PURPOSE: To compare long-term refractive outcomes associated with intravitreal anti-vascular endothelial growth factor (VEGF) versus laser photocoagulation treatment for retinopathy of prematurity (ROP). METHODS: A total of 52 eyes from 27 ROP patients treated at two tertiary referral-based hospitals from August 2006 to December 2013 were reviewed. The primary outcome was refractive error measured at the age of 4 years, accounting for within-patient inter-eye correlation. Secondary outcomes included the recurrence rate and treatment complications. RESULTS: The mean age at refraction was 4.7 ± 0.3 years in the laser group (n = 30) and 4.4 ± 0.3 years in the anti-VEGF group (n = 22). No significant differences were noted in gestational age, birthweight, post-menstrual age at treatment, or ROP stage/zone distribution between groups. Mean spherical equivalent was also not significantly different (−1.0 diopters in the laser group and −0.3 diopters in the injection group, p = 0.603). Clustered regression analysis revealed that only gestational age was significantly correlated with mean spherical equivalent (p < 0.001; 95% confidence interval, −0.007 to −0.002). Recurrence was noted in four eyes (13.3%) in the laser group, but this difference was not significant (p = 0.128). There were no major systemic complications reported in either group. CONCLUSIONS: Treatment type, whether laser or anti-VEGF injection, does not appear to influence long-term refractive outcomes in ROP. Concern regarding refractive outcomes should not be the most important factor when selecting ROP treatment modality.
Child ; Child, Preschool ; Endothelial Growth Factors ; Gestational Age ; Humans ; Intravitreal Injections ; Laser Therapy ; Light Coagulation ; Recurrence ; Refractive Errors ; Retinopathy of Prematurity ; Vascular Endothelial Growth Factor A

PURPOSE: To report a case of central serous chorioretinopathy with peripapillary retinoschisis. CASE SUMMARY: A 64-year-old male presented with abnormal color vision of the left eye, which occurred 6 months prior to his visit. At the initial visit, a funduscopic examination revealed retinal elevation with suspected serous retinal detachment around the optic disc in the left eye. Spectral domain optical coherence tomography showed subretinal fluid on the nasal side of the optic disc and retinoschisis on the temporal side of the optic disc in the left eye. Fluorescein angiography revealed multiple leakages in the left eye. Indocyanine green angiography revealed choroidal vascular hyperpermeability in both eyes. Based on these results, the patient was diagnosed with chronic central serous chorioretinopathy and was treated with argon laser photocoagulation at the leakage points. After 8 weeks of laser therapy, optical coherence tomography indicated that there was no retinoschisis or subretinal fluid in the macula, nasal, or temporal sides of the optic disc. CONCLUSIONS: Peripapillary retinoschisis due to central serous chorioretinopathy improves with argon laser photocoagulation at leakage sites.
Angiography ; Argon ; Central Serous Chorioretinopathy ; Choroid ; Color Vision ; Fluorescein Angiography ; Humans ; Indocyanine Green ; Laser Therapy ; Light Coagulation ; Male ; Middle Aged ; Retinal Detachment ; Retinaldehyde ; Retinoschisis ; Subretinal Fluid ; Tomography, Optical Coherence

Diabetic macular edema is one of the most common causes of visual acuity impairment in adults. Various treatment modalities are currently used. They include laser therapy, intravitreal or periocular injection of steroid, intravitreal injection of anti-vascular endothelial growth factor, and pars plana vitrectomy. Introduction of newer therapeutic agents, such as ranibizumab and aflibercept has changed the paradigm of treatment approaches for diabetic macular edema. However, traditional treatment methods, such as laser photocoagulation and vitrectomy, are still being used effectively in certain situations. Each treatment modality has its own unique mode of action, and has advantages and disadvantages at the same time. Given multiple mechanisms are involved in the development of diabetic macular edema, a combination treatment approach is often employed rather than using only one of the treatment modalities. In this review, treatment outcomes of each approach are summarized and combination approaches are discussed.
Adult ; Bevacizumab ; Dexamethasone ; Endothelial Growth Factors ; Humans ; Injections, Intraocular ; Intravitreal Injections ; Laser Therapy ; Light Coagulation ; Macular Edema* ; Ranibizumab ; Visual Acuity ; Vitrectomy

Increasing number of endovenous techniques are available for the treatment of saphenous vein reflux and endovenous laser ablation (EVLA) is a frequently used method. A newly developed alternative, based on thermal therapy, is endovenous microwave ablation (EMA). This study evaluated the effect of the two procedures, in terms of coagulation and histological changes, in occluding lateral veins in goats. Twelve animals were randomized into two group, with 6 treated with EMA (EMA group), and the rest 6 with EVLA (EVLA group). Results of coagulation, including coagulation, fibrinolysis and platelet activation, were assessed at three or four different time points: before, immediately after, 24 h (and 48 h) after ablation. The diameter change, a measure of efficacy, was ultrasonographically measured before and 1 month after the ablation. Histological changes were grossly and microscopically evaluated immediately, 1 and 3 month(s) after the ablation. The length of the ablated vein and preoperative average diameter were comparable between the two groups. In both EMA and EVLA groups, several coagulation parameters, fibrinolysis and platelet activation parameters only underwent slight changes. Ultrasound imaging displayed that the diameter reduction of the veins treated by EMA was significantly larger than by EVLA, in consistent with the results of macroscopic examination. Microscopic examination revealed necrosis and thickening of the vein wall, and occlusion of the lumen within 3 months after ablation in both EMA and EVLA groups. It is concluded that EMA is a minimally invasive therapy, which appears to be safe and effective for treatment of lateral veins in goats.
Animals ; Female ; Fibrinolysis ; Fibrosis ; etiology ; Goats ; Laser Coagulation ; adverse effects ; instrumentation ; methods ; Male ; Microwaves ; therapeutic use ; Necrosis ; etiology ; Platelet Activation ; Postoperative Complications ; Venous Insufficiency ; etiology ; surgery

No abstract available.
Adult ; Basement Membrane/*pathology ; Follow-Up Studies ; Humans ; Laser Coagulation/*methods ; Lasers, Gas/*therapeutic use ; Male ; Retinal Hemorrhage/diagnosis/etiology/*surgery ; Tomography, Optical Coherence ; *Valsalva Maneuver ; Vitreous Hemorrhage/diagnosis/etiology/*surgery

Radiation-induced hemorrhagic gastritis is an intractable and dangerous condition. We describe a 59-year-old female patient with radiation-induced hemorrhagic gastritis. The patient underwent postoperative radiation therapy with a dose of 54 Gy in 30 fractions after a radical operation for a Klatskin tumor. Radiation volume included the gastric antrum. Approximately three months after radiation therapy, she was admitted for melena and anemia. Esophagogastroduodenoscopy showed an area of bleeding in the gastric antrum that was so diffuse that effective laser coagulation was not feasible. After failure of various treatments and transfusion of 7,040 mL of packed red blood cells, we successfully stopped the hemorrhage using oral prednisolone treatment. Based on this case, we think that oral prednisolone treatment can be tried as a first treatment for potentially life-threatening radiation-induced hemorrhagic gastritis.
Anemia ; Endoscopy, Digestive System ; Erythrocytes ; Female ; Gastritis* ; Hemorrhage* ; Humans ; Klatskin's Tumor ; Laser Coagulation ; Melena ; Middle Aged ; Prednisolone* ; Pyloric Antrum

A 52-yr-old male was referred for progressive visual loss in the left eye. The decimal best-corrected visual acuity (BCVA) was 0.01. Fundus examination revealed diffuse retinal pigment epithelial degeneration, focal yellow-white, infiltrative subretinal lesion with fuzzy border and a live nematode within the retina. Diffuse unilateral subacute neuroretinitis (DUSN) was diagnosed and the direct laser photocoagulation was performed to destroy the live nematode. During eight months after treatment, BCVA gradually improved to 0.2 along with the gradual restoration of outer retinal layers on SD-OCT. We report on the first case of DUSN in Korea. DUSN should be included in the differential diagnosis of unexplained unilateral visual loss in otherwise healthy subjects.
Animals ; Blindness/diagnosis/parasitology ; Eye Infections, Parasitic/diagnosis/parasitology/*therapy ; Fundus Oculi ; Humans ; Laser Therapy/methods ; Light Coagulation/methods ; Male ; Middle Aged ; Nematoda/*pathogenicity ; Republic of Korea ; Retinal Pigment Epithelium/*parasitology/pathology ; Retinitis/diagnosis/*parasitology/*therapy ; Visual Acuity

A 52-yr-old male was referred for progressive visual loss in the left eye. The decimal best-corrected visual acuity (BCVA) was 0.01. Fundus examination revealed diffuse retinal pigment epithelial degeneration, focal yellow-white, infiltrative subretinal lesion with fuzzy border and a live nematode within the retina. Diffuse unilateral subacute neuroretinitis (DUSN) was diagnosed and the direct laser photocoagulation was performed to destroy the live nematode. During eight months after treatment, BCVA gradually improved to 0.2 along with the gradual restoration of outer retinal layers on SD-OCT. We report on the first case of DUSN in Korea. DUSN should be included in the differential diagnosis of unexplained unilateral visual loss in otherwise healthy subjects.
Animals ; Blindness/diagnosis/parasitology ; Eye Infections, Parasitic/diagnosis/parasitology/*therapy ; Fundus Oculi ; Humans ; Laser Therapy/methods ; Light Coagulation/methods ; Male ; Middle Aged ; Nematoda/*pathogenicity ; Republic of Korea ; Retinal Pigment Epithelium/*parasitology/pathology ; Retinitis/diagnosis/*parasitology/*therapy ; Visual Acuity

Diabetic retinopathy(DR) is the leading cause of new onset blindness among working-aged groups in industrialized countries, and its incidence is expected to increase along with the rising incidence of diabetes mellitus. Primary interventions such as strict glycemic control, tight blood pressure regulation, and lipid-lowering therapy can significantly reduce the risk of DR occurrence and progression. Currently, laser photocoagulation is the mainstay of treatment of proliferative DR and some cases of diabetic macular edema (DME). However, a considerable number of DR patients still suffer from severe visual impairment in spite of the application of laser photocoagulation and even of pars plana vitrectomy. Considering the limitations of current DR treatments, ongoing efforts have been devoted to the development of new therapeutic strategies, and it has become necessary to focus on pharmacologic treatment. Since inflammation has been identified as playing a substantial role in the pathogenesis of DR, corticosteroids with an anti-inflammatory effect can be included in the treatment of DR, though this may cause cataract and intraocular pressure elevation. The recent discovery of inhibitors of vascular endothelial growth factor is a revolutionary event in the management of DR, specifically DME. Some new agents aiming at the process of angiogenesis and increased vascular permeability are still under investigation, offering hope for a more effective future treatment of this sight-threatening disease. This paper reviews the current state of knowledge of the clinical presentation, preventive management, and clinical therapeutic strategies of DR and DME.
Adrenal Cortex Hormones ; Blindness ; Blood Pressure ; Capillary Permeability ; Cataract ; Developed Countries ; Diabetes Mellitus ; Diabetic Retinopathy* ; Hope ; Humans ; Incidence ; Inflammation ; Intraocular Pressure ; Laser Coagulation ; Light Coagulation ; Macular Edema ; Vascular Endothelial Growth Factor A ; Vascular Endothelial Growth Factors ; Vision Disorders ; Vitrectomy

PURPOSE: To examine the effects of panretinal photocoagulation (PRP) using a pattern scanning laser (PASCAL) system on the retinal nerve fiber layer (RNFL) thickness in patients with diabetic retinopathy. METHODS: This retrospective study included 105 eyes with diabetic retinopathy, which consisted of three groups: the PASCAL group that underwent PRP with the PASCAL method (33 eyes), the conventional group that underwent conventional PRP treatment (34 eyes), and the control group that did not receive PRP (38 eyes). The peripapillary RNFL thickness was measured by optical coherence tomography before, six months, and one year after PRP to evaluate the changes in peripapillary RNFL. RESULTS: The RNFL thickness in the PASCAL group did not show a significant difference after six months (average 3.7 times, p = 0.15) or one year after the PRP (average 3.7 times, p = 0.086), whereas that in the conventional group decreased significantly after six months (average 3.4 times, p < 0.001) and one year after PRP (average 3.4 times, p < 0.001). CONCLUSIONS: The results of this study suggest that the PASCAL system may protect against RNFL loss by using less energy than conventional PRP.
Diabetic Retinopathy/pathology/*surgery ; Disease Progression ; Female ; Fluorescein Angiography ; Fundus Oculi ; Humans ; Laser Coagulation/*methods ; Male ; Middle Aged ; Nerve Fibers/*pathology ; Retinal Ganglion Cells/*pathology ; Retrospective Studies ; Tomography, Optical Coherence ; Visual Acuity