STUDY DESIGN: A noninterventional, multicenter, cross-sectional study. PURPOSE: We investigated the prevalence of neuropathic pain (NP) and patient-reported outcomes (PROs) of the quality of life (QoL) and functional disability in Korean adults with chronic low back pain (CLBP). OVERVIEW OF LITERATURE: Among patients with CLBP, 20%–55% had NP. METHODS: Patients older than 20 years with CLBP lasting for longer than three months, with a visual analog scale (VAS) pain score higher than four, and with pain medications being used for at least four weeks before enrollment were recruited from 27 general hospitals between December 2014 and May 2015. Medical chart reviews were performed to collect demographic/clinical features and diagnosis of NP (douleur neuropathique 4, DN4). The QoL (EuroQoL 5-dimension, EQ-5D; EQ-VAS) and functional disability (Quebec Back Pain Disability Scale, QBPDS) were determined through patient surveys. Multiple linear regression analyses were performed to compare PROs between the NP (DN4≥4) and non-NP (DN4 < 4) groups. RESULTS: A total of 1,200 patients (females: 65.7%; mean age: 63.4±13.0 years) were enrolled. The mean scores of EQ-5D, EQ-VAS, and QBPDS were 0.5±0.3, 55.7±19.4, and 40.4±21.1, respectively. Among all patients, 492 (41.0%; 95% confidence interval, 38.2%–43.8%) suffered from NP. The prevalence of NP was higher in male patients (46.8%; p < 0.01), in patients who had pain based on radiological and neurological findings (59.0%; p < 0.01), and in patients who had severe pain (49.0%; p < 0.01). There were significant mean differences in EQ-5D (NP group vs. non-NP group: 0.4±0.3 vs. 0.5±0.3; p < 0.01) and QBPDS (NP group vs. non-NP group: 45.8±21.2 vs. 36.3±20.2; p < 0.01) scores. In the multiple linear regression, patients with NP showed lower EQ-5D (β=−0.1; p < 0.01) and higher QBPDS (β=7.0; p < 0.01) scores than those without NP. CONCLUSIONS: NP was highly prevalent in Korean patients with CLBP. Patients with CLBP having NP had a lower QoL and more severe dysfunction than those without NP. To enhance the QoL and functional status of patients with CLBP, this study highlights the importance of appropriately diagnosing and treating NP.
Adult* ; Back Pain ; Cross-Sectional Studies ; Diagnosis ; Hospitals, General ; Humans ; Linear Models ; Low Back Pain* ; Male ; Neuralgia* ; Prevalence* ; Quality of Life ; Visual Analog Scale

PURPOSE: To evaluate preferences and trends in the management of diabetic retinopathy in Korea and Japan. METHODS: An Internet survey comprised of 49 questions was sent to the members of Korean Retina Society (KRS) and Japanese Society of Ophthalmic Diabetology (JSOD). The survey was conducted during the period between June 2012 and July 2012. RESULTS: Ninety-one of 210 members of the KRS (43%) and 120 of 754 members of the JSOD (16%) participated in the survey. For diffuse diabetic macular edema, 'intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF) followed by focal laser treatment' was the most preferred treatment in Korea (48%), while 'sub-tenon steroid injection followed by focal laser treatment' was the most common procedure in Japan (33%). Vitrectomy was the second most common procedure in Japan (18%). In contrast, none of the KRS members preferred vitrectomy in this situation. For refractory diabetic macular edema, however, vitrectomy with or without the use of anti-VEGF was chosen in 75% of the KRS members. In Japan, vitrectomy without the use of intravitreal injection of anti-VEGF or steroid was relatively more preferred. Small-gauge (G) vitrectomy using either a 23 G or 25 G needle was popular in both countries (90% in Korea, 64% in Japan). CONCLUSIONS: Although the trends in diagnostic and surgical environments were similar in Korea and Japan, the preferred treatment approaches for diabetic macular edema were different. Sub-tenon steroid injection and vitrectomy were preferred in Japan, while anti-VEGF injection was most commonly employed in Korea.
Asian Continental Ancestry Group ; Diabetic Retinopathy* ; Endothelial Growth Factors ; Humans ; Internet ; Intravitreal Injections ; Japan* ; Korea* ; Macular Edema ; Needles ; Retina ; Vitrectomy

PURPOSE: To evaluate anatomical and visual results of transconjunctival 25-gauge plus pars plana vitrectomy (PPV) in the management of primary rhegmatogenous retinal detachment (RRD). METHODS: A retrospective analysis of 46 eyes of 46 patients who underwent transconjunctival 25-gauge plus PPV for primary RRD repair between January 2013 and May 2013 with a minimum of 3-month follow-up was performed. Data collected for the study included patient demographics, lens status, preoperative visual acuity, macular status, and location and number of primary breaks. Main outcome measures were anatomical reattachment rate, postoperative visual acuity, operation time, and postoperative complications. RESULTS: The study included 30 men and 16 women. The mean age of the patients was 54.3 years. The locations of retinal breaks were 24 (52.2%) eyes in the superior half, 15 (32.6%) eyes in the inferior half, and 7 (15.2%) eyes on both sides. The macula-on RRD was present preoperatively in 21 (45.7%) of 46 eyes. Of the 33 (71.7%) phakic eyes, 18 (39.1%) underwent combined phacoemulsification, intraocular lens implantation, and PPV. Two different tamponades, C3F8 gas and silicone oil were used in this study. C3F8 gas was injected in the 33 (71.7%) eyes, and the remaining eyes were filled with silicone oil (1,300 centistokes for 11 eyes, 5,700 centistokes for 2 eyes). Mean operation time was 48.8 +/- 13.2 minutes. Retinal reattachment was achieved in 45 (97.8%) of 46 eyes at 3 months. Mean best-corrected visual acuity improved from 1.33 +/- 1.20 log MAR preoperatively to 0.68 +/- 0.94 log MAR postoperatively (p < 0.001). Postoperative complications included transient intraocular pressure elevation in 6 (13.1%) eyes and posterior capsular opacity in 3 (6.5%) eyes. CONCLUSIONS: It seems that transconjunctival 25-gauge plus PPV can be a safe and effective option for surgical management of RRD.
Demography ; Female ; Follow-Up Studies ; Humans ; Intraocular Pressure ; Lens Implantation, Intraocular ; Male ; Outcome Assessment (Health Care) ; Phacoemulsification ; Postoperative Complications ; Retinal Detachment* ; Retinal Perforations ; Retinaldehyde ; Retrospective Studies ; Silicone Oils ; Visual Acuity ; Vitrectomy*

PURPOSE: To evaluate the result of vitrectomy with internal limiting membrane peeling and silicone oil tamponade with short term face-down positioning in highly myopic patients with retinal detachment due to macular hole. METHODS: Eleven eyes of highly myopic patients with retinal detachment caused by macular hole were retrospectively reviewed. All patients underwent pars plana vitrectomy, internal limiting membrane peeling, and silicone oil tamponade with short term (1-3 days) face-down positioning. Silicone oil was removed between 6 and 12 months postoperatively. Outcomes included best-corrected visual acuity, retinal reattachment rate, macular hole closure, and complications. RESULTS: The mean age of patients was 63.3 +/- 8.3 years. During the silicone oil period, all 11 eyes (100%) had complete retinal attachment. After silicone oil removal, retinal detachment recurred in 2 eyes (18.2%). Macular hole closure was observed in 8 eyes (72.7%). The best corrected visual acuity (log MAR) improved from 1.99 +/- 0.94 before surgery to 1.33 +/- 0.62 at final visit. CONCLUSIONS: Pars plana vitrectomy, internal limiting membrane peeling and silicone oil tamponade with short term face-down positioning was effective in treating retinal detachment caused by macular hole in highly myopic eyes.
Humans ; Membranes ; Myopia* ; Prone Position* ; Retinal Detachment* ; Retinal Perforations* ; Retinaldehyde* ; Retrospective Studies ; Silicone Oils* ; Visual Acuity ; Vitrectomy

PURPOSE: To compare the accuracy of refractive outcome measured by Ultrascan(R) (Alcon, Fort Worth, TX, USA) and partial coherence interferometers after phacovitrectomy. METHODS: We performed a retrospective study in 74 eyes of 74 patients who underwent phacovitrectomy. SRK-T formula was used to predict intraocular lens (IOL) power. The difference between the predicted and postoperative refractive outcomes for the 2 methodologies (Ultrascan(R) and IOL Master(R) [Zeiss, Carl Zeiss, Jena, Germany]) were compared. The predicted refractive outcome was defined as the estimated refractive error when the selected IOL was inserted. RESULTS: The axial length measured using IOL Master(R) was statistically longer than when measured using Ultrascan(R) (23.85 +/- 0.15 mm, 23.56 +/- 0.15 mm, p < 0.001). Based on keratometry, statistically significant difference between the 2 groups was not observed. The postoperative refractive error was more accurate when using the IOL Master(R) than Ultrascan(R) (0.08 +/- 0.74, 0.47 +/- 0.69, p < 0.001). However, in cases of vitreous hemorrhage, the postoperative refractive error was 0.42 +/- 0.49 with the IOL Master(R) and 0.07 +/- 0.54 with the Ultrascan(R). CONCLUSIONS: Generally, IOL Master(R) is a more accurate method for calculating the IOL power prior to phacovitrectomy. However, in cases of vitreous hemorrhage, Ultrascan(R) appears superior to IOL Master(R) when calculating the IOL power.
Humans ; Lenses, Intraocular ; Refractive Errors* ; Retrospective Studies ; Ultrasonography* ; Vitreous Hemorrhage

PURPOSE: To compare the accuracy of refractive outcome measured by Ultrascan(R) (Alcon, Fort Worth, TX, USA) and partial coherence interferometers after phacovitrectomy. METHODS: We performed a retrospective study in 74 eyes of 74 patients who underwent phacovitrectomy. SRK-T formula was used to predict intraocular lens (IOL) power. The difference between the predicted and postoperative refractive outcomes for the 2 methodologies (Ultrascan(R) and IOL Master(R) [Zeiss, Carl Zeiss, Jena, Germany]) were compared. The predicted refractive outcome was defined as the estimated refractive error when the selected IOL was inserted. RESULTS: The axial length measured using IOL Master(R) was statistically longer than when measured using Ultrascan(R) (23.85 +/- 0.15 mm, 23.56 +/- 0.15 mm, p < 0.001). Based on keratometry, statistically significant difference between the 2 groups was not observed. The postoperative refractive error was more accurate when using the IOL Master(R) than Ultrascan(R) (0.08 +/- 0.74, 0.47 +/- 0.69, p < 0.001). However, in cases of vitreous hemorrhage, the postoperative refractive error was 0.42 +/- 0.49 with the IOL Master(R) and 0.07 +/- 0.54 with the Ultrascan(R). CONCLUSIONS: Generally, IOL Master(R) is a more accurate method for calculating the IOL power prior to phacovitrectomy. However, in cases of vitreous hemorrhage, Ultrascan(R) appears superior to IOL Master(R) when calculating the IOL power.
Humans ; Lenses, Intraocular ; Refractive Errors* ; Retrospective Studies ; Ultrasonography* ; Vitreous Hemorrhage

PURPOSE: This study was designed to compare the outcomes in idiopathic epiretinal membrane (ERM) surgery according to solvents of indocyanine green (ICG) for internal limiting membrane (ILM) peeling. METHODS: The medical records of 27 patients (27 eyes) with idiopathic ERM who had undergone pars plana vitrectomy with ICG staining for ILM peeling were retrospectively reviewed. The patients were divided into two groups according to solvents of 0.25% ICG solutions. Solvents used were balanced salt solution (BSS) in group I (15 eyes) and 5% glucose in group II (12 eyes). The severity of ERM, the duration of symptoms, the preoperative and postoperative best corrected visual acuity (BCVA) values, the visibility of the stained ILM (Good, Fair, Poor), and the postoperative complications were compared in the two groups. RESULTS: There was no statistically significant difference in the severity of ERM, the duration of symptoms and the preoperative BCVA in the two groups. The postoperative BCVA was significantly improved in both groups, and the difference was not statistically significant (p = 0.675). There was a significantly smaller number of eyes with poor ILM staining in group II than in group I (p = 0.014). No complications such as recurrence of ERM, atrophy of the retinal pigment epithelium (RPE) or retinal detachment were observed in the two groups. CONCLUSIONS: The higher specific gravity of 5% glucose compared with that of BSS as ICG solvents allows for improved ILM visualization. Therefore using the 5% glucose-ICG solution for staining ILM improved the visibility of ILM compared BSS-ICG solution and led to comparable visual recovery.
Atrophy ; Epiretinal Membrane* ; Glucose ; Humans ; Indocyanine Green ; Medical Records ; Membranes* ; Postoperative Complications ; Recurrence ; Retinal Detachment ; Retinal Pigment Epithelium ; Retrospective Studies ; Solvents ; Specific Gravity ; Visual Acuity ; Vitrectomy

PURPOSE: To report the clinical finding of 3 patients with focal choroidal excavation in the macula detected by spectral-domain optical coherence tomography (SD-OCT). CASE SUMMARY: Five eyes of 3 patients with focal choroidal excavation detected by SD-OCT were enrolled in the present study. All patients had myopia (average refractive power -5.60 diopter). Two of the 3 patients had focal choroidal excavation in both eyes. All 5 eyes revealed foveal pigmentary changes on fundus examination. The excavation area in the autofluorescence image was hypofluorescent. Fluorescein angiographic finding was normal to various degrees of hyperfluoresence. Indocyanine green angiography revealed hypofluoresence at the excavation area. The excavation involoved from the retinal pigment epithelium layer to the external limiting membrane or outer nuclear layer and average choroidal thickness at excavation were statistically thinner than the uninvolved area based on SD-OCT (p = 0.002). Retinoschisis, serous pigment epithelial detachment and choroidal neovascularziation (CNV) were detected individually in 3 eyes. The other 2 eyes had no specific abnormalities. CONCLUSIONS: During the follow-up period, the choroidal excavation remained relatively stable in 4 of 5 eyes, but CNV developed in 1 eye. Therefore, intravitreal bevacizumab injection was performed. Longer follow-up periods are necessary to determine the etiology, clinical course and visual prognosis of eyes with focal choroidal excavation.
Angiography ; Choroid* ; Fluorescein ; Follow-Up Studies ; Humans ; Indocyanine Green ; Membranes ; Myopia ; Prognosis ; Retinal Pigment Epithelium ; Retinoschisis ; Tomography, Optical Coherence* ; Bevacizumab

PURPOSE: To compare the anatomical and functional results of vitrectomy for macular hole with and without prone posture. METHODS: We retrospectively reviewed the medical records of 71 eyes of 71 patients who received macular hole repair and were followed up for at least 6 months. The anatomical success, complications, and best corrected visual acuity at postoperative 6 months and last follow-up between patients who were advised to take a prone posture for 1 week (group 1) and patients who were advised to simply avoid the supine position right from the surgery (group 2) were analyzed. Subgroup division analysis according to macular hole size and concurrent phacoemulsification was performed. RESULTS: Macular hole closure rate was 91.7% (33 of 36 eyes) in group 1 and 88.6% (31 of 35 eyes) in group 2 (p=0.710). The mean visual acuity at final follow-up increased in both groups by 4.75 +/- 3.83 and 4.76 +/- 2.96 lines, respectively and revealed no statistically significant difference (p = 0.988). Twenty-seven of 36 eyes (75%) in group 1 and 30 of 35 eyes (85.7%) in group 2 underwent concurrent phacoemulsification, and no difference in macular hole closure rate and visual acuity improvement between the two postures was observed. CONCLUSIONS: Favorable anatomical and functional outcomes were achieved without postoperative face-down posturing in the case of phacovitrectomy with wide internal limiting membrane peeling and gas tamponade.
Follow-Up Studies ; General Surgery* ; Humans ; Medical Records ; Membranes ; Phacoemulsification ; Posture ; Retinal Perforations* ; Retrospective Studies ; Supine Position ; Visual Acuity ; Vitrectomy*

PURPOSE: Vasoproliferative tumor of the retina (VPTR) is a histologically benign lesion that can lead to visual loss due to associated complications. Herein, the authors report the clinical presentation, treatment, and prognosis of 3 VPTR cases. CASE SUMMARY: Three eyes of 3 patients with VPTR were enrolled in the present study. The patients' fundoscopic feature showed characteristic elevated lesions of the peripheral retina without previous history of ocular disease. The patients included 2 males and 1 female, with an average age of 44.7 years. Fluorescein angiography (FAG) and indocyanine green angiography (ICGA) were helpful in establishing the diagnosis of VPTR. Additionally, 1 patient underwent ultrasonography and 2 patients underwent magnetic resonance imaging (MRI). During the follow-up period, subtenon triamcinolone acetonide injection was performed for 1 patient with macular edema, and cryotherapy was performed for 1 patient with increased peripheral exudation. CONCLUSIONS: For an adequate diagnosis of VPTR, careful examination of the peripheral retina is important. In addition, FAG/ICGA and ultrasonography can be helpful in VPTR diagnosis. Furthermore, proper treatment according to each subset of complication during the follow-up period is recommended.
Angiography ; Cryotherapy ; Diagnosis ; Female ; Fluorescein Angiography ; Follow-Up Studies ; Humans ; Indocyanine Green ; Macular Edema ; Magnetic Resonance Imaging ; Male ; Prognosis ; Retina* ; Triamcinolone Acetonide ; Ultrasonography