PURPOSE: To investigate the effectiveness of the pediatric blood culture bottle for vitreous sample culture in endophthalmitis patients. METHODS: All consecutive cases with clinically suspected endophthalmitis treated and cultured in our institution between January 2009 and June 2013 were included in the study. Vitreous samples were obtained by vitreous needle aspiration (tap), anterior chamber aspiration, or mechanized vitreous biopsy (vitrectomy). The samples obtained using the conventional method until August 2011 were classified as group I. Since August 2011, the BacT/Alert PF pediatric blood culture bottle (bioMerieux, Marcy l'Etoile, France) was used for culture in group II. We investigated age, gender, biopsy method, cause of infection, use of antibiotics, bacterial culture, and culture positive rate. RESULTS: Thirty-three cases were included in group I and 17 cases in group II. There was no significant difference in age, gender, sampling technique, cause of infection, and use of antibiotics between the 2 groups. The culture positive rate in group II (60.7%) was significantly higher than group I (33.3%, p = 0.032). In group II, Enterococcus feacalis was the most common pathogen (8 eyes). In group I, Streptococcus pneumoniae and Pseudomonas aeruginosa were confirmed in 3 cases. CONCLUSIONS: The pediatric blood culture bottle can be used successfully in the examination of clinically suspected endophthalmitis. The method showed higher culture positive rate compared with the conventional method. This technique is simple and maintaining a supply of fresh agar media is not necessary.
Agar ; Anterior Chamber ; Anti-Bacterial Agents ; Biopsy ; Endophthalmitis* ; Enterococcus ; Humans ; Needles ; Pseudomonas aeruginosa ; Streptococcus pneumoniae

PURPOSE: To determine the myopic shift and cataract change after lens sparing vitrectomy (LSV) in patients with idiopathic epiretinal membrane (ERM) in their 5th and 6th decade of life. METHODS: The medical records of patients undergoing LSV for idiopathic ERM from 2008 to 2012 were reviewed. Patients with previous intraocular surgery, preoperative significant cataract, under 40 or over 60 years of age and a follow-up period of less than 6 months were excluded. The change in refractive errors, visual acuity, and cataract grade were evaluated for 6 months after LSV as well as the correlation between myopic shift and cataract change at 6 months after LSV. RESULTS: Twenty-eight eyes were included in this study. The cataract status worsened by 1.07 levels, myopia progressed by 3.13 diopters (p < 0.001), and uncorrected visual acuity (log MAR) decreased from 0.73 to 0.98 (p = 0.022) at 6 months after LSV. Additional cataract surgery was performed in 22 eyes (78.6%) at 13.6 months on average during the follow-up period (average 16.9 months). In 6 eyes (21.4%) having myopic change below 1.0 diopters, crystalline lens was preserved for 36 months after vitrectomy. Conversely, 22 eyes (78.6%) with myopic change over 1.5 diopters required cataract surgery. Therefore, myopic change over 1.5 diopters could be a major postoperative change predicting the necessity for cataract surgery (p < 0.001). CONCLUSIONS: LSV for ERM caused a significant myopic shift and cataract changes in patients in their 5th and 6th decade of life and additional cataract surgery was required in 78.6% of patients within 3 years after vitrectomy. The myopic shift over 1.5 diopters at 6 months after vitrectomy could be a major postoperative change predicting the necessity for cataract surgery.
Cataract* ; Epiretinal Membrane* ; Follow-Up Studies ; Humans ; Lens, Crystalline ; Medical Records ; Myopia ; Refractive Errors ; Visual Acuity ; Vitrectomy*

PURPOSE: To determine the myopic shift and cataract change after lens sparing vitrectomy (LSV) in patients with idiopathic epiretinal membrane (ERM) in their 5th and 6th decade of life. METHODS: The medical records of patients undergoing LSV for idiopathic ERM from 2008 to 2012 were reviewed. Patients with previous intraocular surgery, preoperative significant cataract, under 40 or over 60 years of age and a follow-up period of less than 6 months were excluded. The change in refractive errors, visual acuity, and cataract grade were evaluated for 6 months after LSV as well as the correlation between myopic shift and cataract change at 6 months after LSV. RESULTS: Twenty-eight eyes were included in this study. The cataract status worsened by 1.07 levels, myopia progressed by 3.13 diopters (p < 0.001), and uncorrected visual acuity (log MAR) decreased from 0.73 to 0.98 (p = 0.022) at 6 months after LSV. Additional cataract surgery was performed in 22 eyes (78.6%) at 13.6 months on average during the follow-up period (average 16.9 months). In 6 eyes (21.4%) having myopic change below 1.0 diopters, crystalline lens was preserved for 36 months after vitrectomy. Conversely, 22 eyes (78.6%) with myopic change over 1.5 diopters required cataract surgery. Therefore, myopic change over 1.5 diopters could be a major postoperative change predicting the necessity for cataract surgery (p < 0.001). CONCLUSIONS: LSV for ERM caused a significant myopic shift and cataract changes in patients in their 5th and 6th decade of life and additional cataract surgery was required in 78.6% of patients within 3 years after vitrectomy. The myopic shift over 1.5 diopters at 6 months after vitrectomy could be a major postoperative change predicting the necessity for cataract surgery.
Cataract* ; Epiretinal Membrane* ; Follow-Up Studies ; Humans ; Lens, Crystalline ; Medical Records ; Myopia ; Refractive Errors ; Visual Acuity ; Vitrectomy*

PURPOSE: To report early capsular block syndrome (CBS) after phacoemulsification with posterior chamber intraocular lens (IOL) insertion combined with vitrectomy. METHODS: Medical records of 622 eyes of 589 patients who had combined phacoemulsification, IOL implantation and vitrectomy between March 2009 and December 2011 were retrospectively reviewed. Among patients with CBS occurring within 1 month of surgery, the patient's baseline characteristics, type of IOL and ophthalmic viscoelastic devices were analyzed. RESULTS: Nine patients (1.45%) developed CBS with typical capsular bag distension. All CBS occurred within 2 weeks after the surgery. Hydrophilic, large optics and no angulation between optic and haptic were related with the occurrence of CBS. Nd:YAG laser capsulotomy (5 eyes), and surgical capsulectomy (2 eyes) resolved CBS successfully. In 2 eyes with gas tamponade, CBS resolved without intervention with the absorption of gas. CONCLUSIONS: CBS may develop after phacoemulsification with PC IOL insertion combined with vitrectomy and/or vitreous tamponade. Hydrophilic material, large optics and no angulation were risk factors of capsular block by enhancing adhesion between the capsulorrhexis and the optic.
Absorption ; Capsulorhexis ; Eye ; Humans ; Lenses, Intraocular ; Medical Records ; Phacoemulsification ; Retrospective Studies ; Risk Factors ; Vitrectomy

PURPOSE: To report a case of bilateral acute myopia and angle-closure with ciliochoroidal detachment in Vogt-Koyanagi-Harada (VKH) syndrome. CASE SUMMARY: A 43-year-old Korean woman diagnosed with VKH syndrome underwent intravenous methylprednisolone steroid pulse treatment. After oral medication was given for 2 days, the anterior chambers became shallow in both eyes. Intraocular pressure (IOP) increased to 25 mm Hg in the right eye and 23 mm Hg in the left eye. Subretinal fluid increased and visual acuity decreased with myopic shift in both eyes. IOP did not decrease despite maximum tolerated medical therapy. Ultrasound biomicroscopy (UBM) revealed that ciliochoroidal effusion caused forward displacement of the lens-iris diaphragm, which resulted in anterior chamber shallowing and angle closure in both eyes. The patient was treated with cycloplegic eyedrops and intravenous steroid pulse therapy. After intravenous steroid pulse treatment was given for 2 days, the anterior chambers became deep in both eyes. IOP reduced to 13 mm Hg and 14 mm Hg in the right and left eye respectively. Visual acuity increased with normalization of myopic shift. UBM revealed that the ciliochoroidal effusion had resolved in both eyes.
Adult ; Anterior Chamber ; Diaphragm ; Displacement (Psychology) ; Eye ; Female ; Humans ; Intraocular Pressure ; Methylprednisolone ; Microscopy, Acoustic ; Myopia ; Ophthalmic Solutions ; Subretinal Fluid ; Uveomeningoencephalitic Syndrome ; Visual Acuity

PURPOSE: To evaluate the relationship between retinal dot hemorrhage that occurred during membrane peeling (MP) and the damage to the internal limiting membrane (ILM) at idiopathic epiretinal membrane (ERM). METHODS: The authors of the present study retrospectively reviewed 50 eyes of 50 consecutive patients who underwent vitrectomy with MP for idiopathic ERM. For all the patients, the ILM was stained with indocyanine green following MP. ILM damage was evaluated using microscopy during the operation. Tissue was examined by light and electron microscopy. Whether or not retinal hemorrhage occurred during the MP and the location of the hemorrhage were also investigated. RESULTS: During the MP for idiopathic ERM, ILM damage was observed in 43 (86%) of 50 eyes, and some defects of the ILM due to simultaneous removal with the ERM were observed in 37 (74%) of 50 eyes. Retinal dot hemorrhage occurred during the MP in 32 eyes (64%) and did not occur in 18 eyes (36%). In 32 eyes with retinal hemorrhage, ILM damage was observed in 30 eyes (94%). Large or small defects of the ILM due to simultaneous removal with the ERM were observed in 27 of 30 eyes, and ILM tear was observed in 3 eyes. The hemorrhage occurred in 2 eyes without gross ILM damage during the MP. Among 18 eyes without retinal hemorrhage, large or small defects of the ILM due to simultaneous removal with the ERM were observed in 10 eyes (56%). ILM tear was observed in 2 eyes, ILM detachment was observed in 1 eye, while ILM remained intact in 5 eyes (28%). The number of eyes where both ERM and ILM were peeled simultaneously was significantly higher in the cases with retinal hemorrhage (p = 0.047). Cases of hemorrhage in Gass grade 2 were statistically higher than that in Gass grade 1 (p = 0.015). OCT type of ERM did not have significant correlation with retinal hemorrhage or ILM damage during the MP. CONCLUSIONS: During the MP for idiopathic ERM, ILM damage was observed in 86% of patients, and some defects of the ILM due to simultaneous removal with ERM were observed in 74% of patients. It is highly suggestive that ILM is damaged at the hemorrhage site if retinal dot hemorrhage occurred during the MP for idiopathic ERM.
Epiretinal Membrane ; Eye ; Hemorrhage ; Humans ; Indocyanine Green ; Light ; Membranes ; Microscopy ; Microscopy, Electron ; Retinal Hemorrhage ; Retinaldehyde ; Retrospective Studies ; Vitrectomy

BACKGROUND: Reactive oxygen species (ROS) such as superoxide radicals, hydrogen peroxide, nitric oxide, and nitroperoxide, cause oxidative stress which interferes with normal cell functioning, resulting in cell damage. It is reported to be associated with chronic pain, especially neuropathic pain, and inflammatory pain. ROS is also closely related to central sensitization. Therefore, this study was designed to explore the effects of Phenyl N-tert-butylnitrone (PBN), an ROS scavenger, in acute, continuous, and increasing pain caused by central sensitization. METHODS: Male Sprague-Dawley rats were divided into 2 groups, an intraperitoneal group (IP) and an intrathecal group (IT), and once again divided into an experimental group and a control group. The experimental group was injected with Phenyl N-tert-butylnitrone (PBN), a free radical scavenger, either intraperitoneally or intrathecally. After inducing pain by injecting formalin into the hind paw, pain behaviors were measured. Lumbar enlargement immmunohistochemistry was performed to assess nitrotyrosine, an oxidative stress marker, to identify the degree of protein nitration. RESULTS: Both experimental groups of IP and IT showed statistically significant decreases in the number of flinches compared to the control group in phase 1 and 2. Immunohistochemical evaluation in the control group revealed an increase in nitrated proteins in the gray matter of the lumbar spinal cord, but a significant decrease in nitrated proteins in the gray matter of lumbar spinal cord of the experimental group. CONCLUSIONS: Intraperitoneal and intrathecal administration of PBN decreases analgesic behaviors, allowing us to believe that ROS is mainly responsible for acute pain and central sensitization.
Acute Pain ; Animals ; Central Nervous System Sensitization ; Chronic Pain ; Formaldehyde ; Humans ; Hydrogen Peroxide ; Male ; Neuralgia ; Nitric Oxide ; Oxidative Stress ; Pain Measurement ; Proteins ; Rats ; Rats, Sprague-Dawley ; Reactive Oxygen Species ; Spinal Cord ; Superoxides ; Tyrosine

BACKGROUND: Reactive oxygen species (ROS) such as superoxide radicals, hydrogen peroxide, nitric oxide, and nitroperoxide, cause oxidative stress which interferes with normal cell functioning, resulting in cell damage. It is reported to be associated with chronic pain, especially neuropathic pain, and inflammatory pain. ROS is also closely related to central sensitization. Therefore, this study was designed to explore the effects of Phenyl N-tert-butylnitrone (PBN), an ROS scavenger, in acute, continuous, and increasing pain caused by central sensitization. METHODS: Male Sprague-Dawley rats were divided into 2 groups, an intraperitoneal group (IP) and an intrathecal group (IT), and once again divided into an experimental group and a control group. The experimental group was injected with Phenyl N-tert-butylnitrone (PBN), a free radical scavenger, either intraperitoneally or intrathecally. After inducing pain by injecting formalin into the hind paw, pain behaviors were measured. Lumbar enlargement immmunohistochemistry was performed to assess nitrotyrosine, an oxidative stress marker, to identify the degree of protein nitration. RESULTS: Both experimental groups of IP and IT showed statistically significant decreases in the number of flinches compared to the control group in phase 1 and 2. Immunohistochemical evaluation in the control group revealed an increase in nitrated proteins in the gray matter of the lumbar spinal cord, but a significant decrease in nitrated proteins in the gray matter of lumbar spinal cord of the experimental group. CONCLUSIONS: Intraperitoneal and intrathecal administration of PBN decreases analgesic behaviors, allowing us to believe that ROS is mainly responsible for acute pain and central sensitization.
Acute Pain ; Animals ; Central Nervous System Sensitization ; Chronic Pain ; Formaldehyde ; Humans ; Hydrogen Peroxide ; Male ; Neuralgia ; Nitric Oxide ; Oxidative Stress ; Pain Measurement ; Proteins ; Rats ; Rats, Sprague-Dawley ; Reactive Oxygen Species ; Spinal Cord ; Superoxides ; Tyrosine

PURPOSE: To report a case of visual field defect developed after internal limiting membrane (ILM) peeling in a patient with macular epiretinal membrane (ERM). CASE SUMMARY: A 33-year-old female without a history of specific diseases presented with a gradually decreased visual acuity in the right eye for 3 years. The patient was diagnosed as having macular ERM and underwent vitrectomy. During ILM peeling, retinal hemorrhage occurred in the superior region of macula, which spontaneously disappeared 2 weeks after surgery. Transmission electron microscopy showed Muller cell end feet with damaged appearance adherent to the ILM. At 3 months after surgery, the patient developed retinal nerve fiber layer (RNFL) defect in the area where the spot retinal hemorrhage had occurred. Optical coherence tomography showed focal RNFL thinning in the superotemporal region. The automated perimetry revealed corresponding inferior nasal step and scotomas in the right eye. Intraocular pressure was normal throughout the follow-up period and there was no evidence of glaucomatous optic disc change. CONCLUSIONS: The results obtained from the patient in the present study indicated that visual field defect may be the result of a mechanical damage to the RNFL during ILM peeling.
Adult ; Epiretinal Membrane ; Eye ; Female ; Follow-Up Studies ; Foot ; Humans ; Intraocular Pressure ; Membranes ; Microscopy, Electron, Transmission ; Nerve Fibers ; Retinal Hemorrhage ; Retinaldehyde ; Scotoma ; Tomography, Optical Coherence ; Visual Acuity ; Visual Field Tests ; Visual Fields ; Vitrectomy

PURPOSE: To determine the efficacy of using the preferential hyperacuity perimeter (PHP) for the analysis of metamorphopsia following macular-off rhegmatogenous retinal detachment (RRD) surgical repair. METHODS: PHP examination was performed in those who complained of metamorphopsia after successful surgical reattachment of RRD. The subjective symptoms were evaluated based on a scale, ranging from 0 to 10, and were compared with the results of PHP examination. Patients age, duration of retinal detachment, pre and post-operative visual acuity, postoperative presence of subretinal fluid (SRF), surgical methods, presence of epiretinal membrane, and time from operation to PHP test were analyzed to find the correlation with the PHP results. RESULTS: Of the 19 eyes included in this study, nine eyes were found to have a hyperacuity defect upon PHP examination. In this group, the subjective level of metamorphopsia was significantly worse (p<0.01), the age was significantly higher (p=0.02), and SRF persisted in the macula more frequently at two months postoperatively (p=0.04), as compared to those without the defect. There were no significant differences in the other factors. CONCLUSIONS: Subjectively severe metamorphopsia after surgery for RRD could be confirmed objectively using PHP. In the case of older patients and persistent submacular fluid, metamorphopsia would develop more frequently due to displacement of the photoreceptors in the process of reattachment.
Displacement (Psychology) ; Epiretinal Membrane ; Eye ; Humans ; Retinal Detachment ; Subretinal Fluid ; Vision Disorders ; Visual Acuity