PURPOSE: To evaluate the factors contributing to the visual outcome of patients with culture-proven bacterial endophthalmitis. METHODS: We reviewed medical records of all eyes with infectious endophthalmitis between January 1996 and June 2005. The causative bacteria were identified in 18 of 90 eyes, for which we evaluated their clinical features and factors influencing their visual prognosis. RESULTS: Bacterial endophthalmitis occurred after cataract surgery in 6 of 18 eyes, after trabeculectomy or glaucoma implant surgery in 4 eyes, after trauma in 3 eyes, after intravitreal triamcinolone injection in 1 eye, and after endogenous endophthalmitis in 4 eyes. The culture results were similar between gram positive and gram negative organisms. Final vision was 0.1 or better in 6 of the 18 eyes. Final visual acuities showed statistically significant correlation with causative organisms (p=0.018). CONCLUSIONS: For effective management of bacterial endophthalmitis and prediction of prognosis, we recommend thorough bacterial culture. Also, further investigation with a large population is needed.
Bacteria ; Cataract ; Endophthalmitis* ; Glaucoma ; Humans ; Medical Records ; Prognosis* ; Trabeculectomy ; Triamcinolone ; Visual Acuity

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

PURPOSE: To evaluate the clinical results of deep lamellar endothelial keratoplasty (DLEK) surgery in patients with bullous keratopathy. METHODS: Seven eyes of 7 patients diagnosed with bullous keratopathy were evaluated for pre- and postoperative visual acuity, refractive error, astigmatism, and corneal topographic results. Specular microscopy and corneal pachymetry was performed in order to evaluate the corneal endothelial cell status. Postoperative complications such as graft rejection, infection, glaucoma, and graft dislocation were also evaluated. RESULTS: Preoperative visual acuity improved from 0.006 (CF ~ 0.02) to 0.4 (0.1 ~ 0.5) at an average of 1.2+/-0.18 years of follow-up. Manifest refraction, topographic astigmatism, corneal endothelial cell density, and central corneal thickness at the final visit were 1.21+/-0.73D, 2.1+/-0.70D, 1304+/-682 cells/mm2, and 504+/-128 micrometer respectively. Two eyes (28.6%) developed graft rejection, one of which recovered after intensive steroid treatment. However, one patient (14.3%) underwent penetrating keratoplasty due to graft failure at 6 months postoperatively. Seven of 7 eyes were noted to have graft dislocation, all of which were repositioned and attached after air injection or suture. CONCLUSIONS: DLEK surgery is an effective alternative to conventional penetrating keratoplasty for bullous keratopathy patients because of fast visual recovery and low incidence of postoperative astigmatism.
Astigmatism ; Corneal Pachymetry ; Corneal Transplantation* ; Dislocations ; Endothelial Cells ; Follow-Up Studies ; Glaucoma ; Graft Rejection ; Humans ; Incidence ; Keratoplasty, Penetrating ; Microscopy ; Postoperative Complications ; Refractive Errors ; Sutures ; Transplants ; Visual Acuity

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

In amebic liver abscess, communication between liver abscess and intrahepatic bile ducts is an uncommon cause of bile leak. This condition can be treated surgically or endoscopically. However, these treatment modalities are related with high morbidity and mortality. A 49-year-old man was diagnosed with amebic liver abscess. Percutaneous drainage was performed due to poor medical response and for the purpose of preventing abscess rupture. Liver abscess-biliary communication was found at follow-up imaging study. He was treated successfully with medical therapy and supportive care without further interventions.
Abscess ; Bile ; Bile Ducts, Intrahepatic ; Biliary Fistula* ; Drainage ; Follow-Up Studies ; Humans ; Liver ; Liver Abscess ; Liver Abscess, Amebic* ; Middle Aged ; Mortality ; Rupture

Liposuction is one of the most frequently performed cosmetic surgeries worldwide for reshaping the body contour. Although liposuction is minimally invasive and relatively safe, it is a surgical procedure, and it carries the risk of major and minor complications. These complications vary from postoperative nausea to life-threatening events. Common complications include infection, abdominal wall injury, bowel herniation, bleeding, haematoma, seroma, and lymphoedema. Life-threatening complications such as necrotizing fasciitis, deep vein thrombosis, and pulmonary embolism have also been reported. In this paper, we provide a brief introduction to liposuction with the related anatomy and present computed tomography and ultrasonography findings of a wide spectrum of postoperative complications associated with liposuction.
Abdomen/ultrasonography ; Fasciitis, Necrotizing/etiology ; Hematoma/etiology ; Humans ; Lipectomy/*adverse effects ; Postoperative Complications/*etiology ; Pulmonary Embolism/etiology ; Tomography, X-Ray Computed ; Venous Thrombosis/etiology

The incidence of adverse toxic reactions to immunotherapy using immune checkpoint inhibitors is 2-10% in the respiratory system and 3.9% to 12% in the neurologic system. The severity of adverse effects increases when combined immunotherapeutic agents are administered.Current Concepts: In cases of high-grade toxicity, it is important to discontinue immunotherapy immediately. In cases of grade 3 to 4 toxicity, immunosuppressive corticosteroid therapy is the first-line treatment. Short-term steroid treatment does not affect anti-tumor efficacy. It is thus necessary to use steroids for an appropriate period then carefully taper the steroid dose to prevent recurrence. If no improvement is achieved within 48-72 hours after the administration of steroids, it is essential to initiate multidisciplinary treatment involving related departments and add immunosuppressive drugs. If the patient is administrated immunotherapy again, it may be necessary to permanently discontinue the immunotherapy depending on the toxicity grade that first occurred.Discussion and Conclusion: The primary goals for effective management of immunotherapy-related adverse events are early recognition of symptoms and immediate treatment.

PURPOSE: To show Humphrey automated kinetic perimetry can be substituted for Goldmann perimetry, which has been used in the field of disability evaluation field, the differences of normal visual fields between two perimetries were evaluated. METHODS: Goldmann and Humphrey automated kinetic perimetries were performed simultaneously in 70 eyes of 35 normal healthy Koreans who had no specific ophthalmologic disease at 12 meridians; 0degrees, 30degrees, 60degrees, 90degrees, 120degrees, 150degrees, 180degrees, 210degrees, 240degrees, 270degrees, 300degrees, and 330degrees. The mean values of field in each case were compared. In addition, the corrected values were obtained through the calculation of the difference in the two maximal fields. RESULTS: The visual fields of Humphrey and Goldmann kinetic perimetries showed a similar oval shape, but the fields of Goldmann were statistically significantly wider than the Humphrey fields. As the values of Humphrey were compared with the original data of Goldmann, all values of the visual field were narrow. CONCLUSIONS: The visual fields by Humphrey automated kinetic perimetry were smaller than those by Goldmann perimetry. Therefore, if Humphrey kinetic perimetry is used for the evaluation of visual disability, the visual field should be evaluated after the correction.
Disability Evaluation ; Eye ; Visual Field Tests ; Visual Fields

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

PURPOSE: Dermatofibrosarcoma protuberans (DFSP) carries a translocation resulting in the collagen type I alpha 1 (COL1A1)-platelet-derived growth factor beta (PDGFB) fusion gene, which is responsible for PDGFB activation. The purpose of this study is to evaluate the clinicopathological, genetic, and therapeutic features of DFSP in Korean patients. MATERIALS AND METHODS: Clinicopathological features of 37 patients with DFSP were reviewed. Multiplex reverse transcriptase-polymerase chain reaction (PCR) was carried out in 16 patients using formalin-fixed, paraffin-embedded tissues and specific primers for COL1A1 and PDGFB. RESULTS: The mean age of 37 patients was 37.4 years old. The most common tumor location was the trunk. All patients were treated primarily with surgery: 34 (91.7%) cases with Mohs micrographic surgery (MMS) and 3 (8.3%) cases with wide local excision. The median follow-up time was 33.7 months. Two patients, one in each treatment group, demonstrated local recurrence during the follow-up period. The COL1A1-PDGFB fusion gene was expressed in 14 (87.5%) cases, demonstrated by reverse transcriptase PCR analysis. No association was found among the different COL1A1-PDGFB fusion transcripts, the various histological subtypes and clinical features. CONCLUSION: Our results support the effectiveness of MMS in treating DFSP. The COL1A1-PDGFB fusion transcript was observed in 87.5% of patients. Therefore, COL1A1-PDGFB is a useful and accurate tool in diagnosing DFSP in Koreans.
Adolescent ; Adult ; Asian Continental Ancestry Group/*genetics ; Collagen Type I/*genetics ; DNA Primers ; Dermatofibrosarcoma/ethnology/*genetics/*pathology/surgery ; Female ; Humans ; Male ; Middle Aged ; Mohs Surgery ; Multiplex Polymerase Chain Reaction ; Neoplasm Recurrence, Local ; Oncogene Proteins, Fusion/*genetics ; Proto-Oncogene Proteins c-sis/*genetics ; Republic of Korea ; Reverse Transcriptase Polymerase Chain Reaction ; Skin Neoplasms/ethnology/*genetics/*pathology/surgery ; Treatment Outcome