Marfan Syndrome is a rare congenital disease characterized by the abnormalities of Sheletal system, eye and cardio-vascular system which was initially desiribed by Marfan in 1896. One case of marfan syndrome was treated at the department of Orthopedic Surgery, College of Medicine, Seoul National University for multiple skeletal deformities. Moderate degree of scoliosis was treated with Milwaukee brace and finger deformities with Z-plasty and full thickness skin graft.
Braces ; Congenital Abnormalities ; Fingers ; Marfan Syndrome ; Orthopedics ; Scoliosis ; Seoul ; Skin ; Transplants

Two hundreds cases of spine tuberculosis were treated surgically for the period of 7 years between 1970 and 1976 at Seoul National University Hospital and following results were obtained. 1. Many patients failed to be treated with conservative method. Spontaneous fusion was found in 10% of 200 cases with long duration of disease. Anterior fusion was performed in 166 cases and posterior fusion was carried out in 34 cases. In those 34 cases, anterior currettage was combined in 7 cases, anterior fusion combined in 19 cases in which 7 cases were performed anterior and posterior fusion at one stage. Posterior fusion alone was carried out only in 8 cases. 2. Anterior fusion is indicated for: a. decompression in cord involvement b. confirmation of diagnosis c. involvement of one joint space in children d. mild to moderate kyphosis in adult 3. Anterior and posterior fusion is indicated in: a. severe kyphosis for solid funsion b. involvement of more than two joint spaces in children to prevent increasing kyphosis c. one stage operation was technically possible and has many advantages 4. Posterior fusion is indicated in: a. poor general condition b. technically difficult cases.
Adult ; Child ; Decompression ; Diagnosis ; Humans ; Joints ; Kyphosis ; Methods ; Seoul ; Spine ; Tuberculosis

One case of osteoid osteoma in the lamina of the fifth lumbar spine with hamstring muscle tightness was experienced and successfully treated by surgery at the department of orthopedic surgery in Seoul National University Hospital. Literature on the subject was reviewed in detail.
Muscle Tonus ; Orthopedics ; Osteoma, Osteoid ; Seoul ; Spine

We assessed the accuracy of Goldmann or Schi-(phi)tz tonometric readings in the gas filled vitrectomized eyes. We performed pars plana vitrectomy with or without lensectomy in 8 rabbit eyes, and in 6 enucleated porcine eyes. Fluid-air exchange was done at the end of the procedure. Intraocular pressure was measured using Goldmann tonometer and Schi-(phi)tz tonometer and was compared with true pressure which was monitored by manometer with indwelling catheter in the intravitreal cavity. Goldmann and Schi-(phi)tz tonometry always showed lower presure value than manometeric one(P<0.05) and the discrepancy was greater at higher range of intraocular pressure. Between these two methods Goldmann tonometry was more accurate in the rabbit eye (P>0.05).
Catheters, Indwelling ; Intraocular Pressure* ; Manometry ; Reading ; Vitrectomy

Multifocal choroiditis and panuveitis(MCP) is a clinical syndrome characterized by vitritis, and punched-out fundus lesions mimicking presumed ocular histoplasmosis. We diagnosed MCP in a twenty-eight years old woman with the complaint of decreased vision and floater symptom. Retinochoroidal anastomosis via one of retinochoroidal scars was noted in this case. The patient was treated with oral and periocular steroid and ws observed for 11 months during which choroidal neovascularization and macular edema ws not developed. We present this case because, as far as our knowledge goes, There has been no reported case of MCP with retinochoroidal anastomosis.
Choroid* ; Choroidal Neovascularization ; Choroiditis* ; Cicatrix ; Female ; Histoplasmosis ; Humans ; Macular Edema ; Panuveitis*

PURPOSE: There have been several reports of optic neuropathy preceding acute retinal necrosis(ARN) in patients with acquired immunodeficiency syndrome. We report one case of bilateral ARN that followed unilateral optic neuropathy in otherwise healthy person. METHODS: We report on a previous healthy 54-year old man who developed unilateral optic neuropathy 8 weeks after varicella-zoster dermatitis. Central retinal vascular obstruction developed subsequently in his ipsilateral eye. Later on, classic presentation of ARN appeared in his contralateral eye. RESULTS: The patient was diagnosed with bilateral ARN that followed unilateral optic neuropathy. Intravenous acyclovir stopped the progression of retinitis and resulted in healing of retinal lesions. CONCLUSIONS: ARN is a visually devastating clinical syndrome of which prompt diagnosis and early treatment are important in improvement the overall prognosis. This case suggests that optic neuropathy, especially with preceding shingles, should be suspected as prodrome of ARN which necessitates prompt initiation of antiviral therapy.
Acquired Immunodeficiency Syndrome ; Acyclovir ; Dermatitis ; Diagnosis ; Herpes Zoster ; Humans ; Middle Aged ; Optic Nerve Diseases* ; Prognosis ; Retinal Necrosis Syndrome, Acute* ; Retinaldehyde ; Retinitis

Massive subretinal hemorrhage may develop secondary to choroidal neovascularization. The poor visual prognosis associated with submacular hemorrhage can be explained by preexisting abnormality of photoreceptorretinal pigment epithelium-Bruch's membrane complex and fibrin-mediated injury to the outer segment of photoreceptor. An animal experiment showed that subretinal fibrin induced irreversible damage to the retina within 24 hours. We use recombinant tissue plasminogen activator(rt-PA), at doses(3 microgram substantially lower than previously reported, to aid in the surgical evacuation of massive subretinal hemorrhage within 2 days of its development. The subretinal hemorrhage in both patients developed in association with age-related macular degeneration. Postoperative corrected visual acuity improved from counting fingers to 0.3 in one patient and from hand motion to 0.04 in the other. There has been no complication except ocular hypertension which is medically controllable. Subfoveal neovascularization explains poor postoperative vision in one case. It seems that visual recovery is facilitated by early evacuation of massive subretinal hemorrhage and by using low-dose rt-PA. Low-dose rt-PA may minimize the risks of intraocular hemorrhage and retinal toxicity.
Animal Experimentation ; Choroidal Neovascularization ; Fibrin ; Fingers ; Hand ; Hemorrhage* ; Humans ; Macular Degeneration ; Membranes ; Ocular Hypertension ; Plasminogen ; Prognosis ; Retina ; Retinaldehyde ; Tissue Plasminogen Activator* ; Visual Acuity

The authors retrospectively analysed epidemiologic characteristics, natural history and visual prognostic factors of submacular hemorrhage 2ndary to retinal arterial macroaneurysm in consecutive 10 patients. All the patients were female with mean age of 64.8 years and with hypertension in most cases.Typically, preretinal hemorrhage over submacular hemorrhage was the usual initial presentation.It took an average 2.9 months for the absorption of submacular hemorrhage.Average visual acuity was counting finger on initial visit and 0.3 on final visit. The initial visual acuity, the extent of submacular hemorrhage and the duration required for the absorption of it were statistically correlated with the final visual acuity[p<0.05]. But it was not the case with the extent of preretinal hemorrhage and the laser photocoagulation to macroaneurysm. As a conclusion, conservative treatment should be considered for the patient with tolerable initial visual acuity and with small extent of submacular hemorrhage 2ndary to retinal arterial macroaneurysm.
Absorption ; Female ; Fingers ; Hemorrhage* ; Humans ; Hypertension ; Light Coagulation ; Natural History ; Retinaldehyde* ; Retrospective Studies ; Visual Acuity

The purpose of this study was to evaluate the anatomical outcomes of vitrectomy with internal limiting membrane removal in highly myopic eyes with retinal detachment caused by a macular hole. Nineteen, consecutive, highly myopic eyes with full thickness macular hole with retinal detachment were treated by vitrectomy with internal limiting membrane removal, endolaser photocoagulation on the center of the hole and fluid gas exchange. In five eyes with other peripheral breaks, scleral buckling (3 cases), encircling (1 case) and barrier laser (1 case) were combined. In 15 eyes (79.0%) the macular hole was closed after the initial surgery. In 4 eyes (21%) the macular hole was reopened, but these were successfully treated with fluid gas exchange (1 case) or macular buckling (3 cases). The visual acuity was improved in 15 eyes (79.0%). In conclusion, these results suggest that the removal of the perifoveal internal limiting membrane may be an important adjuvant in the treatment of the myopic macular hole with retinal detachment.
Adult ; Aged ; Aged, 80 and over ; Basement Membrane/surgery ; Comparative Study ; Female ; Fundus Oculi ; Humans ; Male ; Middle Aged ; Myopia, Degenerative/*complications ; Retinal Detachment/etiology/*surgery ; Retinal Perforations/*complications ; Retrospective Studies ; Tomography, Optical Coherence ; Treatment Outcome ; Visual Acuity ; Vitrectomy/*methods

Choroidal detachment after retinal detachment surgery is relatively common but preoperative choroidal detachment is very rare. We reviewed three cases of choroidal detachment associated with primary rhegmatogenous retinal detachment to see whether there were common features that may be of help in early diagnosis and treatment. The patients were elderly and presented with markedly decreased vision, profound hypotony and inflammatory cells in anterior chamber. Indirect ophthalmoscopy revealed rhegmatogenous retinal detachment with choroidal detachment and proliferative vitreoretinopathy. They were treated with preoperative and postoperative steroid and undergone surgery including vitrectomy. The follow-up periods were 8, 6 and 2 months respectively. Choroidal detachment disappeared, successful reattachment of retina was achieved and corrected visual acuity was improved in all cases. Choroidal detachment associated with rhegmatogenous retinal detachment seems to be associated with hypotony, intraocular inflammation and unstable vascular system. Careful assessment and proper management including surgical procedure seem to improve its prognosis.
Aged ; Anterior Chamber ; Choroid* ; Early Diagnosis ; Follow-Up Studies ; Humans ; Inflammation ; Ophthalmoscopy ; Prognosis ; Retina ; Retinal Detachment* ; Retinaldehyde* ; Visual Acuity ; Vitrectomy ; Vitreoretinopathy, Proliferative