BACKGROUNDLarge drusen is a known risk factor for the development of late complications of age-related macular degeneration (AMD) and drusen reduction has been found by our previous study. To prospectively evaluate the efficacy and safety of prophylactic laser treatment in Chinese patients with bilateral soft drusen, we examined the structure and function of the macula 8 years after treatment.

METHODSTen patients with more than 10 soft drusen (> 125 mm) and best corrected visual acuity ≥ 20/25 in each eye participated in the study. One eye, with relatively more drusen, was exposed to an argon laser (514 nm) to achieve a barely visible retinal lesion. The contralateral eye was used as a control. Fluorescein angiography, Amsler tests, Fourier-domain optical coherence tomography and visual evoked potential tests were carried out 8 years later.

RESULTSNo choroidal neovascularization was seen in the laser-treated eyes or control eyes. There were no significant differences in visual acuity or P100 latency and amplitude between the laser treated eyes and contralateral eyes (t = 1.685, 1.184; P > 0.05). The thickness of the retinal pigment epithelium of the treated eyes was less than that of the contralateral eyes (t = -4.540; P < 0.05). The full retinal thickness in treated eyes was slightly, but insignificantly, reduced relative to contralateral eyes (t = -1.746; P > 0.05).

CONCLUSIONSThe treatment was associated with a reduction in retinal pigment epithelium thickness elevation compared with the contralateral eyes. Macular function was not impaired.

Aged ; Aged, 80 and over ; Female ; Humans ; Laser Coagulation ; methods ; Male ; Middle Aged ; Retinal Drusen ; surgery ; Wet Macular Degeneration ; surgery

OBJECTIVE: To report the causes of legal blindness in the Department of Health (DOH) Eye Center among working age group patients (16-64 years old) in 2014 and compare these figures to data from 2008.

METHODS: Data were collected from the DOH Eye Center records section. The charts of new patients seen at the general ophthalmology clinic in the years 2008 and 2014 were reviewed individually. Patients between 15 and 64 years old with best corrected visual acuity (BCVA) of 20/200 (6/60) or less in the better-seeing eye were included as subjects in the study. Patients who improved to better than 20/200 (6/60) with BCVA and any medical or surgical means were excluded from the study. Patients whose visual acuity could not be assessed for any reason or with reversible causes of blindness were also excluded from the study.

RESULTS: The DOH Eye Center general ophthalmology clinic had a total of 8,941 registered patients aged 15 to 64 years old during the period January 1 to December 31, 2014. Diabetic retinopathy/maculopathy together with pathologic myopia formed the largest category of irreversible legal blindness (BCVA of 20/200 or less on the better seeing eye) with a total of 26 (18%) patients for each. Retinitis pigmentosa and macular dystrophy under the hereditary retinal disorders formed the second largest cause of legal blindness with 17 (12%) followed by glaucomatous optic neuropathy from all kinds with 15 (10%). Together, these four entities comprised more than 58% of all causes of blindness in the working age group. Optic atrophy, comprised mostly of ethambutol toxic optic neuropathies (ETON), was responsible for 14 (10%) followed by congenital disorders and corneal disorders of the eye with 7 (5%) for each. Other conditions comprised of disorders of the neural cortex; this formed 6 (4%) eligible causes of legal blindness. Uveitic causes and retinal detachment also contributed 6 (4%) each to the pool of eligible cases of legal blindness. Other conditions were endophthalmitis, central retinal artery occlusion and clinically significant macular edema which collectively contributed 6% to the pool. In comparison, the main causes of eligible legal blindness in the DOH Eye Center in 2008 were glaucoma, which accounted for 21% and was the single leading cause of blindness, followed by diabetic retinopathy (16%), retinal detachment 11%), pathologic myopia and optic atrophy (10%).

CONCLUSION: The leading causes of legal blindness in 2014 were shared between diabetic retinopathy/maculopathy and pathologic myopia. In 2008, the single leading cause of legal blindness was glaucoma from all kinds, but after 6 years, it was overtaken by diabetic retinopathy and maculopathy. The decrease in blindness caused by glaucoma may be related to increased promotion of awareness of blindness due to glaucoma. 

Human ; Male ; Female ; Middle Aged ; Adult ; Adolescent ; Diabetic Retinopathy ; Macular Edema ; Ophthalmology ; Macular Degeneration ; Optic Nerve Diseases ; Myopia ; Retinal Artery Occlusion ; Retinitis Pigmentosa

PURPOSE: To report the first case of cystoid macular edema in a retinitis pigmentosa patient with pars plana vitrectomy. CASE SUMMARY: A 43-year-old female visited our hospital with visual disturbances of both eyes. Corrected visual acuity was 20/22 in the right eye and 20/25 in the left eye. Peripheral depigmentation and atrophy of the retinal pigment epithelium, pigmentary retinal degeneration, and attenuated arterioles were observed in both eyes. Cystoid macular edema was observed on optical coherence tomography which showed that the central macular thickness was 308 µm in the right eye and 422 µm in left eye. Intravitreal aflibercept was injected into the left eye. One month after injection, the central macular thickness showed no response with a thickness of 449 µm. An intravitreal dexamethasone implant was then injected, 1 month after injection, the central macular thickness was 367 µm. Six months after injection, the patient again complained of visual disturbance of the left eye with a corrected visual acuity of 20/70. Vitreous opacity was observed and the central macular thickness was 501 µm. The patient underwent pars plana vitrectomy. Three days after surgery, the central macular thickness was 320 µm. One year after surgery, the corrected visual acuity was 20/33 and the central macular thickness was 311 µm. CONCLUSIONS: Pars plana vitrectomy due to cystoid macular edema in a retinitis pigmentosa patient has not been previously reported in the Republic of Korea. Pars plana vitrectomy can therefore be an effective treatment for cystoid macular edema in retinitis pigmentosa patients.
Adult ; Arterioles ; Atrophy ; Dexamethasone ; Female ; Humans ; Macular Edema ; Republic of Korea ; Retinal Degeneration ; Retinal Pigment Epithelium ; Retinitis Pigmentosa ; Retinitis ; Tomography, Optical Coherence ; Visual Acuity ; Vitrectomy

PURPOSE: To evaluate the repeatability of macular thickness and total macular volume measurements made using spectral domain optical coherence tomography (OCT) in normal subjects and subjects with macular disease. METHODS: Among a total of 108 subjects, there were 50 normal subjucts, 20 patients with diabetic macular edema, 10 patients with retinal vein occlusion, 15 patients with age-related macular degeneration, and 13 subjects with other conditions. Two serial macular measurements were obtained from each subject by a single experienced examiner using spectral domain OCT. The repeatability of the measurements was evaluated by comparing two consecutive foveal and perifoveal thickness measurements and total macular volume measurements. The intraclass correlation coefficient was also calculated to evaluate the repeatability of measurements made in normal and macular disease subjects. Result: Spectral domain OCT measurements of macular thickness and macular volume were found to be consistent. Measurements of normal subjects were the most consistent, followed by measurements of patients with age-related macular degeneration, retinal vein occlusion, and diabetic macular edema. CONCLUSIONS: Although measurements made using spectral domain OCT were repeatable across all subjects, they were more consistent in normal subjects than in patients with macular disease. The differences in repeatability should be considered in the context of diseased pathologic anatomy. Physicians should remain cautious when using these measurements for clinical evaluation.
Humans ; Macular Degeneration ; Macular Edema ; Retinal Vein Occlusion ; Tomography, Optical Coherence

Stargardt-like macular dystrophy 4 (STGD4) is a rare macular dystrophy characterized by bull's eye atrophy of the macula and the underlying retinal pigment epithelium. Patients with STGD4 show decreased central vision, which often progresses to severe vision loss. The PROM1 gene encodes prominin-1, which is a 5-transmembrane glycoprotein also known as CD133 and is involved in photoreceptor disk morphogenesis. PROM1 mutations have been identified as genetic causes for STGD4 and other retinal degenerations such as retinitis pigmentosa. We report a case of STGD4 with a PROM1 p.R373C mutation in a Korean patient. Ophthalmic examinations of a 38-yr old man complaining of decreased visual acuity revealed bilateral atrophic macular lesions consistent with STGD4. Targeted exome sequencing of known inherited retinal degeneration genes revealed a heterozygous missense mutation c.1117C>T (p.R373C) of PROM1, which was confirmed by Sanger sequencing. To the best of our knowledge, this is the first case of a PROM1 mutation causing STGD4 in Koreans.
Atrophy ; Exome ; Glycoproteins ; Humans ; Macular Degeneration* ; Morphogenesis ; Mutation, Missense ; Retinal Degeneration ; Retinal Pigment Epithelium ; Retinitis Pigmentosa ; Visual Acuity

Objectives: The aim of this review was to examine the effects of PDT in the treatment of neovascular ARMD.
PHOTOCHEMOTHERAPY ; RETINAL NEOVASCULARIZATION ; MACULAR DEGENERATION

To evaluate the various factors related to the development of electric cataract in electric burn patients, we reviewed medical charts of 663 electric burn patients who were admitted to the department of General Surgery in Hanil General Hospital between 1981 and 1993. Eleven patients(1.7%) had electric cataract in both eyes. All of them were injured by contact with 22,900 voltage current, and developed third degree burns. Fifty-eight electric burn patients had their electric inputs through their head and eight (13.8%) among them developed cataracts. Only three(0.5%) among 567 electric burn patients who had their electric inputs through upper extremities developed cataracts. The interval between the electric injury and the diagnosis was 2 to 18 months. Anterior subcapsular opacity was the most common type of lenticular opacity. Other associated ocular complications included uveitis, macular edema, macular degeneration, and macular hole.
Burns ; Burns, Electric ; Cataract* ; Diagnosis ; Electric Injuries ; Head ; Hospitals, General ; Humans ; Macular Degeneration ; Macular Edema ; Retinal Perforations ; Upper Extremity ; Uveitis

PURPOSE: To report the results of the 2015 questionnaire survey of current trends and practice patterns in the treatment of vitreoretinal diseases, which was conducted by the Korean Retina Society (KRS). METHODS: In October 2015, members of the KRS participated in a survey of current trends and practice patterns in the treatment of vitreoretinal diseases. This survey was comprised of 68 multiple choice and dichotomy questions. RESULTS: One hundred eleven (41%) members participated in this survey. Most respondents (42%) had begun their vitreoretinal subspecialty ≤7 years previously, 32% had practiced for 8-15 years, and 26% for 16 years or more. The preferred primary treatment for newly diagnosed wet-type age-related macular degeneration was ranibizumab or aflibercept, and most clinicians (68%) favored a pro re nata regimen. Seventy percent of respondents treated injection-related endophthalmitis using a combination of immediate vitrectomy and intravitreal antibiotic injection. Bevacizumab was the most commonly (78-87%) preferred first-line therapy for macular edema (ME) secondary to central retinal vein occlusion or branch retinal vein occlusion. When ME did not respond to anti-vascular endothelial growth factor treatment, most respondents (91%) switched patients to dexamethasone implant or triamcinolone acetonide. Eighty-four percent of the respondents performed scleral buckling during retinal detachment surgery in fewer than 40% of cases. Also, most respondents (96%) prescribed an antibiotic eye drop after, or before and after intravitreal drug injection. CONCLUSIONS: This survey reflected the recent trends and practice patterns in the treatment of vitreoretinal diseases in Korea.
Bevacizumab ; Dexamethasone ; Endophthalmitis ; Endothelial Growth Factors ; Humans ; Korea ; Macular Degeneration ; Macular Edema ; Ranibizumab ; Retina* ; Retinal Detachment ; Retinal Vein ; Retinal Vein Occlusion ; Scleral Buckling ; Surveys and Questionnaires ; Triamcinolone Acetonide ; Vitrectomy

It is known that branch retinal vein occlusion (BRVO) is related with systemic vascular diseases. From January 1987 to December 1990, we experienced 46 patients who were diagnosed as BRVO among 18,057 patients who visited eye department during the same period, We evaluated 29 patients of BRVO who were followed up over 1 year. The incidence of BRVO was 026%. Male were 11(38%) and female were 18(62%), and there were no significant difference in morbidity between male and female. The average age of affected patients was 5:3 years. The average distance between the disc margin and the site of occlusion was 0.86 disc diameter. The type of BRVO was non-sichemic in 18 patients and that of remainders was ischemic. Most common site of occlusion was the crossing between the first branch of artery and the first branch of vein. The most common systemic disease associated with BRVO was hypertension. The visual prognosis was not affected by the factors including the associated systemic diseases, the type of BRVO and the site of BRVO. However, there was a significant correlation (pmacular edema. vitreous opacity. epiretinal membrane, macular degeneration and macular edema.
Arteries ; Epiretinal Membrane ; Female ; Humans ; Hypertension ; Incidence ; Macular Degeneration ; Macular Edema ; Male ; Prognosis ; Retinal Vein Occlusion* ; Retinal Vein* ; Retinaldehyde* ; Vascular Diseases ; Veins

A retinal prosthesis is being developed for the restoration of vision in patients with retinitis pigmentosa (RP) and age-related macular degeneration (AMD). Determining optimal electrical stimulation parameters for the prosthesis is one of the most important elements for the development of a viable retinal prosthesis. Here, we investigated the effects of different charge-balanced biphasic pulses with regard to their effectiveness in evoking retinal ganglion cell (RGC) responses. Retinal degeneration (rd1) mice were used (n=17). From the ex-vivo retinal preparation, retinal patches were placed ganglion cell layer down onto an 8x8 multielectrode array (MEA) and RGC responses were recorded while applying electrical stimuli. For asymmetric pulses, 1st phase of the pulse is the same with symmetric pulse but the amplitude of 2nd phase of the pulse is less than 10 microA and charge balanced condition is satisfied by lengthening the duration of the pulse. For intensities (or duration) modulation, duration (or amplitude) of the pulse was fixed to 500 micros (30 microA), changing the intensities (or duration) from 2 to 60 microA (60 to 1000 micros). RGCs were classified as response-positive when PSTH showed multiple (3~4) peaks within 400 ms post stimulus and the number of spikes was at least 30% more than that for the immediate pre-stimulus 400 ms period. RGC responses were well modulated both with anodic and cathodic phase-1st biphasic pulses. Cathodic phase-1st pulses produced significantly better modulation of RGC activity than anodic phase-1st pulses regardless of symmetry of the pulse.
Animals ; Electric Stimulation ; Ganglion Cysts ; Humans ; Macular Degeneration ; Mice* ; Prostheses and Implants ; Retinal Degeneration* ; Retinal Ganglion Cells* ; Retinaldehyde ; Retinitis Pigmentosa ; Visual Prosthesis