.114 and 0.412, respectively). Eight eyes (34.8%) showed more than 3 lines improvement of BCVA and 4 eyes (17.4%) showed stable BCVA increasing 2 lines or less. CFT was significantly improved from 512 ± 166 µm to 310 ± 139 µm after 1 month and to 324 ± 159 µm after 3 months of IVTA injections (p = 0.014 and 0.031, respectively). CONCLUSIONS: IVTA was beneficial in some patients with macular edema secondary to BRVO refractory to intravitreal bevacizumab therapy. This study indicates that IVTA could be considered as a treatment option for refractory macular edema associated with BRVO.
Bevacizumab ; Humans ; Macular Edema* ; Observational Study ; Retinal Vein Occlusion* ; Retinal Vein* ; Retinaldehyde* ; Retrospective Studies ; Tomography, Optical Coherence ; Triamcinolone* ; Visual Acuity

PURPOSE: Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder with widespread manifestations that rarely include the eye. We present a case of SLE-associated choroidoretinopathy and secondary angle closure attack in both eyes. CASE SUMMARY: A 58-year-old male was admitted into the urologic department complaining of right scrotal swelling, and then consulted with the ophthalmology department regarding both ocular pain and eye injection. The patient was diagnosed with acute angle closure attack using a slit lamp test and tonometry secondary to choroidoretinitis with choroidal detachment at fundus examination in both eyes. The rheumatologist performed systemic evaluation, including serologic tests, and then diagnosed the patient with SLE. After systemic steroid therapy, intraocular pressure was decreased and choroidal detachment disappeared with improvements of choroidoretinitis in both eyes. CONCLUSIONS: Patients with systemic lupus erythematosus choroidopathy can develop secondary angle closure attack, which can be effectively treated using systemic steroid therapy and antiglaucoma drugs.
Choroid ; Choroiditis ; Humans ; Intraocular Pressure ; Lupus Erythematosus, Systemic* ; Male ; Manometry ; Middle Aged ; Ophthalmology ; Serologic Tests ; Slit Lamp

PURPOSE: To compare therapeutic outcome of intravitreal bevacizumab in treating macular edema between major and macular branch retinal vein occlusion (BRVO). METHODS: This retrospective, observational study included 58 eyes from 58 patients with macular edema secondary to BRVO. All patients were treated with intravitreal bevacizumab injection at baseline, followed by further injections as required with monthly follow-up. Central foveal thickness and best-corrected visual acuity (BCVA) were evaluated after treatment between major and macular BRVO during 12 months of follow-up. RESULTS: The mean best-corrected visual acuity (BCVA) in the major BRVO group (39 eyes), expressed as the logarithm of the minimum angle of resolution (logMAR), decreased from 0.66 ± 0.47 to 0.34 ± 0.28 after 12 months of treatment (p = 0.011). Similarly, in the macular BRVO group (19 eyes), the BCVA decreased from 0.60 ± 0.41 to 0.30 ± 0.22 (p = 0.014). The central foveal thickness decreased in the major BRVO group from 498.5 ± 194.3 µm to 311.3 ± 178.5 µm and in the macular BRVO group from 442.4 ± 155.8 µm to 297.2 ± 145.7 µm (p = 0.004 and 0.002, respectively). However, there was no significant difference between the groups with regard to either BCVA improvement or decrease in central foveal thickness. The mean injection number of macular BRVO (2.6 ± 1.6) was significantly lower than that of major BRVO (3.5 ± 1.4, p = 0.021). CONCLUSIONS: The visual acuity improvement achieved after 12 months of intravitreal bevacizumab injection did not differ significantly between major and macular BRVO. However, significantly fewer injections were required for macular BRVO than major BRVO.
Bevacizumab* ; Follow-Up Studies ; Humans ; Macular Edema* ; Observational Study ; Retinal Vein Occlusion* ; Retinal Vein* ; Retinaldehyde* ; Retrospective Studies ; Visual Acuity

PURPOSE: To compare therapeutic outcome of intravitreal bevacizumab in treating macular edema between major and macular branch retinal vein occlusion (BRVO). METHODS: This retrospective, observational study included 58 eyes from 58 patients with macular edema secondary to BRVO. All patients were treated with intravitreal bevacizumab injection at baseline, followed by further injections as required with monthly follow-up. Central foveal thickness and best-corrected visual acuity (BCVA) were evaluated after treatment between major and macular BRVO during 12 months of follow-up. RESULTS: The mean best-corrected visual acuity (BCVA) in the major BRVO group (39 eyes), expressed as the logarithm of the minimum angle of resolution (logMAR), decreased from 0.66 ± 0.47 to 0.34 ± 0.28 after 12 months of treatment (p = 0.011). Similarly, in the macular BRVO group (19 eyes), the BCVA decreased from 0.60 ± 0.41 to 0.30 ± 0.22 (p = 0.014). The central foveal thickness decreased in the major BRVO group from 498.5 ± 194.3 µm to 311.3 ± 178.5 µm and in the macular BRVO group from 442.4 ± 155.8 µm to 297.2 ± 145.7 µm (p = 0.004 and 0.002, respectively). However, there was no significant difference between the groups with regard to either BCVA improvement or decrease in central foveal thickness. The mean injection number of macular BRVO (2.6 ± 1.6) was significantly lower than that of major BRVO (3.5 ± 1.4, p = 0.021). CONCLUSIONS: The visual acuity improvement achieved after 12 months of intravitreal bevacizumab injection did not differ significantly between major and macular BRVO. However, significantly fewer injections were required for macular BRVO than major BRVO.
Bevacizumab* ; Follow-Up Studies ; Humans ; Macular Edema* ; Observational Study ; Retinal Vein Occlusion* ; Retinal Vein* ; Retinaldehyde* ; Retrospective Studies ; Visual Acuity

PURPOSE: To identify factors associated with care of diabetic retinopathy. METHODS: The fourth Korea National Health and Nutrition Examination Survey (KNHANES IV) is a nationwide survey. This survey included 1, 257 people aged 40 years and older with a history of diabetic mellitus who answered questions, "Within one year, have you ever received eye examination (fundus photography) for screening diabetic retinopathy?" Factors that affect care of diabetic retinopathy were identified using multiple logistic regression analysis. RESULTS: Among the 1,257 people aged 40 years and older, 464 (36.9%) received screening for diabetic retinopathy. People aged 65 years and older (aOR = 0.7, 95% CI: 0.51-0.85) with university education (aOR = 0.5, 95% CI: 0.32-0.74) were more likely to undergo screening for diabetic retinopathy compared to those in the reference category (40-64 years old and those who had elementary school or lower education). People living in rural areas were less likely to undergo screening for diabetic retinopathy compared to those living in urban areas (aOR = 1.7, 95% CI: 1.32-2.24). Diabetic retinopathy screening was also associated with self-reported health status (ref: unhealthy [aOR = 1], fair [aOR = 1.7, 95% CI: 1.25-2.23], and healthy [aOR = 1.8, 95% CI: 1.30-2.44]). CONCLUSIONS: To increase nationwide screening rates for diabetic retinopathy, more attention should be given to underserved groups, particularly people aged between 40 and 64 years, those with a low education level, those living in rural areas, and those with a positive attitude toward self-reported health status. These issues highlight the need for a new emphasis in health education and public health policies aimed towards these underserved groups.
Aged ; Diabetic Retinopathy ; Eye ; Health Education ; Humans ; Korea ; Logistic Models ; Mass Screening ; Nutrition Surveys ; Public Health

PURPOSE: To compare changes in human central corneal thickness after instillation of proparacaine with those after oxybuprocaine instillation, over a period of 10 minutes. METHODS: Eighteen healthy young participants were recruited. Baseline central corneal thicknesses were measured every 30 seconds for 10 minutes using a noncontact specular microscope. Changes in central corneal thickness were measured every 20 seconds for 10 minutes after the administration of one drop of 0.5% proparacaine into the right eye, and one drop of 0.4% oxybuprocaine into the left eye. RESULTS: Mean baseline central corneal thickness was 531 +/- 45 micrometer in the right eye and 531 +/- 42 micrometer in the left. The central corneal thickness after proparacaine instillation increased to 8.6 micrometer (4.5-12.6 micrometer, 95% CI) and then returned to baseline within 80 seconds. Central corneal thickness after oxybuprocaine instillation increased to 7.7 micrometer (3.6-11.2 micrometer, 95% CI) and then returned to baseline within 80 seconds. There was a second transient increase about 5 minute after proparacaine instillation but no additional transient increase after oxybuprocaine instillation. CONCLUSIONS: The severity of oxybuprocaine's effect on central corneal thickness is similar to that of proparacaine. Central corneal thickness instability may occur for 5 minutes after proparacaine administration. Therefore, changes in central corneal thickness after topical anesthetics instillation should be considered when measuring central corneal thickness.
Anesthetics* ; Humans

OBJECTIVE: The aim of this study was to determine the role of survivin, caspase 3, p53 and Ki-67 expression in the carcinogenesis of cervical carcinoma and aggressiveness of cervical intraepithelial neoplasia (CIN). METHODS: The pathology specimens of 94 patients with a diagnosis of Low grade CIN (31 cases), High grade CINL (32 cases) and squamous cell carcinoma (31 cases) were evaluated immunohistochemically for the expression of survivin, caspase 3, p53 and Ki-67 in paraffin sections. RESULTS: Survivin, p53 and Ki-67 expressions were progressively increased in accordance with the increasing degree of malignancy, but caspase 3 immunoreactivity was higher in high grade CIN than in low grade CIN and invasive cervical cancers. There was no significant difference between Ki-67 index and survivin, caspase 3 and p53 expression with the increasing degree of malignancy. The Ki-67 index was closely related to p53 overexpression in invasive cervical carcinoma group. CONCLUSION: A sequential increase of survivin, p53, and Ki-67 was observed in paralleling the progression of grade of CIN and cervical cancer. In addition, caspase 3 expression increased proportionally to the low-grade CIN to high grade CIN.
Carcinoma, Squamous Cell ; Caspase 3 ; Cervical Intraepithelial Neoplasia ; Humans ; Paraffin ; Uterine Cervical Neoplasms

PURPOSE: To examine the occurrence and risk factors of decompensation and the additional treatment of increased hyperopia in refractive accommodative esotropia. METHODS: Seventy children with refractive accommodative esotropia were followed up for at least 2 years. Time of decompensation and additional treatment, initial refractive error, initial deviation, and controlled deviation were all studied. RESULTS: Decompensation and additional treatment occurred on average at 21.8 months and 22.2 months in eight patients, respectively, and constant survival was achieved after 4 years of full correction of the refractive error, as shown on a Kaplan-Meier survival curve. In the decompensation, additional treatment and control groups, initial refractive errors were 3.97+/-1.07D, 4.06+/-1.92D and 4.60+/-1.29D, respectively; initial deviations were 36.25+/-12.75PD, 31.25+/-10.61PD and 26.02+/-8.62PD, respectively; and controlled deviations were 4.50+/-6.30PD, 4.50+/-4.63PD and 2.65+/-4.10PD, respectively. There was a significant difference in initial deviation between the decompensation and control groups (p=0.011). CONCLUSIONS: The treatment of decompensation and increased hyperopia warranted careful follow-up in the first 4 years after treatment, and patients with large initial deviation risked decompensation.
Child ; Esotropia* ; Follow-Up Studies ; Humans ; Hyperopia ; Refractive Errors ; Risk Factors*

Recently identified second messenger molecules of signal transmission were derived from inositol phospholipid and several phospholipase C(PLC) isoenzyme were reconized. But the role of PLC in embryonal organ development, differentiation and growth is not described, yet. And, Siah gene of mouse is expressed at a higher level in a restricted number of sites during development. So, it is suggested that the Siah gene plays a significant role in development of vertebrates.Therefore, this study was aimed to investigate the role of PLC isoenzymes and Siah gene during murine fetal development by use of immunehistochemistry. The results are as follow: 1. PLC-beta1 and PLC-gammal are expressed apparently at early fetal stage, PLC-betal is observed focally, whereas PLC-gamma1 is diffusely expressed. 2. PLC-delta1 is not expressed during early and mid murine fetal age but strongly expressed in placental tissue. 3. PLC-beta1 is observed mainly in neural tissues including brain at mid fetal stage. PLC-gamma1 is expressed in entire organs, especially in liver tissue, and then their expression is reduced after mid stage. 4. Siah gene product is significantly expressed in olfactory epithelium, retina, neuron of brain and choroid plexus from mid fetal stage to late gestation. These results suggest that PLC-betal play a important role in central neural development and PLC-gamma1 in entire orgaans, especially in liver development. The strong expression of PLC-deltal in placenta suggest its involvement in early development, indirectly. Siah gene product expressed at a higher levels in olfactory epithelium, retina, neuron and choroid plexus, so Siah gene may play a important role in these organ developments.
Animals ; Brain ; Choroid Plexus ; Fetal Development* ; Gestational Age ; Immunohistochemistry* ; Inositol ; Isoenzymes ; Liver ; Mice ; Neurons ; Olfactory Mucosa ; Phospholipases* ; Placenta ; Pregnancy ; Retina ; Second Messenger Systems ; Type C Phospholipases*

PURPOSE: To evaluate the effect of acrylic refractive prism and Fresnel membrane prism on stereoacuity in intermittent exotropia. MATERIALS AND METHODS: Stereoacuities of fifty-two patients (mean age, 12.4 years; range 6 to 45 years) with intermittent exotropia were measured using the Titmus and TNO stereotests, while they wore prisms of varying power on nonfixating eye or evenly on each eye. RESULTS: Stereoacuities were significantly reduced with increasing prism power for both prisms, ranging from 8 to 25 prism dipotres. The effects on stereoacuity in single acrylic prism and single Fresnel prism were similar, whereas spilt Fresnel prisms reduced stereoacuity more than spilt acrylic prisms. Spilt prisms were found to have much less effect on stereoacuity than single prisms for both acrylic and Fresnel prisms. CONCLUSION: The use of acrylic refractive prism shared evenly on each eye would be optimal method to minimize the reduction of stereoacuity during the prismatic therapy for intermittent exotropia.
Adolescent ; Adult ; Child ; Depth Perception/*physiology ; Exotropia/physiopathology/*therapy ; *Eyeglasses ; Female ; Humans ; Male ; Refraction, Ocular/physiology ; Visual Acuity/*physiology ; Young Adult