No abstract available.
Asian Continental Ancestry Group ; Corneal Dystrophies, Hereditary/diagnosis/*genetics ; Cytochrome P450 Family 4/*genetics ; DNA Mutational Analysis ; Fluorescein Angiography ; Humans ; Male ; Middle Aged ; *Mutation ; Polymerase Chain Reaction ; Republic of Korea ; Retinal Diseases/diagnosis/*genetics ; Retinal Pigment Epithelium/pathology ; Tomography, Optical Coherence ; Visual Acuity

Rheumatic diseases are associated various extra-articular manifestations, such as eye, nerve, pericardium, and pleura. The anterior part of the eye has distinguished anatomic structure resembling synovial joints, thus it is a common site of ocular manifestation in rheumatic disease. These changes include sicca syndrome, peripheral ulcerative keratitis, episcleritis, scleritis, and iritis. Some of these findings may be the clues for the diagnosis of the rheumatic diseases, and some ocular manifestations may represent the activity or prognosis of the rheumatic diseases. These ocular complications may leads to severe visual loss. It is crucial to rule out underlying systemic diagnosis in rheumatic disease associated ocular diseases, and when diagnosed, the coordination of the rheumatologist with the ophthalmologist in the treatment is imperative.
Corneal Ulcer ; Diagnosis ; Eye Diseases* ; Iritis ; Joints ; Pericardium ; Pleura ; Prognosis ; Rheumatic Diseases* ; Scleritis ; Sjogren's Syndrome

PURPOSE: To compare 2-year clinical outcomes of Descemet's stripping automated endothelial keratoplasty (DSAEK) and penetrating keratoplasty (PK) in patients with bullous keratopathy. METHODS: A retrospective chart review was performed to obtain 2 years of follow-up data of DSAEK or PK at a single center from March 2009 to September 2012. The study comprised 15 eyes of DSAEK and 11 eyes of PK. Outcome measures included best-corrected visual acuity (BCVA), spherical and keratometric changes, central corneal thickness, endothelial cell density, intraocular pressure, and postoperative complications. Graft survival rate was assessed by Kaplan-Meier survival analysis. RESULTS: There were no differences in patient baseline characteristics between the two groups. At postoperative 2 years, better BCVA of 0.69 ± 0.51 logarithm of the minimum angle of resolution (logMAR) was found after DSAEK compared to 0.88 ± 0.48 logMAR after PK. Refractive cylinder in DSAEK and PK was −2.60 ± 1.53 and −6.00 ± 1.05 diopters (D), respectively, and keratometric cylinder was 3.27 ± 3.70 and 6.34 ± 3.51 D, respectively, at postoperative 2 years. The difference of mean spherical equivalents between postoperative 1 month and 2 years was 0.84 D after DSAEK and 2.05 D after PK. A hyperopic shift of 1.17 D was present after 2 years of DSAEK. The mean endothelial cell density at postoperative 2 years was 1,548 ± 456 cells/mm² for DSAEK and 1,052 ± 567 cells/mm² for PK, with a cell loss of 19.96% vs. 52.38%, respectively when compared to postoperative 1 month. No significant difference in central corneal thickness was found between DSAEK and PK (592 ± 75 vs. 563 ± 90 µm, respectively). Finally, the 2-year survival rate did not differ significantly between DSAEK and PK (93.3% vs. 81.8%, respectively, p = 0.344). CONCLUSIONS: Compared to PK, DSAEK provided more stable refractive errors with better visual outcome, lower endothelial cell loss, and a lower rate of graft rejection at postoperative 2 years in patients with bullous keratopathy.
Cornea/diagnostic imaging/*surgery ; Corneal Diseases/diagnosis/*surgery ; Descemet Stripping Endothelial Keratoplasty/*methods ; Female ; Follow-Up Studies ; Graft Survival ; Humans ; Keratoplasty, Penetrating/*methods ; Male ; Middle Aged ; *Refraction, Ocular ; Retrospective Studies ; Time Factors ; Treatment Outcome ; Visual Acuity

PURPOSE: To unveil the etiology, pathogenic mechanism and the clinical significance of the corneal iron line through various clinical aspects of the corneal iron line. METHODS: This study included 45 eyes of 39 patients who visited the Department of Ophthalmology in Chungnam National University Hospital between April 2011 and March 2014. Anterior segment of the eye was photographed during the diagnostic process. The medical history of the patient was investigated and corneal topography was performed to discover the relationship between the position of the corneal iron line and the curvature of the corneal surface. RESULTS: The corneal iron line was identified in various corneal diseases such as herpetic stromal keratitis and; corneal ulcer. The average age of patients was 57.8 years. Corneal topography was performed in 12 patients and a connection was found between the curvature of the corneal surface and the position of corneal iron line at 75%. During the research period, corneal disease progressed and associated corneal iron line became clearer in 2 eyes. However, there was no repositioning or new appearance in different areas. The corneal iron line was not associated with visual acuity and the shape varied in accordance with the accompanying corneal disorder. The location where the tears repeatedly accumulate was associated with corneal surface. CONCLUSIONS: Based on the occurrence location and the shape of the corneal iron line, we could understand that the occurrence of corneal iron line is associated with the past and current corneal surface irregularities, which verified the validity of the tear pooling hypothesis. Therefore, this result can aid in establishing the diagnosis and treatment plan when the corneal iron line is discovered during clinical practice.
Chungcheongnam-do ; Corneal Diseases ; Corneal Topography ; Corneal Ulcer ; Diagnosis ; Humans ; Iron* ; Keratitis ; Ophthalmology ; Tears ; Visual Acuity

PURPOSE: To unveil the etiology, pathogenic mechanism and the clinical significance of the corneal iron line through various clinical aspects of the corneal iron line. METHODS: This study included 45 eyes of 39 patients who visited the Department of Ophthalmology in Chungnam National University Hospital between April 2011 and March 2014. Anterior segment of the eye was photographed during the diagnostic process. The medical history of the patient was investigated and corneal topography was performed to discover the relationship between the position of the corneal iron line and the curvature of the corneal surface. RESULTS: The corneal iron line was identified in various corneal diseases such as herpetic stromal keratitis and; corneal ulcer. The average age of patients was 57.8 years. Corneal topography was performed in 12 patients and a connection was found between the curvature of the corneal surface and the position of corneal iron line at 75%. During the research period, corneal disease progressed and associated corneal iron line became clearer in 2 eyes. However, there was no repositioning or new appearance in different areas. The corneal iron line was not associated with visual acuity and the shape varied in accordance with the accompanying corneal disorder. The location where the tears repeatedly accumulate was associated with corneal surface. CONCLUSIONS: Based on the occurrence location and the shape of the corneal iron line, we could understand that the occurrence of corneal iron line is associated with the past and current corneal surface irregularities, which verified the validity of the tear pooling hypothesis. Therefore, this result can aid in establishing the diagnosis and treatment plan when the corneal iron line is discovered during clinical practice.
Chungcheongnam-do ; Corneal Diseases ; Corneal Topography ; Corneal Ulcer ; Diagnosis ; Humans ; Iron* ; Keratitis ; Ophthalmology ; Tears ; Visual Acuity

PURPOSE: To describe the clinical course of congenital aniridia and to evaluate prognostic factors for visual outcome after long-term follow-up. METHODS: The medical records of 120 eyes from 60 patients with congenital aniridia were retrospectively reviewed. The prevalence and clinical course of ophthalmic characteristics, systemic disease, refractive errors, and visual acuity were assessed. Prognostic factors for final visual outcomes were analyzed. RESULTS: Aniridic keratopathy developed in 82 (69%) of 119 eyes. Macular hypoplasia was observed in 70 eyes of 35 patients (91%). Cataract was observed in 63 of 120 eyes (53%). Nystagmus was present in 41 patients (68% of 60 patients) at the initial visit but decreased in five patients (8% of 60 patients). Ocular hypertension was detected in 19 eyes (20% of 93 eyes), six (32% of 19 eyes) of which developed secondarily after cataract surgery. The mean changes in spherical equivalent and astigmatism during the follow-up period were -1.10 and 1.53 diopter, respectively. The mean final visual acuity was 1.028 logarithm of minimal angle of resolution. Nystagmus and ocular hypertension were identified as prognostic factors for poor visual outcome. CONCLUSIONS: Identification of nystagmus and ocular hypertension was important to predict final visual outcome. Based on the high rate of secondary ocular hypertension after cataract surgery, careful management is needed.
Adolescent ; Adult ; Aniridia/*diagnosis/physiopathology ; Cataract/diagnosis ; Child ; Child, Preschool ; Corneal Diseases/diagnosis ; Eye Abnormalities/diagnosis ; Eye Diseases/*diagnosis/physiopathology ; Follow-Up Studies ; Humans ; Infant ; Infant, Newborn ; Nystagmus, Pathologic/diagnosis ; Ocular Hypertension/diagnosis ; Prognosis ; Retina/abnormalities ; Retrospective Studies ; Visual Acuity/*physiology ; Young Adult

Adult ; Corneal Diseases ; diagnosis ; etiology ; Humans ; Male ; Multiple Myeloma ; complications ; diagnosis

We report a case of vortex keratopathy in a patient treated with vandetanib for non-small cell lung cancer (NSCLC). A 44-year-old female who underwent two cycles of chemotherapy for NSCLC complained of visual blurring in both eyes after the initiation of vandetanib, an anti-epidermal growth factor receptor (EGFR) and anti-vascular endothelial growth factor receptor 2 protein tyrosine kinase inhibitor. On ophthalmic examination, visual acuities were 20 / 20 OU and, with the exception of diffuse vortex keratopathy in both eyes, other findings were unremarkable. Vandetanib is believed to have caused vortex keratopathy in this patient. Anti-EGFR properties affecting normal corneal epithelial cell migration and wound healing or drug associated metabolite deposition, which is the case in numerous drug-associated vortex keratopathies, may be possible underlying mechanisms in the formation of this corneal complication.
Adult ; Carcinoma, Non-Small-Cell Lung/*drug therapy/pathology ; Cornea/drug effects/*pathology ; Corneal Diseases/*chemically induced/diagnosis ; Diagnosis, Differential ; Dose-Response Relationship, Drug ; Female ; Follow-Up Studies ; Humans ; Lung Neoplasms/*drug therapy/pathology ; Microscopy, Acoustic ; Piperidines/administration & dosage/*adverse effects ; Quinazolines/administration & dosage/*adverse effects ; Visual Acuity

Two schizophrenic patients who had been taking medication for a long period presented with visual disturbance of 6-month duration. Slit-lamp examination revealed fine, discrete, and brownish deposits on the posterior cornea. In addition, bilateral star-shaped anterior subcapsular lens opacities, which were dense, dust-like granular deposits, were noted. Although we strongly suspected that the patient might have taken one of the drugs of the phenothiazine family, we were unable to obtain a history of medications other than haloperidol and risperidone, which were taken for 3 yr. We performed a drug profiling test using urine samples and detected methotrimeprazine. The patient underwent surgery for anterior subcapsular lens opacities. Visual acuity improved in both eyes, but the corneal deposits remained. We report an unusual case of methotrimeprazine-induced corneal deposits and cataract in a patient with psychosis, identified by using the urine drug profiling test.
Adult ; Antipsychotic Agents/*adverse effects/therapeutic use/urine ; Cataract/*chemically induced ; Corneal Diseases/*chemically induced ; Female ; Humans ; Male ; Mental Retardation/diagnosis/drug therapy ; Methotrimeprazine/*adverse effects/therapeutic use/urine ; Middle Aged ; Schizophrenia/diagnosis/drug therapy ; Visual Acuity

PURPOSE: To evaluate the risk factors for cataract formation and cataract extraction after penetrating keratoplasty to determine whether a combined surgery should be performed. METHODS: Variables from 189 phakic eyes that underwent penetrating keratoplasty from April 1992 to November 2004 were analyzed for the possibility of cataract extraction after penetrating keratoplasty according to sex, age, diagnosis, accompanied glaucoma, preoperative vision and steroid use. The mean interval between penetrating keratoplasty and cataract extraction was also studied. RESULTS: Cataract extraction was performed in 27 eyes (14.3%) and the mean interval between keratoplasty and cataract extraction was 24.5 months. Age was determined to be the most important independent risk factor for cataract extraction (p=0.0009) associated glaucoma also shown to be a risk factor (p=0.0011). Sex and corneal disease before keratoplasty were not shown to be risk factors. In the mean interval cataract extraction following penetrating keratoplasty, no statistically significant difference was found according to age, sex and diagnosis. Posterior subcapsular cataract was predominant (55.6%) and the mean visual acuity improved from 0.10 to 0.42. CONCLUSIONS: The likelihood of cataract formation and cataract extraction subsequent to penetrating keratoplasty increased with age and associated glaucoma. The results from this study can help surgeons to determine whether combined surgery should be performed and help them to counsel patients on the risk of cataract formation.
Cataract Extraction ; Cataract* ; Corneal Diseases ; Corneal Transplantation ; Diagnosis ; Glaucoma ; Humans ; Keratoplasty, Penetrating* ; Risk Factors ; Visual Acuity