1.Kyrieleis Plaques Associated with Ocular Toxoplasmosis: Case Report
Moon Young CHOI ; Jae Pil SHIN
Journal of Retina 2026;11(1):60-63
Purpose:
We report two cases of Kyrieleis plaques associated with ocular toxoplasmosis.Case summary: A 65-year-old man presented with decreased vision in the right eye. Fundus examination showed vitreous inflammation and small peripheral retinochoroiditis. Serologic testing revealed elevated Toxoplasma gondii immunoglobulin G (IgG) titers. Other infectious or autoimmune causes were excluded. The patient was treated with oral sulfamethoxazole/trimethoprim. During work-up, multiple segmental whitish opacities developed along retinal arteries, consistent with Kyrieleis plaques. These gradually regressed as inflammation subsided. A 66-year-old man presented with unilateral vitritis and peripheral chorioretinal atrophic lesion. Laboratory tests were positive for T. gondii IgG and negative for other infectious or inflammatory markers. The patient received oral sulfamethoxazole/trimethoprim and showed gradual improvement. Segmental periarterial opacifications appeared during recovery but resolved completely with inflammation control.
Conclusions
Recognition of this distinctive but benign finding is essential to distinguishing it from retinal artery emboli or occlusion, preventing unnecessary systemic work-up, and supporting the appropriate management of inflammatory ocular diseases.
2.Korean colorectal cancer screening guidelines for asymptomatic, average-risk adults: the 2025 revision
EunKyo KANG ; Jae Myung CHA ; Seo Young KANG ; Kiheon LEE ; Su Young KIM ; Younghoon KIM ; An Na SEO ; Hyo-Jin KANG ; Jong Keon JANG ; Kwang-Pil KO ; Aesun SHIN ; Dae Kyung SOHN ; Youngki HONG ; Eun-Jung CHO ; Minje HAN ; Soo Young KIM ; Hyeon Ji LEE ; Chang Kyun CHOI ; Mina SUH
Journal of the Korean Medical Association 2026;69(3):268-280
Purpose:
To develop the 2025 update to the Korean colorectal cancer (CRC) screening guidelines by systematically evaluating recent evidence, integrating domestic data, and addressing changes since the 2015 guideline revision, thereby providing an evidence-based standard for clinicians and policymakers.
Methods:
A multidisciplinary committee developed the guidelines using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology. The process included formulation of three key questions addressing screening efficacy, diagnostic accuracy, and optimal screening age and interval. A systematic review of international guidelines and primary literature was conducted, yielding 327 eligible studies. In addition, a utility-based analysis using a Markov model was performed to determine optimal screening ages and intervals.
Results:
The evidence synthesis identified high-certainty evidence supporting the use of the fecal immunochemical test (FIT) for reducing CRC mortality and moderate-certainty evidence for colonoscopy. Evidence for computed tomographic colonography (CTC) and stool DNA testing was rated as very low certainty. Based on the evidence review and cost-utility analysis, the committee conditionally recommends CRC screening for asymptomatic, average-risk adults aged 45–74 years using either colonoscopy every 10 years or FIT every 1–2 years. CTC and stool DNA testing were not recommended owing to insufficient evidence.
Conclusion
The 2025 Korean Guidelines for Colorectal Cancer Screening present updated, evidence-based recommendations tailored to the domestic healthcare context. By conditionally endorsing both colonoscopy and FIT for individuals aged 45–74 years, these guidelines aim to improve population-level screening effectiveness and reduce the burden of CRC in South Korea.
3.Four Cases of 0.625% Povidone-Iodine Intravitreal Injection Followed by Vitrectomy for Acute Endophthalmitis after Cataract Surgery: Case Report
Moon Young CHOI ; Gahyung RYU ; Daruchi MOON ; Jae Pil SHIN ; Si Dong KIM ; Si Yeol KIM ; Yong Koo KANG ; Han Sang PARK ; Yang Jae KIM
Journal of Retina 2024;9(2):204-209
Purpose:
We sought to report the results of 0.625%/0.1 mL of povidone–iodine (PI) intravitreal injection (0.013% PI vitreous concentration) for treating acute endophthalmitis after cataract surgery.Case summary: Case 1 developed acute endophthalmitis one day after cataract surgery. Prompt intervention with PI injection and vitrectomy led to full resolution of inflammation and a visual acuity of 0.8, and the patient remained stable at 10 months. Case 2, a patient with persistent post-cataract inflammation, was treated with PI injection and vitrectomy, resulting in complete resolution of inflammation and improvement of visual acuity to 0.6 by eight months. Case 3 was a diabetic patient who experienced severe acute endophthalmitis.The patient was treated with the above intervention, resulting in full resolution of endophthalmitis; however, he eventually lost vision due to neovascular glaucoma. Case 4 developed recurrent endophthalmitis caused by Achromobacter xylosoxidans after cataract surgery. This patient required multiple vitrectomies, PI injections, and intraocular lens removal, which led to a resolution of inflammation and restoration of visual acuity to 1.0 after 14 months.
Conclusions
0.625%/0.1-mL IPI injection followed by vitrectomy was performed in four acute endophthalmitis patients after cataract surgery and were successfully treated.
4.Association between Obesity and Heart Failure and Related Atrial Fibrillation: Patient-Level Data Comparisons of Two Cohort Studies
Young Shin LEE ; Pil-Sung YANG ; Eunsun JANG ; Daehoon KIM ; Hee Tae YU ; Tae-Hoon KIM ; Jae-Sun UHM ; Jung-Hoon SUNG ; Hui-Nam PAK ; Moon-Hyoung LEE ; Boyoung JOUNG
Yonsei Medical Journal 2024;65(1):10-18
Purpose:
Heart failure (HF) and atrial fibrillation (AF) frequently coexist, with over 50% patients with HF having AF, while onethird of those with AF develop HF. Differences in obesity-mediated association between HF and HF-related AF among Asians and Europeans were evaluated.
Materials and Methods:
Using the Korean National Health Insurance Service-Health Screening (K-NHIS-HealS) cohort and the UK Biobank, we included 394801 Korean and 476883 UK adults, respectively aged 40–70 years. The incidence and risk of HF were evaluated based on body mass index (BMI).
Results:
The proportion of obese individuals was significantly higher in the UK Biobank cohort than in the K-NHIS-HealS cohort (24.2% vs. 2.7%, p<0.001). The incidence of HF and HF-related AF was higher among the obese in the UK than in Korea. The risk of HF was higher among the British than in Koreans, with adjusted hazard ratios of 1.82 [95% confidence interval (CI), 1.30–2.55] in KNHIS-HealS and 2.00 (95% CI, 1.69–2.37) in UK Biobank in obese participants (p for interaction <0.001). A 5-unit increase in BMI was associated with a 44% greater risk of HF-related AF in the UK Biobank cohort (p<0.001) but not in the K-NHIS-HealS cohort (p=0.277).
Conclusion
Obesity was associated with an increased risk of HF and HF-related AF in both Korean and UK populations. The higher incidence in the UK population was likely due to the higher proportion of obese individuals.
5.Local Ablation for Hepatocellular Carcinoma: 2024 Expert Consensus-Based Practical Recommendations of the Korean Liver Cancer Association
Seungchul HAN ; Pil Soo SUNG ; Soo Young PARK ; Jin Woong KIM ; Hyun Pyo HONG ; Jung-Hee YOON ; Dong Jin CHUNG ; Joon Ho KWON ; Sanghyeok LIM ; Jae Hyun KIM ; Seung Kak SHIN ; Tae Hyung KIM ; Dong Ho LEE ; Jong Young CHOI ; Research Committee of the Korean Liver Cancer Association
Gut and Liver 2024;18(5):789-802
Local ablation for hepatocellular carcinoma, a non-surgical option that directly targets and destroys tumor cells, has advanced significantly since the 1990s. Therapies with different energy sources, such as radiofrequency ablation, microwave ablation, and cryoablation, employ different mechanisms to induce tumor necrosis. The precision, safety, and effectiveness of these therapies have increased with advances in guiding technologies and device improvements.Consequently, local ablation has become the first-line treatment for early-stage hepatocellular carcinoma. The lack of organized evidence and expert opinions regarding patient selection, preprocedure preparation, procedural methods, swift post-treatment evaluation, and follow-up has resulted in clinicians following varied practices. Therefore, an expert consensus-based practical recommendation for local ablation was developed by a group of experts in radiology and hepatology from the Research Committee of the Korean Liver Cancer Association in collaboration with the Korean Society of Image-Guided Tumor Ablation to provide useful information and guidance for performing local ablation and for the pre- and post-treatment management of patients.
6.Local ablation for hepatocellular carcinoma: 2024 expert consensus-based practical recommendation of the Korean Liver Cancer Association
Seungchul HAN ; Pil Soo SUNG ; Soo Young PARK ; Jin Woong KIM ; Hyun Pyo HONG ; Jung-Hee YOON ; Dong Jin CHUNG ; Joon Ho KWON ; Sanghyeok LIM ; Jae Hyun KIM ; Seung Kak SHIN ; Tae Hyung KIM ; Dong Ho LEE ; Jong Young CHOI ;
Journal of Liver Cancer 2024;24(2):131-144
Local ablation for hepatocellular carcinoma (HCC), a non-surgical option that directly targets and destroys tumor cells, has advanced significantly since the 1990s. Therapies with different energy sources, such as radiofrequency ablation, microwave ablation, and cryoablation, employ different mechanisms to induce tumor necrosis. The precision, safety, and effectiveness of these therapies have increased with advances in guiding technologies and device improvements. Consequently, local ablation has become the firstline treatment for early-stage HCC. The lack of organized evidence and expert opinions regarding patient selection, pre-procedure preparation, procedural methods, swift post-treatment evaluation, and follow-up has resulted in clinicians following varied practices. Therefore, an expert consensus-based practical recommendation for local ablation was developed by a group of experts in radiology and hepatology from the Research Committee of the Korean Liver Cancer Association in collaboration with the Korean Society of Image-guided Tumor Ablation to provide useful information and guidance for performing local ablation and for the pre- and posttreatment management of patients.
7.Device Closure or Antithrombotic Therapy After Cryptogenic Stroke in Elderly Patients With a High-Risk Patent Foramen Ovale
Pil Hyung LEE ; Jung-Sun KIM ; Jae-Kwan SONG ; Sun U. KWON ; Bum Joon KIM ; Ji Sung LEE ; Byung Joo SUN ; Jong Shin WOO ; Soe Hee ANN ; Jung-Won SUH ; Jun Yup KIM ; Kyusup LEE ; Sang Yeub LEE ; Ran HEO ; Soo JEONG ; Jeong Yoon JANG ; Jang-Whan BAE ; Young Dae KIM ; Sung Hyuk HEO ; Jong S. KIM
Journal of Stroke 2024;26(2):242-251
Background:
and Purpose In young patients (aged 18–60 years) with patent foramen ovale (PFO)- associated stroke, percutaneous closure has been found to be useful for preventing recurrent ischemic stroke or transient ischemic attack (TIA). However, it remains unknown whether PFO closure is also beneficial in older patients.
Methods:
Patients aged ≥60 years who had a cryptogenic stroke and PFO from ten hospitals in South Korea were included. The effect of PFO closure plus medical therapy over medical therapy alone was assessed by a propensity-score matching method in the overall cohort and in those with a high-risk PFO, characterized by the presence of an atrial septal aneurysm or a large shunt.
Results:
Out of the 437 patients (mean age, 68.1), 303 (69%) had a high-risk PFO and 161 (37%) patients underwent PFO closure. Over a median follow-up of 3.9 years, recurrent ischemic stroke or TIA developed in 64 (14.6%) patients. In the propensity score-matched cohort of the overall patients (130 pairs), PFO closure was associated with a significantly lower risk of a composite of ischemic stroke or TIA (hazard ratio [HR]: 0.45; 95% confidence interval [CI]: 0.24–0.84; P=0.012), but not for ischemic stroke. In a subgroup analysis of confined to the high-risk PFO patients (116 pairs), PFO closure was associated with significantly lower risks of both the composite of ischemic stroke or TIA (HR: 0.40; 95% CI: 0.21–0.77; P=0.006) and ischemic stroke (HR: 0.47; 95% CI: 0.23–0.95; P=0.035).
Conclusion
Elderly patients with cryptogenic stroke and PFO have a high recurrence rate of ischemic stroke or TIA, which may be significantly reduced by device closure.
8.Clinical Outcomes of Topical Bromfenac Combined with Intravitreal Aflibercept Injection for Exudative Age-related Macular Degeneration
Mi Sun KWON ; Jin Young KIM ; Yu Min KIM ; Jae Rock DO ; Yong Koo KANG ; Jae Pil SHIN ; Dong Ho PARK
Journal of the Korean Ophthalmological Society 2024;65(1):27-34
Purpose:
To evaluate the efficacy of topical bromfenac combined with intravitreal aflibercept (IVA) injection in the treatment of exudative age-related macular degeneration over a 2-year period.
Methods:
We retrospectively studied 43 patients (43 eyes) with exudative age-related macular degeneration. Patients were included if they received IVA injections under an as-needed protocol and had > 2 years of follow-up. Among the 43 eyes, 25 received only IVA (IVA group), whereas 18 received a combination of IVA and topical bromfenac (bromfenac group). The primary outcome measure was the total number of IVA injections administered over 2 years from the initial injection compared between groups. We also compared changes in best-corrected visual acuity (BCVA) and central retinal thickness (CRT) between groups.
Results:
The bromfenac group received a significantly lower number of IVA injections over 2 years (7.4 ± 1.0), compared with the IVA group (9.0 ± 1.9) (p < 0.01). Both groups showed improvements in BCVA and CRT after 2 years compared with their baseline values. However, changes in BCVA and CRT at 2 years did not significantly differ between groups (p = 0.786 and p = 0.905, respectively).
Conclusions
Among patients with exudative age-related macular degeneration, the total number of IVA injections over 2 years was lower in the bromfenac group than in the IVA group. More studies are needed to confirm the efficacy of topical bromfenac in a combined treatment regimen.
9.Exudative Retinal Detachment after Pembrolizumab Treatment in Metastatic Cutaneous Melanoma
So Hyeon LEE ; Yoon Seok CHOI ; Jin Young KIM ; Yu Min KIM ; Jae Rock DO ; Yong Koo KANG ; Dong Ho PARK ; Jae Pil SHIN
Journal of the Korean Ophthalmological Society 2024;65(6):394-399
Purpose:
To report a case of exudative retinal detachment after using pembrolizumab in a patient with metastatic cutaneous melanoma.Case summary: A 67-year-old woman, diagnosed with malignant melanoma of the right thumb and axillary metastasis, presented with bilateral visual disturbance 3 days after adjuvant chemotherapy with pembrolizumab. Her best corrected visual acuity was 0.2 in the right eye and 0.7 in the left, while the intraocular pressure was 14 mmHg in both eyes. Fundus examination showed serous retinal detachment and choroidal detachment in the right eye, as well as a chorioretinal folding in both eyes. Optical coherence tomography showed exudative retinal detachment and choroidal detachment in the right eye, along with choroidal folding in both eyes. The pembrolizumab was stopped immediately, and the patient began treatment with systemic and topical steroids. After 1 month, the visual acuity improved and there was no exudative retinal detachment or choroidal detachment. However, 3 weeks later, exudative retinal detachment recurred in both eyes. The patient started treatment with oral steroids and cyclosporine, which resulted in the resolution of the exudative retinal detachment after 1 month.
Conclusions
Exudative retinal detachment may occur as a side effect of pembrolizumab treatment. Therefore, a differential diagnosis and appropriate treatment of ocular side effects are necessary.
10.Local Ablation for Hepatocellular Carcinoma: 2024Expert Consensus-Based Practical Recommendations of the Korean Liver Cancer Association
Seungchul HAN ; Pil Soo SUNG ; Soo Young PARK ; Jin Woong KIM ; Hyun Pyo HONG ; Jung-Hee YOON ; Dong Jin CHUNG ; Joon Ho KWON ; Sanghyeok LIM ; Jae Hyun KIM ; Seung Kak SHIN ; Tae Hyung KIM ; Dong Ho LEE ; Jong Young CHOI ; Research Committee of the Korean Liver Cancer Association
Korean Journal of Radiology 2024;25(9):773-787
Local ablation for hepatocellular carcinoma (HCC), a non-surgical option that directly targets and destroys tumor cells, has advanced significantly since the 1990s. Therapies with different energy sources, such as radiofrequency ablation, microwave ablation, and cryoablation, employ different mechanisms to induce tumor necrosis. The precision, safety, and effectiveness of these therapies have increased with advances in guiding technologies and device improvements. Consequently, local ablation has become the first-line treatment for early-stage HCC. The lack of organized evidence and expert opinions regarding patient selection, pre-procedure preparation, procedural methods, swift post-treatment evaluation, and follow-up has resulted in clinicians following varied practices. Therefore, an expert consensus-based practical recommendation for local ablation was developed by a group of experts in radiology and hepatology from the Research Committee of the Korean Liver Cancer Association in collaboration with the Korean Society of Image-guided Tumor Ablation to provide useful information and guidance for performing local ablation and for the pre- and post-treatment management of patients.

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