Transvaginal cervical cerclage for the prevention of pregnancy loss in patients with cervical incompetence is well accepted. However, there is a small subject of patients with incompetence of cervix, congenital or surgical shortening of the cervix, previously failed transvaginal cerclage and deep cervical damage or tears in the fornices. We experienced a case of the transabdominal cervical cerclage. 'Ihe patient had a past history of deep cervical laceration due to vaginal delivery. Therefore, we present here a surgical technique of transabdominal cerdage and report it with brief review of literatures.
Cerclage, Cervical ; Cervix Uteri* ; Female ; Humans ; Lacerations ; Pregnancy

No abstract available.
Nursing Homes* ; Nursing* ; Nutritional Status*

Results of vitrectomy as treatment of full thickness(stage 3,4) macular hole were reported large variability and difference n anatomical and funtional success rate. So many surgeons fely difficulty in expectation of postoperative results before operation on stage 3,4. To use decision of proper operation time & effective treatment and expect the postoperative results before operation, after anatomical & functional factor affecting postoperative results & prognosis were arranged, relationship of these data after vitrectomy were evaluated. Pars plana vitrectomy in 25 patients(25 eyes) with stage 3(8 eyes) and stage 4(17 eyes) macular hole was performed. Functional success was seen in 7 eye(28%) and Anatomical success was seen in 12 eyes(48%). Preoperative factors such an stage of macular hole, preoperative visual acuity, size or macular hole, and sex were not found any association with postoperative functional & anatomical success rate. the group that had completely attached hole after vitrectomy and small preoperative cuff size(<1.0mm) were showed improvement of visual acuity compared with the other group. But these results were statistically not significant. And patients (5 eyes) with additional removal of ILM with PVD or memb peeling were showed good anatomical success rate(80%), but no difference of postoperative visual acuity compared with the other group. Although preoperative fluid cuff size and around hole and completely closure of hole after surgery were statistically not significant, highly correlated with postoperative visual acuity compared with the other factor. But long-term follow-up & recruitment of additional cases are required to consider as one of the significant factor on deciding operation time & expecting postoperative result.
Follow-Up Studies ; Humans ; Prognosis* ; Retinal Perforations* ; Visual Acuity ; Vitrectomy*

PURPOSE: To report a case of delayed sealing of full-thickness macular hole associated with diabetic retinopathy after vitrectomy with silicone oil tamponade. CASE SUMMARY: A 63-year-old woman visited our clinic complaining of decreased visual acuity in her left eye. Fundoscopy showed a full-thickness macular hole with vitreomacular traction in the left eye and bilateral proliferative diabetic retinopathy. The patient underwent uncomplicated phacoemulsification and pars plana vitrectomy with silicone oil tamponade because her vision in the contralateral eye was only light perception. She was unable to maintain a prone position postoperatively due to anterior chamber hyphema. At 1.5 months after surgery, vitreomacular traction was removed but the hole was not sealed as observed on optical coherence tomography. Approximately 3 months after vitrectomy, the macular hole was sealed with minimal subfoveal fluid. At 6 months after vitrectomy, the macular hole was closed completely with no subfoveal fluid.
Anterior Chamber ; Diabetic Retinopathy ; Eye ; Female ; Humans ; Hyphema ; Light ; Phacoemulsification ; Prone Position ; Retinal Perforations ; Silicone Oils ; Tomography, Optical Coherence ; Traction ; Vision, Ocular ; Visual Acuity ; Vitrectomy

PURPOSE: The relationship between central serous chorioretinopathy associated with retinal macrovessel remains controversial due to its rareness. We report a case of central serous chorioretinopathy diagnosed by spectral domain optical coherence tomography (SD-OCT) in a patient with a retinal macrovessel that improved spontaneously. CASE SUMMARY: A 36-year-old healthy male patient visited our clinic complaining of blurred vision in his left eye. Fundus examination of the left eye revealed central serous chorioretinopathy with retinal macrovessel in the macular area. Fundus fluorescent angiography showed an ink blot-shaped leakage, which was not clearly distinguishable due to a retinal macrovessel. Serous retinal detachment under the neurosensory retina was identified on OCT. A small pigment epithelial detachment was observed and considered as a leaking point. However, no visible exudates appeared to be leaking around the retinal macrovessel. CONCLUSIONS: Central serous chorioretinopathy with a retinal macrovessel in a Korean patient was evaluated by SD-OCT. When compared with typical cases, no differences were observed in this case and no significant associations between central serous chorioretinopathy and retinal macrovessel were shown.
Angiography ; Central Serous Chorioretinopathy ; Exudates and Transudates ; Eye ; Humans ; Ink ; Male ; Retina ; Retinal Detachment ; Retinaldehyde ; Tomography, Optical Coherence ; Vision, Ocular

No abstract available.
Korea*

PURPOSE: To investigate systemic factors associated with central serous chorioretinopathy (CSC). METHODS: We retrospectively reviewed the medical records of 113 Korean patients who were diagnosed with CSC and who underwent history taking with a specialized questionnaire for CSC. They were matched for age and gender at a ratio of 1 : 3 to 339 normal controls. Normal controls were consecutively selected from a database at the Health Promotion Center. General characteristics and medical histories were compared between the two groups. The statistical analyses used included independent t-test, Mann-Whitney test, Fisher's exact test, and multivariate logistic regression analysis. RESULTS: There were 90 men and 23 women in the CSC group, and the male-female ratio for both groups was 3.9 : 1. The mean age of the patients was 45.6 years. In multivariate analysis, hypertension (odds ratio [OR], 2.327; 95% confidence interval [CI], 1.349-4.013), use of medicinal plants (OR, 2.198; 95% CI, 1.193-4.049), sleep disturbances (OR, 1.732; 95% CI, 1.096-2.739), and snoring (OR, 1.727; 95% CI, 1.058-2.820) were strongly associated with CSC. CONCLUSIONS: Hypertension, sleep disturbance, snoring, and medicinal plant use were identified as factors associated with CSC. Expanded history taking, including systemic factors and culture-specific behavior related to stress or fatigue such as use of medicinal plants, will be helpful in identifying Korean patients at an increased risk for CSC.
Asian Continental Ancestry Group ; Case-Control Studies ; Central Serous Chorioretinopathy/*epidemiology/*etiology ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Questionnaires ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Factors ; Statistics, Nonparametric

PURPOSE: To quantitatively compare the role of posterior vitreous detachment in macular edema associated with branch retinal vein occlusion (BRVO) using OCT. METHODS: A retrospective study of 36 eyes with BRVO-associated macular edema was carried out from November 2003 to February 2005. There was posterior vitreous detachment (PVD) in 23 eyes [PVD (+) group], and vitreoretinal attachment on the fovea in 31 eyes [PVD (-) group]. PVD was detected with an indirect ophthalmoscope or 90D lens. The foveal thicknesses of the two groups were measured and compared. RESULTS: The mean foveal thicknesses of the PVD (-) and PVD (+) groups were 398.0+/-217.2 micrometer and 233.6+/-80.6 micrometer, respectively (p=0.000, Mann-Whitney test). The mean BCVA (log MAR) was 0.77+/-0.52 in the PVD (-) group and 0.40+/-0.37 in the PVD (+) group (p=0.002, Mann-Whitney test). CONCLUSIONS: The extent of macular edema associated with BRVO was significantly less in the PVD(+) group and BCVA was significantly better in the PVD (+) group as well.
Macular Edema* ; Ophthalmoscopes ; Retinal Vein Occlusion* ; Retinal Vein* ; Retinaldehyde* ; Retrospective Studies ; Vitreous Detachment*

No abstract available.
Cause of Death* ; Fever* ; Humans

PURPOSE: To evaluate the changes of choroidal perfusion after photodynamic therapy (PDT) documented by indocyanine green angiography (ICGA) and in pretreatment and posttreatment variables in patients with choroidal neovascularization (CNV) of age-related macular degeneration (AMD) and myopia (M). METHODS: Eight eyes (seven patients) with CNV in M (Group 1) and 30 eyes (29 patients) with CNV in AMD (Group 2) were included among 38 eyes (36 patients) that underwent PDT. ICGA, fluorescein angiography, optical coherence tomography (OCT) for central foveal thickness were conducted. Changes of choroidal perfusion were graded on a five point scales based on the degree of choridal hypoperfusion in the early and late phases of ICGA. RESULTS: Choriocapillary hypoperfusion was seen in 10 eyes among 30 eyes (33.3%) in group 2, but not in group 1 and the difference was statistically significant (p=0.002). However there is a limitation in confirming choroidal hypoperfusion owing to the thinning of both choriocapillaris and the RPE-Bruch's membrane complex in myopic CNV. In patients with CNV in AMD (Group 2), presence of choroidal hypoperfusion before PDT was accociated with the progression of hypoperfusion after PDT (p=0.001). CONCLUSIONS: In CNV in AMD, presence of choroidal hypoperfusion before treatment seems to play a role in progression of hypoperfusion after treatment.
Angiography ; Choroid ; Choroidal Neovascularization ; Eye ; Fluorescein Angiography ; Humans ; Indocyanine Green ; Macular Degeneration ; Membranes ; Myopia ; Perfusion ; Photochemotherapy ; Tomography, Optical Coherence ; Triazenes ; Weights and Measures