PURPOSE: To investigate whether endogenous and exogenous female hormone exposures were associated with risks for age-related macular degeneration (AMD) in postmenopausal women. METHODS: This study included 4,479 postmenopausal females aged 45 years and older who completed the Korea National Health and Nutrition Examination Survey (KNHANES) V. The participants were divided into 4 groups: subjects with AMD, subjects without AMD, subjects with early AMD, and subjects with late AMD. Variables associated with endogenous and exogenous female hormone exposures were analyzed. RESULTS: Among the 4,479 participants, 516 were found to have AMD and 3,963 were normal. There was no significant difference between the AMD and normal groups execpt for age in the risk analysis. Of the total 516 AMD participants, 488 had early AMD and 28 had late AMD. Women with AMD who had used oral contraceptives longer in the past had significantly higher odds of late AMD than early AMD (odds ratio [OR] = 1.013, 95% confidence interval [CI]: 1.002–1.024). Increasing number of children was also associated with decreased odds of late AMD (OR = 0.672, 95% CI: 0.506-0.893). CONCLUSIONS: These findings suggest that exposure to endogenous and exogenous female hormones may influence the risk of AMD progression.
Child ; Contraceptives, Oral ; Female* ; Humans ; Korea ; Macular Degeneration* ; Nutrition Surveys

PURPOSE: This study evaluated the relationship of nasal cavity state and surgical results after endonasal dacryocystorhinostomy (DCR). METHODS: We retrospectively analyzed 306 eyes of 204 patients between January 2007 and December 2011. The correlation between the existence of preoperative nasal cavity abnormality, postoperative nasal cavity complications after proper management of nasal cavity abnormality, and postoperative nasal cavity complications according to nasal packing material were investigated. We analyzed the success rates and the correlation between each set of factors. RESULTS: The success rate of primary operations performed six months after tube removal was 87.3% (267/306). The success rate after secondary revision, granuloma removal and punctoplasty was 90.5% (277/306). Postoperative nasal cavity complications were inspected in 40 eyes. Of the 306 eyes, patients treated with Nasopore showed significantly more postoperative nasal cavity complications (47.8%, 32/67) than in patients treated with Merocel (3.3%, 8/239). The rate of postoperative nasal cavity complications was 8.7% in patients with normal nasal cavity, 16.7% in patients who received treatment, and 20% in patients without treatment, with significant statistical increase if the nasal cavity was abnormal (p = 0.019). The incidence of complications influenced the primary success rate (p = 0.008); however, preoperative nasal cavity abnormalities were not correlated with primary success (p = 0.479). CONCLUSIONS: In the case of endonasal DCR, preoperative nasal cavity abnormality and type of nasal packing material used did not affect the success rate but significantly affected postoperative nasal cavity complications. In conclusion, endonasal DCR with preoperative treatment of nasal cavity abnormality and Merocel packing is expected to reduce postoperative nasal cavity complications and increase patient satisfaction.
Dacryocystorhinostomy* ; Granuloma ; Humans ; Incidence ; Nasal Cavity* ; Patient Satisfaction ; Retrospective Studies

PURPOSE: This study evaluated the relationship of nasal cavity state and surgical results after endonasal dacryocystorhinostomy (DCR). METHODS: We retrospectively analyzed 306 eyes of 204 patients between January 2007 and December 2011. The correlation between the existence of preoperative nasal cavity abnormality, postoperative nasal cavity complications after proper management of nasal cavity abnormality, and postoperative nasal cavity complications according to nasal packing material were investigated. We analyzed the success rates and the correlation between each set of factors. RESULTS: The success rate of primary operations performed six months after tube removal was 87.3% (267/306). The success rate after secondary revision, granuloma removal and punctoplasty was 90.5% (277/306). Postoperative nasal cavity complications were inspected in 40 eyes. Of the 306 eyes, patients treated with Nasopore showed significantly more postoperative nasal cavity complications (47.8%, 32/67) than in patients treated with Merocel (3.3%, 8/239). The rate of postoperative nasal cavity complications was 8.7% in patients with normal nasal cavity, 16.7% in patients who received treatment, and 20% in patients without treatment, with significant statistical increase if the nasal cavity was abnormal (p = 0.019). The incidence of complications influenced the primary success rate (p = 0.008); however, preoperative nasal cavity abnormalities were not correlated with primary success (p = 0.479). CONCLUSIONS: In the case of endonasal DCR, preoperative nasal cavity abnormality and type of nasal packing material used did not affect the success rate but significantly affected postoperative nasal cavity complications. In conclusion, endonasal DCR with preoperative treatment of nasal cavity abnormality and Merocel packing is expected to reduce postoperative nasal cavity complications and increase patient satisfaction.
Dacryocystorhinostomy* ; Granuloma ; Humans ; Incidence ; Nasal Cavity* ; Patient Satisfaction ; Retrospective Studies

PURPOSE: To evaluate 25-gauge transconjunctival sutureless vitrectomy for primary repair of rhegmatogenous retinal detachment (RRD). METHODS: We performed a retrospective study of 46 consecutive eyes of 46 patients who underwent 25-gauge transconjunctival sutureless vitrectomy to repair primary RRD. Outcome measures included single surgery anatomical success rate, final anatomical success rate, postoperative visual acuity, and surgical complications. RESULTS: Forty eyes were phakic and six eyes were pseudophakic. Twenty-six eyes had superior quadrant retinal tear, 12 eyes had inferior quadrant tear and eight eyes had both. The mean operation time was 56.3 minutes. The single surgery anatomical success rate was 93.48% (43/46). Two eyes with recurrent retinal detachment underwent fluid gas exchange: one received barrier laser treatment in the outpatient clinic, and the other underwent reoperation; the final success rate was 100%. The best corrected visual acuity improved from 1.34 log MAR to 0.48 log MAR (p < 0.01) in macula - off patients (30 eyes) and from 0.32 log MAR to 0.07 log MAR (p = 0.279) in macula - on patients (16 eyes). Postoperative complications included wound leaking (two eyes), cataract progression (13 eyes), vitreous hemorrhage (one eye), transient hypotony (one eye), and increased intraocular pressure (seven eyes). CONCLUSIONS: Primary repair of RRD using 25-gauge transconjunctival vitrectomy resulted in an excellent final anatomical success rate and postoperative visual outcomes.
Ambulatory Care Facilities ; Cataract ; Humans ; Intraocular Pressure ; Outcome Assessment (Health Care) ; Postoperative Complications ; Reoperation ; Retinal Detachment* ; Retinal Perforations ; Retrospective Studies ; Visual Acuity ; Vitrectomy* ; Vitreous Hemorrhage ; Wounds and Injuries

Radilogy plays an important role in evaluating patients with suspected adrenal gland pathology. Morphologicdelineation of adrenal gland is especially valuable in patients with clinical and/or biochemical evidence of adisturbance in adrenal function. Many diagnostic radiologic methods are avilable for demonstrating adrenallesions. CT overcomes many of the disadvantages of these other radiologic techniques. The high degree of spatialand density resolution allows precise demonstration of the normal adrenal glands as well as detection of bothsmall and large tumors in almost all patients. So CT of adrenal gland is an excellet nonivasive screening methodand definitive imaging technique. The authers have investigated the capability of CT to image the nomral size,location and shape of both glands. Knowledge of the range of normal is useful for optimal interpretation of CTscans in patients with suspected aderenal pathology. We reviewed CT scan of 150 cases without evidence of adrenaldisease. The following results were obtained: 1. There were 90 male and 60 female patients. 2. Their ages rangedfrom 20 to 60 years. 3. On CT, both gland were shown in 135 (90.0%), the right in 143(95.3%), the left in142(94.6%). 4. In the shape of adrenal glands, most of right adrenal gland was linear or comet shaped; 68(47.6%),most of left adrenal gland was inverted-Y shaped: 103(72.6%). 5. In the length of adrenal glands, theright was2.5+-0.77cm, the left was 2.9+-0.75cm. 6. In the width of adrenal glands, the right was 3.2+-0.74cm, the left was2.7+-0.57cm. 7. In the thickness of adrenal glands, the right was 0.5+-0.14cm, the left was 0.6+-0.16cm.
Adrenal Glands ; Female ; Humans ; Male ; Mass Screening ; Pathology ; Pheniramine ; Tomography, X-Ray Computed

PURPOSE: To report a case of rapidly progressed orbital abscess after central retinal artery occlusion. CASE SUMMARY: A 60-year-old man with right periorbital pain and edema starting 3 days earlier visited the hospital. His first visual acuity was 1.0 for the right eye with peripheral edema and tenderness; severe hemorrhagic chemosis, proptosis (approximately 3 mm) and extraocular motility limitation were also observed. According to the CT findings, a 2.5 x 1 cm-sized encapsulated cystic mass was found in the right orbital cavity, along the medial orbital wall; with a diagnosis of orbital abscess, he was hospitalized with systemic antibiotic treatment and abscess drainage. On the second day of hospitalization, the best corrected visual acuity was reduced to light perception, and relative afferent pupillary defect, pale retina and cherry red spot were found. Therefore, emergent incisional drainage, optic massage, and antibiotics were given to the patient. Immediately after the surgery, the peripheral edema and proptosis improved; nevertheless, central retinal artery occlusion did not resolve and vision did not improve. Two months later, best corrected visual acuity for the right eye was counting fingers and central retinal artery occlusion showed no further improvement. CONCLUSIONS: No case report on rapidly progressing orbital abscess has been proposed in Korea to date. In the case of rapidly progressed orbital abscess, incisional drainage and antibiotics should be administered promptly.
Abscess ; Anti-Bacterial Agents ; Drainage ; Edema ; Exophthalmos ; Eye ; Fingers ; Hospitalization ; Humans ; Korea ; Light ; Massage ; Middle Aged ; Orbit ; Prunus ; Pupil Disorders ; Retina ; Retinal Artery ; Retinal Artery Occlusion ; Vision, Ocular ; Visual Acuity

PURPOSE: To clarify the relationship between various factors (sociodemographic factors, health behavioral risk factors and health status, and diabetic factors) related to diabetic retinopathy and to suggest improvements regarding the associated medical examination. METHODS: The subjects were 1,444 diabetic patients diagnosed in the 5th Korean National Health and Nutrition Examination Survey (KNHANES), aged 19 years or older, who underwent non-mydriatic fundus photography. The criteria for diagnosing diabetes were a fasting glucose level ≥ 126 mg/dL and a previous diagnosis of diabetes or currently undergoing treatment. The diagnosis of diabetic retinopathy followed the modified Airlie House classification. Univariate and multivariate analyses of diabetic retinopathy were performed. RESULTS: Among the 1,444 patients who were diagnosed with diabetes, 277 had diabetic retinopathy; the prevalence rate was 19.18%. The higher the body mass index, the lower the risk of diabetic retinopathy by 0.924 times (p = 0.001; 95% confidence interval [CI], 0.883–0.966). The longer the duration of diabetes, the greater the risk of diabetic retinopathy; the prevalence period group of more than 11 years had a 26.025-fold higher risk than the newly diagnosed group (p < 0.001; 95% CI, 10.840–62.482). The risk of diabetic retinopathy increased with the hemoglobin A1c (HbA1c) level; the risk was 5.973-fold higher in the group with HbA1c above 11.0% (p < 0.001; 95% CI, 2.984–11.956) compared with the group with HbA1c < 6.0%. The risk of diabetic retinopathy was 2.050-fold greater with insulin injections (p = 0.003; 95% CI, 1.284–3.275). CONCLUSIONS: The risk of diabetic retinopathy was higher in patients with a longer duration of diabetes, a high HbA1c level, and in those using insulin. These findings highlight the need for early education and ophthalmologic examinations for at-risk patients.
Body Mass Index ; Classification ; Diabetic Retinopathy ; Diagnosis ; Education ; Fasting ; Glucose ; Health Behavior ; Humans ; Insulin ; Multivariate Analysis ; Nutrition Surveys ; Photography ; Prevalence ; Risk Factors

Purpose: To analyze the repeatability of manual measurement of foveal avascular zone (FAZ) area in an optical coherence tomography angiography (OCTA) image in high myopia. Methods: This study comprised patients with high myopia and controls. Two consecutive FAZ areas of the superficial and deep capillary plexus were obtained using OCTA. The intraclass correlation coefficient (ICC) and coefficient of variation (CV) were assessed, and univariate and multivariate generalized linear mixed models were conducted to identify factors related to repeatability. Results: Thirty eyes with high myopia and 34 eyes of healthy subjects were included in the study. The mean age in high myopia and control subjects was 55.5 and 60.8 years, respectively, the mean spherical equivalent was −9.98 and −0.55 diopters, and the mean axial length was 28.0 and 23.9 mm. The ICCs of FAZ area of the superficial capillary plexus (SCP) were 0.891 and 0.919, while the CVs were 8.8% and 8.5%. In measurement of the deep capillary plexus, the ICCs were 0.788 and 0.907, while the CVs were 11.2% and 11.0%, which were acceptable but exhibited lower repeatability than those of SCP. Multivariate analyses showed that older age (p = 0.030) and greater axial length (p = 0.005) were significantly associated with lower repeatability of SCP FAZ area measurements. In addition, greater axial length (p = 0.044) was a significant factor for lower repeatability of deep capillary plexus FAZ area measurements. Conclusions Manual measurement of FAZ area using OCTA exhibited relatively good repeatability for high myopia. Age and axial length affected repeatability and should be considered when analyzing FAZ areas in high myopia patients.

Purpose: To evaluate the differences in individual segmental retinal layer thickness in adult patients with high myopia. Methods: This study compared the retinal layers of patients with high myopia (axial length of ≥26.0 mm) with those of normal controls using spectral-domain optical coherence tomography. The thicknesses of the retinal layers were compared using nine Early Treatment Diabetic Retinopathy Study subfields. Choroidal thickness was also measured in the subfoveal area. Results: We included 37 eyes with high myopia and 37 eyes of healthy subjects. The mean age was 42.95 and 47.73 years (p = 0.114), and the mean axial length was 27.28 and 24.47 mm (p < 0.001), respectively. The parafoveal areas (outer ring segment) of the ganglion cell layer and inner plexiform layer, all segmental areas except the subfoveal region of the inner nuclear layer, most segmental areas (inner superior, inner inferior, outer superior, outer temporal, and outer nasal) of outer plexiform layer, and most segmental areas (subfovea, inner temporal, inner inferior, inner nasal, outer temporal, and outer inferior) of outer nuclear layer were thinner in eyes with high myopia than in normal eyes (all p < 0.05). There were no statistically significant differences between the levels of photoreceptor layer, retinal pigment epithelium, and nerve fiber layer. The mean choroidal thickness was 153.81 ± 64.80 and 239.54 ± 44.28 μm in the high myopia and control groups, respectively, which were significantly different (p < 0.001). Conclusions In high myopia without pathologic changes, there was a meaningful thinning of the retina and choroid, especially in most Early Treatment Diabetic Retinopathy Study subfield areas of the deep vascular complex, perifoveal area of the superficial vascular complex, and most areas of the outer nuclear layer in the outer retinal layer, which are associated with myopic axial elongation.

Purpose: To evaluate the differences in individual segmental retinal layer thickness in adult patients with high myopia. Methods: This study compared the retinal layers of patients with high myopia (axial length of ≥26.0 mm) with those of normal controls using spectral-domain optical coherence tomography. The thicknesses of the retinal layers were compared using nine Early Treatment Diabetic Retinopathy Study subfields. Choroidal thickness was also measured in the subfoveal area. Results: We included 37 eyes with high myopia and 37 eyes of healthy subjects. The mean age was 42.95 and 47.73 years (p = 0.114), and the mean axial length was 27.28 and 24.47 mm (p < 0.001), respectively. The parafoveal areas (outer ring segment) of the ganglion cell layer and inner plexiform layer, all segmental areas except the subfoveal region of the inner nuclear layer, most segmental areas (inner superior, inner inferior, outer superior, outer temporal, and outer nasal) of outer plexiform layer, and most segmental areas (subfovea, inner temporal, inner inferior, inner nasal, outer temporal, and outer inferior) of outer nuclear layer were thinner in eyes with high myopia than in normal eyes (all p < 0.05). There were no statistically significant differences between the levels of photoreceptor layer, retinal pigment epithelium, and nerve fiber layer. The mean choroidal thickness was 153.81 ± 64.80 and 239.54 ± 44.28 μm in the high myopia and control groups, respectively, which were significantly different (p < 0.001). Conclusions In high myopia without pathologic changes, there was a meaningful thinning of the retina and choroid, especially in most Early Treatment Diabetic Retinopathy Study subfield areas of the deep vascular complex, perifoveal area of the superficial vascular complex, and most areas of the outer nuclear layer in the outer retinal layer, which are associated with myopic axial elongation.