PURPOSE: To evaluate the correlation between central corneal thickness (CCT) and scleral thickness (ST) in glaucoma patients. METHODS: Seventy-eight eyes of 78 patients with no previous history of intraocular surgery and 23 control eyes were enrolled in the present study. For all eyes, CCT, ST, axial length, anterior chamber depth and refractive error were measured by a single examiner. The correlations among the measurements were analyzed. RESULTS: The mean patient age was 57.32 +/- 9.44 years, and the mean CCT was 532.80 +/- 43.75 microm. The mean CCT of ocular hypertension (576.00 +/- 26.59 microm) was thicker than that of the normal control group (530.30 +/- 35.34 microm, p = 0.028), although the mean STs of the groups were not significantly different. No significant correlation was found between CCT and ST (r = -0.073, p = 0.466). CONCLUSIONS: In the present study, no correlation between CCT and ST was observed. In addition, the STs of the groups were not significantly different.
Anterior Chamber ; Eye ; Glaucoma ; Humans ; Microscopy, Acoustic ; Ocular Hypertension ; Refractive Errors

Purpose: To identify the correlation between near work and the occurrence of delayed-onset consecutive esotropia after surgery for intermittent exotropia. Methods: A survey and retrospective review were conducted on patients in two groups. The study included patients who visited from January 2019 to January 2020. Patients who re-developed esodeviation after recovering orthophoria after the initial postoperative overcorrection for the surgical correction of intermittent exotropia were included in the delayed-onset esotropia group (Group 1), and patients with persistent orthotropia for at least 3 years after bilateral lateral rectus recession for intermittent exotropia were included in Group 2. We evaluated the daily frequency and hours of distanceear work in both groups. Results: A total of 42 patients were evaluated. Preoperative exodeviation at a distance was 28.5 ± 4.4 prism diopters (PD) in group 1 and 30.5 ± 5.2 PD in group 2, with no significant difference between the two groups. The percentages of patients who chose two or more extremely near-work activities a day were 47.8% and 15.8% for groups 1 and 2, respectively; these values were statistically significant (p = 0.02). Twelve patients in Group 2 answered “watching TV” (63.2%) as the most common activity, which was statistically significant compared to Group 1 (26.1% in Group 1, p = 0.02). The total numbers of hours of extremely near-work a day were 2.7 ± 2.1 and 1.5 ± 1.2 hours for groups 1 and 2, respectively, which was also statistically significant (p = 0.037). Conclusions We found a significant correlation with occurrence of delayed-onset consecutive esotropia with the frequency and hours of extremely near-work after bilateral lateral rectus recession for intermittent exotropia. More attention to extremely near-work should be considered carefully after bilateral lateral rectus recession for intermittent exotropia.

Purpose: To identify the correlation between near work and the occurrence of delayed-onset consecutive esotropia after surgery for intermittent exotropia. Methods: A survey and retrospective review were conducted on patients in two groups. The study included patients who visited from January 2019 to January 2020. Patients who re-developed esodeviation after recovering orthophoria after the initial postoperative overcorrection for the surgical correction of intermittent exotropia were included in the delayed-onset esotropia group (Group 1), and patients with persistent orthotropia for at least 3 years after bilateral lateral rectus recession for intermittent exotropia were included in Group 2. We evaluated the daily frequency and hours of distanceear work in both groups. Results: A total of 42 patients were evaluated. Preoperative exodeviation at a distance was 28.5 ± 4.4 prism diopters (PD) in group 1 and 30.5 ± 5.2 PD in group 2, with no significant difference between the two groups. The percentages of patients who chose two or more extremely near-work activities a day were 47.8% and 15.8% for groups 1 and 2, respectively; these values were statistically significant (p = 0.02). Twelve patients in Group 2 answered “watching TV” (63.2%) as the most common activity, which was statistically significant compared to Group 1 (26.1% in Group 1, p = 0.02). The total numbers of hours of extremely near-work a day were 2.7 ± 2.1 and 1.5 ± 1.2 hours for groups 1 and 2, respectively, which was also statistically significant (p = 0.037). Conclusions We found a significant correlation with occurrence of delayed-onset consecutive esotropia with the frequency and hours of extremely near-work after bilateral lateral rectus recession for intermittent exotropia. More attention to extremely near-work should be considered carefully after bilateral lateral rectus recession for intermittent exotropia.

PURPOSE: To evaluate the clinical analysis of intermittent exotropia patients who required more than three reoperations and to investigate the factors leading to situations that require more than three reoperations. METHODS: We retrospectively analyzed the results of 13 patients who underwent more than three reoperations for recurrence after the second operation, as well as for 29 patients who had successful results for operation at least 1 year after the second operation. We investigated the factors associated with surgical outcomes of the second operation using multiple logistic regression analysis, which included; onset of symptom, primary, secondary, tertiary, and fourth ages of surgery, stereopsis before and after surgery, distance and near deviation before and after surgery, and constancy of exotropia. RESULTS: There were more cases in which symptoms occurred before 1 year of age (p = 0.011) and which had constant exotropia (p = 0.023), with a large deviation at first operation (p = 0.003) after more than three operations compared to patients who only had two operations. There were less cases that achieved initial overcorrection after first operation (p = 0.003) and successful postoperative stereopsis after second operation (p = 0.043) in the three operations group than in the two operations group. Among these factors, the most important factor affecting reoperation and success after second operation was related to successful recovery of stereopsis using multiple regression analysis (odds ratio [OR] = 50.00, 95% confidence interval [CI] = 4.392–569.224, p = 0.002). CONCLUSIONS: In cases of intermittent exotropia occurring before 1 year of age, constant exotropia with a large deviation at first operation, and insufficient initial overcorrection after operation, it may be necessary for patients to receive more than three operations because of recurrence. Further, recovery of postoperative stereopsis after the second operation was the most important predictor for postoperative results.
Depth Perception ; Exotropia* ; Humans ; Logistic Models ; Recurrence ; Reoperation ; Retrospective Studies

No abstract available.
Cardiomyopathies* ; Peripartum Period*

PURPOSE: To report a case of cyclic exotropia in a pediatric patient. CASE SUMMARY: There was a pediatric exotropia patient with large variation of prism diopter on alternate cover test at each visits. Not large enough for going through the surgery, she was recommended for the regular check-ups. Sometimes, she was orthophoria and some other times, distinct exotropia. After a few times of follow up, she showed 25-prism diopter exotropia on alternate cover test. The surgery was scheduled and she was admitted after 2 weeks. At the preoperative evaluation, she was orthophoria. She was discharged without having the surgery. To evaluate daily eyeball deviation status, the parents were asked to write a daily note on patient's eye condition. For 3-months, daily strabismus note was thoroughly reviewed and alternate cover test was performed monthly. Patch test was performed twice, and results were 10 and 12 prism diopter exotropia, each. Analyzing the note, a cycle of being the orthophoria and exotropia was noted. With the cycle of 72-hours, she was diagnosed with cyclic exotropia and the surgery was re-scheduled. Ulnilateral lateral rectus recession was performed. Without undercorrection or recurrence, she has been stayed stable over two years of follow up period.
Exotropia* ; Follow-Up Studies ; Humans ; Parents ; Patch Tests ; Recurrence ; Strabismus

PURPOSE: To evaluate changes in the degree of pseudomyopia and prognosis in patients with convergence spasm and acquired pseudomyopia. METHODS: The medical records of patients with convergence spasm and acquired pseudomyopia at the Korea University Medical Center from 2011 to 2014 were identified. We reviewed the patients' gender, age, onset time, visual acuity, refractive error, angle of strabismic deviation and the selected management (cycloplegics, patching, cycloplegics + patching, prism glasses). RESULTS: At the first medical examination, the mean age was 20.08 years. The mean spherical equivalent was -3.75 diopter (D) in the right eye and -4.03 D in the left eye based on manifest refraction and -2.59 D in right eye and -2.85 D in left eye using cycloplegic refraction. Eleven of 12 patients had esodeviation with a mean esodeviation of 10.42 D. The pupil size was 3.63 mm in the right eye and 3.63 mm in the left eye. No patient experienced severe miosis (pupil size <2 mm). Observation (5), patching (3), cycloplegics (2), patching + cycloplegics (1) and prism (1) management were performed in 12 patients. Outcomes included completely cured (3), improvement (7) and no change or recurrence (2). CONCLUSIONS: Active management is necessary for patients with convergence spasm and acquired pseudomyopia.
Academic Medical Centers ; Esotropia ; Humans ; Korea ; Medical Records ; Methods* ; Miosis ; Mydriatics ; Prognosis ; Pupil ; Recurrence ; Refractive Errors ; Spasm* ; Visual Acuity

PURPOSE: To report a case of Miller Fisher syndrome in a pediatric patient with gastroenteritis associated with seroconversion of Campylobacter jejuni titer during the development of neurological symptoms and positive anti-GQ1b IgG. CASE SUMMARY: An 8-year-old male patient visited our clinic with bilateral ophthalmoplegia, diplopia, and ptosis of the right upper lid. He had experienced gastroenteritis one week previous, and antibodies to Campylobacter jejuni were detected in his plasma. Ophthalmic examination revealed a corrected visual acuity of 20/20 in both eyes. Ocular motor examination revealed limitations in all positions of gaze. Neurologic examination demonstrated areflexia and ataxia. The serologic anti-GQ1b IgG test was positive. Intravenous immunoglobulin and steroid pulse therapy were started. Extraocular movement, ptosis, and ataxia gradually improved after one month of treatment. CONCLUSIONS: We confirmed a case of Miller Fisher syndrome in a pediatric patient with bilateral ophthalmoplegia, ptosis, and a positive anti-GQ1b antibody test.
Antibodies ; Ataxia ; Campylobacter jejuni ; Child ; Diplopia ; Gastroenteritis ; Humans ; Immunoglobulin G* ; Immunoglobulins ; Male ; Miller Fisher Syndrome* ; Neurologic Examination ; Ophthalmoplegia ; Plasma ; Visual Acuity

PURPOSE: To evaluate the effects of bilateral inferior oblique transposition (BIOT) on horizontal deviation from primary position among patients with bilateral dissociated vertical deviation (DVD) associated with inferior oblique overaction (IOOA) in infantile strabismus. METHODS: Retrospective chart review was conducted among 19 patients with infantile strabismus. All patients had DVD and IOOA with consecutive or recurrent horizontal deviation and underwent modified BIOT surgery. Patients were divided into three subgroups: patients who underwent BIOT (BIOT group, n = 9) alone, BIOT with medial rectus recession or lateral rectus resection simultaneously (ET BIOT group, n = 6), or BIOT with lateral rectus recession or medial rectus resection simultaneously (XT BIOT group, n = 4). Postoperative angle of horizontal deviation (prism diopter, PD) and corrected magnitude of horizontal deviation (PD) at final visit after surgery were analyzed in each group. RESULTS: The mean age was 55.11 ± 21.05 months (range, 32 to 115). The mean follow-up period was 8.68 ± 2.87 months (range, 6 to 18). Preoperative horizontal deviation was 4.23 ± 5.99 PD (range, 0 to 16) in BIOT, −17.33 ± 6.76 PD (range, −30 to −10) in ET BIOT, and 17.50 ± 2.52 PD (range, 14 to 20) in XT BIOT. Esodeviation is represented by negative values. DVD and IOOA were reduced less than +1 in all patients. The corrected amount of horizontal deviation was 3.56 ± 5.18 PD (range, 0 to 16) in BIOT surgery alone and larger in XT BIOT (18.50 ± 3.41 PD) than in ET BIOT (12.33 ± 5.57 PD, p = 0.004). CONCLUSIONS: Minimal exodeviation was corrected by BIOT alone. In addition, secondary eso- or exodeviation at great magnitudes should be corrected with proper horizontal muscle surgery along with BIOT.
Esotropia ; Exotropia ; Follow-Up Studies ; Humans ; Retrospective Studies ; Strabismus*

After surgical operation in patients with arteriovenous malformation (AVM), normal pressure perfusion breakthrough (NPPB) is one of the major complications. Brain perfusion SPECT with acetazolamide stress was known to be useful to evaluate the vascular reserve in several neurological and neurosurgical conditions. The authors performed acetazolamide brain perfusion SPECT in patients with AVM and compared the brain perfusion in the post-operative clinical courses. The acetazolamide brain perfusion SPECT was helpful in defining the prognosis of the patients with AVM. We describe 4 patients with AVM who had acetazolamide brain perfusion SPECT to examine the prognosis.
Acetazolamide* ; Arteriovenous Malformations* ; Brain* ; Humans ; Perfusion* ; Prognosis* ; Technetium Tc 99m Exametazime ; Tomography, Emission-Computed, Single-Photon*