We investigated differences in clinical findings among normal-tension glaucoma(NTG)patients between those with wedge-shaped nerve fiber layer(NFL)defect and with diffuse atrophy. Forty-one eyes of patients with NTG having diurnal intraocular pressure < 21mmHg, glaucomatous visual field defect, optic disc analysis with Heidelberg Retina Tomograph(HRT), and brain magnetic resonance imaging were divided into wedge-shaped defect group and diffuse atrophy group according to the types of NFL atrophy. We found no difference between two groups in the mean deviation of visual field, area of peripapillary atrophy measured with HRT, and presence of peripapillary atrophy. The patients with diffuse atrophy were older than those with wedge-shaped defect(p=0.01). The intraocular pressure was slightly higher (p=0.02)and maximal cup depth was larger(p=0.03)in patients with wedge-shaped defect compared with diffuse atrophy. Cerebral small vessel disease was more frequent in patients with diffuse atrophy than with wedge-shaped defect(p=0.02). This study suggests that cerebral small vessel disease is more common in patients with diffuse atrophy and potentially suggests indirectly ischemia may cause more diffuse damage than localized damage in patients with NTG.
Atrophy* ; Brain ; Cerebral Small Vessel Diseases ; Glaucoma* ; Humans ; Intraocular Pressure ; Ischemia ; Magnetic Resonance Imaging ; Nerve Fibers ; Retina ; Visual Fields

We retrospectively analyzed long-term outcome of graft rejection after penetrating keratoplasty in 128 eyes of 110 patients at Seoul National University Hospital, over 66 months period. The most common preoperative diagnosis of recipients was keratoconus, and aphakic bullous keratopathy, herpes simplex keratitis and corneal ulcer were in order. The results obtained are as follows : The rejection rate was 45.3% (58 eyes) in all of the graft, and it was 35.1% in keratoconus. Graft rejection developed in 52 eyes(92.1%) within 1 year and two eyes after 3 years, and a eyes at 5 years after graft. Graft rejection was reversed in 39.7% (23 eyes) of all graft rejection cases and 75%(15 eyes) in keratoconus. Best corrected visual acuity of 100/200 or better was achieved by 64.9%, and that of keratoconus was 82.5%. In univariate analysis of graft survival, peripheral anterior synechia, previous history of glaucoma, the presence of combined operation, technique of suture, corneal neovascularization showed high correlation with graft rejection however donor age, recipient age, re-keratoplasty and the size of donor corneal button didn`t show correlation with development of graft rejection. In multivariate analysis of graft survival, previous history of glaucoma, lens status and the presence of combined operation showed high correlation with graft rejection.
Corneal Neovascularization ; Corneal Transplantation ; Corneal Ulcer ; Diagnosis ; Glaucoma ; Graft Rejection* ; Graft Survival ; Humans ; Keratitis, Herpetic ; Keratoconus ; Keratoplasty, Penetrating* ; Multivariate Analysis ; Retrospective Studies ; Risk Factors ; Seoul ; Survival Rate ; Sutures ; Tissue Donors ; Transplants* ; Visual Acuity

PURPOSE: To analyze the fitting characteristics of contact lens, according to the clinical findings keratoconus of in Koreans. METHODS: The topographic indices were evaluated in 106 keratoconic eyes of the 53 patients, who had been followed up for at least 1 month, and their fitting pattern parameters retrospectively analyzed. The visual acuity, epithelial erosion, glare, daily lens wearing time, pain and the changes in the topographic indices were evaluated after fitting. RESULTS: The number of eyes fitted with spherical RGP, aspherical RGP and multicurve RGP were 19, 6 and 81 eyes with mean base curve radius (BCR) of 7.67, 7.17, and 6.76 mm, respectively. The Sim K and temporal K 3 mm from the center were significantly correlated with the BCR. 77 eyes achieved visual acuity of 20/30 or better, and the mean daily wearing time was 11.6 hours. Glare and pain were reported in 4 and 7 eyes, respectively, and progression of epithelial erosion was found in 8 eyes. The mean anterior elevation and sim Kmax in lens intolerable eyes were 0.0745 mm and 59.35 D, which were significantly higher than 0.0584 mm and 54.22 D in lens tolerable eyes. No progressive keratoconic changes were observed in the topographic indices for the eyes fitted with the multicurve lenses. CONCLUSIONS: Appropriate fitting guide-lines could be established by analyzing the fitting and clinical characteristics in keratoconus.
Glare ; Humans ; Keratoconus* ; Radius ; Retrospective Studies ; Visual Acuity

Effective dose of laser photocoagulation in proliferative diabetic retinopathy. We retrospectively studied 153 eyes of 106 patients to know correlation between the regression and the amount of retinal ablation, and to know clinical result after panretinal photocoagulation. Regression was observed in 100 eyes (65.4%), stationary status in 39 eyes (25.5%) and progression in 14 eyes (9.2%) in the 6 to 8 weeks following treatment. Stabilization was achieved in 98 eyes (64.1%) in the minimum follow-up of one year. Regression was observed in 78 eyes(79.6%) of low risk PDR versus 22 eyes (40.0%) of high risk PDR, and it was statistically significant (p=0.0001). The mean ablation area was 231.01+/-83.54 mm2. In high risk PDR, ablation area of eyes which were regressed was 279.33+/-111.39 mm2, compared to 220.42+/-91.61 mm2 which were not regressed(p=0.0337). In low risk PDR, there are no correlation between the ablation area and regression. Vision was decreased after photocoagulation 31 eyes(20.3%), and cystoid macular edema(CME) was the main cause of visual loss, however, the CME was not correlated with ablation area. Regression of new vessel was highly correlated with ablation area in high risk PDR.
Diabetic Retinopathy ; Follow-Up Studies ; Humans ; Light Coagulation* ; Retinaldehyde ; Retrospective Studies

To investigate the clinical similarity between the siblings, we retrospectively studied the medical records of 64 patients, 32 pairs. 31 pairs showed the similar entity of strabismus between siblings. There was exotropia in 22 pairs, esotropia in 5 pairs, bilateral superior obliqre palsy in 2 pairs, exotropia, esotropia and Duane`s retraction syndrome in 1 pair. One was exotropia and the other was exotropia and Duane`s retraction syndrome in one pair. One pair was bilateral supperior obliqre palsy and esotropia and the other was right gypertropia and exotropia. The difference in the amount of deviation was less than 10 prism diopter in 23 pairs. There was no association between the strabismic siblings in refractive anomaly, amblyopia, and anisometropea. The surgical results were similar in 7 pairs of siblings among 8 pairs who underwent corrective operations.
Amblyopia ; Duane Retraction Syndrome ; Esotropia ; Exotropia ; Humans ; Medical Records ; Paralysis ; Retrospective Studies ; Siblings* ; Strabismus*

To investigate the clinical similarity between the siblings, we retrospectively studied the medical records of 64 patients, 32 pairs. 31 pairs showed the similar entity of strabismus between siblings. There was exotropia in 22 pairs, esotropia in 5 pairs, bilateral superior obliqre palsy in 2 pairs, exotropia, esotropia and Duane`s retraction syndrome in 1 pair. One was exotropia and the other was exotropia and Duane`s retraction syndrome in one pair. One pair was bilateral supperior obliqre palsy and esotropia and the other was right gypertropia and exotropia. The difference in the amount of deviation was less than 10 prism diopter in 23 pairs. There was no association between the strabismic siblings in refractive anomaly, amblyopia, and anisometropea. The surgical results were similar in 7 pairs of siblings among 8 pairs who underwent corrective operations.
Amblyopia ; Duane Retraction Syndrome ; Esotropia ; Exotropia ; Humans ; Medical Records ; Paralysis ; Retrospective Studies ; Siblings* ; Strabismus*

To investigate the incidence, clinical findings and risk factors of retinopathy of juvenile diabetes, we retrospectively studied the medical records of patients from 1986 to 1997. We analysed 140 eyes in 70 patients underwent on annual indirect ophthalmoscopic examination and, when needed, a fluorescein angiography. After mean follow-up of 5.5 years, diabetic retinopathy was observed in 20 eyes(11 patients) and majority of them was mild nonproliferative diabetic retinopathy. In three eyes(two patients) proliferative diabetic retinopathy was developed. The mean age of the diagnosis of retinopathy was 16.2 years and at the first detection of diabetes was 9.0 years. In the univariate analysis, the total duration of diabetes, the duration of diabetes after puberty, sex and hypertension were not related to diabetic retinopathy but the HbAlc level, family history, and microalbuminuria were related. These results show important considerations during follow-up examination of the fundus in juvenile diabetes.
Adolescent ; Diabetic Retinopathy ; Diagnosis ; Fluorescein Angiography ; Follow-Up Studies ; Humans ; Hypertension ; Incidence ; Medical Records ; Puberty ; Retrospective Studies ; Risk Factors

Purpose: We investigated the refractive outcomes of second-operated eyes whose diopters of intraocular lens (IOL) were selected based on the prediction error (PE) of the first-operated eye in 1-week-delayed sequential bilateral cataract surgery. Methods: Medical records of 100 patients who had undergone delayed sequential bilateral cataract surgery with a 1-week interval were reviewed retrospectively. The postoperative subjective refraction was evaluated at 1 week and 1 month after surgery. The refractive error (RE) was determined by comparing postoperative refraction with the intended postoperative refractive target. The PE was determined by comparing postoperative refraction with the predicted postoperative refraction calculated by multiple different formulae (SRK-T, Hoffer Q, and Haigis). When the PE of the first eye was outside the range of ± 0.25 diopters (D) at postoperative 1 week, selection of IOL power was adjusted to reduce the PE of the second eye. Mean numerical and mean absolute errors of RE were calculated. The correlations between PE of the first eye measured at 1 week and PE of the second eye measured at 1 month were analyzed. Results: The mean absolute value of RE was decreased on the second operated eye, but was not significant (p > 0.05). The subgroup whose RE of the first eye was > ± 0.5 D at 1 week showed a significantly decreased mean absolute value of RE in the second eye (p < 0.05). The PE of the first eye measured at 1 week and of the second eye at 1 month showed significant correlation (r = 0.483 [SRK-T], 0.593 [Hoffer Q], 0.547 [Haigis]; p < 0.001). Conclusions Delayed sequential bilateral cataract surgery with a 1-week interval may enable refinement of the refractive outcome of the second operated eye when the first operated eye shows a RE >0.5 D.

PURPOSE: To investigate the feasibility of estimating effective lens position (ELP) and calculating intraocular lens power using corneal height (CH), as measured using anterior segment optical coherence tomography (AS-OCT), in patients who have undergone corneal refractive surgery. METHODS: This study included 23 patients (30 eyes) who have undergone myopic corneal refractive surgery and subsequent successful cataract surgery. The CH was measured with AS-OCT, and the measured ELP (ELP(m)) was calculated. Intraocular lens power, which could achieve actual emmetropia (P(real)), was determined with medical records. Estimated ELP (ELP(est)) was back-calculated using P(real), axial length, and keratometric value through the SRK/T formula. After searching the best-fit regression formula between ELP(m) and ELP(est), converted ELP and intraocular lens power (ELP(conv), P(conv)) were obtained and then compared to ELP(est) and P(real), respectively. The proportion of eyes within a defined error was investigated. RESULTS: Mean CH, ELP(est), and ELP(m) were 3.71 +/- 0.23, 7.74 +/- 1.09, 5.78 +/- 0.26 mm, respectively. The ELP(m) and ELP(est) were linearly correlated (ELP(est) = 1.841 x ELP(m) - 2.018, p = 0.023, R = 0.410) and ELP(conv) and P(conv) agreed well with ELP(est) and P(real), respectively. Eyes within +/-0.5, +/-1.0, +/-1.5, and +/-2.0 diopters of the calculated P(conv), were 23.3%, 66.6%, 83.3%, and 100.0%, respectively. CONCLUSIONS: Intraocular lens power calculation using CH measured with AS-OCT shows comparable accuracy to several conventional methods in eyes following corneal refractive surgery.
Axial Length, Eye/pathology ; Cornea/pathology/*surgery ; Humans ; *Lenses, Intraocular ; Male ; Middle Aged ; *Refractive Surgical Procedures ; Retrospective Studies ; Tomography, Optical ; Tomography, Optical Coherence

PURPOSE: To investigate the additive effect of oral steroid with topical nonsteroidal anti-inflammatory drug (NSAID) on cystoid macular edema (CME) in patients with epiretinal membrane (ERM) after cataract surgery. METHODS: Medical records of subjects who underwent uneventful cataract surgery (n = 1,349) were retrospectively reviewed; among these patients, those with pre-existing ERM (n = 81) were included. Patients were divided into two groups: one group had postoperative administration of oral steroid for 1 week (n = 45) and the other group did not have oral steroid administration (n = 36). Changes in macular thickness and incidence of CME were compared in both groups. Topical NSAIDs were administered in both groups for 1 month postoperatively. Definite CME and probable CME were defined by changes in retinal contour with or without cystoid changes. Change in central macular thickness of more than three standard deviations (≥90.17 µm) was defined as possible CME. Macular thickness was measured at 1 month after the operation by optical coherence tomography. RESULTS: The incidence of definite, probable, and possible CME were 2.22%, 4.44%, and 8.89% with the use of steroid and 2.78%, 5.56%, and 8.33% without steroid, respectively (p = 0.694, p = 0.603, and p = 0.625), and regardless of treatment group, the incidences in these patients were higher compared to incidences in whole subjects (1.26%, 2.30%, and 4.32%; p = 0.048, p = 0.032, and p = 0.038, respectively). The differences in macular thickness were not statistically different between the two groups. Average changes of central foveal thickness in 3 mm and 6 mm zone were 29.29 µm, 35.93 µm, and 38.02 µm with the use of steroid and 32.25 µm, 44.08 µm, and 45.39 µm without steroid (p = 0.747, p = 0.148, and p = 0.077, respectively). CONCLUSIONS: This study suggests that administration of oral steroid may not have a synergistic effect in reduction of CME and retinal thickness in patients with pre-existing ERM after cataract surgery, when topical NSAIDs are applied.
Anti-Inflammatory Agents, Non-Steroidal ; Cataract* ; Epiretinal Membrane* ; Humans ; Incidence ; Macular Edema* ; Medical Records ; Retinaldehyde ; Retrospective Studies ; Tomography, Optical Coherence