• Journal of The Korean Ophthalmological Society
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• v.59 no.11
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• pp.1091-1096
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• 2018

Purpose: We report a case of bilateral nonarteritic anterior ischemic optic neuropathy (NAION) following acute angle-closure crisis (AACC). Case summary: A 76-year-old female visited our clinic because of a 1-day history of ocular pain and vision loss in both eyes. The visual acuity was 0.02 in both eyes and her intraocular pressure (IOP) was 52 mmHg in the right eye (RE) and 50 mmHg in the left eye (LE). She had corneal edema and a shallow anterior chamber in both eyes, with 4 mm fixed dilated pupils. After decreasing the IOP with intravenous mannitol, laser iridotomy was performed. However, 2 days later, visual acuity was further reduced to finger counting at 10 cm RE and at 50 cm LE, and her optic disc was swollen. Bilateral NAION following AACC was diagnosed. One month later, visual acuity slightly improved to 0.02 RE and 0.04 LE, and the optic disc edema resolved. A small cup-disc ratio, optic disc pallor, and atrophy were observed. Humphrey visual fields demonstrated superior and inferior altitudial visual field defects in the LE, and almost total scotoma in the RE. Conclusions: AACC can be a predisposing factor for NAION, so the relative afferent pupillary defect, papilledema, and presentation of other risk factors are important clues to a diagnosis of NAION.

• Journal of The Korean Ophthalmological Society
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• v.59 no.12
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• pp.1122-1128
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• 2018

Purpose: To compare the measurements of the rebound tonometer (RT), Goldmann applanation tonometer (GAT) and noncontact tonometer (NCT) in patients who underwent penetrating keratoplasty (PKP), and to evaluate the reproducibility of the RT measurements. Methods: This study included 19 PKP eyes and 28 normal eyes. We compared the intraocular pressure (IOP) measurements of the GAT and NCT with the RT in both groups using Spearman's correlation analysis and the Wilcoxon signed-rank test. The IOP, as measured with an RT in each group, was assessed with respect to reproducibility using the intraclass correlation coefficient (ICC). Results: In normal eyes, there was no significant difference in the measurements obtained with the RT, GAT, and NCT (p > 0.050). In the patient group, the RT measurements were not significantly different from those of the GAT (p = 0.872), but they were significantly lower than those obtained with the NCT (p = 0.011). However, the RT measurements showed a relatively high correlation with those of the GAT and NCT (r = 0.770 and 0.879, respectively). The ICC of the RT was 0.986 for the PKP eye group and 0.961 for the normal eye group, both of which were highly reproducible. Conclusions: In PKP eyes, the measurements obtained with the RT showed a relatively high correlation with those of the GAT and NCT, and the repeatability of the RT measurements was high and similar to those for normal eyes. The RT can therefore be considered a useful method for measuring the IOP in PKP eyes.

• Journal of Naturopathy
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• v.9 no.2
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• pp.71-78
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• 2020

Purpose: This study was to present home-care cases of gangrene sores or prevalent diseases using fake energy salt (FES) water containing energy. Methods: The health functional foods used for disease management were FES Water. Each product was Myeongil Leaf powder, dried yeast, propolis, fermented organic calcium, and royal jelly. Changes were investigated after taking this food. Some of them were combined with hospital treatment, and most of them were experienced by patients at home while managing the affected area. Results: One patient with high fever swine flu, who was treated in a hospital, had a fever dropping to the normal range in 2 hours, and one patient with a leg fracture healed in about six weeks, and one patient had bone adhesion in 2 weeks. Patients with rhinitis recovered after taking FES, and the intraocular pressure of patients with damaged retinopathy fell from 40 mmHg to 20 mmHg after taking FES. One patient with postpartum sequelae was said to have improved their aching limbs four days, and a Covid-19 confirmed patient admitted to the hospital was discharged ten days after starting taking FES during treatment. The size of the gangrene sores in 19 subjects initially ranged from 1 to 7 cm. Most of them were alleviated or healed by continuing to manage them at home with health functional food intake and FES for two weeks to a year. Conclusions: The above results are personal experiences and health functions, such as fake energy salts. It was possible to recognize that food was helpful for health promotion, but no final medical diagnosis was made.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.36 no.4
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• pp.156-163
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• 2023

Objectives : The purpose of this study is to report the effect of Korean medical treatments on idiopathic bilateral strabismus. Methods : We treated a 43-year-old male idiopathic bilateral strabismus patient who was told to wait without a prescription as there was no problem in intraocular pressure test, fundus test, brain computed tomography, brain magnetic resonance imaging and angiography test, and cerebrospinal fluid test. The patient was admitted to Cheonan Korean medical hospital for 3 months to get Korean medical treatments including acupuncture, electroacupuncture, vapor treatment, pharmacopuncture therapy. The degree of improvement in idiopathic bilateral strabismus was determined by the objective measures of internal and external rotation disorders, and the patient's subjective opinions on eye pain and double vision discomfort. Results : The results of this patient showed distinct improvements on objective measures of internal and external rotation disorders in both eyes. Distance from the outer corner of the right eye when abducted decreased from 7mm to 0mm, and left eye decreased from 7mm to 0mm. Distance from the inner corner of the right eye when adducted decreased from 5mm to 0mm, and left eye decreased from 4mm to 0mm. In addition, eye pain decreased from 10 to 0 and diplopia decreased from 10 to 2 according to the patient's subjective opinions. Conclusions : This study shows the possibility that such medical treatment in Koreans can improve the rare idiopathic bilateral perspective among strabismus patients.

• Journal of The Korean Ophthalmological Society
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• v.59 no.11
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• pp.1030-1038
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• 2018

Purpose: To evaluate whether early visual acuity response at 4 weeks after the first intravitreal anti-vascular endothelial growth factor (VEGF) injection or 4 weeks after the third injection in neovascular age-related macular degeneration (nAMD) is associated with 12-month follow-up outcome. Methods: Thirty treatment-naive patients (30 eyes) with nAMD, treated with intravitreal anti-VEGF, were retrospectively included. Initially, all patients were injected at least three times for three consecutive months and followed up with a pro re nata regimen for at least 12 months. The relationship between 4 weeks after the first and third anti-VEGF injections in visual acuity response was explored, including the mean change from baseline in best-corrected visual acuity (BCVA). The mean change in BCVA was classified into three groups according to visual improvement: <1, 1-<3, or ${\geq}3$ logMAR line(s) in BCVA. The associations among baseline characteristics (gender, age, duration of symptoms, initial BCVA, central macular thickness, and intraocular pressure) and visual acuity responses 4 weeks after the first and third anti-VEGF injections were also assessed. Results: The proportions of eyes with <1, 1-<3, and ${\geq}3-line(s)$ improvement at 4 weeks after the first injection were 6 eyes (20%), 7 eyes (23.3%), and 17 eyes (56.6%), respectively. The proportions of eyes with <1, 1-<3, and ${\geq}3-line(s)$ improvement at 4 weeks after the third injection were 9 eyes (30%), 9 eyes (30%), and 12 eyes (40%), respectively. A BCVA response ${\geq}3-lines$ improvement at 4 weeks after the third injection showed significant associations with ${\geq}3-line(s)$ improvement and BCVA response at 12 months in multiple logistic and linear regression analyses (p = 0.04). Conclusions: In this study, BCVA response ${\geq}3-lines$ improvement at 4 weeks after the third injection showed a significant association with ${\geq}3-line(s)$ improvement and BCVA response at 12 months.

• Journal of The Korean Ophthalmological Society
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• v.58 no.8
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• pp.960-967
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• 2017

Purpose: To compare the macular choroidal thickness in patients with thyroid-associated ophthalmopathy (TAO) with those with normal tension glaucoma (NTG). Methods: A total of 70 normal eyes, 74 eyes with TAO and 60 eyes with NTG were enrolled in this study. All patients underwent spectral-domain optical coherence tomography (SD-OCT) (Cirrus HD-OCT, Carl Zeiss Meditec Inc., Dublin, CA, USA). Macular choroidal thickness was assessed using enhanced depth imaging. The average macular choroidal thickness was defined as the average value of three measurements: at the fovea and at the points located 1.5 mm in the nasal and temporal directions from the fovea. Generalized estimating equations were used to uncover factors affecting the average macular choroidal thickness. Results: The average, superior and inferior quadrant retinal nerve fiber layer thicknesses were significantly thinner in the NTG group compared with the TAO and control groups (p < 0.001). The average macular choroidal thickness of the TAO group, NTG group and controls was $281.01{\pm}60.06{\mu}m$, $241.66{\pm}55.00{\mu}m$ and $252.07{\pm}55.05{\mu}m$, respectively, which were significantly different (p = 0.013). The subfoveal, nasal and temporal side choroidal thicknesses were significantly thinner in the NTG group compared with the TAO group (p = 0.014, 0.012 and 0.034, respectively). Subjects with TAO were associated with a thicker average macular choroidal thickness compared with the NTG group after adjusting for age, sex, spherical equivalent and intraocular pressure (${\beta}=32.61$, p = 0.017). Conclusions: Macular choroidal thickness was significantly thicker in patients with TAO compared with those with NTG. Further evaluation is required to determine if a thick choroid in subjects with TAO has any role in glaucomatous optic neuropathy.

• Journal of The Korean Ophthalmological Society
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• v.59 no.12
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• pp.1142-1151
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• 2018

Purpose: We assessed the visual and anatomical outcomes, and the safety profile of long-term intravitreal anti-vascular endothelial growth factor (VEGF) injections (aflibercept, ranibizumab, and bevacizumab) given to treat neovascular age-related macular degeneration (NAMD). Methods: We analyzed medical records collected over 7 years of treatment-naive NAMD patients who received outpatient clinic-based intravitreal anti-VEGF injections. All were treated employing either "treat-and-extend" or "as needed" protocols at the discretion of the retinal specialist. The number of injections, adverse events associated with injection, and measures of visual acuity (VA), central foveal thickness (CFT), and intraocular pressure (IOP) were recorded. Results: Overall, we assessed 196 eyes of 196 patients (average age $68.6{\pm}9.6years$; 77 females). Patients received an average of $17.3{\pm}13.5$ injections over $78.0{\pm}16.5months$ of clinical follow-up. The initial mean VA (logMAR) was $0.75{\pm}0.58$ and the CFT was $349.7{\pm}152.6{\mu}m$. Both parameters exhibited maximal improvements at the 6-month visit (p < 0.05). However, the clinical outcomes worsened over the 7-year clinical course; the best-corrected visual acuity (BCVA) was $0.91{\pm}0.78$ and the CFT was $284.5{\pm}105.8{\mu}m$ at 7 years. The BCVA at 7 years was significantly correlated with the initial BCVA. IOP-related events increased 11-fold and anterior chamber reactions increased 3-fold over the years, but no significant complications such as endophthalmitis were recorded. Conclusions: The use of intravitreal anti-VEGF agents was associated with initial visual improvements over 6 months but did not prevent the worsening of NAMD over 5 years. The BCVA at the initial visit was a strong predictor of the final BCVA. A more intensive injection schedule might improve long-term outcomes.