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Huh MG, Shin YI, Jeong Y, Kim YK, Park KH, Jeoung JW. Long-term Follow-up of Myopic Glaucoma: Progression Rates and Associated Factors. J Glaucoma 2024:00061198-990000000-00344. [PMID: 38506760 DOI: 10.1097/ijg.0000000000002373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 02/16/2024] [Indexed: 03/21/2024]
Abstract
PURPOSE To investigate the progression rate of myopic glaucoma and associated factors by long-term analysis of its clinical course. DESIGN Longitudinal observational study. METHODS Patients who had had at least 5 years of follow-up and a spherical equivalent of - 0.5 diopters or less were included in this study. They were divided into three myopia groups according to myopic grade, namely mild myopia (-0.5 to -3.0 diopters), moderate myopia (-3.0 to -6.0 diopters), and high myopia (-6.0 diopters or more), and the clinical course, progression rate, and associated factors were compared among the groups and analyzed. RESULTS A total of 121 eyes of 121 glaucoma patients with myopia were included in the study. The average follow-up period was 10.4 ± 2.9 years. In the analysis of progression rate, the change rate of average retinal nerve fiber layer (RNFL) thickness [-0.75 μm/yr in mild myopia, -0.82 μm/yr in moderate myopia, -0.84 μm/yr in high myopia] and the mean deviation change [-0.30 dB/yr in mild myopia, -0.37 dB/yr in moderate myopia, -0.39 dB/yr in high myopia] both tended to be faster as the myopic grade increased. In a Kaplan-Meier survival analysis, the high myopia groups demonstrated a significantly faster visual acuity loss (of more than 3 lines) and a higher incidence of newly developed central visual field defect (CVFD) than did the mild and moderate myopia groups. Longer axial length (OR: 1.72, CI : 1.03 - 3.07, P = 0.047) and retinal nerve fiber layer defect (RNFLD) extending to the macula (OR: 4.14, CI : 1.54 - 12.30, P = 0.007) were significantly associated with newly developed CVFD. CONCLUSIONS In myopic glaucoma patients, the higher the degree of myopia, the faster the rate of visual acuity loss and CVFD occurrence. Occurrence of CVFD was associated with longer axial length and widening of RNFLD to the macula.
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Affiliation(s)
- Min Gu Huh
- Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
| | - Young In Shin
- Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
| | - Yoon Jeong
- Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
| | - Young Kook Kim
- Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
| | - Ki Ho Park
- Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
| | - Jin Wook Jeoung
- Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
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Ahn EJ, Shin YI, Kim YK, Jeoung JW, Park KH. Hemifield-based analysis of pattern electroretinography in normal subjects and patients with preperimetric glaucoma. Sci Rep 2024; 14:5116. [PMID: 38429373 PMCID: PMC10907379 DOI: 10.1038/s41598-024-55601-9] [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: 12/11/2023] [Accepted: 02/26/2024] [Indexed: 03/03/2024] Open
Abstract
This prospective cross-sectional study investigated the visual function of preperimetric glaucoma (PPG) patients based on hemifield (HF) pattern electroretinogram (PERG) amplitudes. Thirty-two (32) normal subjects and 33 PPG patients were enrolled in control and PPG groups, respectively. All of the participants had undergone full ophthalmic examinations, including spectral-domain optical coherence tomography (SD-OCT), visual field (VF) examination and pattern electroretinography (PERG). The PERG parameters along with the HF ratios of SD-OCT and PERG were compared between the control and PPG groups. Pairwise Pearson's correlation coefficients and linear regression models were fitted to investigate the correlations. The PERG N95 amplitudes were significantly lower in the PPG group (P < 0.001). The smaller/larger HF N95 amplitude ratio of the PPG group was found to be smaller than that of the control group (0.73 ± 0.20 vs. 0.86 ± 0.12; P = 0.003) and showed positive correlations with affected HF average ganglion cell-inner plexiform layer (GCIPL) thickness (r = 0.377, P = 0.034) and with average GCIPL thickness (r = 0.341, P = 0.005). The smaller/larger HF N95 amplitude ratio did not significantly change with age (β = - 0.005, P = 0.195), whereas the full-field N95 amplitude showed a negative correlation with age (β = - 0.081, P < 0.001). HF analysis of PERG N95 amplitudes might be particularly useful for patients with early glaucoma.
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Affiliation(s)
- Eun Jung Ahn
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
- Daehakro Seoul Eye Clinic, Seoul, Korea
| | - Young In Shin
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
- Department of Ophthalmology, Gachon University Gil Hospital, Incheon, Korea
| | - Young Kook Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
- Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea
| | - Jin Wook Jeoung
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
- Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea
| | - Ki Ho Park
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.
- Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea.
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Jeong Y, Bak E, Jang M, Ha A, Shin YI, Huh MG, Kim YK, Jeoung JW, Park KH. Clinical Significance of Optic Disc Hemorrhage Size in Visual Field Progression in Glaucoma. Am J Ophthalmol 2024; 263:109-116. [PMID: 38395332 DOI: 10.1016/j.ajo.2024.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 02/14/2024] [Accepted: 02/15/2024] [Indexed: 02/25/2024]
Abstract
PURPOSE To investigate the correlation between optic disc hemorrhage (DH) size and glaucoma progression. DESIGN A retrospective observational cohort study METHODS: SETTING: A single tertiary hospital in South Korea STUDY POPULATION: Two hundred and fifty (250) open-angle glaucoma (OAG) patients with DH. Participants were followed for 5 years or longer, with a minimum of 5 visual field (VF) tests. OBSERVATION PROCEDURE The DH area was calculated by comparing the pixel numbers of the DH area with the disc area based on optical coherence tomography (OCT). For recurrent DH cases, we calculated the average DH area. DH size was classified as large or small based on the median value. Rates of mean deviation (MD) loss were determined using guided progression analysis (GPA). Univariable and multivariable regression analyses were performed to identify significant predictors of MD loss. MAIN OUTCOME MEASURES DH size and longitudinal VF progression RESULTS: The mean follow-up period was 11.1 ± 3.6 years. The group with large DH showed faster global MD loss relative to the group with small DH (-0.51±0.48 dB/y vs -0.36 ± 0.42 dB/y, P = .01). In the multivariable model, mean DH size, maximum DH size, and initial MD were all significantly associated with the overall rate of MD loss (all P < .05). CONCLUSIONS DH size was associated with the rate of VF deterioration. Eyes with larger DH showed more pronounced VF progression.
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Affiliation(s)
- Yoon Jeong
- From the Department of Ophthalmology (Y.J., Y.S., M.G.H., Y.K.K., J.W.J., K.H.P.), Seoul National University Hospital, Seoul, Korea
| | - Eunoo Bak
- Department of Ophthalmology, Uijeongbu Eulji Medical Center (E.B.), Eulji University School of Medicine, Uijeongbu, Korea
| | - Mirinae Jang
- Department of Ophthalmology (M.J.), Yeongdong Eye Clinic, Pohang, Korea
| | - Ahnul Ha
- Department of Ophthalmology (A.H.), Jeju National University Hospital, Jeju-si, Korea; Department of Ophthalmology (A.H.), Jeju National University College of Medicine, Jeju-si, Korea
| | - Young In Shin
- From the Department of Ophthalmology (Y.J., Y.S., M.G.H., Y.K.K., J.W.J., K.H.P.), Seoul National University Hospital, Seoul, Korea
| | - Min Gu Huh
- From the Department of Ophthalmology (Y.J., Y.S., M.G.H., Y.K.K., J.W.J., K.H.P.), Seoul National University Hospital, Seoul, Korea
| | - Young Kook Kim
- From the Department of Ophthalmology (Y.J., Y.S., M.G.H., Y.K.K., J.W.J., K.H.P.), Seoul National University Hospital, Seoul, Korea; Department of Ophthalmology (Y.K.K., J.W.J. K.H.P.), Seoul National University College of Medicine, Seoul, Korea
| | - Jin Wook Jeoung
- From the Department of Ophthalmology (Y.J., Y.S., M.G.H., Y.K.K., J.W.J., K.H.P.), Seoul National University Hospital, Seoul, Korea; Department of Ophthalmology (Y.K.K., J.W.J. K.H.P.), Seoul National University College of Medicine, Seoul, Korea
| | - Ki Ho Park
- From the Department of Ophthalmology (Y.J., Y.S., M.G.H., Y.K.K., J.W.J., K.H.P.), Seoul National University Hospital, Seoul, Korea; Department of Ophthalmology (Y.K.K., J.W.J. K.H.P.), Seoul National University College of Medicine, Seoul, Korea.
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Lee J, Park JS, Jeong Y, Shin YI, Huh MG, Jeoung JW, Park KH, Kim YK. Prevalence Ratio of Primary Angle-Closure and Primary Open-Angle Glaucoma in Asian Population: A Meta-Analysis and Multiple Meta-Regression Analysis. Korean J Ophthalmol 2024; 38:42-50. [PMID: 38104594 PMCID: PMC10869426 DOI: 10.3341/kjo.2023.0057] [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: 05/25/2023] [Revised: 10/31/2023] [Accepted: 12/05/2023] [Indexed: 12/19/2023] Open
Abstract
PURPOSE To investigate the prevalence ratio of primary angle-closure glaucoma (PACG) and primary open-angle glaucoma (POAG) in the Asian population. METHODS Systematic searches of PubMed, Embase, and Cochrane databases for population-based studies in Asia published until August 5, 2022. We conducted a meta-analysis for PACG to POAG prevalence ratio using inverse variance-weighted random-effects meta-analyses so as to combine the study-specific measures of association. Between-study outcome variation (i.e., heterogeneity) was quantified with the I2 statistic. The multiple meta-regression analyses were performed in order to further account for the reasons for heterogeneity. RESULTS Twenty studies, with a total study population of 52,522 individuals, had been conducted in 13 countries. The pooled PACG to POAG prevalence ratio was 2.204 (95% confidence interval, 1.617-3.004) with high heterogeneity (p < 0.001). In multiple meta-regression model, prevalence of POAG is the most important predictor for heterogeneity (model importance, 0.954), followed continent (0.508), and publication year (0.222). For every additional elevation of POAG prevalence (i.e., increase of 1.0%), the PACG to POAG prevalence ratio is expected to rise by 0.471. CONCLUSIONS We estimated the pooled PACG to POAG prevalence ratio in the Asian population. The POAG prevalence is the most important factor to determine the PACG to POAG prevalence ratio.
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Affiliation(s)
- Jaekyoung Lee
- Department of Ophthalmology, Seoul National University Hospital, Seoul,
Korea
| | - Ji Sun Park
- Department of Ophthalmology, Seoul National University Hospital, Seoul,
Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul,
Korea
| | - Yoon Jeong
- Department of Ophthalmology, Seoul National University Hospital, Seoul,
Korea
| | - Young In Shin
- Department of Ophthalmology, Seoul National University Hospital, Seoul,
Korea
| | - Min Gu Huh
- Department of Ophthalmology, Seoul National University Hospital, Seoul,
Korea
| | - Jin Wook Jeoung
- Department of Ophthalmology, Seoul National University Hospital, Seoul,
Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul,
Korea
| | - Ki Ho Park
- Department of Ophthalmology, Seoul National University Hospital, Seoul,
Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul,
Korea
| | - Young Kook Kim
- Department of Ophthalmology, Seoul National University Hospital, Seoul,
Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul,
Korea
- EyeLight Data Science Laboratory, Seoul,
Korea
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Shin YI, Jeong Y, Huh MG, Kim YK, Park KH, Jeoung JW. Longitudinal evaluation of advanced glaucoma: ten year follow-up cohort study. Sci Rep 2024; 14:476. [PMID: 38177211 PMCID: PMC10766632 DOI: 10.1038/s41598-023-50512-7] [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: 10/26/2023] [Accepted: 12/20/2023] [Indexed: 01/06/2024] Open
Abstract
This study focused on patients with advanced open-angle glaucoma (OAG) and aimed to identify key factors for monitoring them. We included 127 such patients who were followed for seven years or more, undergoing annual ophthalmic examinations. Glaucoma progression was defined as a deterioration in either structure or function. The progression rates and risk factors were evaluated. The patients were divided into upper- and lower-half subgroups based on the reduction in intraocular pressure (IOP) from the baseline. Over an 11-year period, glaucoma progression was detected in 59 eyes (46.5%). The rate of change in mean deviation (MD) was - 0.43 dB/year for the entire population; - 0.67 dB/year for progressors; and - 0.20 dB/year for non-progressors. Hypertension and disc hemorrhage (DH) were more common in progressors compared to non-progressors (45.8 vs. 23.5%, 11.9 vs. 1.5%; P = 0.008 and P = 0.016). Multivariate Cox's proportional hazard model revealed that the presence of DH and a better baseline MD were associated with glaucoma progression. Additionally, patients with a higher percentage reduction in IOP (> 20.94%) had a lower risk of progression compared to those with less reduction. Inadequate IOP reduction, better baseline MD, presence of DH, and lower central corneal thickness were identified as risk factors for progression in advanced OAG patients.
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Affiliation(s)
- Young In Shin
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
- Department of Ophthalmology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea
| | - Yoon Jeong
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
- Department of Ophthalmology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea
| | - Min Gu Huh
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
- Department of Ophthalmology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea
| | - Young Kook Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
- Department of Ophthalmology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea
| | - Ki Ho Park
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
- Department of Ophthalmology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea
| | - Jin Wook Jeoung
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.
- Department of Ophthalmology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea.
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Kim SH, Kim YK, Shin YI, Kang G, Kim SP, Lee H, Hong IH, Chang IB, Hong SB, Yoon HJ, Ha A. Nighttime Outdoor Artificial Light and Risk of Age-Related Macular Degeneration. JAMA Netw Open 2024; 7:e2351650. [PMID: 38227312 DOI: 10.1001/jamanetworkopen.2023.51650] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2024] Open
Abstract
Importance Light pollution's impact on human health is increasingly recognized, but its link to exudative age-related macular degeneration (EAMD) remains unclear. Objective To investigate the association between exposure to outdoor artificial light at night (OALAN) and the risk of incident EAMD. Design, Setting, and Participants In this nationwide population-based case-control study, all individuals 50 years or older with newly diagnosed EAMD between January 1, 2010, and December 31, 2011, were identified with reference to the Korean National Health Insurance Service registration program database for rare and intractable diseases. Birth year- and sex-matched controls (with no EAMD diagnosis until 2020) were selected at a 1:30 ratio. Data were acquired from May 1 to December 31, 2021, and analyzed from June 1 to November 30, 2022. Exposures Mean levels of OALAN at participants' residential addresses during 2008 and 2009 were estimated using time-varying satellite data for a composite view of persistent nighttime illumination at an approximate scale of 1 km2. Main Outcomes and Measures The hazard ratios (HRs) and 95% CIs of the association between residential OALAN and risk of incident EAMD were determined based on maximum likelihood estimation after adjusting for sociodemographic characteristics, comorbidities, and area-level risk factors (ie, nighttime traffic noise and particulate matter of aerodynamic diameter ≤10 μm in each participant's administrative district of residence). Results A total of 126 418 participants were included in the analysis (mean [SD] age, 66.0 [7.9] years; 78 244 men [61.9%]). Of these, 4078 were patients with newly diagnosed EAMD and 122 340 were EAMD-free matched controls. In fully adjusted models, an IQR (55.8 nW/cm2/sr) increase in OALAN level was associated with an HR of 1.67 (95% CI, 1.56-1.78) for incident EAMD. The exposure-response curve demonstrated a nonlinear, concave upward slope becoming more pronounced at higher levels of light exposure (ie, at approximately 110 nW/cm2/sr). In a subgroup analysis, an IQR increase in OALAN was associated with increased risk of incident EAMD in urban areas (HR, 1.46 [95% CI, 1.33-1.61]) but not in rural areas (HR, 1.01 [95% CI, 0.84-1.22]). Conclusions and Relevance In this nationwide population-based case-control study, higher levels of residential OALAN were associated with an increased risk of incident EAMD. Future studies with more detailed information on exposure, individual adaptive behaviors, and potential mediators are warranted.
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Affiliation(s)
- Su Hwan Kim
- Biomedical Research Institute, Seoul National University Hospital (SNUH), Seoul, Korea
| | - Young Kook Kim
- Department of Ophthalmology, SNUH, Seoul, Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
- EyeLight Data Science Laboratory, Seoul National University College of Medicine, Seoul, Korea
| | - Young In Shin
- Department of Ophthalmology, SNUH, Seoul, Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
| | - Goneui Kang
- EyeLight Data Science Laboratory, Seoul National University College of Medicine, Seoul, Korea
| | - Seong Pyo Kim
- Interdisciplinary Program of Medical Informatics, Seoul National University College of Medicine, Seoul, Korea
| | - Hajoung Lee
- EyeLight Data Science Laboratory, Seoul National University College of Medicine, Seoul, Korea
| | - In Hwan Hong
- Department of Ophthalmology, Dongtan Sacred Heart Hospital, Hwaseong, Korea
- Department of Ophthalmology, Hallym University Medical Center, Hwaseong, Korea
| | | | - Soon-Beom Hong
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
- Department of Psychiatry, SNUH, Seoul, Korea
- Institute of Human Behavioral Medicine, SNU Medical Research Center, Seoul, Korea
| | - Hyung-Jin Yoon
- Medical Bigdata Research Center, SNU College of Medicine, Seoul, Korea
| | - Ahnul Ha
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
- Department of Ophthalmology, Jeju National University Hospital, Jeju, Korea
- Department of Ophthalmology, Jeju National University College of Medicine, Jeju, Korea
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Shin YI, Ha A, Jeong Y, Huh MG, Jeoung JW, Park KH, Kim YK. Incidence of and Risk Factors for Fellow-Eye Involvement in Sturge-Weber Syndrome Children With Unilateral Glaucoma. J Glaucoma 2024; 33:40-46. [PMID: 37671496 DOI: 10.1097/ijg.0000000000002295] [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: 05/03/2023] [Accepted: 07/23/2023] [Indexed: 09/07/2023]
Abstract
PRCIS Among children with unilateral glaucoma associated with Sturge-Weber syndrome (SWS), 7 of 47 demonstrated involvement in the fellow eye, and that group had had earlier first-eye surgery relative to the noninvolvement group. PURPOSE The aim of this study was to determine the incidence of and risk factors for fellow-eye involvement in children with unilateral SWS-associated glaucoma. MATERIALS AND METHODS Children diagnosed with a unilateral facial port-wine stain and ipsilateral glaucoma before the age of 5 and followed up for at least 5 years were enrolled. The incidence rates of fellow-eye glaucoma involvement were estimated per 100 person-years, and factors associated with a higher incidence of fellow-eye involvement were investigated. RESULTS A total of 47 children [24 (51.1%) girls] with unilateral SWS-associated glaucoma were included. All of them had facial port-wine stain involving ophthalmic division of the trigeminal nerve, and 18 (38.3%) had neurological comorbidities. The mean age at glaucoma diagnosis was 0.8±1.2 years [range, 0.08 (1 mo)-4.0 y]. Over a median follow-up of 8.4 years, glaucoma was diagnosed in the fellow eye of 7 of the children (14.9%; incidence rate of 1.8 per 100 person-years), 6 of whom were girls ( P =0.097) and 5 of whom were diagnosed before the age of 4 years ( P =0.508). The fellow-eye-involvement group showed significantly higher mean follow-up intraocular pressure in the fellow eye, older age at first-eye surgery (both P <0.005), and higher frequency of choroidal hemangioma both at first onset and in fellow eyes ( P =0.026 and 0.019, respectively). CONCLUSIONS In this cohort of SWS children diagnosed with unilateral glaucoma, the risk of fellow-eye involvement was higher in girls, within the first 4 years, and in cases with choroidal hemangioma. The fellow-eye-involved children underwent surgery on the first eye earlier than those without fellow-eye involvement.
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Affiliation(s)
- Young In Shin
- Department of Ophthalmology, Seoul National University College of Medicine
- Department of Ophthalmology, Seoul National University Hospital
| | - Ahnul Ha
- Department of Ophthalmology, Seoul National University College of Medicine
- Department of Ophthalmology, Jeju National University Hospital
- Department of Ophthalmology, School of Medicine, Jeju National University, Jeju, Korea
| | - Yoon Jeong
- Department of Ophthalmology, Seoul National University College of Medicine
- Department of Ophthalmology, Seoul National University Hospital
| | - Min Gu Huh
- Department of Ophthalmology, Seoul National University College of Medicine
- Department of Ophthalmology, Seoul National University Hospital
| | - Jin Wook Jeoung
- Department of Ophthalmology, Seoul National University College of Medicine
- Department of Ophthalmology, Seoul National University Hospital
| | - Ki Ho Park
- Department of Ophthalmology, Seoul National University College of Medicine
- Department of Ophthalmology, Seoul National University Hospital
| | - Young Kook Kim
- Department of Ophthalmology, Seoul National University College of Medicine
- Department of Ophthalmology, Seoul National University Hospital
- Department of Pediatric Ophthalmology, Seoul National University Children's Hospital, Seoul
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Huh MG, Shin YI, Jeong Y, Kim YK, Jeoung JW, Park KH. Papillomacular bundle defect (PMBD) in glaucoma patients with high myopia: frequency and risk factors. Sci Rep 2023; 13:21958. [PMID: 38081858 PMCID: PMC10713584 DOI: 10.1038/s41598-023-48687-0] [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: 03/24/2023] [Accepted: 11/29/2023] [Indexed: 12/18/2023] Open
Abstract
Little is known about the papillomacular bundle defect (PMBD) in glaucoma. As such, we investigated the frequency of PMBD in glaucoma patients with high myopia, and its risk factors. In this retrospective, cross-sectional study, retinal nerve fiber layer (RNFL) defect was analyzed in 92 glaucomatous eyes with high myopia (axial length of 26.0 mm or more or an average spherical value of - 6.0 diopters or less). After dividing them into two groups with and without PMBD, the clinical characteristics of the groups were compared and analyzed. The mean age of the patients was 52.1 ± 10.5 years, and there were 53 males and 39 females. PMBD were observed in 55 eyes (59.8%). There was no significant intergroup difference in baseline or follow-up intraocular pressure (IOP). Parapapillary atrophy (PPA)-to-disc-area ratio (OR 3.83, CI: 1.58-10.27, p = 0.010), lamina cribrosa defect (LCD; OR 2.92, CI: 1.14-8.13, p = 0.031) and central visual field defect (CVFD; OR 3.56, CI: 1.38-9.58, p = 0.010) were significantly associated with the PMBD..
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Affiliation(s)
- Min Gu Huh
- Department of Ophthalmology, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Young In Shin
- Department of Ophthalmology, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yoon Jeong
- Department of Ophthalmology, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Young Kook Kim
- Department of Ophthalmology, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jin Wook Jeoung
- Department of Ophthalmology, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Ki Ho Park
- Department of Ophthalmology, Seoul National University Hospital, Seoul, Republic of Korea.
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea.
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Shin YI, Kim YK, Jeoung JW, Park KH. Intraocular pressure reduction and progression of highly myopic glaucoma: a 12-year follow-up cohort study. Br J Ophthalmol 2023:bjo-2022-323069. [PMID: 38164537 DOI: 10.1136/bjo-2022-323069] [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: 12/12/2022] [Accepted: 11/05/2023] [Indexed: 01/03/2024]
Abstract
AIMS To investigate any association between intraocular pressure (IOP) reduction amount and open-angle glaucoma (OAG) progression in highly myopic eyes and to determine the associated risk factors. METHODS One hundred and thirty-one (131) eyes of 131 patients with highly myopic OAG, all of whom had received topical medications and been followed for 5 years or longer, were enrolled. Based on the IOP reduction percentage, patients were categorised into tertile groups, and subsequently, the upper-tertile and lower-tertile groups were compared for the cumulative probability of glaucoma progression. Kaplan-Meier survival analysis and log-rank testing were applied in the comparison, and multivariate analysis with Cox's proportional hazard model, additionally, was performed to identify progression risk factors. RESULTS Throughout the average 11.6±4.4 year follow-up on the 131 eyes (mean age, 41.2 years at initial visit; baseline IOP, 16.4 mm Hg), 72 eyes (55.0%) showed glaucoma progression. The upper-tertile group (IOP reduction percentage>23.7%) showed a high cumulative probability of non-progression relative to the lower-tertile group (IOP reduction percentage<11.0%; p=0.034), according to the Kaplan-Meier analysis. Presence of disc haemorrhage (DH; HR=2.189; p=0.032) was determined by the multivariate Cox's proportional hazard model to be significantly associated with glaucoma progression. For progressors, the average rate of retinal nerve fibre layer thickness thinning was -0.88±0.74 µm/year, while the MD change was -0.42±0.36 dB/year. CONCLUSIONS Glaucoma progression is associated with amount of IOP reduction by topical medications in highly myopic eyes, and DH occurrence is a glaucoma progression risk factor.
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Affiliation(s)
- Young In Shin
- Department of Ophthalmology, Seoul National University Hospital, Jongno-gu, South Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South Korea
| | - Young Kook Kim
- Department of Ophthalmology, Seoul National University Hospital, Jongno-gu, South Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South Korea
| | - Jin Wook Jeoung
- Department of Ophthalmology, Seoul National University Hospital, Jongno-gu, South Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South Korea
| | - Ki Ho Park
- Department of Ophthalmology, Seoul National University Hospital, Jongno-gu, South Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South Korea
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Huh MG, Kim YK, Lee J, Shin YI, Lee YJ, Choe S, Kim DW, Jeong Y, Jeoung JW, Park KH. Relative Risks for Dementia among Individuals with Glaucoma: A Meta-Analysis of Observational Cohort Studies. Korean J Ophthalmol 2023; 37:490-500. [PMID: 37899286 PMCID: PMC10721395 DOI: 10.3341/kjo.2023.0059] [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: 05/25/2023] [Revised: 09/27/2023] [Accepted: 10/05/2023] [Indexed: 10/31/2023] Open
Abstract
PURPOSE To investigate the relative risks (RRs) for dementia among individuals with glaucoma. METHODS We conducted a search of PubMed, Web of Science, Scopus, and Cochrane databases for observational cohort studies examining the association between glaucoma and dementia until March 2023. Two authors independently screened all titles and abstracts according to predefined inclusion and exclusion criteria. Pooled RR and 95% confidence intervals (CIs) were generated using random-effect models. RESULTS The meta-analysis included 18 cohort studies conducted in eight countries and involving 4,975,325 individuals. The pooled RR for the association between glaucoma and all-cause dementia was 1.314 (95% CI, 1.099-1.572; I2 = 95%). The pooled RRs for the associations of open-angle glaucoma with Alzheimer dementia and Parkinson disease were 1.287 (95% CI, 1.007-1.646; I2 = 96%) and 1.233 (95% CI, 0.677-2.243; I2 = 73%), respectively. The pooled RRs for the associations of angle-closure glaucoma with all-cause dementia and Alzheimer dementia were 0.978 (95% CI, 0.750-1.277; I2 = 17%) and 0.838 (95% CI, 0.421-1.669; I2 = 16%), respectively. No evidence of publication bias was detected in the Begg-Mazumdar adjusted rank correlation test (p = 0.47). CONCLUSIONS Based on current observational cohort studies, there is evidence supporting that glaucoma is a risk factor for dementia in the adult population.
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Affiliation(s)
- Min Gu Huh
- Department of Ophthalmology, Seoul National University Hospital, Seoul,
Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul,
Korea
| | - Young Kook Kim
- Department of Ophthalmology, Seoul National University Hospital, Seoul,
Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul,
Korea
- EyeLight Data Science Laboratory, Seoul National University College of Medicine, Seoul,
Korea
| | - Jaekyoung Lee
- Department of Ophthalmology, Seoul National University Hospital, Seoul,
Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul,
Korea
| | - Young In Shin
- Department of Ophthalmology, Seoul National University Hospital, Seoul,
Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul,
Korea
| | - Yun Jeong Lee
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul,
Korea
- Department of Ophthalmology, Chungnam National University Hospital, Daejeon,
Korea
| | - Sooyeon Choe
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul,
Korea
- Department of Ophthalmology, Chungnam National University Hospital, Daejeon,
Korea
| | - Dai Woo Kim
- Department of Ophthalmology, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu,
Korea
| | - Yoon Jeong
- Department of Ophthalmology, Seoul National University Hospital, Seoul,
Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul,
Korea
| | - Jin Wook Jeoung
- Department of Ophthalmology, Seoul National University Hospital, Seoul,
Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul,
Korea
| | - Ki Ho Park
- Department of Ophthalmology, Seoul National University Hospital, Seoul,
Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul,
Korea
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Wy S, Shin YI, Kim YK, Jeoung JW, Park KH. Bleb Morphology on Anterior-Segment Optical Coherence Tomography after XEN Gel Stent Implantation. J Clin Med 2023; 12:6740. [PMID: 37959206 PMCID: PMC10648008 DOI: 10.3390/jcm12216740] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 10/24/2023] [Accepted: 10/24/2023] [Indexed: 11/15/2023] Open
Abstract
We investigated the internal morphology of filtration blebs after XEN gel stent implantation using anterior segment optical coherence tomography (AS-OCT) and identified factors related to intraocular pressure (IOP) postoperatively. Eighteen eyes of 18 patients who had undergone XEN gel stent implantation were analyzed. Blebs were imaged using Visante OCT (Carl Zeiss Meditec AG, Germany) at 6 months and 1 year after surgery and evaluated for quantitative parameters including bleb height, maximum height of internal cavity, maximum bleb wall thickness, and maximum bleb epithelial thickness. Subjects were classified into two groups according to the presence or absence of a definite internal cavity between the conjunctiva and sclera using AS-OCT imaging. Nine eyes (50%) were assigned to the internal cavity group and 9 (50%) to the uniform group. Postoperative IOP was significantly lower in the internal cavity group than in the uniform group both at 6 months and 1 year after surgery (p = 0.024 and p = 0.040). Postoperative IOP showed statistically significant negative correlations with bleb height and the height of the internal cavity (Spearman correlation coefficient r = -0.518, p = 0.028 and r = -0.453, p = 0.034, respectively). AS-OCT facilitates analysis of bleb morphology after XEN gel stent implantation. A larger height of the internal cavity of the bleb appeared to correlate with lower IOP after XEN implantation.
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Affiliation(s)
- Seoyoung Wy
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul 03080, Republic of Korea; (S.W.); (Y.I.S.); (Y.K.K.); (J.W.J.)
- Hangil Eye Hospital, Incheon 21388, Republic of Korea
| | - Young In Shin
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul 03080, Republic of Korea; (S.W.); (Y.I.S.); (Y.K.K.); (J.W.J.)
- Department of Ophthalmology, Seoul National University Hospital, Seoul 03080, Republic of Korea
| | - Young Kook Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul 03080, Republic of Korea; (S.W.); (Y.I.S.); (Y.K.K.); (J.W.J.)
- Department of Ophthalmology, Seoul National University Hospital, Seoul 03080, Republic of Korea
| | - Jin Wook Jeoung
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul 03080, Republic of Korea; (S.W.); (Y.I.S.); (Y.K.K.); (J.W.J.)
- Department of Ophthalmology, Seoul National University Hospital, Seoul 03080, Republic of Korea
| | - Ki Ho Park
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul 03080, Republic of Korea; (S.W.); (Y.I.S.); (Y.K.K.); (J.W.J.)
- Department of Ophthalmology, Seoul National University Hospital, Seoul 03080, Republic of Korea
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12
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Shin YI, Jung JH. Modified Harada-Ito Procedure with Intraoperative Adjustable Sutures Using a Mendez Ring for Excyclotorsion. J Korean Ophthalmol Soc 2022. [DOI: 10.3341/jkos.2022.63.2.211] [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: We report a case of using a modified Harada-Ito procedure with intraoperative adjustment via a Mendez ring in a patient with bilateral superior oblique palsy, resulting in satisfactory postoperative outcomes.Case summary: A 47-year-old male patient presented with bilateral diplopia after cerebral hemorrhage. Bilateral superior oblique palsy was diagnosed, and double Maddox rod tests confirmed 20° of excyclotorsion in both eyes. After 6 months of observation, surgical correction was attempted. To check the amount of cyclodeviation, a modified Harada–Ito procedure was performed on the superior oblique muscle after marking at the 6 and 12 o'clock positions of the corneal limbus. Following the procedure, a Mendez ring was placed on the limbus to check for the amount of incyclotorsion. Thirty degrees of incyclotorsion was aimed at both eyes, and a 5-mm resection of the right superior oblique tendon was performed for additional correction. There was no complaint of diplopia at 6 months postoperatively, and no deviation was observed.Conclusions: A modified Harada-Ito procedure with intraoperative adjustment using a Mendez ring effectively corrected excyclotorsion with torsional diplopia.
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Shin YI, Kim YK, Choe S, Lee YJ, Jang M, Wy S, Jeoung JW, Park KH. Clinical Features of the Fellow Eyes of Children with Unilateral Facial Port-Wine Stains and Ipsilateral Glaucoma. J Korean Ophthalmol Soc 2021. [DOI: 10.3341/jkos.2021.62.12.1637] [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 clinical features of non-affected fellow eyes in patients with unilateral facial port-wine stain (PWS) and ipsilateral secondary glaucoma.Methods: We performed a retrospective analysis of the medical records of 35 patients with unilateral facial PWS glaucoma and those of controls (35 subjects without both facial PWS and glaucoma) between September 1996 and May 2020. We noted patients’ age at the glaucoma diagnosis (for unilateral facial PWS glaucoma patients) or at the initial examination (for controls), cup-to-disc ratio (CDR), and intraocular pressure (IOP). We compared the clinical features between the glaucoma-free eyes in patients with unilateral facial PWS glaucoma and the controls.Results: The mean age at the glaucoma diagnosis for unilateral facial PWS glaucoma patients was 0.56 ± 0.99 years (range, 0.08-4). The mean IOP of the glaucoma-free eyes was 16.68 ± 5.73 mmHg (range, 9-22.9), and the mean CDR was 0.37 ± 0.14 (range, 0.15-0.80) at glaucoma diagnosis. The mean IOP of the glaucoma-free eyes was 14.14 ± 6.29 mmHg (range, 8.1-26.7), and the mean CDR was 0.37 ± 0.12 (range, 0.26-0.82) at final examination. When comparing glaucoma-free eyes of the unilateral facial PWS glaucoma patients with the control group (mean age, 11.2 ± 7.4 years), the mean CDR was significantly greater (0.37 ± 0.12 vs. 0.30 ± 0.08; p = 0.014) but there was no significant difference in the mean IOP (14.14 ± 6.29 mmHg vs. 14.57 ± 2.49 mmHg; p = 0.712).Conclusions: The glaucoma-free eyes of unilateral facial PWS glaucoma patients showed greater CDR compared to the non-facial PWS and non-glaucoma controls. Additional longitudinal studies are needed to investigate the clinical course of those eyes, whether the risk of developing glaucoma is increased.
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Shin YI, Lee KM, Kim M, Oh S, Kim SH. Short foveo-disc distance in situs inversus of optic disc. Sci Rep 2020; 10:17740. [PMID: 33082477 PMCID: PMC7576120 DOI: 10.1038/s41598-020-74743-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 03/19/2020] [Accepted: 10/06/2020] [Indexed: 12/01/2022] Open
Abstract
Situs inversus of optic disc (SIOD) is thought to be a congenital optic disc abnormality that is caused by dysversion of optic nerve insertion. SIOD, however, has many additional features that cannot be explained by abnormal optic-nerve-insertion directionality. In this study, we measured the distance between the fovea and disc in 22 eyes of 15 SIOD patients. For comparison, two control eyes were matched with each SIOD eye by age and axial length. The vertical distance between the temporal vascular arcades also was measured. The foveo-disc distance was shorter in the SIOD eyes than in the control eyes, while the inter-arcade distance did not differ. Further, we measured the circumpapillary retinal nerve fiber layer thickness, which showed nasal crowding of two humps in the SIOD eyes. This nasal crowding disappeared when we shifted the circle scan by the mean difference (465 μm) of the foveal-disc distance between the two groups. Our findings suggest that the optic disc was located closer to the fovea than it would have been normally. Thus, SIOD might reflect incomplete expansion of the posterior pole in the direction of the fovea-disc axis.
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Affiliation(s)
- Young In Shin
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.,Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea
| | - Kyoung Min Lee
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.,Department of Ophthalmology, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Martha Kim
- Department of Ophthalmology, Dongguk University Ilsan Hospital, Goyang, Korea
| | - Sohee Oh
- Department of Ophthalmology, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Seok Hwan Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea. .,Department of Ophthalmology, Seoul National University Boramae Medical Center, Seoul, Korea.
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Shin YI, Kim K, Kim JA, Noh HR, Jhe W, Oh K, Paek UC. Diffraction-limited dark laser spot produced by a hollow optical fiber. Opt Lett 2001; 26:119-121. [PMID: 18033522 DOI: 10.1364/ol.26.000119] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
By using the diffracted field of the LP(11) mode of a hollow-core optical fiber, we have produced a micrometer-sized, focused dark laser spot in the near field of the fiber. The minimum half-width of the dark spot is less than 1 mum . In particular, by masking the hollow core and metal coating the cladding with a microsphere, we blocked the light propagating in the cladding and obtained a clean dark spot, which may be useful in atom-optical experiments such as with atomic lenses, atom traps, and atom switches.
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Ro YS, Shin YI. A case of lichen striatus following Blaschko lines. Cutis 2001; 67:31-2, 34. [PMID: 11204601] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
We present a case of lichen striatus (LS) in a 36-year-old woman with skin lesions on the right side of the chest distributed along Blaschko lines that showed a swirling s-shaped pattern. The differential diagnosis of LS includes a variety of nevoid and acquired conditions following Blaschko lines, particularly acquired relapsing self-healing Blaschko dermatitis. The extent to which these 2 conditions overlap remains contentious.
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Affiliation(s)
- Y S Ro
- Department of Dermatology, Hanyang University Hospital, Haengdang-dong, Sungdong-gu 133-792, Seoul, Korea
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