• Design & Manufacturing
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• v.17 no.1
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• pp.40-47
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• 2023

Macular degeneration and glaucoma are representative age-related retinal diseases that rank second and third in the prevalence of retinal diseases, and are a kind of degenerative neurological disease. Irreversible visual acuity and visual field damage may occur, and the number of patients is rapidly increasing as the population ages. Since this retinal disease is a chronic disease, continuous drug treatment is required. There are various drug delivery methods for treatment, but direct injection of the drug into the intravitreal is the most effective for continuous delivery of the drug over a long period of time. In order to solidify Dexamethasone, a retinal disease treatment, and insert it into the primary intravitreal, it is important to develop a technology to miniaturize the treatment and an applicator to deliver the treatment. In this study, a mold technology was developed to integrate the cannula and hub, which are one part of applicator. In addition, surface treatment was performed on the outside of the cannula to improve the bonding strength between the cannula and the hub, and the bonding strength according to each condition was analyzed through a tensile test.

• The Korean Journal of Physiology and Pharmacology
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• v.19 no.2
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• pp.167-175
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• 2015

A retinal prosthesis is being developed for the restoration of vision in patients with retinitis pigmentosa (RP) and age-related macular degeneration (AMD). Determining optimal electrical stimulation parameters for the prosthesis is one of the most important elements for the development of a viable retinal prosthesis. Here, we investigated the effects of different charge-balanced biphasic pulses with regard to their effectiveness in evoking retinal ganglion cell (RGC) responses. Retinal degeneration (rd1) mice were used (n=17). From the ex-vivo retinal preparation, retinal patches were placed ganglion cell layer down onto an $8{\times}8$ multielectrode array (MEA) and RGC responses were recorded while applying electrical stimuli. For asymmetric pulses, 1st phase of the pulse is the same with symmetric pulse but the amplitude of 2nd phase of the pulse is less than $10{\mu}A$ and charge balanced condition is satisfied by lengthening the duration of the pulse. For intensities (or duration) modulation, duration (or amplitude) of the pulse was fixed to $500{\mu}s$($30{\mu}A$), changing the intensities (or duration) from 2 to $60{\mu}A$(60 to $1000{\mu}s$). RGCs were classified as response-positive when PSTH showed multiple (3~4) peaks within 400 ms post stimulus and the number of spikes was at least 30% more than that for the immediate pre-stimulus 400 ms period. RGC responses were well modulated both with anodic and cathodic phase-1st biphasic pulses. Cathodic phase-1st pulses produced significantly better modulation of RGC activity than anodic phase-1st pulses regardless of symmetry of the pulse.

• Database Research
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• v.34 no.3
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• pp.124-136
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• 2018

There have been active research activities to use neural networks to analyze OCT images and make medical decisions. One requirement for these approaches to be promising solutions is that the trained network must be generalized to new devices without a substantial loss of performance. In this paper, we use a deep convolutional neural network to distinguish AMD from normal patients. The network was trained using a data set generated from an OCT device. We observed a significant performance degradation when it was applied to a new data set obtained from a different OCT device. To overcome this performance degradation, we propose an image normalization method which performs segmentation of OCT images to identify the retina area and aligns images so that the retina region lies horizontally in the image. We experimentally evaluated the performance of the proposed method. The experiment confirmed a significant performance improvement of our approach.

• Progress in Medical Physics
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• v.19 no.1
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• pp.73-79
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• 2008

Retinal prosthesis is regarded as the most feasible method for the blind caused by retinal diseases such as retinitis pigmentosa (RP) or age related macular degeneration (AMD). Recently Korean consortium launched for developing retinal prosthesis. One of the prerequisites for the success of retinal prosthesis is the optimization of the electrical stimuli applied through the prosthesis. Since electrical characteristics of degenerate retina are expected to differ from those of normal retina, we performed voltage stimulation experiment both in normal and degenerate retina to provide a guideline for the optimization of electrical stimulation for the upcoming prosthesis. After isolation of retina, retinal patch was attached with the ganglion cell side facing the surface of microelectrode arrays (MEA). $8{\times}8$ grid layout MEA (electrode diameter: $30{\mu}m$, electrode spacing: $200{\mu}m$, and impedance: $50k{\Omega}$ at 1 kHz) was used to record in-vitro retinal ganglion cell activity. Mono-polar electrical stimulation was applied through one of the 60 MEA channel, and the remaining channels were used for recording. The electrical stimulus was a constant voltage, charge-balanced biphasic, anodic-first square wave pulse without interphase delay, and 50 trains of pulse was applied with a period of 2 sec. Different electrical stimuli were applied. First, pulse amplitude was varied (voltage: $0.5{\sim}3.0V$). Second, pulse duration was varied $(100{\sim}1,200{\mu}s)$. Evoked responses were analyzed by PSTH from averaged data with 50 trials. Charge density was calculated with Ohm's and Coulomb's law. In normal retina, by varying the pulse amplitude from 0.5 to 3V with fixed duration of $500{\mu}s$, the threshold level for reliable ganglion cell response was found at 1.5V. The calculated threshold of charge density was $2.123mC/cm^2$. By varying the pulse duration from 100 to $1,200{\mu}s$ with fixed amplitude of 2V, the threshold level was found at $300{\mu}s$. The calculated threhold of charge density was $1.698mC/cm^2$. Even after the block of ON-pathway with L-(1)-2-amino-4-phosphonobutyric acid (APB), electrical stimulus evoked ganglion cell activities. In this APB-induced degenerate retina, by varying the pulse duration from 100 to $1200{\mu}s$ with fixed voltage of 2 V, the threshold level was found at $300{\mu}s$, which is the same with normal retina. More experiment with APB-induced degenerate retina is needed to make a clear comparison of threshold of charge density between normal and degenerate retina.

• Progress in Medical Physics
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• v.19 no.3
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• pp.157-163
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• 2008

Retinal prosthesis is regarded as the most feasible method for the blind caused by retinal diseases such as retinitis pigmentosa or age-related macular degeneration. One of the prerequisites for the success of retinal prosthesis is the optimization of the electrical stimuli applied through the prosthesis. Since electrical characteristics of degenerate retina are expected to differ from those of normal retina, we investigated differences of the retinal waveforms in normal and degenerate retina to provide a guideline for the optimization of electrical stimulation for the upcoming prosthesis. After isolation of retina, retinal patch was attached with the ganglion cell side facing the surface of microelectrode arrays (MEA). $8{\times}8$ grid layout MEA (electrode diameter: $30{\mu}m$, electrode spacing: $200{\mu}m$, and impedance: 50 $k{\Omega}$ at 1 kHz) was used to record in-vitro retinal ganglion cell activity. In normal mice (C57BL/6J strain) of postnatal day 28, only short duration (<2 ms) retinal spikes were recorded. In rd/rd mice (C3H/HeJ strain), besides normal spikes, waveform with longer duration (~100 ms), the slow wave component was recorded. We attempted to understand the mechanism of this slow wave component in degenerate retina using various synaptic blockers. We suggest that stronger glutamatergic input from bipolar cell to the ganglion cell in rd/rd mouse than normal mouse contributes the most to this slow wave component. Out of many degenerative changes, we favor elimination of the inhibitory horizontal input to bipolar cells as a main contributor for a relatively stronger input from bipolar cell to ganglion cell in rd/rd mouse.

• Progress in Medical Physics
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• v.21 no.2
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• pp.209-217
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• 2010

Retinal prostheses are being developed to restore vision for the blind with retinal diseases such as retinitis pigmentosa (RP) or age-related macular degeneration (AMD). Since retinal prostheses depend upon electrical stimulation to control neural activity, optimal stimulation parameters for successful encoding of visual information are one of the most important requirements to enable visual perception. Therefore, in this paper, we focused on retinal ganglion cell (RGC) responses to different voltage stimulation parameters and compared threshold charge densities in normal and rd1 mice. For this purpose, we used in vitro preparation for the retina of normal and rd1 mice on micro-electrode arrays. When the neural network of rd1 mouse retinas is stimulated with voltage-controlled pulses, RGCs in degenerated retina also respond to voltage amplitude or voltage duration modulation as well in wild-type RGCs. But the temporal pattern of RGCs response is very different; in wild-type RGCs, single peak within 100 ms appears while in RGCs in degenerated retina multiple peaks (~4 peaks) with ~10 Hz rhythm within 400 ms appear. The thresholds for electrical activation of RGCs are overall more elevated in rd1 mouse retinas compared to wild-type mouse retinas: The thresholds for activation of RGCs in rd1 mouse retinas were on average two times higher ($70.50{\sim}99.87\;{\mu}C/cm^2$ vs. $37.23{\sim}61.65\;{\mu}C/cm^2$) in the experiment of voltage amplitude modulation and five times higher ($120.5{\sim}170.6\;{\mu}C/cm^2$ vs. $22.69{\sim}37.57\;{\mu}C/cm^2$) in the experiment of voltage duration modulation than those in wild-type mouse retinas. This is compatible with the findings from human studies that the currents required for evoking visual percepts in RP patients is much higher than those needed in healthy individuals. These results will be used as a guideline for optimal stimulation parameters for upcoming Korean-type retinal prosthesis.

• Journal of Korean Ophthalmic Optics Society
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• v.16 no.2
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• pp.209-217
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• 2011

Purpose: In this study, eye-health inequity was investigated by analyzing the relationship between household incomes and eye-health of senior citizens. Further, this study suggested the preliminary data for establishment of public eye-health policy in order to improve low income senior citizens' life quality. Methods: The data from the 2009 Survey of Korea National Health and Nutrition Examination were analyzed in this study. The objectives of the KNHNE survey were over 65 year old group (1,668 people). Main factors of eye-health (visual acuity, cataract, pterygium, intraocular pressure, retinophathy, age-related macular degeneration, diabetic retinophathy, myopia, hyperopia, astigmatism, and anisometropia prevalence) were analyzed with t-test and chi square test. Results: Low income group revealed that refractive error rate and intraocular pressure were low, however, naked eye visual acuity and corrected visual acuity were high at 0.1 to less than 0.5. On the other hands, in the high income group, there was high prevalence of hyperopia. Cataract mainly occurred at low income group besides group which maximum corrected visual acuity was below 0.8 also highly showed cataract. Moreover, the prevalence of cataract showed that it related with smoking, drinking, occupation, and education level. Conclusions: Results revealed that there was inequity of eye-health which related with socioeconomic status of the elderly. Especially, the prevalence of cataract was correlated with life quality. Consequently, establishment of public eye-health policy seems to be required for eye-health inequity of low income senior citizens.

• Clinical and Experimental Reproductive Medicine
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• v.37 no.2
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• pp.89-98
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• 2010

Sex and its tropic hormones influence the lacrimal system, corneal anatomy and disease, aqueous humor dynamics and glaucoma, crystalline lens and cataract, and retinal disease. Dry eye occurs especially frequently during pregnancy, oral contraceptive use, and after menopause, during which androgen levels decrease. Androgen control development, differentiation, and lipid production of sebaceous glands throughout the body, and androgen deficiency also leads to meibomian gland dysfunction and evaporative dry eye. On the other hand, estrogen causes a reduction in size, activity, and lipid production of sebaceous glands. Sex and its tropic hormones also influence the corneal anatomy and disease, and corneal thickening occurred on the second day of the menstrual cycle and around the time of ovulation and appeared to be related to estrogen levels. Fuchs' dystrophy is more commonly seen in postmenopausal women than men and may be linked to hormonal changes that occur with aging. In addition, overexpression of estrogen and progesterone receptors in the conjunctiva of vernal keratoconjunctivitis patients. Serum progesterone levels also may be associated with intraocular pressure especially in pregnant women, and for the women. For women with cataracts, hormone levels were typical of menopause, and there was a significant negative correlation between estradiol and follicular stimulating hormone levels. In addition, serum testosterone levels are associated with the development of diabetic retinopathy. Although the role of sex hormones on the eye is largely unknown, and the results should be interpreted with caution until replicated, the functions of sex hormones in ocular disease remains to be investigated, because they may be involved in structure and function of the ocular components, which are important in the pathogenesis of ocular disease.

• Journal of Korean Ophthalmic Optics Society
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• v.21 no.1
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• pp.69-76
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• 2016

Purpose: The study was conducted to determine that photoreceptors of mouse having pigment in RPE(retinal pigment epithelium) can be damaged by blue-light and apoptosis of specific cells among photoreceptors are induced by blue-light, and to assist the investigation of AMD(Age-related macular degeneration) mechanisms and development of AMD drugs. Methods: C57Black mice were injured by irradiating $2800{\pm}10lux$ of 463 nm LED for 6 hours after 24 hours dark adaptation and eyes were enucleated 1, 3, 7 days. Damage of retina induced by blue-light was determined by western blotting GFAP(Glial fibrillary acidic protein) expression. In the light-injured retina, cell death of photoreceptors was determined by TUNEL(Terminal deoxynucleotidyl transferase dUTP nick end labeling) assay. ERK(Extracellular signal-regulated kinases), JNK, and SRC(sarcoma) expression were assessed by western blotting to determine regulated pathway. Blue light-injured retina were immunostained with antibodies against Opsin and Rhodopsin as markers of photoreceptors to compared the damage cone cells with rod cells. Results: After 1, 3 and 7 days from exposure to blue-light, thickness of retina was more decreased than control, and more decreased at nuclear layer than at outer plexiform layer and GFAP expression was increased day 1 after blue-light injured. While phosphorylated ERK and SRC protein expressions at day 1 were increased after blue-light injured, phosphorylated c-JUN was decreased. Fluorescence intensity analysis showed that markers of cone and rod cells were decreased after blue-light injured and Opsin was more decreased than Rhodopsin. Conclusions: The study suggests possibilities that the blue-light promotes retinal damage and causes apoptotic cell death via ERK and SRC pathway in mouse retina, and blue-light retinal damage is more induced cone cells apoptosis than rod cells directly.

• Radiation Oncology Journal
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• v.25 no.2
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• pp.63-69
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• 2007

[ $\underline{Purpose}$ ]: We performed this prospective randomized study to evaluate the efficacy and the complications of radiotherapy for Subfoveal CNV in ARMD and to compare the treatment results at two dosages (14.4 Gy and 19.8 Gy). $\underline{Materials\;and\;Methods}$: 60 eyes of 55 patients were enrolled, and randomized into 14.4 Gy (31 eyes) or 19.8 Gy (29 eyes) groups. CT was used to plan the radiotherapy. All patients received radiotherapy with a 1.8 Gy daily dose using 4 MV photon. We categorized treatment results as improved, stable, or deteriorated based on visual acuity changes of more than 2 lines on the ETDRS chart. $\underline{Results}$: Median follow-up period was 33.5 months. At 12 months, visual acuity improved in 9 (16.7%), stable in 41 (75.9%), and aggravated in 4 (7.4%) of 54 evaluated eyes. At 24 months, 49 eyes (81.7%) were evaluated. Visual acuity improved in 6 (12.2%), was stable in 33 (67.4%), and deteriorated in 10 (20.4%). At 36 months, 37 eyes were evaluated. Six (16.2%) eyes were improved, 21 (56.8%) stable, and 10 (27.0%) deteriorated. No significant difference in response was observed between the 14.4 Gy and 19.8 Gy groups (Mantel-Haenszel $x^2=0.4756$). The proportion of eyes with a vision of $20/100{\leq}increased$ from 28.3% initially to 32.7% after 24 months of radiotherapy. There were no severe acute or chronic complications. $\underline{Conclusion}$: External beam radiotherapy with doses of 14.4 or 19.8 Gy may be an effective treatment for subfoveal CNV in ARMD. No dose-response relationships with respect to treatment response or toxicity were observed between the 14.4 Gy and 19.8 Gy groups.