Purpose: We used a noninvasive ocular surface analyzer to explore changes in the ocular surface parameters of patients who underwent 25-gauge pars plana vitrectomy (PPV). Methods: The medical records of 82 patients (163 eyes) who underwent PPV were retrospectively reviewed. The non-invasive tear film break-up time (NIBUT), the lipid layer thickness, meibomian gland loss status, and the tear meniscus height were measured before, and 1 and 3 months after treatment. Consecutive changes in the ocular surface indices of operative and non-operative fellow eyes were statistically compared. Also, factors that reduced the NIBUT at 1 month after surgery were analyzed. Results: One month after surgery, the NIBUT was significantly decreased in the operative group compared to before surgery (p = 0.006). Compared to non-operative eyes, the NIBUT of operative eyes decreased significantly 1 month after surgery (p = 0.003). Older age and lower preoperative NIBUT (p = 0.029, p = 0.002) were significantly associated with lower NIBUT 1 month after surgery. Conclusions Twenty-five gauge PPV significantly reduces the NIBUT 1 month after surgery.

Purpose: To describe a case of ocular sarcoidosis manifesting as an atypical subretinal mass.Case summary: A 59-year-old woman reported reduced visual acuity in her left eye lasting for 1 month. Her best corrected visual acuity in the left eye had diminished to 0.3. A fundus examination revealed a whitish elevated lesion, approximately one disc diameter in size, in the perimacular area of the left eye. Optical coherence tomography identified a hyporeflective oval-shaped mass in the choriocapillaris region accompanied by subretinal fluid. Initial assessment suggested choroidal osteoma with choroidal neovascularization. Consequently, the patient underwent two intravitreal bevacizumab injections, which did not lead to improvement. To rule out systemic diseases, including syphilis, tuberculosis, and sarcoidosis, further radiologic and laboratory tests were conducted. A chest computed tomography highlighted mediastinal lymph node enlargement and pervasive nodules in both lung parenchymata, and serum angiotensin-converting enzyme levels were elevated to 77 U/L. Based on these findings, a diagnosis of sarcoidosis was confirmed, and the patient commenced treatment with oral prednisolone. Eight weeks after treatment, the subretinal lesion and fluid had resolved, and the best corrected visual acuity in the patient’s left eye had improved to 0.9. Conclusions Ocular sarcoidosis can manifest as a subretinal mass. This presentation should be differentiated from other subretinal lesions.

Purpose: To investigate the characteristics and treatment results of patients aged ≥ 85 years who were diagnosed with treatment-naïve neovascular age-related macular degeneration (nAMD). Methods: The medical records of patients diagnosed with treatment-naïve nAMD who were ≥ 85 years old at the time of diagnosis with at least 12 months follow-up were retrospectively reviewed. The number of intravitreal injections of anti-vascular endothelial growth factor (VEGF) and agents used during the entire period were investigated. Best-corrected visual acuity and optical coherence tomography results before and after treatment were analyzed. Visual acuity of the fellow eye was also collected. Results: A total of 40 eyes of 40 patients with mean age of 87.5 ± 2.4 were included in the study. The mean logarithm of the minimal angle of resolution visual acuity was 0.85 ± 0.57, and the mean of the fellow eye was 0.93 ± 0.99. Compared to before the treatment, there was no significant difference after intravitreal injection in terms of visual acuity. Central retinal thickness showed significant reduction at all time points after treatment. Conclusions In patients aged ≥ 85 years at the time of diagnosis, intravitreal injections of anti-VEGF prevented deterioration of visual acuity and showed successful anatomical outcomes. Especially, many had poor visual acuity in the fellow eye, suggesting the importance of maintaining visual acuity. Therefore, active treatment is necessary in the elderly.

Background: Remote ischemic postconditioning (RIPoC) is induced by several cycles of brief, reversible, mechanical blood flow occlusion, and reperfusion of the distal organs thereby protecting target organs. We investigated if RIPoC ameliorated liver injury in a lipopolysaccharide (LPS)-induced endotoxemic rats. Methods: Protocol 1) Rats were administered LPS and samples collected at 0, 2, 6, 12, and 18 h. 2) After RIPoC at 2, 6, and 12 h (L+2R+18H, L+6R+18H, and L+12R+18H), samples were analyzed at 18 h. 3) RIPoC was performed at 2 h, analysis samples at 6, 12, 18 h (L+2R+6H, L+2R+12H, L+2R+18H), and RIPoC at 6 h, analysis at 12 h (L+6R+12H). 4) Rats were assigned to a control group while in the RIPoC group, RIPoC was performed at 2, 6, 10, and 14 h, with samples analyzed at 18 h. Results: Protocol 1) Liver enzyme, malondialdehyde (MDA), tumor necrosis factor-α (TNF-α), and nuclear factor-κB (NF-κB) levels increased while superoxide dismutase (SOD) levels decreased over time. 2) Liver enzyme and MDA levels were lower while SOD levels were higher in L+12R+18H and L+6R+18H groups when compared with L+2R+18H group. 3) Liver enzyme and MDA levels were lower while SOD levels were higher in L+2R+6H and L+6R+12H groups when compared with L+2R+12H and L+2R+18H groups. 4) Liver enzyme, MDA, TNF-α, and NF-κB levels were lower while SOD levels were higher in RIPoC group when compared with control group. Conclusions RIPoC attenuated liver injury in the LPS-induced sepsis model by modifying inflammatory and oxidative stress response for a limited period.

Morning glory syndrome (MGS) is a rare congenital optic disc anomaly with a characteristic fundal finding with severe visual impairment. It may occur in association with various systemic manifestations, even though most of the reported cases were isolated. A 6-year-old male visited the nephrology clinic with a history of microscopic hematuria and at the age of 12 years, he was diagnosed thin glomerular basement membrane nephropathy by kidney biopsy. After the following years, the patient had progressive deterioration of visual acuity, and diagnosed as MGS. Whole Exome Sequencing of this patient and his mother revealed heterozygous COL4A4 mutations [c.81_86del (p.Ile29_Leu30del)]. It is more reasonable to consider MGS seen in this patient as a coincidental finding of autosomal dominant Alport syndrome. To our knowledge, this case represents the first case report of autosomal dominant Alport syndrome associated with MGS.

Purpose: To analyze the choroidal vascularity index (CVI) in an eye with retinal detachment and the fellow eye of a patient with monocular primary rhegmatogenous retinal detachment (RRD). Methods: We retrospectively analyzed optical coherence tomography data of both eyes at the first visit of patients who underwent surgery for monocular RRD from January 2017 to January 2018. The subfoveal CVIs of the RD eye, the fellow eye, and the postoperative 3-months RD eye were analyzed using Image J software by two independent ophthalmologists. Results: Forty-five subjects were included. Of the 45 RD eyes, 25 eyes (55.6%) showed macula invasion. The subfoveal CVI was statistically lower in the RD eye compared with the fellow eye (65.61 ± 3.37 vs. 67.28 ± 3.44, respectively; p = 0.024). In the macula-on RD group, the preoperative subfoveal CVI was statistically higher than the subfoveal CVI of postoperative 3 months (67.62 ± 2.35 vs. 65.84 ± 3.04, respectively; p = 0.009). However, the preoperative subfoveal CVI was statistically lower than the subfoveal CVI of postoperative 3 months in the macula-off RD group (64.01 ± 3.21 vs. 66.69 ± 2.64, respectively; p < 0.001). Conclusions In primary RRD eyes, the subfoveal CVI was lower in the RD eye compared to the fellow eye. In macula-off RD eyes, the subfoveal CVI was lower in preoperative RD eyes compared to postoperative RD eyes. The subfoveal CVI was higher in the preoperative RD eyes compared to postoperative RD eyes in macula-on RD eyes. Further studies are needed to investigate the effects of RD on changes in the lumina and stoma in the choroid.

Purpose: We analyzed the choroidal thickness in the subfoveal area and area of retinal detachment (RD) in monocular primary rhegmatogenous retinal detachment (RRD) patients and compared the RD eye with the fellow eye. Methods: We retrospectively analyzed, optical coherence tomography data of both eyes at the first visit in patients who underwent surgery for monocular RRD from January 2013 to December 2016. Choroidal thickness was examined manually in the subfoveal and RD areas by two independent ophthalmologists; subjects without data from at least one of the two investigators were excluded. Results: Ninety-five subjects were included in this study. Of the 95 RD eyes, 61 (64.2%) and 44 (46.3%) eyes showed macula and fovea invasion, respectively. The subfoveal choroidal thickness was statistically significant in the RD eye compared with the fellow eye (244.7 ± 79.0 µm vs. 220.1 ± 78.9 µm; p < 0.001). Moreover, the choroidal thickness of the RD area in the RD eye was thicker compared with the non-detachment area and corresponding area in the fellow eye (273.8 ± 53.4 µm vs. 215.2 ± 44.0 µm and 233.3 ± 56.7 µm, respectively; p < 0.001). Conclusions In the primary RRD eye, the choroidal thickness in the detachment area was thicker than that of the fellow eye. Further studies are needed to investigate the mechanism of choroidal thickness change and its impact on RD.

Purpose: To analyze the choroidal vascularity index (CVI) in an eye with retinal detachment and the fellow eye of a patient with monocular primary rhegmatogenous retinal detachment (RRD). Methods: We retrospectively analyzed optical coherence tomography data of both eyes at the first visit of patients who underwent surgery for monocular RRD from January 2017 to January 2018. The subfoveal CVIs of the RD eye, the fellow eye, and the postoperative 3-months RD eye were analyzed using Image J software by two independent ophthalmologists. Results: Forty-five subjects were included. Of the 45 RD eyes, 25 eyes (55.6%) showed macula invasion. The subfoveal CVI was statistically lower in the RD eye compared with the fellow eye (65.61 ± 3.37 vs. 67.28 ± 3.44, respectively; p = 0.024). In the macula-on RD group, the preoperative subfoveal CVI was statistically higher than the subfoveal CVI of postoperative 3 months (67.62 ± 2.35 vs. 65.84 ± 3.04, respectively; p = 0.009). However, the preoperative subfoveal CVI was statistically lower than the subfoveal CVI of postoperative 3 months in the macula-off RD group (64.01 ± 3.21 vs. 66.69 ± 2.64, respectively; p < 0.001). Conclusions In primary RRD eyes, the subfoveal CVI was lower in the RD eye compared to the fellow eye. In macula-off RD eyes, the subfoveal CVI was lower in preoperative RD eyes compared to postoperative RD eyes. The subfoveal CVI was higher in the preoperative RD eyes compared to postoperative RD eyes in macula-on RD eyes. Further studies are needed to investigate the effects of RD on changes in the lumina and stoma in the choroid.

Purpose: We analyzed the choroidal thickness in the subfoveal area and area of retinal detachment (RD) in monocular primary rhegmatogenous retinal detachment (RRD) patients and compared the RD eye with the fellow eye. Methods: We retrospectively analyzed, optical coherence tomography data of both eyes at the first visit in patients who underwent surgery for monocular RRD from January 2013 to December 2016. Choroidal thickness was examined manually in the subfoveal and RD areas by two independent ophthalmologists; subjects without data from at least one of the two investigators were excluded. Results: Ninety-five subjects were included in this study. Of the 95 RD eyes, 61 (64.2%) and 44 (46.3%) eyes showed macula and fovea invasion, respectively. The subfoveal choroidal thickness was statistically significant in the RD eye compared with the fellow eye (244.7 ± 79.0 µm vs. 220.1 ± 78.9 µm; p < 0.001). Moreover, the choroidal thickness of the RD area in the RD eye was thicker compared with the non-detachment area and corresponding area in the fellow eye (273.8 ± 53.4 µm vs. 215.2 ± 44.0 µm and 233.3 ± 56.7 µm, respectively; p < 0.001). Conclusions In the primary RRD eye, the choroidal thickness in the detachment area was thicker than that of the fellow eye. Further studies are needed to investigate the mechanism of choroidal thickness change and its impact on RD.

BACKGROUND: Analyzing the medical care utilization behavior and conception of disease treatment of dermatologic patients is important. However, the Korean literature has few studies reporting this information. OBJECTIVE: The aim of this study is to evaluate medical care utilization behavior and conception of disease treatment of dermatologic patients. METHODS: A written questionnaire concerning personal information, treatment behavior, treatment conception, patient satisfaction, and patient compliance was completed by 442 outpatients who visited the department of dermatology at a university hospital. RESULTS: According to the patients, satisfactory outpatient consultation time for dermatology was 14.2 minutes for the first-visit consultation, and 9.92 minutes for the second-visit consultation. Most (76.0%) patients initially sought the dermatologic clinics for dermatoses, but only 39.8% of patients knew how to distinguish dermatologists from other doctors. Among the participants, 26.7% of patients directly visited a tertiary medical center without visiting primary clinics. Before visiting the hospital, 52.3% of patients sought disease information, and 28.3% of patients obtained information about doctors. Some respondents (39.7%) had a negative attitude about dermatologic medicine because of lay referral. Men were highly satisfied with explanations of drugs and had more positivity towards drugs, but showed low compliance to applying topical medication. Patients of older age, lower education level, and lower economic status had lower satisfaction with explanations given during the examination. CONCLUSION: We advise dermatologists to play a major role in enlightening patients and constructing proper information delivery systems via diversified routes to prevent unreasonable medical care utilization behavior and groundless negative conceptions about dermatologic treatment.
Compliance ; Surveys and Questionnaires ; Dermatology ; Education ; Fertilization ; Humans ; Male ; Outpatients* ; Patient Compliance ; Patient Satisfaction ; Referral and Consultation ; Skin Diseases* ; Skin*