PURPOSE: To compare the characteristics of the pattern visual evoked potential (PVEP) in patients with severe visual loss and normal controls, and to demonstrate the range of PVEP parameters in normal Koreans. METHODS: The patients were divided into three groups according to visual acuity: group 1, ranging from no light perception to less than 0.02; group 2, ranging from 0.02 to 0.1; and group 3, ranging from 0.125 to 0.25. Group 4 was established as a healthy control group. The 95% confidence intervals (CIs) of the PVEP parameters were calculated for group 4. The PVEP parameters were compared among these four groups, and the amplitudes were evaluated with respect to the 95% CIs. We used the area under the curve to integrate the sensitivity and the specificity of the PVEP parameter quantitative values (7.01 to 9.57 microV and 6.75 to 10.11 microV). RESULTS: A total of 101 eyes were investigated. The 95% CIs of the P100 and N135 amplitudes of group 4 were 7.01 to 9.57 microV and 6.75 to 10.11 microV, respectively. The amplitudes of P100 and N135 were significantly higher in group 4 (p < 0.001). The P100 and N135 amplitude were below the 95% CI in all group 1 patients. The area under the curve of the P100 amplitude was the highest (0.789). CONCLUSIONS: No legally blind patient in the present study exhibited a value within the 95% CI of the controls. The P100 amplitude may be the best parameter for defining blindness in patients.
Adult ; Blindness/*physiopathology ; *Evoked Potentials, Visual ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Vision, Low/*physiopathology ; *Visual Acuity ; Young Adult

PURPOSE: To compare the characteristics of the pattern visual evoked potential (PVEP) in patients with severe visual loss and normal controls, and to demonstrate the range of PVEP parameters in normal Koreans. METHODS: The patients were divided into three groups according to visual acuity: group 1, ranging from no light perception to less than 0.02; group 2, ranging from 0.02 to 0.1; and group 3, ranging from 0.125 to 0.25. Group 4 was established as a healthy control group. The 95% confidence intervals (CIs) of the PVEP parameters were calculated for group 4. The PVEP parameters were compared among these four groups, and the amplitudes were evaluated with respect to the 95% CIs. We used the area under the curve to integrate the sensitivity and the specificity of the PVEP parameter quantitative values (7.01 to 9.57 microV and 6.75 to 10.11 microV). RESULTS: A total of 101 eyes were investigated. The 95% CIs of the P100 and N135 amplitudes of group 4 were 7.01 to 9.57 microV and 6.75 to 10.11 microV, respectively. The amplitudes of P100 and N135 were significantly higher in group 4 (p < 0.001). The P100 and N135 amplitude were below the 95% CI in all group 1 patients. The area under the curve of the P100 amplitude was the highest (0.789). CONCLUSIONS: No legally blind patient in the present study exhibited a value within the 95% CI of the controls. The P100 amplitude may be the best parameter for defining blindness in patients.
Adult ; Blindness/*physiopathology ; *Evoked Potentials, Visual ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Vision, Low/*physiopathology ; *Visual Acuity ; Young Adult

No abstract available.
Blood Donors* ; Hepacivirus* ; Hepatitis C* ; Hepatitis* ; Humans

No abstract available.

PURPOSE: The aim of this study was to investigate the quantitative effect of inferior oblique (IO) 10- and 14-mm recession on postoperative horizontal deviation. METHODS: Patients (22 men and 18 women) who underwent IO recession were divided into two groups for comparison studies: group 1 (10-mm IO recession, 15 patients) and group 2 (14-mm IO recession, 25 patients). Preoperative and postoperative horizontal deviations were measured, and the resulting horizontal deviations from the 10- and 14-mm IO recession surgeries were compared. The effects of superior oblique underaction, IO overaction, and combined exodeviation on postoperative horizontal deviation were analyzed. RESULTS: Although group 1 did not show a significant horizontal deviation change after surgery (1.9 ± 4.5 prism diopters [PD], p = 0.452), group 2 had a meaningful horizontal change after 14-mm recession (2.2 ± 3.8 PD, p = 0.022). Both groups showed a significant esodrift in horizontal deviation (group 1, p = 0.017; group 2, p = 0.030) in patients with exodeviation over 8 PD. The mean change in horizontal deviation was 6.0 ± 5.4 PD for group 1 and 9.0 ± 5.0 PD for group 2. Although the amount of superior oblique underaction did not affect the extent of change in horizontal deviation, patients with severe IO overaction showed a significant change in horizontal deviation after 14-mm IO recession. CONCLUSIONS: Fourteen-millimeter IO recession could make a statistically significant change in horizontal deviation after surgery. In addition, esodrift should be considered after IO recession in patients with a preoperative exodeviation greater than 8 PD or severe IO overaction.
Exotropia ; Humans ; Jupiter ; Male ; Strabismus

A 46-year-old man presented with visual disturbances in both eyes. His best corrected visual acuity was 0.7 (both eyes). Ptosis and limitation of ocular movement in every direction were observed. Slit lamp examination showed a bilateral iridescent cataract. Fundus examination showed peripheral depigmentation of the retinal pigment epithelium and pigmentary clumping in both eyes that agreed with blocked fluorescence and widow defects on fluorescein angiography. The amplitude of b-wave was decreased on electroretinography. Fourteen months later, the patient's best corrected visual acuity decreased to 0.3 due to increased lens opacity. Phacoemulsification and intraocular lens implantation were performed on both eyes. At the patient's final visit, retinal findings were stable with a best corrected visual acuity of 0.7 in both eyes. In conclusion, the visual disturbance could have been caused by both cataracts and retinal degeneration, meaning the fundus should be examined carefully in patients with myotonic dystrophy.
Diagnosis, Differential ; Fluorescein Angiography ; Fundus Oculi ; Humans ; Male ; Middle Aged ; Myotonic Dystrophy/*complications/diagnosis ; Pigment Epithelium of Eye/*pathology ; Retinal Degeneration/diagnosis/*etiology

Homozygous familial hypercholesterolemia (HoFH) is a rare inherited disorder that presents as abnormally elevated levels of low-density lipoprotein cholesterol and premature heart disease, requiring frequent intervention through lipid apheresis for management. The risk of perioperative cardiac events is higher in patients with HoFH because of its pathophysiological manifestations in the vascular system. Careful cardiac precautions and anesthetic assessments are necessary to ensure patient safety. In the following case report, we discuss the clinical course and anesthetic considerations for a 14-year-old girl with HoFH undergoing sedation for dental extractions and mandibular molar uprighting in an outpatient oral surgery clinic. Considerations included the use of heparin in the patient's weekly plasma lipid apheresis treatment. In order to reduce the risks of peri- and postoperative bleeding and perioperative cardiac events, the operation was scheduled for 4 days after apheresis. This allowed for adequate heparin clearance, while also reducing the likelihood of possible cardiac events. A literature review revealed no results for the outpatient management of patients with HoFH undergoing sedation for noncardiac procedures. Our reported case serves as a clinical example for physicians to be utilized in the future.

PURPOSE: We evaluated fundus and fluorescein angiography (FAG) findings and characteristics that can help distinguish nonarteritic anterior ischemic optic neuropathy (NAION) from optic neuritis (ON). METHODS: Twenty-three NAION patients and 17 ON with disc swelling patients were enrolled in this study. We performed fundus photography and FAG. The disc-swelling pattern, hyperemia grade, presence of splinter hemorrhages, cotton-wool spots, artery/vein ratio and degree of focal telangiectasia were investigated. The FAG findings for each patient were compared with respect to the following features: the pattern of disc leakage in the early phase, arteriovenous (artery/vein) transit time (second), and the presence and pattern of the filling delay. RESULTS: Cotton-wool spots, focal telangiectasia, and venous congestion were more common in the affected eyes of NAION patients. Upon FAG, 76.5% of the patients in the ON group exhibited normal choroidal circulation. However, 56.5% of patients in the NAION group demonstrated abnormal filling defects, such as peripapillary, generalized, or watershed zone filling delays. CONCLUSIONS: Fundus findings, including cotton-wool spots, focal telangiectasia, and venous congestion in the affected eye, may be clues that can be used to diagnose NAION. In addition, choroidal insufficiencies on FAG could be also helpful in differentiating NAION from ON.
Choroid/blood supply/*diagnostic imaging ; Female ; Fluorescein Angiography/*methods ; Fundus Oculi ; Humans ; Male ; Middle Aged ; Optic Disk/blood supply/*diagnostic imaging ; Optic Neuritis/*diagnosis ; Optic Neuropathy, Ischemic/*diagnosis ; Photography/*methods ; Retrospective Studies

A 62-year-old woman has been suffered from cavernous sinus thrombophlebitis which was confirmed by four-vessel angiography, orbit magnetic resonance imaging, and blood culture. Three weeks after recovery of cavernous sinus thrombophlebitis, right eye proptosis and complete third, fourth, and sixth cranial nerve palsies developed. Best-corrected visual acuity decreased to 20/70 in the right eye. Repeat magnetic resonance imaging demonstrated a 1.5-cm-sized mass in the right cavernous sinus, suspicious for mycotic aneurysm. Amphotericin B supplementation was begun and was followed by successful transarterial Guglielmi detachable coil embolization. Four months later, extraocular movement was normalized, and visual acuity improved to 20/25 in the right eye.
Amphotericin B/therapeutic use ; Aneurysm, Infected/*etiology/*therapy ; Angiography ; Antifungal Agents/therapeutic use ; Cavernous Sinus Thrombosis/*complications ; Embolization, Therapeutic/*methods ; Female ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Visual Acuity

To determine the effects of excessive drinking and alcohol dependency on mortality and chronic health problems in a rural community in South Korea, this study represents a nested case-control study. In 1998, we conducted the Alcohol Dependence Survey (ADS), a population survey of a village in Korea. To measure the effects of alcohol on chronic health conditions and mortality over time, in 2004, we identified 290 adults from the ADS sample (N=1,058) for follow-up. Of those selected, 145 were adults who had alcohol problems, either alcohol dependence as assessed in the ADS by the Severity of Alcohol Dependence Questionnaire (N=59), or excessive drinking without dependency (N=86). Further 145 nondrinkers were identified, matching those with alcohol problems in age and sex. We revisited the village in 2004 and completed personal interviews with them. In multivariate logistic regressions, the rates of mortality and morbidity of chronic health conditions were three times greater for alcohol dependents compared with the rate for nondrinkers. Importantly, however, excessive drinking without dependency was not associated with the rates of either mortality or morbidity. Future investigations would benefit by attending more specifically to measures for alcohol dependence as well as measures for alcohol consumption.
Adult ; Aged ; Aged, 80 and over ; Alcohol-Related Disorders/epidemiology ; Alcoholism/complications/*mortality ; Chronic Disease ; Female ; Humans ; Korea/epidemiology ; Logistic Models ; Male ; Middle Aged ; Rural Population ; Sex Factors ; Smoking/epidemiology