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Kwon HJ, Heo J, Park SH, Park SW, Byon I. Accuracy of generative deep learning model for macular anatomy prediction from optical coherence tomography images in macular hole surgery. Sci Rep 2024; 14:6913. [PMID: 38519532 PMCID: PMC10959933 DOI: 10.1038/s41598-024-57562-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 03/19/2024] [Indexed: 03/25/2024] Open
Abstract
This study aims to propose a generative deep learning model (GDLM) based on a variational autoencoder that predicts macular optical coherence tomography (OCT) images following full-thickness macular hole (FTMH) surgery and evaluate its clinical accuracy. Preoperative and 6-month postoperative swept-source OCT data were collected from 150 patients with successfully closed FTMH using 6 × 6 mm2 macular volume scan datasets. Randomly selected and augmented 120,000 training and 5000 validation pairs of OCT images were used to train the GDLM. We assessed the accuracy and F1 score of concordance for neurosensory retinal areas, performed Bland-Altman analysis of foveolar height (FH) and mean foveal thickness (MFT), and predicted postoperative external limiting membrane (ELM) and ellipsoid zone (EZ) restoration accuracy between artificial intelligence (AI)-OCT and ground truth (GT)-OCT images. Accuracy and F1 scores were 94.7% and 0.891, respectively. Average FH (228.2 vs. 233.4 μm, P = 0.587) and MFT (271.4 vs. 273.3 μm, P = 0.819) were similar between AI- and GT-OCT images, within 30.0% differences of 95% limits of agreement. ELM and EZ recovery prediction accuracy was 88.0% and 92.0%, respectively. The proposed GDLM accurately predicted macular OCT images following FTMH surgery, aiding patient and surgeon understanding of postoperative macular features.
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Affiliation(s)
- Han Jo Kwon
- Department of Ophthalmology, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Gudeok-ro 179, Seo-gu, Busan, 49241, South Korea
| | - Jun Heo
- Department of Ophthalmology, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Gudeok-ro 179, Seo-gu, Busan, 49241, South Korea
| | - Su Hwan Park
- Department of Ophthalmology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Geumo-ro 20, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, 50612, South Korea
| | - Sung Who Park
- Department of Ophthalmology, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Gudeok-ro 179, Seo-gu, Busan, 49241, South Korea
| | - Iksoo Byon
- Department of Ophthalmology, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Gudeok-ro 179, Seo-gu, Busan, 49241, South Korea.
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Kim E, Kwon HJ, Park SW, Byon I. Effect of topical bromfenac on intraretinal cystoid lesion in simultaneous cataract and idiopathic epiretinal membrane surgery. BMC Ophthalmol 2024; 24:120. [PMID: 38491368 PMCID: PMC10943811 DOI: 10.1186/s12886-024-03380-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 03/04/2024] [Indexed: 03/18/2024] Open
Abstract
PURPOSE To investigate the effect of topical nonsteroidal anti-inflammatory drugs (NSAIDs,) bromfenac on the intraretinal cystic lesions (IRC) when performing simultaneous cataract and idiopathic epiretinal membrane (iERM) surgery. METHODS This study included patients with iERM who had been followed up for 6 months after vitrectomy, membrane removal, and concurrent cataract surgery. Eyes were treated with topical bromfenac or not. The baseline fluorescein angiography (FA) was obtained to assess the microvascular leakage (ML). Structural changes of macula, including IRC and central macular thickness (CMT) were assessed using optical coherence tomography (OCT). The main outcome measures were changes in IRCs and best-corrected visual acuity (BCVA) regarding FA findings. RESULTS One hundred eighteen eyes were included. IRC and ML were observed in 51 eyes (43.2%) and 63 eyes (53.4%), respectively. The IRC did not show any association with the ML. Of total, 29 eyes (24.6%) were treated with topical bromfenac (Group A). Compared to Group B, topical bromfenac did not show beneficial effects in aspect of preventions for the newly developed IRC and treatment for pre-existed IRC. Whether the ML existed or not, topical bromfenac did not show any different effect on the changes in BCVA and IRC. CONCLUSION When performing simultaneous cataract and ERM surgery, topical NSAIDs, bromfenac did not show beneficial effects on the preventions and treatment of IRC in both eyes with and without the ML.
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Affiliation(s)
- EunAh Kim
- Department of Ophthalmology, Inje University Haeundae Paik Hospital, Busan, South Korea
| | - Han Jo Kwon
- Department of Ophthalmology, Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Sung Who Park
- Department of Ophthalmology, Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
- Pusan National University School of Medicine, Yangsan, South Korea
| | - Iksoo Byon
- Department of Ophthalmology, Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea.
- Pusan National University School of Medicine, Yangsan, South Korea.
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Park SW, Kim KH, Kwon HJ, Byon IS, Khan YH, Nguyen QD. Ocular syphilis masquerading as refractory retinal diseases. BMC Infect Dis 2024; 24:165. [PMID: 38326787 PMCID: PMC10848460 DOI: 10.1186/s12879-023-08739-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 10/23/2023] [Indexed: 02/09/2024] Open
Abstract
PURPOSE To report two cases of syphilis masquerading as chronic refractory macular diseases. CASE DESCRIPTIONS Two patients had been diagnosed with neovascular age-related macular degeneration (neovascular AMD) and diabetic macular edema (DME), respectively. The disease worsened despite repeated intravitreal injections of anti-vascular endothelial growth factor (VEGF) and also surgical treatment (in suspected case of DME). Systemic evaluations were positive for syphilis. Intravenous penicillin was started, and the macular diseases improved. The lesions were well controlled afterward. CONCLUSIONS The current two cases demonstrated that ocular syphilis can masquerade as refractory chronic retinal diseases such as DME and neovascular AMD. Laboratory evaluations for syphilis may be needed, not only for uveitis but also for refractory retinal diseases. Indocyanine green angiography may be helpful to reveal occult syphilis.
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Affiliation(s)
- Sung Who Park
- Department of Ophthalmology, School of Medicine, Pusan National University, Busan, South Korea
- Medical Research Institute, School of Medicine, Pusan National University Hospital, Busan, South Korea
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University, 2370 Watson Court, Suite 200, Palo Alto, CA, 94303, USA
| | - Kye-Hyung Kim
- Department of Infection, School of Medicine, Pusan National University, Busan, South Korea
| | - Han Jo Kwon
- Department of Ophthalmology, School of Medicine, Pusan National University, Busan, South Korea
- Medical Research Institute, School of Medicine, Pusan National University Hospital, Busan, South Korea
| | - Ik Soo Byon
- Department of Ophthalmology, School of Medicine, Pusan National University, Busan, South Korea
- Medical Research Institute, School of Medicine, Pusan National University Hospital, Busan, South Korea
| | - Youan Hasan Khan
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University, 2370 Watson Court, Suite 200, Palo Alto, CA, 94303, USA
| | - Quan Dong Nguyen
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University, 2370 Watson Court, Suite 200, Palo Alto, CA, 94303, USA.
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Choi SK, Byon IS, Kwon HJ, Park SW. Case series of neuroretinitis in Korea. BMC Ophthalmol 2024; 24:24. [PMID: 38238693 PMCID: PMC10795416 DOI: 10.1186/s12886-024-03290-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 01/10/2024] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND To present the clinical characteristics of neuroretinitis in Korea. METHODS Twelve patients with neuroretinitis between January 2009 and September 2020 were retrospectively reviewed. Neuroretinitis was diagnosed based on fundus findings, optical coherence tomography, and fluorescein angiography. The serological findings of each patient were reviewed. RESULTS Fifteen eyes of 12 patients (9 male and 3 female), with a mean age of 46.0 ± 10.7 years were included. Of the nine patients who underwent serological testing for Toxocara antibodies, six (66.6%) were positive. One patient had high titers of Toxoplasma immunoglobulins M and G. One patient diagnosed with dengue fever was suspected to have neuroretinitis in both eyes. There were no related abnormalities in the serological findings in four patients (33.3%) out of 12 patients. There were no suspected cases of cat-scratch disease. The six patients who were positive for Toxocara antibodies were older (mean age: 54.5 ± 9.1 years) than the others (mean age: 37.5 ± 4.4 years, p = 0.004). The four patients without any abnormal serological findings were relatively younger (mean age: 35.7 ± 3.0 years) than the other 8 patients (mean age: 51.1 ± 10.1 years, p = 0.008). CONCLUSIONS Two-thirds of neuroretinitis patients were seropositive for Toxocara in the current cohort from Koreans. Causative factors in cases of neuroretinitis may vary according to age and region.
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Affiliation(s)
- Seung Kwon Choi
- Department of Ophthalmology, Pusan National University College of Medicine, Busan, South Korea
- Department of Ophthalmology, Biomedical Research Institute, Pusan National University Hospital, 179, Gudeok-ro, Seo-gu, Busan, 49241, South Korea
| | - Ik Soo Byon
- Department of Ophthalmology, Pusan National University College of Medicine, Busan, South Korea
- Department of Ophthalmology, Biomedical Research Institute, Pusan National University Hospital, 179, Gudeok-ro, Seo-gu, Busan, 49241, South Korea
| | - Han Jo Kwon
- Department of Ophthalmology, Pusan National University College of Medicine, Busan, South Korea
- Department of Ophthalmology, Biomedical Research Institute, Pusan National University Hospital, 179, Gudeok-ro, Seo-gu, Busan, 49241, South Korea
| | - Sung Who Park
- Department of Ophthalmology, Pusan National University College of Medicine, Busan, South Korea.
- Department of Ophthalmology, Biomedical Research Institute, Pusan National University Hospital, 179, Gudeok-ro, Seo-gu, Busan, 49241, South Korea.
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Kang MS, Kwon HJ. RETINAL NEOVASCULARIZATION IN ACQUIRED PERIPHERAL RETINOSCHISIS THROUGH INNER RETINAL ISCHEMIA: OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHIC FINDINGS. Retin Cases Brief Rep 2023; 17:702-709. [PMID: 35594561 PMCID: PMC10597440 DOI: 10.1097/icb.0000000000001292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE To present two cases of concomitant retinal neovascularization (RNV) in acquired peripheral retinoschisis and analyze its characteristics on optical coherence tomography angiography and based on a literature review. METHODS This was an observational, retrospective case study. RESULTS Case 1 presented with bullous retinoschisis and RNV near the schisis cavity. Optical coherence tomography angiography revealed no angioflow into the retinal arterioles of the cavity. An arterial filling delay to the retinoschisis with extensive leakage from the RNV was noted on fluorescein angiography. Case 2 involved the superficial retinoschisis and telangiectatic vessels inside the schisis cavity. Optical coherence tomography angiography revealed damage to the superficial capillary plexus of the cavity, absence of angioflow to the inner schisis layer, and increased angioflow to the RNV. Fluorescein angiography showed focal leakage from the RNV and diffuse leakage from telangiectasia. No vision-threatening complications were identified in either patient up to the last follow-up, subsequent to laser photocoagulation. CONCLUSION Acquired peripheral retinoschisis is associated with RNV. Inner retinal ischemia caused by hemodynamic resistance or a damaged superficial capillary plexus can interrupt angioflow to the inner schisis retinal layer on optical coherence tomography angiographic findings and develop RNV inside or outside the retinoschisis.
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Affiliation(s)
- Min Seung Kang
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea
- Department of Ophthalmology, Pusan National University Yangsan Hospital, Yangsan, South Korea; and
| | - Han Jo Kwon
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea
- Department of Ophthalmology, Pusan National University Yangsan Hospital, Yangsan, South Korea; and
- Department of Ophthalmology, Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
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Kim E, Byon I, Lee JJ, Seol YM, Kwon HJ, Park SW, Lee JE. Endogenous Endophthalmitis From a Klebsiella pneumoniae Liver Abscess: The Incidence, Risk Factors, and Utility of Imaging. Am J Ophthalmol 2023; 252:69-76. [PMID: 36963602 DOI: 10.1016/j.ajo.2023.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 03/09/2023] [Accepted: 03/14/2023] [Indexed: 03/26/2023]
Abstract
PURPOSE We investigated the rate of ophthalmologic examinations to detect endogenous endophthalmitis in patients with pyogenic liver abscesses (PLAs) and the incidence and risk factors of endophthalmitis from a PLA caused by Klebsiella pneumoniae (PLA-K). DESIGN Retrospective case series. METHODS A total of 536 patients admitted to a university hospital in Korea to treat PLAs during 2012-2022 were included. The proportion of patients who were referred for ophthalmologic examinations was investigated and the incidence of endophthalmitis in 248 patients with PLA-K was calculated. Univariate and multivariate logistic regression analyses were performed to define risk factors including demographic characteristics, underlying diseases, radiologic findings, and systemic conditions. RESULTS A comprehensive ophthalmologic examination was performed in 73.7% of all patients with PLAs, and the incidence of endophthalmitis from a PLA-K was 7.3%. A liver abscess >5 cm increased the incidence of endogenous endophthalmitis 4-fold compared with smaller abscesses (odds ratio [OR] = 4.01 [95% confidence interval {CI}, 1.02-15.78], P = .047) and portal or hepatic vein thrombophlebitis increased the incidence approximately 4-fold (OR = 4.04 [95% CI, 1.10-14.83], P = .036). Acute cholangitis was approximately 8-fold (OR = 8.33 [95% CI, 1.25-55.71], P = .029), and disseminated intravascular coagulation was approximately 6-fold (OR = 5.76 [95% CI, 1.22-27.21], P = .027) more related to prevalence of endophthalmitis. Other extrahepatic infections increased the incidence approximately 43-fold (OR = 43.06 [95% CI, 10.14-182.90], P < .001). CONCLUSIONS Clinicians should consider the risk of endogenous endophthalmitis when PLA-K patients have large liver abscesses (>5 cm), acute cholangitis, portal or hepatic vein thrombophlebitis, disseminated intravascular coagulation, or other extrahepatic infections.
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Affiliation(s)
- EunAh Kim
- Department of Ophthalmology (E.K., I.B., H.J.K., S.W.P., J.E.L.), Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea; Department of Ophthalmology (E.K.), Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea.
| | - Iksoo Byon
- Department of Ophthalmology (E.K., I.B., H.J.K., S.W.P., J.E.L.), Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | | | - Young Mi Seol
- Department of Internal Medicine (Y.M.S.), Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Han Jo Kwon
- Department of Ophthalmology (E.K., I.B., H.J.K., S.W.P., J.E.L.), Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Sung Who Park
- Department of Ophthalmology (E.K., I.B., H.J.K., S.W.P., J.E.L.), Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Ji Eun Lee
- Department of Ophthalmology (E.K., I.B., H.J.K., S.W.P., J.E.L.), Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea; Lee Eye Clinic (J.E.L.), Busan, South Korea
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Lim YJ, Byon I, Kim HW, Park SW, Kwon HJ, Kim E. Incidence and Risk Factors of Recurrent Anterior Uveitis in Initial Acute-Onset Vogt-Koyanagi-Harada Disease. Korean J Ophthalmol 2023; 37:299-306. [PMID: 37400085 PMCID: PMC10427900 DOI: 10.3341/kjo.2023.0017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 04/25/2023] [Accepted: 06/23/2023] [Indexed: 07/05/2023] Open
Abstract
PURPOSE We report the estimated incidence of, and risk factors for, recurrent anterior uveitis in patients with initial acute-onset Vogt-Koyanagi-Harada (VKH) disease using survival analyses. METHODS Patients who were diagnosed with initial acute-onset VKH disease during 2003-2022 at two university hospitals were included. Recurrent anterior uveitis was defined as the first occurrence of the granulomatous anterior uveitis with anterior chamber cells and flare of 2+ or more by the Standardization of Uveitis Nomenclature (SUN) Working Group grading scheme, after the disappearance of conspicuous uveitis and serous retinal detachment for at least 3 months, regardless of systemic or local treatment. The univariate log-rank test and multivariate Cox regression analyses were performed, including patients' demographic characteristics, underlying diseases, presence of prodromal symptoms, duration of visual symptoms, visual acuity, slit-lamp and fundus findings, and height of serous retinal detachment. The treatment method and response to treatment were also included. RESULTS The estimated incidence was 39.3% at 10 years. Fifteen of 55 patients (27.3%) had recurrent anterior uveitis during the mean follow-up of 4.5 years. The presence of focal posterior synechiae at the diagnosis increased the risk of recurrent anterior uveitis 6.97-fold compared to the absence of synechiae (95% confidence interval [CI], 2.20-22.11; p < 0.001). Use of systemic high-dose steroid therapy more than 7 days after the development of visual symptoms resulted in a hazard ratio of 4.55 (95% CI, 1.27-16.40; p = 0.020). CONCLUSIONS This study reports the estimated incidence and risk factors of recurrent anterior uveitis in VKH disease from survival analyses. However, because of the retrospective nature of this study, it is hard to confirm the consistency of the medical records regarding risk factors, thus, the presence of focal posterior synechiae can be inconclusive as a risk factor. Further studies are warranted.
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Affiliation(s)
- Yeon Ju Lim
- Department of Ophthalmology, Inje University Haeundae Paik Hospital, College of Medicine, Inje University, Busan,
Korea
| | - Iksoo Byon
- Department of Ophthalmology, Pusan National University Hospital, Pusan National University School of Medicine, Busan,
Korea
| | - Hyun Woong Kim
- Department of Ophthalmology, Inje University Haeundae Paik Hospital, College of Medicine, Inje University, Busan,
Korea
| | - Sung Who Park
- Department of Ophthalmology, Pusan National University Hospital, Pusan National University School of Medicine, Busan,
Korea
| | - Han Jo Kwon
- Department of Ophthalmology, Pusan National University Hospital, Pusan National University School of Medicine, Busan,
Korea
| | - EunAh Kim
- Department of Ophthalmology, Inje University Haeundae Paik Hospital, College of Medicine, Inje University, Busan,
Korea
- Department of Ophthalmology, Pusan National University Hospital, Pusan National University School of Medicine, Busan,
Korea
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Kwon HJ, Kang MS, Park SW, Byon I. TOPOGRAPHIC ASSESSMENT OF INTRARETINAL CYSTOID SPACE AND ITS PROGNOSTIC VALUES IN IDIOPATHIC EPIRETINAL MEMBRANE. Retina 2023; 43:1321-1330. [PMID: 37104817 DOI: 10.1097/iae.0000000000003819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
PURPOSE To assess the topographical distribution of intraretinal cystoid space (IRC) and its prognostic value in idiopathic epiretinal membrane (iERM). METHODS One hundred twenty-two eyes of iERM that had been followed up for 6 months after membrane removal were included. Based on the baseline IRC distribution, the eyes were divided into Groups A, B, and C (absence, IRC within 3 mm, and 6 mm from the fovea, respectively). The best-corrected visual acuity (BCVA), central subfield macular thickness (CSMT), ectopic inner foveal layer, and microvascular leakage (ML) were assessed. RESULTS Fifty-six eyes (45.9%) had IRC, of which 35 (28.7%) were in Group B and 21 (17.2%) in Group C at baseline. Compared with group B, group C showed worse BCVA, thicker CSMT, and a greater association with ML (OR = 5.415; P = 0.005) at baseline; and also presented with worse BCVA, thicker CSMT, and wider distribution of IRC postoperatively. A wide distribution of IRC was an unfavorable baseline factor in achieving good visual acuity (OR = 2.989; P = 0.031). CONCLUSION Widely distributed IRCs were associated with advanced disease phenotype as poor BCVA, thick macula, and baseline ML in iERM and also showed a poor visual outcome after membrane removal.
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Affiliation(s)
- Han Jo Kwon
- Department of Ophthalmology, Pusan National University School of Medicine, Gyeongsangnam-do, South Korea
- Department of Ophthalmology, Biomedical Research Institute, Pusan National University Hospital, Gudeok-ro, South Korea
- Department of Ophthalmology, Pusan National University, Yangsan Hospital, Gyeongsangnam-do, South Korea; and
| | - Min Seung Kang
- Department of Ophthalmology, Pusan National University, Yangsan Hospital, Gyeongsangnam-do, South Korea; and
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Gyeongsangnam-do, South Korea
| | - Sung Who Park
- Department of Ophthalmology, Pusan National University School of Medicine, Gyeongsangnam-do, South Korea
- Department of Ophthalmology, Biomedical Research Institute, Pusan National University Hospital, Gudeok-ro, South Korea
| | - Iksoo Byon
- Department of Ophthalmology, Pusan National University School of Medicine, Gyeongsangnam-do, South Korea
- Department of Ophthalmology, Biomedical Research Institute, Pusan National University Hospital, Gudeok-ro, South Korea
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Park BH, Kwon HJ, Park SW, Lee JE, Byon I. A Case of Lyme Disease Presenting as Bilateral Panuveitis. Ocul Immunol Inflamm 2023:1-6. [PMID: 37433086 DOI: 10.1080/09273948.2023.2231534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 06/22/2023] [Accepted: 06/24/2023] [Indexed: 07/13/2023]
Abstract
Here, we describe a case of Lyme disease presenting as bilateral panuveitis. A 25-year-old woman presented to our clinic with decreased visual acuity of 20/320 and 20/160 in the right and left eye, respectively. An ophthalmic examination revealed the presence of anterior chamber cells 3+, vitreous cells 1+, vitreous haziness 2+/1+, and retinal infiltration in both eyes. She also had fever, headache, and difficulty in breathing. An initial blood analysis did not detect infection; however, high levels of erythrocyte sedimentation rate and C-reactive protein were noted. Pleural and pericardial effusions, and multiple reactive arthritis lesions were observed on chest computed tomography and bone scans, respectively. Oral steroids (30 mg/day) and steroid eye drops were initiated. Ten days later, she was diagnosed with Lyme disease, based on an indirect immunofluorescence antibody test. Ceftriaxone (2 g) was intravenously administered for 2 weeks followed by administration of oral trimethoprim-sulfamethoxazole (400 mg/80 mg/day) for 1 week. Thereafter, she received a 4-week course of doxycycline (100 mg) twice daily. Her symptoms and ocular findings improved; however, a gradually increasing dose of oral steroid was needed to control retinal lesions for some time, since multiple retinitis lesions developed in the peripheral retina after tapering the oral steroid dose to 5 mg/day. In conclusion, panuveitis can occur in patients with Lyme disease and can be treated with systemic antibiotics and steroids.
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Affiliation(s)
- Bo Hyun Park
- Department of Ophthalmology, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, South Korea
| | - Han Jo Kwon
- Department of Ophthalmology, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, South Korea
| | - Sung Who Park
- Department of Ophthalmology, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, South Korea
| | - Jeong Eun Lee
- Division of Infectious Disease, Department Internal Medicine, Pusan National University School of Medicine and Medical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Iksoo Byon
- Department of Ophthalmology, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, South Korea
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Park BH, Kim J, Park SH, Kang MS, Lee JJ, Lee SM, Park SW, Byon IS, Park HJ, Lee JE, Kwon HJ. Incidence and Clinical Course of Acute Endophthalmitis after Idiopathic Epiretinal Membrane Surgery with Microincision Vitrectomy. J Korean Ophthalmol Soc 2023. [DOI: 10.3341/jkos.2023.64.2.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
Purpose: To investigate the incidence and clinical course of acute endophthalmitis after idiopathic epiretinal membrane (iERM) surgery employing microincision vitrectomy (MIVS).Methods: We retrospectively reviewed the medical records of eyes with acute endophthalmitis developing after iERM surgery via 23- or 25-gauge MIVS from 2011 to 2021. The incidence, culture-positive rate (and responsible bacteria), final visual acuity (VA), and factors affecting poor visual outcomes were assessed.Results: Acute endophthalmitis developed in 20 of the 12,921 eyes (0.15%) after MIVS. Of these, 14 of 3,180 eyes treated via iERM (0.44%, one per 227 procedures) developed endophthalmitis; the incidence ratio (iERM versus non-iERM) was 7.1 (<i>p</i> < 0.001, 95% confidence interval [CI] = 2.6-22.7). At least one sclerotomy remained unsutured in all eyes after iERM surgery. Thirteen eyes (92.9%) were given intravitreal antibiotic injections after emergency vitrectomy, and one eye was treated with intravitreal antibiotic injection alone. <i>Staphylococcus epidermidis</i> was cultured from four eyes (28.6%); three strains were methicillin-resistant. All final VAs were not better than the initial VAs; the average VA decreased from 20/42 to 20/259 (<i>p</i> < 0.001). Six eyes (42.9%) attained legal blindness status (final VA < 20/200); Macular invasion was a unique risk factor for such blindness (<i>p</i> = 0.020, odds ratio = 35.0, 95% CI = 1.7-703.0).Conclusions: Acute endophthalmitis developing after iERM surgery with MIVS was more common than such endophthalmitis after other retinal surgery. Approximately 40% of the former patients became legally blind, and the risk was higher in eyes with macular involvement of endophthalmitis.
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Jo SH, Kim SH, Lee SM, Byon IS, Lee JE, Kwon HJ. Bilateral Extensive Syphilitic Punctate Inner Retinitis Triggering Macular Ischemia after Intravitreal Triamcinolone Injections. J Korean Ophthalmol Soc 2022. [DOI: 10.3341/jkos.2022.63.12.1038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Purpose: To report a case of extensive syphilitic punctate inner retinitis (SPIR) triggering bilateral macular ischemia after intravitreal triamcinolone injections, and the multimodal retinal imaging findings.Case summary: A 69-year-old male patient with nonproliferative diabetic retinopathy was transferred to our hospital because of bilateral visual deterioration (to counting fingers) after the first intravitreal triamcinolone injection. Fundus examination revealed numerous yellow punctate precipitates in the superficial retinae, retinal arteriolitis, and vitritis. The punctate lesions and surrounding retinal regions showed decreased vascular density on optical coherence tomography angiography, and focal hypofluorescence on fluorescein angiography. The patient was positive for all of the Venereal Disease Research Laboratory test, the fluorescent treponemal antibody-absorption test, and <i>Treponema pallidum</i> hemagglutination; we diagnosed bilateral SPIR. After treatment with aqueous crystalline penicillin solutions (24 million units per day for 14 days), the punctate lesions reduced but arteriolitis progressed to obliterative vasculitis. After 6 months, the bilateral SPIR and vitritis resolved, and the bilateral visual acuity improved to 20/100. However, inner retinal and macular ischemia persisted because of capillary nonperfusion attributable to obliterative vasculitis.Conclusions: Extensive SPIR can develop after an initial intravitreal steroid injection; the inner retinal ischemia and visual loss may persist after treatment because obliterative vasculitis develops. Therefore, patients scheduled for intravitreal steroid injections should be screened for syphilis infection.
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Abstract
INTRODUCTION We present a case of ischemic retinal vasculitis in adult-onset Henoch-Schönlein purpura (HSP) and the first report of capillary reperfusion through regenerative angiogenesis using optical coherence tomography angiography (OCTA). CASE REPORT A 34-year-old male complained of bilateral blurred vision after successive episodes of abdominal pain, purpura, and hematuria. Fundus examination showed perivascular infiltration and phlebitis. Fluorescein angiography and OCTA revealed extensive capillary nonperfusion. Laser photocoagulation was performed on the peripheral nonperfused area. Intravenous methylprednisolone with azathioprine was administered and continuously tapered. With consecutive OCTA follow-up, the capillary nonperfusion of the maculae progressively reperfused. Capillary buds and loops emerged within the nonperfused area, continued to elongate and branch, and finally connected with adjacent preexisting capillaries. CONCLUSIONS Regenerative angiogenesis was the mainstay process for capillary reperfusion in this patient. Systemic steroid therapy might support capillary reperfusion and recover the damaged ischemic maculae from ischemic retinal vasculitis of HSP.
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Affiliation(s)
- Min Seung Kang
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea.,Department of Ophthalmology, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Han Jo Kwon
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea.,Department of Ophthalmology, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Ji Eun Lee
- Department of Ophthalmology,Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea.,Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, South Korea.,Lee Eye Clinic, Busan, South Korea
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13
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Kang MS, Kim SY, Kwon HJ. Case Report: Recanalization of Branch Retinal Artery Occlusion Due to Microthrombi Following the First Dose of SARS-CoV-2 mRNA Vaccination. Front Pharmacol 2022; 13:845615. [PMID: 35401231 PMCID: PMC8988066 DOI: 10.3389/fphar.2022.845615] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 02/25/2022] [Indexed: 11/25/2022] Open
Abstract
Background: We report on a patient with a branch retinal artery occlusion (RAO) and its recanalization based on multimodal retinal and angiographic images after he was administered the first dose of the SARS-CoV-2 mRNA vaccine. Case summary: A 64-year-old man complained of a right, painless, inferior field defect 3 days after the first dose of BNT162b2 vaccination. Fundus examination revealed decolorization of the right upper macula, including microthrombi in the superior proximal branch of the retinal artery. Optical coherence tomography angiography revealed upper macular hypoperfusion. Fluorescein angiography revealed prolonged arteriovenous transit to the macula. After paracentesis with antiplatelet medications, the artery was recanalized as the thrombi dissolved, and the right visual field was recovered. Re-occlusion did not occur during the 3 months after the second mRNA vaccination. Conclusion: Non-embolic thrombotic RAO may develop shortly after the SARS-CoV-2 mRNA vaccine. Ophthalmologists should consider RAO as a possible post-vaccination adverse event. The temporal association between mRNA vaccination and RAO onset with evidence of microthrombi might provide additional clues to elucidate the unpredictive arterial thrombosis following SARS-CoV-2 mRNA vaccination.
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Affiliation(s)
- Min Seung Kang
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea
- Department of Ophthalmology, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Sang Yoon Kim
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea
- Department of Ophthalmology, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Han Jo Kwon
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea
- Department of Ophthalmology, Pusan National University Yangsan Hospital, Yangsan, South Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
- *Correspondence: Han Jo Kwon,
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14
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Choi Y, Kim SH, Choi SK, Lee JJ, Lee SM, Kwon HJ, Park SW, Lee JE, Byon IS. Intraocular Cytokine Changes in Patients with Polypoidal Choroidal Vasculopathy Treated with Ranibizumab. J Korean Ophthalmol Soc 2022. [DOI: 10.3341/jkos.2022.63.2.166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Purpose: To investigate the changes in intraocular cytokines after ranibizumab treatment in patients with polypoidal choroidal vasculopathy (PCV).Methods: This multicenter, prospective study enrolled patients with PCV treated with three monthly ranibizumab followed by a pro re nata regimen for 24 weeks. Best corrected visual acuity, slit lamp examination, fundus photography, and optical coherence tomography were performed every 4 weeks. Aqueous humor was collected to measure intraocular cytokines at baseline, week 8, and the time of recurrence or week 20. The association of changes in intraocular cytokines with visual acuity, central macular thickness, central choroidal thickness, area of abnormal vessels, and polyp closure was assessed.Results: This study included 25 eyes. The mean patient age was 70.3 ± 6.1 years. The vascular endothelial growth factor (VEGF) concentration decreased at week 8, but only interferon (IFN)-γ, tissue inhibitors of matrix metalloproteinases (TIMP)-2, and monocyte chemoattractant protein (MCP)-2 decreased at the time of recurrence. The recurrence interval was positively associated with the baseline epithelial-neutrophil activating peptide (ENA)-78, interleukin (IL)-17, leptin, and transforming growth factor-β1, and baseline central macular thickness was positively correlated with the baseline fibroblast growth factor-4 and IL-10. Thick central choroidal thickness was associated with a low basic fibroblast growth factor and high IFN-γ at baseline. The MCP-3 and Tie-2 levels decreased in two eyes with polyp closure.Conclusions: Ranibizumab significantly reduced intraocular VEGF concentrations and consequently improved PCV. However, the cytokines IFN-γ, TIMP-2, and MCP-2, rather than VEGF, were associated with PCV recurrence. Further studies of intraocular cytokines involved in neovascularization in PCV are needed.
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15
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Kim SY, Kang MS, Kwon HJ. Bilateral Panuveitis Mimicking Vogt-Koyanagi-Harada Disease following the First Dose of ChAdOx1 nCoV-19 Vaccine. Ocul Immunol Inflamm 2022; 30:1218-1221. [PMID: 35113750 DOI: 10.1080/09273948.2022.2026410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
METHOD We report a case of bilateral panuveitis and its resolution based on multimodal retinal images after she was administered the first dose of a viral vector-based vaccine against SARS-CoV-2. CASE REPORT A 72-year-old woman complained of bilateral blurred vision with headache, neck stiffness, and tinnitus 3 days after receiving the first dose of the ChAdOx1 nCoV-19 vaccine. Initial examination revealed anterior chamber reactions, left optic disc hyperemia, and bilateral chorioretinal folds with choroidal thickening. Fluorescein and indocyanine green angiography revealed bilateral choroiditis and papillitis. Systemic steroid therapy dramatically alleviated panuveitis and meningeal signs. No recurrence was noted until 3 months after discontinuation of steroids. CONCLUSIONS Bilateral panuveitis mimicking Vogt-Koyanagi-Harada disease can develop shortly after the first dose of the ChAdOx1 nCoV-19 vaccine. Ophthalmologists should consider bilateral panuveitis as a presumed post-vaccination adverse event. Systemic steroid therapy may be effective for the nCoV-19 vaccine-associated panuveitis.
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Affiliation(s)
- Sang Yoon Kim
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea.,Department of Ophthalmology, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Min Seung Kang
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea.,Department of Ophthalmology, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Han Jo Kwon
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea.,Department of Ophthalmology, Pusan National University Yangsan Hospital, Yangsan, South Korea
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16
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Mitchell D, Kwon HJ, Kubica PA, Huff WX, O’Regan R, Dey M. Brain metastases: An update on the multi-disciplinary approach of clinical management. Neurochirurgie 2022; 68:69-85. [PMID: 33864773 PMCID: PMC8514593 DOI: 10.1016/j.neuchi.2021.04.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/16/2021] [Accepted: 04/03/2021] [Indexed: 01/03/2023]
Abstract
IMPORTANCE Brain metastasis (BM) is the most common malignant intracranial neoplasm in adults with over 100,000 new cases annually in the United States and outnumbering primary brain tumors 10:1. OBSERVATIONS The incidence of BM in adult cancer patients ranges from 10-40%, and is increasing with improved surveillance, effective systemic therapy, and an aging population. The overall prognosis of cancer patients is largely dependent on the presence or absence of brain metastasis, and therefore, a timely and accurate diagnosis is crucial for improving long-term outcomes, especially in the current era of significantly improved systemic therapy for many common cancers. BM should be suspected in any cancer patient who develops new neurological deficits or behavioral abnormalities. Gadolinium enhanced MRI is the preferred imaging technique and BM must be distinguished from other pathologies. Large, symptomatic lesion(s) in patients with good functional status are best treated with surgery and stereotactic radiosurgery (SRS). Due to neurocognitive side effects and improved overall survival of cancer patients, whole brain radiotherapy (WBRT) is reserved as salvage therapy for patients with multiple lesions or as palliation. Newer approaches including multi-lesion stereotactic surgery, targeted therapy, and immunotherapy are also being investigated to improve outcomes while preserving quality of life. CONCLUSION With the significant advancements in the systemic treatment for cancer patients, addressing BM effectively is critical for overall survival. In addition to patient's performance status, therapeutic approach should be based on the type of primary tumor and associated molecular profile as well as the size, number, and location of metastatic lesion(s).
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Affiliation(s)
- D Mitchell
- Department of Neurosurgery, Indiana University School of Medicine, Indiana University Purdue University Indianapolis, IN, USA
| | - HJ Kwon
- Department of Neurosurgery, Indiana University School of Medicine, Indiana University Purdue University Indianapolis, IN, USA
| | - PA Kubica
- Department of Neurosurgery, University of Wisconsin School of Medicine & Public Health, UW Carbone Cancer Center, Madison, WI, USA
| | - WX Huff
- Department of Neurosurgery, Indiana University School of Medicine, Indiana University Purdue University Indianapolis, IN, USA
| | - R O’Regan
- Department of Medicine/Hematology Oncology, University of Wisconsin School of Medicine & Public Health, UW Carbone Cancer Center, Madison, WI, USA
| | - M Dey
- Department of Neurosurgery, University of Wisconsin School of Medicine & Public Health, UW Carbone Cancer Center, Madison, WI, USA,Correspondence Should Be Addressed To: Mahua Dey, MD, University of Wisconsin School of Medicine & Public Health, 600 Highland Ave, Madison, WI 53792; Tel: 317-274-2601;
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17
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Kim SY, Kim TH, Lee SJ, Kwon HJ. Endophthalmitis Caused by Curtobacterium pusillum Following Open Globe Injury. J Korean Ophthalmol Soc 2021. [DOI: 10.3341/jkos.2021.62.9.1292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Purpose: To report the first case of <i>Curtobacterium</i> endophthalmitis within 6 hours after open globe injury, with extensive phlebitis and secondary subretinal neovascularization. Case summary: A 53-year-old man with hypersensitivity to beta-lactam antibiotics was admitted due to visual disturbance in the left eye experienced while working in a rural area. Fundus examination was impossible due to a full-layer corneal laceration and traumatic cataract in the left eye. B-scan ultrasonography and orbital computed tomography showed no shadowing of retained intraocular foreign bodies. After a corneal scraping smear, primary closure, lensectomy, and vitrectomy were performed. Organic material was observed in a focal area of pale macula, accompanied by extensive retinal phlebitis in the mid-periphery. After diagnosing acute bacterial endophthalmitis, intravitreal vancomycin and dexamethasone were injected. <i>Curtobacterium pusillum</i> was cultured on an automated microbial identification system. Intravenous vancomycin and oral clarithromycin were administered for 2 weeks. After 3 months, endophthalmitis had not recurred, and the visual acuity reached 20/100. However, subretinal neovascularization was newly detected under the damaged macula. No complications of neovascularization were observed until 6 months after primary closure. Conclusions: <i>Curtobacterium pusillum</i> can induce acute endophthalmitis through direct penetration in cases of ocular trauma, and may be accompanied by extensive phlebitis and secondary subretinal neovascularization. In cases of open globe injury sustained in rural areas, acute endophthalmitis caused by a rare Gram-positive bacillus, such as <i>Curtobacterium</i> species, should be considered.
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18
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Park SH, Kwon HJ, Park SW, Byon IS, Lee SM. Iatrogenic Retinal Breaks in Macular Hole and Epiretinal Membrane Using 25-gauge Vitrectomy. J Korean Ophthalmol Soc 2021. [DOI: 10.3341/jkos.2021.62.6.806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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19
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Kang MS, Lee SM, Kwon HJ. Characteristics of Optical Coherence Tomography Angiography Findings in Chronic Inactive Branch Retinal Vein Occlusion. J Korean Ophthalmol Soc 2021. [DOI: 10.3341/jkos.2021.62.6.777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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20
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Lee JJ, Choi SK, Kwon HJ, Lee SM, Park SW, Byon IS, Lee JE. Atypical Retinal Hemorrhages after Vitrectomy for Idiopathic Macular Hole: Possible Toxicity of Brilliant Blue G. Korean J Ophthalmol 2021; 35:207-214. [PMID: 34120419 PMCID: PMC8200588 DOI: 10.3341/kjo.2020.0124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 04/21/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose To describe the development of multiple retinal hemorrhages after uncomplicated macular hole (MH) surgery, and to determine the associated factors. Methods The medical records of 163 patients (167 eyes) diagnosed with idiopathic MHs and who underwent surgery at Pusan National University Hospital between March 2016 and July 2018 were retrospectively reviewed. The development of retinal hemorrhages was evaluated using ultra-widefield fundus photographs. Multiple retinal hemorrhages were defined as three or more dot or blot hemorrhages that had not been observed before and during the surgery. The patients were divided into two groups according to the presence of multiple retinal hemorrhages. The variable parameters were compared between the two groups to find the risk factors. The associated factors were evaluated further for the independent factor using multiple logistic regression analysis. Results Multiple retinal hemorrhages were observed in 31 eyes (18.6%) after MH surgery. The associated factors were the surgical induction of posterior vitreous detachment (PVD) (p = 0.003), use of the internal limiting membrane flap technique (p = 0.028), and staining with Brilliant Blue G (BBG) (p = 0.003). Retinal hemorrhages were exclusively observed in eyes in which BBG was used. Surgical PVD induction was the only independent risk factor (odds ratio, 13.099; p = 0.013). No statistically significant differences were observed between the two groups in the postoperative visual outcomes and MH closure rate. Additionally, patients who underwent surgery for idiopathic epiretinal membrane during the study period were reviewed to validate the above findings. Multiple retinal hemorrhages were noted in only one case (0.4%) in which BBG was used after surgical induction of PVD. Conclusions Multiple retinal hemorrhages after MH surgery appear to be related to the intravitreal use of BBG in eyes that sustained mechanical damage because of surgical induction of PVD; however, they did not affect surgical outcomes.
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Affiliation(s)
- Jae Jung Lee
- Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Seung Kwon Choi
- Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Han Jo Kwon
- Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea.,Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Seung Min Lee
- Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea.,Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Sung Who Park
- Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Ik Soo Byon
- Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Ji Eun Lee
- Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea.,Lee Eye Clinic, Busan, Korea
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21
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Abstract
PURPOSE To investigate the correlation between postoperative metamorphopsia and macular deformation after macular hole surgery. METHODS This study included 28 eyes of 28 patients who underwent vitrectomy and internal limiting membrane removal for an idiopathic macular hole. The retinal vasculatures were compared between preoperative and postoperative photographs, and postoperative deformation of the macula was assessed as deformation of the square grid. The displacement of each node was measured, and deformation of the grid was calculated as differences in the coordinates of the adjacent nodes. These parameters were analyzed to find correlation with metamorphopsia measured using the M-charts after 6 postoperative months. RESULTS The average deformations in the vertical and horizontal lines of the grid were 94.29 μm and 49.72 μm, respectively. Perifoveal deformation was significantly greater than parafoveal deformation (P = 0.001∼0.019). The multiple regression analysis demonstrated that the vertical M-score correlated with superior perifoveal deformation of the vertical line on the fovea (P = 0.036), and the horizontal M-score correlated with temporal perifoveal deformation of the horizontal line on the fovea (P = 0.032). CONCLUSION The parafoveal tissue was displaced with the fovea concurrently after internal limiting membrane removal in macular hole surgery causing perifoveal deformation, which correlated with postoperative metamorphopsia.
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Affiliation(s)
- Sun Ho Park
- Department of Ophthalmology, School of Medicine, Pusan National University, Yangsan, South Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea; and
| | - Keun Heung Park
- Department of Ophthalmology, School of Medicine, Pusan National University, Yangsan, South Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea; and
| | - Hwa Yeong Kim
- Department of Ophthalmology, School of Medicine, Pusan National University, Yangsan, South Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea; and
| | - Jae Jung Lee
- Department of Ophthalmology, School of Medicine, Pusan National University, Yangsan, South Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea; and
| | - Han Jo Kwon
- Department of Ophthalmology, School of Medicine, Pusan National University, Yangsan, South Korea
- Research Institute of Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Sung Who Park
- Department of Ophthalmology, School of Medicine, Pusan National University, Yangsan, South Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea; and
| | - Ik Soo Byon
- Department of Ophthalmology, School of Medicine, Pusan National University, Yangsan, South Korea
- Research Institute of Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Ji Eun Lee
- Department of Ophthalmology, School of Medicine, Pusan National University, Yangsan, South Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea; and
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22
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Huh S, Chung JH, Kwon HJ, Ko HY. Unilateral Diaphragm Paralysis Associated With Neurosyphilis: A Case Report. Ann Rehabil Med 2020; 44:338-341. [PMID: 32721985 PMCID: PMC7463115 DOI: 10.5535/arm.19216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 04/20/2020] [Indexed: 11/10/2022] Open
Abstract
Diaphragm dysfunction can originate from various etiologies, and bilaterality of the dysfunction depends on the cause. Symptoms of diaphragm dysfunction vary depending on the degree of phrenic nerve denervation, spinal cord lesion, and involvement of the diaphragm. Several infectious diaphragmatic dysfunctions have been reported, including the human immunodeficiency virus, poliovirus, West Nile virus, and dengue virus. Here, we report a case of unilateral diaphragm paralysis in a 34-year-old man with neurosyphilis.
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Affiliation(s)
- Sungchul Huh
- Department of Rehabilitation Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Jae Heun Chung
- Department of Pulmonology, Allergy and Critical Care Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Han Jo Kwon
- Department of Ophthalmology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Hyun-Yoon Ko
- Department of Rehabilitation Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
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23
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Kwon W, Kim H, Han Y, Hwang YJ, Kim SG, Kwon HJ, Vinuela E, Járufe N, Roa JC, Han IW, Heo JS, Choi SH, Choi DW, Ahn KS, Kang KJ, Lee W, Jeong CY, Hong SC, Troncoso AT, Losada HM, Han SS, Park SJ, Kim SW, Yanagimoto H, Endo I, Kubota K, Wakai T, Ajiki T, Adsay NV, Jang JY. Role of tumour location and surgical extent on prognosis in T2 gallbladder cancer: an international multicentre study. Br J Surg 2020; 107:1334-1343. [PMID: 32452559 DOI: 10.1002/bjs.11618] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 02/29/2020] [Accepted: 03/16/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND In gallbladder cancer, stage T2 is subdivided by tumour location into lesions on the peritoneal side (T2a) or hepatic side (T2b). For tumours on the peritoneal side (T2a), it has been suggested that liver resection may be omitted without compromising the prognosis. However, data to validate this argument are lacking. This study aimed to investigate the prognostic value of tumour location in T2 gallbladder cancer, and to clarify the adequate extent of surgical resection. METHODS Clinical data from patients who underwent surgery for gallbladder cancer were collected from 14 hospitals in Korea, Japan, Chile and the USA. Survival and risk factor analyses were conducted. RESULTS Data from 937 patients were available for evaluation. The overall 5-year disease-free survival rate was 70·6 per cent, 74·5 per cent for those with T2a and 65·5 per cent among those with T2b tumours (P = 0·028). Regarding liver resection, extended cholecystectomy was associated with a better 5-year disease-free survival rate than simple cholecystectomy (73·0 versus 61·5 per cent; P = 0·012). The 5-year disease-free survival rate was marginally better for extended than simple cholecystectomy in both T2a (76·5 versus 66·1 per cent; P = 0·094) and T2b (68·2 versus 56·2 per cent; P = 0·084) disease. Five-year disease-free survival rates were similar for extended cholecystectomies including liver wedge resection versus segment IVb/V segmentectomy (74·1 versus 71·5 per cent; P = 0·720). In multivariable analysis, independent risk factors for recurrence were presence of symptoms (hazard ratio (HR) 1·52; P = 0·002), R1 resection (HR 1·96; P = 0·004) and N1/N2 status (N1: HR 3·40, P < 0·001; N2: HR 9·56, P < 0·001). Among recurrences, 70·8 per cent were metastatic. CONCLUSION Tumour location was not an independent prognostic factor in T2 gallbladder cancer. Extended cholecystectomy was marginally superior to simple cholecystectomy. A radical operation should include liver resection and adequate node dissection.
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Affiliation(s)
- W Kwon
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - H Kim
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - Y Han
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - Y J Hwang
- School of Medicine, Kyungpook National University, Daegu, South Korea.,Kyungpook National University Chilgok Hospital, Daegu, South Korea
| | - S G Kim
- School of Medicine, Kyungpook National University, Daegu, South Korea.,Kyungpook National University Chilgok Hospital, Daegu, South Korea
| | - H J Kwon
- School of Medicine, Kyungpook National University, Daegu, South Korea.,Kyungpook National University Chilgok Hospital, Daegu, South Korea
| | - E Vinuela
- Department of Digestive Surgery, Santiago, Chile
| | - N Járufe
- Department of Digestive Surgery, Santiago, Chile
| | - J C Roa
- Pathology, Faculty of Medicine, Catholic University of Chile, Santiago, Chile
| | - I W Han
- Department of Surgery, Samsung Medical Centre, Sungkyunkwan University College of Medicine, Seoul, South Korea
| | - J S Heo
- Department of Surgery, Samsung Medical Centre, Sungkyunkwan University College of Medicine, Seoul, South Korea
| | - S-H Choi
- Department of Surgery, Samsung Medical Centre, Sungkyunkwan University College of Medicine, Seoul, South Korea
| | - D W Choi
- Department of Surgery, Samsung Medical Centre, Sungkyunkwan University College of Medicine, Seoul, South Korea
| | - K S Ahn
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Keimyung University Dongsan Medical Centre, Daegu, South Korea
| | - K J Kang
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Keimyung University Dongsan Medical Centre, Daegu, South Korea
| | - W Lee
- Department of Surgery, Gyeongsang National University College of Medicine, Jinju, South Korea
| | - C-Y Jeong
- Department of Surgery, Gyeongsang National University College of Medicine, Jinju, South Korea
| | - S-C Hong
- Department of Surgery, Gyeongsang National University College of Medicine, Jinju, South Korea
| | - A T Troncoso
- Department of Surgery, Universidad de la Frontera, Temuco, Chile
| | - H M Losada
- Department of Surgery, Universidad de la Frontera, Temuco, Chile
| | - S-S Han
- Department of Surgery, Centre for Liver Cancer, National Cancer Centre, Goyang, South Korea
| | - S-J Park
- Department of Surgery, Centre for Liver Cancer, National Cancer Centre, Goyang, South Korea
| | - S-W Kim
- Department of Surgery, Centre for Liver Cancer, National Cancer Centre, Goyang, South Korea
| | - H Yanagimoto
- Department of Surgery, Kansai Medical University, Hirakata, Japan
| | - I Endo
- Department of Gastroenterological Surgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - K Kubota
- Department of Gastroenterological Surgery, Dokkyo Medical University, Tochigi, Japan
| | - T Wakai
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - T Ajiki
- Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - N V Adsay
- Department of Pathology, Koc University, Istanbul, Turkey.,Department of Pathology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - J-Y Jang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
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24
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Lee SM, Kwon JM, Shin J, Kwon HJ. Multiple Retinal Capillary Hemangioma Associated with NeurofibromatosisType 1. J Korean Ophthalmol Soc 2020. [DOI: 10.3341/jkos.2020.61.4.432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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25
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Lee JJ, Kwon HJ, Lee SM, Byon IS, Lee JE, Park SW. Duration of room air tamponade after vitrectomy. Jpn J Ophthalmol 2020; 64:216-222. [DOI: 10.1007/s10384-020-00714-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 11/21/2019] [Indexed: 11/29/2022]
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26
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Lee JJ, Jo YJ, Kwon HJ, Lee SM, Park SW, Byon IS, Lee JE. Perioperative intraretinal fluid observed using optical coherence tomography in the epiretinal membrane. BMC Ophthalmol 2020; 20:33. [PMID: 31969121 PMCID: PMC6977267 DOI: 10.1186/s12886-019-1289-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Accepted: 12/27/2019] [Indexed: 11/18/2022] Open
Abstract
Background Postoperative intraretinal fluid (IRF) is reportedly associated with visual outcomes after epiretinal membrane (ERM) surgery. However, preoperative IRF is common, and persistent IRF would have different impact on visual function from postoperative newly developed IRF. Therefore, we aimed to investigate the incidence rate and clinical implications of perioperative IRF in ERM. Methods Medical records of patients who underwent vitrectomy for idiopathic ERM between January 2014 and January 2017 were reviewed retrospectively. The incidence of IRF was analyzed using optical coherence tomography preoperatively and 1, 3, and 6 months postoperatively. On the basis of the presence or absence and the time of detection of IRF, patients were divided into three groups, namely preoperative IRF group, New IRF group, and IRF(−) group. Correlations of various parameters including age, sex, baseline visual acuity (VA), central subfield macular thickness, lens status, and surgical factors with IRF, along with the effect of IRF on VA, were evaluated. Results This study included 155 eyes from 155 patients. Thirty-six (23.2%) and 49 (31.6%) eyes demonstrated preoperative and newly developed IRF, respectively. Seventy eyes (45.2%), which did not exhibit IRF during the study period, were assigned to the IRF(−) group. At baseline, the IRF(−) group showed a better VA than the other two groups. Postoperatively, VA improved significantly in all three groups. There was no difference in VA between the IRF(−) and new IRF groups at 6 months; however, the preoperative IRF group had significantly lower VA than the other two groups. Conclusion IRF associated with ERM was frequently observed preoperatively and postoperatively, but it did not prevent postoperative vision improvement. Preoperative IRF was related to lower postoperative vision improvement.
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Affiliation(s)
- Jae Jung Lee
- Department of Ophthalmology, Pusan National University Hospital, 179 Gudeok-ro, Seo-gu, Busan, 49241, South Korea.,Department of Ophthalmology, School of Medicine, Pusan National University, Yangsan, South Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Yeon Ji Jo
- Department of Ophthalmology, Pusan National University Hospital, 179 Gudeok-ro, Seo-gu, Busan, 49241, South Korea.,Department of Ophthalmology, School of Medicine, Pusan National University, Yangsan, South Korea
| | - Han Jo Kwon
- Department of Ophthalmology, Pusan National University Hospital, 179 Gudeok-ro, Seo-gu, Busan, 49241, South Korea.,Department of Ophthalmology, School of Medicine, Pusan National University, Yangsan, South Korea.,Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Seung Min Lee
- Department of Ophthalmology, Pusan National University Hospital, 179 Gudeok-ro, Seo-gu, Busan, 49241, South Korea.,Department of Ophthalmology, School of Medicine, Pusan National University, Yangsan, South Korea.,Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Sung Who Park
- Department of Ophthalmology, Pusan National University Hospital, 179 Gudeok-ro, Seo-gu, Busan, 49241, South Korea.,Department of Ophthalmology, School of Medicine, Pusan National University, Yangsan, South Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Ik Soo Byon
- Department of Ophthalmology, Pusan National University Hospital, 179 Gudeok-ro, Seo-gu, Busan, 49241, South Korea.,Department of Ophthalmology, School of Medicine, Pusan National University, Yangsan, South Korea.,Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Ji Eun Lee
- Department of Ophthalmology, Pusan National University Hospital, 179 Gudeok-ro, Seo-gu, Busan, 49241, South Korea. .,Department of Ophthalmology, School of Medicine, Pusan National University, Yangsan, South Korea. .,Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea.
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Kim HY, Lee JJ, Kwon HJ, Park SW, Lee JE. Long-term Outcomes of Macular Hole Retinal Detachment in Highly Myopic Eyes after Surgical Reattachment. Korean J Ophthalmol 2019; 33:539-546. [PMID: 31833251 PMCID: PMC6911791 DOI: 10.3341/kjo.2019.0045] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 07/17/2019] [Accepted: 08/05/2019] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To evaluate visual acuity changes over 3 years following surgical reattachment of macular hole retinal detachment (MHRD) developed in high myopia. METHODS A retrospective analysis was performed using the medical records of patients with highly myopic eyes who underwent pars plana vitrectomy with internal limiting membrane peeling or the internal limiting membrane flap technique for MHRD. Changes in best-corrected visual acuity (BCVA) were measured at baseline, 6 months, 1 year, 2 years, and 3 years. RESULTS Of the 22 eyes analyzed, macular hole was closed in 13 and unclosed in nine. BCVA significantly improved from 1.61 ± 0.39 logarithm of the minimum angle of resolution (logMAR) at baseline to 1.17 ± 0.43 logMAR at 6 months and 1.33 ± 0.48 logMAR at 2 years after MHRD surgery. At 3 years, BCVA significantly decreased compared with that at 6 months, and visual improvement from baseline was not significant. BCVA and proportion of vision loss ≥0.3 logMAR were not different between the closed and unclosed macular hole groups. CONCLUSIONS Visual improvement after surgical reattachment of MHRD in high myopia was not maintained, and favorable macular hole closure effects were not observed at 3-year follow-up.
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Affiliation(s)
- Hwa Yeong Kim
- Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Jae Jung Lee
- Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Han Jo Kwon
- Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea.,Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Sung Who Park
- Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Ji Eun Lee
- Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
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Lee SM, Park KH, Kwon HJ, Park SW, Byon IS, Lee JE. Displacement of the Foveal Retinal Layers After Macular Hole Surgery Assessed Using En Face Optical Coherence Tomography Images. Ophthalmic Surg Lasers Imaging Retina 2019; 50:414-422. [PMID: 31344240 DOI: 10.3928/23258160-20190703-02] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 01/17/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE To investigate the displacement of foveal retinal layers in surgically closed macular holes (MHs) after removal of the internal limiting membrane (ILM). PATIENTS AND METHODS Medical records of 26 consecutive patients who underwent vitrectomy and removal of the ILM for idiopathic MH were retrospectively reviewed. En face optical coherence tomography images were exported at the level of the choroid, ellipsoid zone (EZ), and inner plexiform layer (IPL) at baseline and at 1, 3, and 6 months. The foveal center of the EZ and IPL was marked in the choroid en face image. The choroidal images were overlapped to match the vasculature in each patient, and the postoperative displacement of the foveal center was compared to baseline. RESULTS The center of the EZ and IPL was displaced significantly toward the disc during the first 3 months. The mean horizontal displacement at 1, 3, and 6 months was 52.7 μm, 112.5 μm, and 115.4 μm, respectively, for the EZ and 75.2 μm, 117.1 μm, and 136.5 μm, respectively, for the IPL. The location of the foveal center was significantly correlated between the EZ and the IPL (P ≤ .016). CONCLUSIONS The fovea was displaced nasally and slightly inferiorly after removal of the ILM. The displacement of the photoreceptor and inner retinal layers was concurrent. [Ophthalmic Surg Lasers Imaging Retina. 2019;50:414-422.].
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Kwon HJ, Lee JJ, Park SW, Byon IS, Lee JE. Enlargement of polypoidal choroidal vasculopathy lesion without exudative findings assessed in en face optical coherence tomography images. Graefes Arch Clin Exp Ophthalmol 2019; 257:1621-1629. [PMID: 31098753 DOI: 10.1007/s00417-019-04317-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 02/26/2019] [Accepted: 04/01/2019] [Indexed: 11/30/2022] Open
Abstract
PURPOSE This study aimed to investigate growth of polypoidal choroidal vasculopathy (PCV) without exudative findings assessed in en face optical coherence tomography (OCT) images and its clinical implications. METHODS Fifty patients who were diagnosed with PCV and had no disease activity after treatment with intravitreal anti-vascular endothelial growth factor (anti-VEGF) were included. Patients were followed up for at least 12 months. Measurement of best-corrected visual acuity and volume scan using swept-source OCT was performed at each visit. The neovascular area of PCV was assessed using en face OCT. Growth group comprised patients who showed increase in neovascular area in the en face images without exudative findings. The main outcome measure was relationship between growth of PCV and recurrence. RESULTS Among 50 eyes of 50 patients with average age of 68.5 ± 8.6 years, 25 (50%) eyes were included in the growth group. Exudative recurrence was noted more frequently in the growth group (18 eyes, 72%) than in the non-growth group (6 eyes, 24%, P = .002, odds ratio = 8.143). More injections were performed in the growth group (4.7 ± 2.1 vs. 1.9 ± 2.4, P = .002), but there was no difference in visual acuity at 1 year. After an exudative recurrence following the lesion growth, more frequent injections were required than before the recurrence to achieve no disease activity (P = .002). CONCLUSION PCV lesion growth without fluid preceded exudative recurrence and worsening of response to anti-VEGF treatment.
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Affiliation(s)
- Han Jo Kwon
- Department of Ophthalmology, College of Medicine, Pusan National University, Yangsan, South Korea.,Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Jae Jung Lee
- Department of Ophthalmology, College of Medicine, Pusan National University, Yangsan, South Korea.,Medical Research Institute, Pusan National University Hospital, 179 Gudeok-ro Seo-gu, Busan, 49241, South Korea
| | - Sung Who Park
- Department of Ophthalmology, College of Medicine, Pusan National University, Yangsan, South Korea.,Medical Research Institute, Pusan National University Hospital, 179 Gudeok-ro Seo-gu, Busan, 49241, South Korea
| | - Ik Soo Byon
- Department of Ophthalmology, College of Medicine, Pusan National University, Yangsan, South Korea.,Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Ji Eun Lee
- Department of Ophthalmology, College of Medicine, Pusan National University, Yangsan, South Korea. .,Medical Research Institute, Pusan National University Hospital, 179 Gudeok-ro Seo-gu, Busan, 49241, South Korea.
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Kwon HJ, Jeon J, Kim DH, Jang HR, Sung HH, Han DH, Park JB, Lee JE, Huh W, Kim SJ, Kim YG, Kim DJ, Oh HY. Clinical Impact of a Protocolized Kidney Donor Follow-up System. Transplant Proc 2019; 51:692-700. [PMID: 30979452 DOI: 10.1016/j.transproceed.2018.10.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Accepted: 10/23/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Adequate kidney donor management after donation is increasingly emphasized due to concerns of renal function impairment after nephrectomy with increasing life expectancy. In this study, the clinical impact of a protocolized kidney donor follow-up system by nephrologists was evaluated. METHODS A total of 427 living kidney donors underwent nephrectomy from January 2010 to December 2014 and were followed for at least 2 years at the Samsung Medical Center. Donors were followed-up by nephrologists after the establishment of a donor clinic with systemized protocols in January 2013. The primary outcomes were incidence of post-donation low estimated glomerular filtration rate (eGFR) and renal function adaptability. Secondary outcomes were changes in compliance and incidence of hyperuricemia and microalbuminuria. RESULTS The patients were divided into 2 groups according to the time of nephrectomy: the pre-donor clinic period (n = 182) and the donor clinic period (n = 172). Preoperative eGFR in patients in the pre-donor clinic period was higher than that in patients in the donor clinic period. After donation, poor renal adaptation was less frequent in the donor clinic period compared to the pre-donor clinic period. Low eGFR tended to be less common during the donor clinic period. Shorter mean outpatient clinic visit intervals with more visits within 6 months after donation and earlier detection of de novo hyperuricemia were found during the donor clinic period. CONCLUSION A protocolized donor clinic run by nephrologists may improve post-nephrectomy renal outcomes and compliance and facilitate better management of potential risk factors of chronic kidney disease in donors.
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Affiliation(s)
- H J Kwon
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - J Jeon
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - D H Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - H R Jang
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
| | - H H Sung
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - D H Han
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - J B Park
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - J E Lee
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - W Huh
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - S J Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Y G Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - D J Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - H Y Oh
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Bae MH, Lee NR, Han YM, Yoon L, Kim YM, Byun SY, Lee JJ, Kwon HJ, Kwak MJ, Park KH. Bilateral Acute Retinal Necrosis and Encephalomalacia Due to Herpes Simplex Virus Infection in a Premature Infant. Neonatal Med 2019. [DOI: 10.5385/nm.2019.26.1.63] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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32
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Peng C, de Sousa FB, Gan HY, Kwon HJ, Park S, Kilpatrick-Liverman L, Wang W, Lavender S, Pilch S, Han J. Enhanced Delivery of F -, Ca 2+, K +, and Na + Ions into Enamel by Electrokinetic Flows. J Dent Res 2019; 98:430-436. [PMID: 30676839 DOI: 10.1177/0022034518818463] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
As the outermost layer of the tooth crown, dental enamel is the most mineralized tissue in mammals, consisting of hydroxyapatite crystallites separated by long and narrow nanochannels. A major challenge in dentistry is how various molecules can be infiltrated into these nanopores in an efficient and controlled way. Here we show a robust method to transport various ions of interest, such as fluoride (F-), potassium (K+), calcium (Ca++), and sodium (Na+), into these nanopores by electrokinetic flows. It is verified by fluorescence microscopy, laser-scanning confocal microscopy, mass spectrometry, and ion selective electrode technique. Different ions are demonstrated to infiltrate through the entire depth of the enamel layer (~1 mm), which is significantly enhanced penetration compared with diffusion-based infiltration. Meanwhile, transport depth and speed can be controlled by infiltration time and applied voltage. This is the first demonstration of reliably delivering both anions and cations into the enamel nanopores. This technique opens opportunities in caries prevention, remineralization, tooth whitening, and nanomedicine delivery in clinical dentistry, as well as other delivery challenges into various biomaterials such as bones.
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Affiliation(s)
- C Peng
- 1 Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - F B de Sousa
- 2 Department of Morphology, Health Sciences Center, Fereral University of Paraiba, Joao Pessoa, Cidade Universitaria, Paraiba, Brazil
| | - H Y Gan
- 3 Engineering Cluster, Singapore Institute of Technology, Singapore
| | - H J Kwon
- 1 Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - S Park
- 4 Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA, USA
| | | | - W Wang
- 5 Colgate-Palmolive Technology Center, Piscataway, NJ, USA
| | - S Lavender
- 5 Colgate-Palmolive Technology Center, Piscataway, NJ, USA
| | - S Pilch
- 5 Colgate-Palmolive Technology Center, Piscataway, NJ, USA
| | - J Han
- 1 Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, MA, USA.,6 Department of Electric Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA, USA.,7 Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
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Kim HK, Park SH, Lee JJ, Kwon HJ, Park KH, Park SW, Lee JE. The Shortest Radius of Curvature of Bruch's Membrane in Macular Optical Coherence Tomography. J Korean Ophthalmol Soc 2019. [DOI: 10.3341/jkos.2019.60.9.867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Hui Kyung Kim
- Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea
- Research Institute, Pusan National University Hospital, Pusan, Korea
| | - Sun Ho Park
- Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea
- Research Institute, Pusan National University Hospital, Pusan, Korea
| | - Jae Jung Lee
- Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea
- Research Institute, Pusan National University Hospital, Pusan, Korea
| | - Han Jo Kwon
- Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea
- Research Institute, Pusan National University Hospital, Pusan, Korea
| | - Keun Heung Park
- Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea
- Research Institute, Pusan National University Hospital, Pusan, Korea
| | - Sung Who Park
- Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea
- Research Institute, Pusan National University Hospital, Pusan, Korea
| | - Ji Eun Lee
- Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea
- Research Institute, Pusan National University Hospital, Pusan, Korea
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34
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Lee IH, Lee JJ, Kwon HJ, Park SW, Lee JE. Clinical Changes after Switching from Ranibizumab/Aflibercept to Bevacizumab in Exudative Age-related Macular Degeneration. J Korean Ophthalmol Soc 2019. [DOI: 10.3341/jkos.2019.60.1.40] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- In Ho Lee
- Department of Ophthalmology, School of Medicine, Pusan National University, Yangsan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Jae Jung Lee
- Department of Ophthalmology, School of Medicine, Pusan National University, Yangsan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Han Jo Kwon
- Department of Ophthalmology, School of Medicine, Pusan National University, Yangsan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Sung Who Park
- Department of Ophthalmology, School of Medicine, Pusan National University, Yangsan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Ji Eun Lee
- Department of Ophthalmology, School of Medicine, Pusan National University, Yangsan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
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Park SH, Lee JJ, Kwon HJ, Lee JE, Park SW. Clinical Characteristics of Intraocular Foreign Bodies According to Entrance Location: Corneal vs. Non-Corneal. J Korean Ophthalmol Soc 2019. [DOI: 10.3341/jkos.2019.60.4.348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Sun Ho Park
- Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea
- Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Jae Jung Lee
- Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea
- Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Han Jo Kwon
- Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea
- Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Ji Eun Lee
- Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea
- Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Sung Who Park
- Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea
- Medical Research Institute, Pusan National University Hospital, Busan, Korea
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36
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Lee SM, Kwon HJ, Park SW, Lee JE, Byon IS. Microstructural changes in the fovea following autologous internal limiting membrane transplantation surgery for large macular holes. Acta Ophthalmol 2018. [PMID: 28636130 DOI: 10.1111/aos.13504] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Seung Min Lee
- Department of Ophthalmology; Research Institute for Convergence of Biomedical Science and Technology; Pusan National University Yangsan Hospital; Yangsan South Korea
| | - Han Jo Kwon
- Department of Ophthalmology; Medical Research Institute; Pusan National University Hospital; Busan South Korea
| | - Sung Who Park
- Department of Ophthalmology; Medical Research Institute; Pusan National University Hospital; Busan South Korea
- College of Medicine; Pusan National University; Yangsan South Korea
| | - Ji Eun Lee
- Department of Ophthalmology; Medical Research Institute; Pusan National University Hospital; Busan South Korea
- College of Medicine; Pusan National University; Yangsan South Korea
| | - Ik Soo Byon
- Department of Ophthalmology; Research Institute for Convergence of Biomedical Science and Technology; Pusan National University Yangsan Hospital; Yangsan South Korea
- College of Medicine; Pusan National University; Yangsan South Korea
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37
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Park SW, Kim SH, Kwon HJ, Lee SM, Byon IS, Lee JE. Diagnostic Value of Positive Findings of Toxoplasma gondii-Specific Immunoglobulin M Serum Antibody in Uveitis Patients to Confirm Ocular Toxoplasmosis. Ocul Immunol Inflamm 2018. [PMID: 29513626 DOI: 10.1080/09273948.2018.1433303] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Purpose: To assess the value of positive immunoglobulin (Ig) M serum antibody (Ab) findings in uveitis patients. Methods: We reviewed medical records of patients who had a positive serological test for Toxoplasma gondii-specific IgM Ab. Their clinical data, including history, demographic characteristics, laboratory findings, clinical findings, treatment outcomes, and recurrences, were reviewed retrospectively. Results: Of 2919 uveitis patients who underwent a serological test for suspected ocular toxoplasmosis (OT), 18 presented with positive Ig M results. All 18 patients (100.0% specificity) were clinically diagnosed with OT. None had any retinochoroidal scar at the initial visit, indicating the OT was a recent and primary infection. However, 15 patients (83.3%) had no history suspected to account for the Toxoplasma transmission. Conclusions: The T. gondii IgM serum Ab is a specific biomarker for diagnosis of primary OT. Epidemiological studies are warranted to investigate the non-classic transmission routes of T. gondii in OT.
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Affiliation(s)
- Sung Who Park
- a Department of Ophthalmology , School of Medicine, Pusan National University , Busan , South Korea.,c Biomedical Research Institute , School of Medicine, Pusan National University Hospital , Busan , South Korea
| | - So Hee Kim
- a Department of Ophthalmology , School of Medicine, Pusan National University , Busan , South Korea
| | - Han Jo Kwon
- a Department of Ophthalmology , School of Medicine, Pusan National University , Busan , South Korea
| | - Seung Min Lee
- b Department of Ophthalmology , Pusan National University Yangsan Hospital , Yangsan , South Korea
| | - Ik Soo Byon
- a Department of Ophthalmology , School of Medicine, Pusan National University , Busan , South Korea.,b Department of Ophthalmology , Pusan National University Yangsan Hospital , Yangsan , South Korea
| | - Ji Eun Lee
- a Department of Ophthalmology , School of Medicine, Pusan National University , Busan , South Korea.,c Biomedical Research Institute , School of Medicine, Pusan National University Hospital , Busan , South Korea
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Kwon HJ, Kim DH, Jang HR, Jung SH, Han DH, Sung HH, Park JB, Lee JE, Huh W, Kim SJ, Kim YG, Kim DJ, Oh HY. Predictive Factors of Renal Adaptation After Nephrectomy in Kidney Donors. Transplant Proc 2017; 49:1999-2006. [PMID: 29149951 DOI: 10.1016/j.transproceed.2017.09.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 08/01/2017] [Accepted: 09/02/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Despite compensatory hyperfiltration in remaining nephrons following donor nephrectomy, some donors show impaired renal adaptation and low estimated glomerular filtration rate (eGFR). We investigated the factors predicting early renal adaptation after nephrectomy and identified kidney donors at risk of inadequate renal adaptation. METHODS A total of 265 living kidney donors from 2010 to 2013 were retrospectively analyzed. Renal function was serially followed for 6 months after the operation. Regression analyses were performed to identify the independent predictors of low eGFR (eGFR <60 mL/min/1.73 m2) and impaired renal adaptation (%Modification of Diet in Renal Disease [MDRD] <66% of baseline eGFR). RESULTS A total of 148 donors belonged to the low eGFR group, and changes in eGFR (ΔeGFR) at postoperative (PO) 1 day and 1 month were identified as independent predictors of low eGFR. Impaired renal adaptation was related to age, ΔeGFR PO 2-3 days, and ΔeGFR PO 1 month. Early renal adaptation was associated with age, male gender, and residual kidney computerized tomography angiography (CTA) volume. The best sensitivity and specificity were obtained with a cutoff value of ΔeGFR 31 at PO 1 day and 1 month for predicting low eGFR and with a value of ΔeGFR 27 at PO 2-3 days and 1 month for predicting impaired renal adaptation. CONCLUSIONS Our study showed that the degree of early renal adaptation determines subsequent renal function in kidney donors. Closer monitoring and management may be required in old or male donors with small residual CTA kidney volume as well as donors with persistent ΔeGFR >27 within 1 month of nephrectomy.
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Affiliation(s)
- H J Kwon
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - D H Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - H R Jang
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
| | - S-H Jung
- Biostatics and Clinical Epidemiology Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - D H Han
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - H H Sung
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - J B Park
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - J E Lee
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - W Huh
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - S J Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Y-G Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - D J Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - H Y Oh
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Kwon HJ, Lee SM, Pak KY, Park SW, Lee JE, Byon IS. Gender Differences in the Relationship between Sex Hormone Deficiency and Soft Drusen. Curr Eye Res 2017; 42:1527-1536. [DOI: 10.1080/02713683.2017.1337155] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Han Jo Kwon
- Department of Ophthalmology, Medical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Seung Min Lee
- Department of Ophthalmology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Kang Yeun Pak
- Department of Ophthalmology, Haeundae Paik Hospital, Inje University, Busan, South Korea
| | - Sung Who Park
- Department of Ophthalmology, Medical Research Institute, Pusan National University Hospital, Busan, South Korea
- College of Medicine, Pusan National University, Busan, South Korea
| | - Ji Eun Lee
- Department of Ophthalmology, Medical Research Institute, Pusan National University Hospital, Busan, South Korea
- College of Medicine, Pusan National University, Busan, South Korea
| | - Ik Soo Byon
- Department of Ophthalmology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea
- College of Medicine, Pusan National University, Busan, South Korea
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40
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Kwon HJ, Brasch HD, Benison S, Marsh RW, Itinteang T, Titchener GW, Evans J, Tan ST. Erratum to "Changing prevalence and treatment outcomes of patients with p16 human papillomavirus related oropharyngeal squamous cell carcinoma in New Zealand" [Br J Oral Maxillofac Surg 54 (8) (2016) 898-903]. Br J Oral Maxillofac Surg 2017; 55:754. [PMID: 28687136 DOI: 10.1016/j.bjoms.2017.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- H J Kwon
- Department of Otolaryngology - Head and Neck Surgery, Wellington Regional Hospital, Wellington, New Zealand
| | - H D Brasch
- Gillies McIndoe Research Institute, Wellington, New Zealand; Department of Pathology, Hutt Hospital, Wellington, New Zealand
| | - S Benison
- Department of Pathology, Hutt Hospital, Wellington, New Zealand
| | - R W Marsh
- Gillies McIndoe Research Institute, Wellington, New Zealand; Auckland University, Auckland, New Zealand
| | - T Itinteang
- Gillies McIndoe Research Institute, Wellington, New Zealand
| | - G W Titchener
- Department of Otolaryngology - Head and Neck Surgery, Wellington Regional Hospital, Wellington, New Zealand
| | - J Evans
- Wellington Blood and Cancer Centre, Wellington Regional Hospital, Wellington, New Zealand
| | - S T Tan
- Gillies McIndoe Research Institute, Wellington, New Zealand; Wellington Regional Plastic, Maxillofacial & Burns Unit, Hutt Hospital, Wellington, New Zealand.
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41
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Park SW, Kwon HJ, Byon IS, Lee JE, Oum BS. Impact of Age on Scleral Buckling Surgery for Rhegmatogenous Retinal Detachment. Korean J Ophthalmol 2017; 31:328-335. [PMID: 28752694 PMCID: PMC5540988 DOI: 10.3341/kjo.2016.0024] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 04/12/2016] [Indexed: 11/23/2022] Open
Abstract
Purpose The purpose of this study is to investigate new prognostic factors in associated with primary anatomical failure after scleral buckling (SB) for uncomplicated rhegmatogenous retinal detachment (RRD). Methods The medical records of patients with uncomplicated RRD treated with SB were retrospectively reviewed. Eyes with known prognostic factors for RRD, such as fovea-on, proliferative vitreoretinopathy, pseudophakia, aphakia, multiple breaks, or media opacity, were excluded. Analysis was performed to find correlations between anatomical success and various parameters, including age. Results This study analyzed 127 eyes. Binary logistic regression analysis revealed that older age (≥35) was the sole independent prognostic factor (odds ratio, 3.5; p = 0.022). Older age was correlated with worse preoperative visual acuity (p < 0.001), shorter symptom duration (p < 0.001), presence of a large tear (p < 0.001), subretinal fluid drainage (p < 0.001), postoperative macular complications (p = 0.048), and greater visual improvement (p = 0.003). Conclusions Older age (≥35) was an independent prognostic factor for primary anatomical failure in SB for uncomplicated RRD. The distinguished features of RRD between older and younger patients suggest that vitreous liquefaction and posterior vitreous detachment are important features associated with variation in surgical outcomes.
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Affiliation(s)
- Sung Who Park
- Department of Ophthalmology, Pusan National University Hospital, Busan, Korea
| | - Han Jo Kwon
- Department of Ophthalmology, Pusan National University Hospital, Busan, Korea
| | - Ik Soo Byon
- Department of Ophthalmology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Ji Eun Lee
- Department of Ophthalmology, Pusan National University Hospital, Busan, Korea.,Medical Research Institute, Pusan National University Hospital, Busan, Korea.
| | - Boo Sup Oum
- Department of Ophthalmology, Pusan National University Hospital, Busan, Korea
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Kim YY, Hwang J, Kim HS, Kwon HJ, Kim S, Lee JH, Lee JH. Genetic alterations in mesiodens as revealed by targeted next-generation sequencing and gene co-occurrence network analysis. Oral Dis 2017; 23:966-972. [PMID: 28415132 DOI: 10.1111/odi.12680] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 03/21/2017] [Accepted: 04/06/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Mesiodens is the most common type of supernumerary tooth which includes a population prevalence of 0.15%-1.9%. Alongside evidence that the condition is heritable, mutations in single genes have been reported in few human supernumerary tooth cases. Gene sequencing methods in tradition way are time-consuming and labor-intensive, whereas next-generation sequencing and bioinformatics are cost-effective for large samples and target sizes. MATERIALS AND METHODS We describe the application of a targeted next-generation sequencing (NGS) and bioinformatics approach to samples from 17 mesiodens patients. Subjects were diagnosed on the basis of panoramic radiograph. A total of 101 candidate genes which were captured custom genes were sequenced on the Illumina HiSeq 2500. Multistep bioinformatics processing was performed including variant identification, base calling, and in silico analysis of putative disease-causing variants. RESULTS Targeted capture identified 88 non-synonymous, rare, exonic variants involving 42 of the 101 candidate genes. Moreover, we investigated gene co-occurrence relationships between the genomic alterations and identified 88 significant relationships among 18 most recurrent driver alterations. CONCLUSION Our search for co-occurring genetic alterations revealed that such alterations interact cooperatively to drive mesiodens. We discovered a gene co-occurrence network in mesiodens patients with functionally enriched gene groups in the sonic hedgehog (SHH), bone morphogenetic proteins (BMP), and wingless integrated (WNT) signaling pathways.
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Affiliation(s)
- Y Y Kim
- Institute of Oral Science, Apple Tree Dental Hospital, Ilsansuh-gu, Goyang, Korea
| | - J Hwang
- Department of IT Convergence and Engineering, Pohang University of Science and Technology, Pohang, Gyeongbuk, Korea
| | - H-S Kim
- Institute of Oral Science, Apple Tree Dental Hospital, Ilsansuh-gu, Goyang, Korea
| | - H J Kwon
- Institute of Oral Science, Apple Tree Dental Hospital, Ilsansuh-gu, Goyang, Korea
| | - S Kim
- Department of Life Science, Pohang University of Science and Technology, Pohang, Gyeongbuk, Korea
| | - J H Lee
- Department of Clinical Pharmacology and Therapeutics, Kyung Hee University College of Medicine, Dongdaemoon-gu, Seoul, Korea
| | - J H Lee
- Department of Prosthodontics, Yonsei University College of Dentistry, Seodaemoon-gu, Seoul, Korea
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Lee SJ, Park KY, Kwon HJ, Park SW, Lee JE. A Case of Delayed Infective Endophthalmitis Associated with Exposure of Scleral Fixation Knot. J Korean Ophthalmol Soc 2017. [DOI: 10.3341/jkos.2017.58.3.342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Seok Jae Lee
- Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea
| | - Kang Yoon Park
- Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea
| | - Han Jo Kwon
- Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea
| | - Sung Who Park
- Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Ji Eun Lee
- Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
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44
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Kwon JM, Lee SM, Kwon HJ, Park SW, Lee JE, Byon IS. Treatment Outcome of Serous Macular Detachment in Circumscribed Choroidal Hemangioma. J Korean Ophthalmol Soc 2017. [DOI: 10.3341/jkos.2017.58.3.289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Jeong Min Kwon
- Research Institute for Convergence of Biomedical Science and Technology, Department of Ophthalmology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Seung Min Lee
- Research Institute for Convergence of Biomedical Science and Technology, Department of Ophthalmology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Han Jo Kwon
- Medical Research Institute, Department of Ophthalmology, Pusan National University Hospital, Busan, Korea
| | - Sung Who Park
- Medical Research Institute, Department of Ophthalmology, Pusan National University Hospital, Busan, Korea
- Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea
| | - Ji Eun Lee
- Medical Research Institute, Department of Ophthalmology, Pusan National University Hospital, Busan, Korea
- Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea
| | - Ik Soo Byon
- Research Institute for Convergence of Biomedical Science and Technology, Department of Ophthalmology, Pusan National University Yangsan Hospital, Yangsan, Korea
- Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea
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Affiliation(s)
- Su Gyeong Jang
- Department of Ophthalmology, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Kang Yeun Pak
- Department of Ophthalmology, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Han Jo Kwon
- Department of Ophthalmology, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Seung Min Lee
- Department of Ophthalmology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Sung Who Park
- Department of Ophthalmology, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Ik Soo Byon
- Department of Ophthalmology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Ji Eun Lee
- Department of Ophthalmology, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
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46
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No YA, Kwon HJ, Park KY, Hong SA, Seo SJ, Hong CK. Unilateral, erythematous, swollen, sclerosing patch with nodular progression on the right side of the face. Clin Exp Dermatol 2016; 41:945-947. [PMID: 27766675 DOI: 10.1111/ced.12919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Y A No
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
| | - H J Kwon
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
| | - K Y Park
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
| | - S A Hong
- Department of Pathology, Chung-Ang University College of Medicine, Seoul, Korea
| | - S J Seo
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
| | - C K Hong
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
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Jeong HS, Lee J, Lim BJ, Kwon HJ, Kim YS, Kim BS, Huh KH, Kim SI, Kim MS, Jeong HJ. Concurrent Post-Transplantation Diabetes Mellitus in Renal Allograft Recipients With Immunoglobulin A Nephropathy. Transplant Proc 2016; 48:887-9. [PMID: 27234759 DOI: 10.1016/j.transproceed.2015.11.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Accepted: 11/06/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND The prevalence of post-transplantation immunoglobulin A nephropathy (PTIgAN) and diabetes mellitus (PTDM) increases with time after transplantation, and recognition and management of these conditions is becoming more important in renal allograft recipients as graft survival increases. METHODS We explored the influence of concurrent PTDM on renal allograft histology and function in 111 cases with PTIgAN diagnosed from 2000 to 2010 at our institution. RESULTS Sixteen patients (14.4%) had PTDM at the time of diagnosis of PTIgAN, which increased to 28 patients (25.2%) at the last follow-up (10.4 years after transplantation). Donor ages were younger in PTIgAN patients with concurrent PTDM. However, other clinical and demographic data were not significantly different between PTIgAN patients with and without PTDM. Histologically, Banff "mm" scores were higher and "M1" of the Oxford classification was more frequent in PTIgAN patients with concurrent PTDM than in patients without PTDM, but the difference did not reach statistical significance. Serum creatinine levels and proteinuria at the time of biopsy and overall graft survival did not vary according to the presence of PTDM both at biopsy and at the last follow-up. CONCLUSIONS Concurrent PTDM does not significantly influence graft function or outcome for 10 years after transplantation in PTIgAN patients.
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Affiliation(s)
- H S Jeong
- Department of Pathology, Yonsei University College of Medicine, Seoul, Korea
| | - J Lee
- Department of Transplantation Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - B J Lim
- Department of Pathology, Yonsei University College of Medicine, Seoul, Korea
| | - H J Kwon
- Department of Pathology, Yonsei University College of Medicine, Seoul, Korea
| | - Y S Kim
- Department of Transplantation Surgery, Yonsei University College of Medicine, Seoul, Korea; Institute of Transplantation, Yonsei University College of Medicine, Seoul, Korea
| | - B S Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - K H Huh
- Department of Transplantation Surgery, Yonsei University College of Medicine, Seoul, Korea; Institute of Transplantation, Yonsei University College of Medicine, Seoul, Korea
| | - S I Kim
- Department of Transplantation Surgery, Yonsei University College of Medicine, Seoul, Korea; Institute of Transplantation, Yonsei University College of Medicine, Seoul, Korea
| | - M S Kim
- Department of Transplantation Surgery, Yonsei University College of Medicine, Seoul, Korea; Institute of Transplantation, Yonsei University College of Medicine, Seoul, Korea
| | - H J Jeong
- Department of Pathology, Yonsei University College of Medicine, Seoul, Korea; Institute of Transplantation, Yonsei University College of Medicine, Seoul, Korea.
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Lee SJ, Kwon HJ, Park KY, Park SW, Byon IS, Lee JE. Prognostic Factors of Anatomical Success in Microincisional Vitrectomy for Rhegmatogenous Retinal Detachment. J Korean Ophthalmol Soc 2016. [DOI: 10.3341/jkos.2016.57.10.1613] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Seok Jae Lee
- Department of Ophthalmology, Pusan National University College of Medicine, Busan, Korea
| | - Han Jo Kwon
- Department of Ophthalmology, Pusan National University College of Medicine, Busan, Korea
| | - Kang Yoon Park
- Department of Ophthalmology, Pusan National University College of Medicine, Busan, Korea
| | - Sung Who Park
- Department of Ophthalmology, Pusan National University College of Medicine, Busan, Korea
- Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Ik Soo Byon
- Department of Ophthalmology, Pusan National University College of Medicine, Busan, Korea
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Ji Eun Lee
- Department of Ophthalmology, Pusan National University College of Medicine, Busan, Korea
- Medical Research Institute, Pusan National University Hospital, Busan, Korea
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Park SW, Kwon HJ, Kim HY, Byon IS, Lee JE, Oum BS. Comparison of scleral buckling and vitrectomy using wide angle viewing system for rhegmatogenous retinal detachment in patients older than 35 years. BMC Ophthalmol 2015; 15:121. [PMID: 26362540 PMCID: PMC4566311 DOI: 10.1186/s12886-015-0109-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 09/04/2015] [Indexed: 11/23/2022] Open
Abstract
Background To compare scleral buckling (SB) and pars plana vitrectomy (PPV) using a wide angle viewing system (WAVS) for uncomplicated phakic rhegmatogenous retinal detachment (RRD). Methods The medical records of patients with uncomplicated phakic RRD were retrospectively reviewed. Eyes with pseudophakic or attached fovea were excluded. Patients treated with SB were classified as group B, and PPV using WAVS as group V. Primary success rate, visual acuity (VA), macular complications, and sustained subretinal fluid (SRF) were compared between groups. Results Seventy-two eyes were included in group B and 57 eyes in group V. Group B had better preoperative VA (1.38 ± 0.87 vs 1.84 ± 0.97 in LogMAR, P = 0.010), but worse final VA (0.51 ± 0.48 vs 0.30 ± 0.23, P = 0.012) than group V. The primary success rate of 94.7 % in group V was higher than 77.8 % in group B (P = 0.010). Final success rate was 100 % in both groups. There was no significant difference in macular complications between groups (P = 0.087). Sustained SRF was found in 22 eyes in group B (38.6 %), while only two eyes in group V exhibited sustained SRF (2.8 %, P < 0.001). Conclusions Pars plana vitrectomy using WAVS was more efficacious than SB for treating uncomplicated phakic RRD.
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Affiliation(s)
- Sung Who Park
- Department of Ophthalmology, Pusan National University Hospital, Pusan, South Korea. .,Biomedical Research Institute, Pusan National University Hospital, Pusan, South Korea.
| | - Han Jo Kwon
- Department of Ophthalmology, Pusan National University Hospital, Pusan, South Korea.
| | - Ho Yun Kim
- Department of Ophthalmology, Pusan National University Hospital, Pusan, South Korea.
| | - Ik Soo Byon
- Department of Ophthalmology, Pusan National University Yangsan Hospital, Yangsan, South Korea.
| | - Ji Eun Lee
- Department of Ophthalmology, Pusan National University Hospital, Pusan, South Korea. .,Medical Institute, School of Medicine, Pusan National University, Pusan, South Korea. .,Biomedical Research Institute, Pusan National University Hospital, Pusan, South Korea.
| | - Boo Sup Oum
- Department of Ophthalmology, Pusan National University Hospital, Pusan, South Korea.
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50
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Byon IS, Jo SH, Kwon HJ, Kim KH, Park SW, Lee JE. Changes in Visual Acuity after Idiopathic Epiretinal Membrane Removal: Good versus Poor Preoperative Visual Acuity. Ophthalmologica 2015; 234:127-34. [DOI: 10.1159/000437359] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 06/29/2015] [Indexed: 11/19/2022]
Abstract
Purpose: To investigate postoperative visual acuity changes following idiopathic epiretinal membrane (ERM) surgery as well as investigate the relationship between outcome and baseline visual acuity. Methods: The medical records of 159 consecutive eyes were retrospectively reviewed for best corrected visual acuity (BCVA), central subfield macular thickness (CSMT), and the ellipsoid zone (EZ) signal of the photoreceptor layer at baseline and 1, 3, and 6 months after surgery. Patients were divided into two groups: group A, with good vision of 20/50 or better, and group B, with poor visual acuity worse than 20/50. Results: Seventy-nine eyes were included in group A and 80 eyes in group B. Mean baseline BCVA was 0.28 and 0.65 logarithm of the minimum angle of resolution (logMAR), and the mean baseline CSMT was 423.7 and 505.6 μm in group A and group B, respectively. In group A, BCVA worsened to 0.39 logMAR at 1 month (p < 0.001) and gradually improved to 0.25 logMAR at 6 months, which was not different from baseline BCVA. In group B, BCVA and CSMT improved at 1, 3, and 6 months (p < 0.05). The EZ signal improved in group B (p = 0.003) but not in group A. The area under the receiver operating characteristic curve for the improvement in BCVA of ≥2 lines was significant for preoperative BCVA (0.717, 95% confidence interval 0.638-0.797; p < 0.001). The cutoff value was 0.35 on the logMAR scale. Conclusion: After ERM surgery, patients with good vision maintained visual acuity after temporary worsening of vision, and patients with poor vision achieved significant BCVA improvement.
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