PURPOSE: To assess the diagnostic efficacy of macular and peripapillary retinal thickness measurements for the staging of diabetic retinopathy (DR) and the prediction of disease progression. METHODS: In this prospective study, 149 diabetic patients (149 eyes) and 50 non-diabetic control subjects were included. Baseline optical coherence tomography was employed to measure retinal thickness in the macula (horizontal, vertical, and central) and the peripapillary zone (superior, inferior, nasal, and concentric to the optic disc). Seven baseline parameters were correlated with the DR stages identified by fluorescein angiography. Baseline retinal thickness was compared between groups of patients requiring panretinal photocoagulation (PRP) within 6 months (PRP group) and patients not requiring PRP (No-PRP group). RESULTS: Macular and peripapillary retinal thicknesses in diabetic subjects were significantly greater than that in normal controls (p<0.05). All retinal thickness parameters, and particularly peripapillary circular scans, tended to increase with increasing DR severity (p<0.05). The baseline thicknesses of the peripapillary circular scans were greater in the PRP group than in the no-PRP group (p<0.05). CONCLUSIONS: Peripapillary retinal thickness may prove to be a useful criterion for DR severity and may also serve as an indicator of disease progression.
Aged ; Diabetic Retinopathy/*diagnosis/surgery ; Disease Progression ; Female ; Fluorescein Angiography ; Humans ; Light Coagulation ; Male ; Middle Aged ; Optic Disk ; Prospective Studies ; Retina/*pathology/surgery ; *Severity of Illness Index ; *Tomography, Optical Coherence

To find out the optimal temperature of infusion fluid during vitrectomy, five rabbit eyes were infused with body temperature (37C) Balanced Salt Solution Plus (BSS Plus, Alcon Laboratories) and the other five eyes with room temperature (22C) BSS Plus. We recorded the ERGs before operation and 2 days, 7 days and 28 days after operation and each recording was plotted on paper with automatically measured amplitude. The a-wave amplitude, b-wave amplitude and b/a ratio showed no significant difference between 22C and 37C groups before operation and 2 days, 7 days and 28 days after operation. The a-wave amplitudes were decreased, b/a ratios were increased and b-wave amplitudes was not changed after operation in both 22C and 37C group. We suggest that there is no difference in the effects of infusion fluid to retinal function whether we use room temperature or body temperature infusion fluid.
Body Temperature ; Retina* ; Retinaldehyde ; Vitrectomy*

No abstract available.
Carcinoma, Hepatocellular* ; Heart Atria*

To describe the clinical and optical coherence tomography (OCT) features of a macular hole (MH) or its precursor lesion in patients treated with systemic antiestrogen agents. We reviewed the medical history of the patient, ophthalmic examination, and both fundus and OCT findings. Three female patients receiving antiestrogen therapy sought treatment for visual disturbance. All of the patients showed foveal cystic changes with outer retinal defect upon OCT. Visual improvement was achieved through surgery for the treatment of MH in two patients. Antiestrogen therapy may result in MH or its precursor lesion, in addition to perifoveal refractile deposits. OCT examination would be helpful for early detection in such cases.
Adult ; Breast Neoplasms/drug therapy/surgery ; Estrogen Antagonists/*adverse effects ; Female ; Humans ; Middle Aged ; Retinal Perforations/*chemically induced/diagnosis/surgery ; Tamoxifen/*adverse effects ; Vitrectomy

BACKGROUND: It has been sugested that excessive airway narrowing in asthma may be detected by a decrease in forced vital capacity (FVC). A volume differrence between slow vital capacity (SVC) and FVC may be used as a surrogate index of airway collapse. OBJECTIVE: To investigate the relationship between an airway collapsibility index (CI) and airflow limitation or airway hyperresponsiveness in asthma. METHODS: Forty-six patients with suspected asthma and 21 normal control subjects were enrolled. CI was defined as a difference between SVC and FVC, and measured before and after a methacholine (MCh) bronchoprovocation test. Positive response to MCh was defined as a fall of FEV1 by more than 12%. RESULTS: CI significantly increased from 1.10+/-3.86% to 5.52+/-7.91% after MCh in the positive MCh group (n=19, p<0.01). Not only FVC but also SVC was significantly decreased after MCh. One-fifth of the decrease in FVC was caused by the increase in CI. Both FVC and SVC were significantly related to baseline FEV1 values and in percent change after MCh. Although CI was also significantly related to FEV1 in percent change after MCh. CI was significantly higher in the positive MCh group than in the control and was not significantly related to baseline FEV1 values. Furthermore, the relationship of CI values between before and after MCh was significant (r=0.622, p<0.01). CI was not significantly different according to the severity of MCh-PC20. CONCLUSION: Because the relationship between CI and the severity of airflow limitation or MCh-PC20 was less significant. CI may be better than FVC to represent the characteristic of excessive airway narrowing in asthma.
Asthma* ; Humans ; Methacholine Chloride ; Vital Capacity

PURPOSE: To determine the relation between the pathogenesis of idiopathic macular hole and perifoveal vitreous detachment using OCT scan. METHODS: On 28 eyes with idiopathic macular hole stage 1,2,3 which was graded according to using the classification described by Gass and on 123 eyes from the normal contrast group, OCT scan were performed to obtain axial views of the vitreoretinal interface in the posterior pole. The incidence of perifoveal vitreous detachment was assessed. RESULTS: 18 of the 28 eyes (64.2%) from the macular hole group and 15 of the 123 eyes (12.1%) from the normal contrast group had perifoveal vitreous detachment on OCT scan. The difference was statistically significant (p<0.05).There was no statistically significant difference on the incidence of perifoveal vitreous detachment according to stage of macular hole. CONCLUSIONS: These results led to the conclusion that there is a significant relation between the pathogenesis of macular hole and the papillofoveal traction.
Classification ; Incidence ; Retinal Perforations* ; Tomography, Optical Coherence ; Traction ; Vitreous Detachment*

PURPOSE: To evaluate the short-term efficacy and safety of intravitreal bevacizumab injection (IVBI) in patients with retinal angiomatous proliferation (RAP). METHODS: Seven eyes of 5 patients with RAP were included in this study. All of the eyes evidenced stage 2 RAP lesions, except for one eye with a stage 3 lesion. IVBI (1.25 mg/0.05 cc) were conducted at 4 or 6-week intervals. Complete ocular examinations, angiographic results and optical coherence tomographic findings before and after the IVBI were analyzed at baseline and upon the follow-up visits. RESULTS: Seven eyes were studied in 5 patients who had undergone IVBI. Partial (3 eyes) or complete (4 eyes) regression of RAP was noted after IVBI in all of the studied eyes. Visual acuity improved in 5 of the eyes, and was stable in 2 of the eyes. One eye evidenced severe intraocular inflammation after IVBI and a subsequent development of new RAP, which was controlled with vitrectomy and repeat IVBI. CONCLUSIONS: This treatment was effective over 6 months, stabilizing or improving visual acuity and reducing angiographic leakage. These short-term results suggest that IVBI may constitute a promising therapeutic option, particularly in the early stages of RAP.
Aged ; Aged, 80 and over ; Angiogenesis Inhibitors/*administration & dosage ; Antibodies, Monoclonal/*administration & dosage ; Female ; Fluorescein Angiography ; Follow-Up Studies ; Fundus Oculi ; Humans ; Injections ; Male ; Middle Aged ; Retinal Neovascularization/complications/*drug therapy/pathology ; Treatment Outcome ; Vascular Endothelial Growth Factor A ; Visual Acuity ; Vitreoretinopathy, Proliferative/complications/*drug therapy/pathology ; Vitreous Body

BACKGROUND: Wheezing is one of the characteristics of asthma, Intensity of wheezing is correlated with the severity of airway obstruction. However, some asthmatic patients may show wheezing despite normal ventilatory function. OBJECTIVE: To determine the cause of wheezing in asthmatic patients with normal ventilatory function. METHODS: Thirty-eight consecutive asthmatic patients with wheezing despite FEV1> or =80% of predicted value were retrospectively examined for clinical data. RESULTS: Twenty-seven patients (71.1%) were women. Sixteen patients (42.1%) showed airway obstruction based on the Intermountain Thoracic Society criteria. Patients with airway obstruction had significantly lower FEF50% than did those without it (P<.001). When the patients with no wheezing were re-examined by the pulmonary function test. 14 patients (48.3%) showed a significant bronchodilation. In patients without airway obstruction, FEF50/FIF50 was significantly higher than in those with it (P<.01), and FEF50/FIF50 >1 suggesting upper airway obstruction was observed in 7 of 16 (43.8%) patients. Associated diseases were rhinitis in 21 (55.3%) patients, sinusitis in 18 (47.4%), and postnasal drip syndrome in 3 (7.9%). CONCLUSIONS: Wheezing despite normal ventilatory function in asthma occurs more often in women. It may be related to reversible airway obstruction in nearly half patients and to upper airway obstruction such as rhinitis. in considerable numbers of the remaining patients.
Airway Obstruction ; Asthma* ; Female ; Humans ; Respiratory Function Tests ; Respiratory Sounds* ; Retrospective Studies ; Rhinitis ; Sinusitis

PURPOSE: To report the clinical features and management of circumscribed choroidal hemangioma. METHODS: Seven patients with circumscribed choroidal hemangioma were reviewed retrospectively. One eye having a small tumor without subretinal fluid was observed. Four eyes with large tumors around the posterior pole were treated with laser photocoagulation or/and transpupillary thermotherapy. Stereotactic radiosurgery with a gamma knife was applied in 2 eyes with large tumors on the peripheral retina. RESULTS: In all cases, the retinal detachment showed complete resolution. Tumor thickness was decreased in 2 cases treated with stereotactic radiosurgery. Visual acuity was either improved or unchanged in 6 eyes and decreased in one eye after treatment. CONCLUSIONS: Circumscribed choroidal hemangioma is a rare intraocular tumor. These tumors can be treated with variable modalities based on their size, location, and subretinal fluid. They have a favorable prognosis. Stereotactic radiotherapy is a reasonable treatment alternative for large symptomatic choroidal hemangiomas.
Choroid* ; Hemangioma* ; Humans ; Hyperthermia, Induced ; Light Coagulation ; Prognosis ; Radiosurgery ; Radiotherapy ; Retina ; Retinal Detachment ; Retrospective Studies ; Subretinal Fluid ; Visual Acuity

Behcet's disease is a systemic vasculitis of an unknown etiology involving the arteries and veins of all sizes. There are reports showing that a pulmonary artery aneurysm or thromboembolism and superior vena cava thrombosis are present in 5-10% of patients with Behcet's disease and that lung parenchymal lesions are mainly airway consolidations resulting from hemorrhage or infarction. We encountered a patient with increasing pulmonary cavitary changes and localized aspergilloma. The patient was a 43-year-old man diagnosed with Behcet's disease with a history of recurrent oro-genital ulceration and uveitis, and who was administered methotrexate, colchicines, prednisolone. During the follow up he developed progressive dyspnea upon exertion and finger clubbing. Therefore further evaluations were performed. Chest computed tomography showed more advanced consolidations and cavitations than the previous film with the previously known aspergilloma still observable. An open lung biopsy was carried out to determine the presence of malignant changes, which revealed nonspecific vasculitis. Azathioprine was added resultion in an improvement of symptoms.
Adult ; Aneurysm ; Arteries ; Azathioprine ; Biopsy ; Dyspnea ; Fingers ; Follow-Up Studies ; Hemorrhage ; Humans ; Infarction ; Lung* ; Methotrexate ; Prednisolone ; Pulmonary Artery ; Superior Vena Cava Syndrome ; Systemic Vasculitis ; Thorax ; Thromboembolism ; Ulcer ; Uveitis ; Vasculitis ; Veins