• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.33 no.2
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• pp.1-11
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• 2020

Objectives : The purpose of this study was to analyze and report status of Korean Medicine Ophthalmology patients who did funduscopy examination. Through this, we hope that the development of our diagnosis and treatment. Methods : From June 1, 2010 to May 31, 2019, Based on the electronic medical records of patients who had funduscopy examination at Korean Medicine Ophthalmology, Busan University Korean Medicine Hospital, the gender, age, visiting motives and paths, diagnosis, examination number of years, other eye examinations and treatments method were summarized and analyzed. Results : 463 patients were able to check the electronic medical records. They were 283 females and 180 males. The mean age of the patients was 51.5 years and elderly patients who 50s and 60s were 49.3% of whole patients. The most common motives for Korean Medicine Ophthalmology visitation was 'combination treatment with other department in Korean Medicine Hospital'. Outer eye diseases were 283 cases, inner eye diseases were 198 cases. Dry eye syndrome, asthenopia, visual discomfort, conjunctivitis, and eye discomfort were most common in the outer eye diseases. Cataracts, Vitreous floater, Macular Degeneration, Glaucoma and Ocular Pain were most common in the inner eye disease. The most common parts of outer eye diseases were Conjunctival, lacrimal gland, paralytic, corneal, eyelid and front uveal, scleral disease and then in inner eye diseases parts, Retinal, lens, vitreous, glaucoma, optic nerve, behind uveal, choroid disease were most common. The number of funduscopy examination was ups and downs. Herbal medicine was the most common used. Conclusions : The funduscopy examination is essential for diagnosis and treatment of eye disease. We hope that the use of fundus examination and other ophthalmologic examination will be expanded soon in Korean Medicine Ophthalmology.

• 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.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.36 no.2
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• pp.26-44
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• 2023

Objectives : This study was designed to examine and analyze the recent trend of Korean medicine research on retinal and optic nerve diseases, which is increasing. Methods : This study examines papers related to diseases occurring in the retina and optic nerve that were published in Korean journals of Korean medicine, and analyzes the results of research so far by classifying them by year, journal, disease type and type of paper. Results : 1. Since it was first published in 1995, a total of 17 articles have been published until 2018, with 2 articles(11.1%) each in 1997, 2014 and 2018, and 1 article(5.6%) each in other years. 2. The number of searched journals was 17 paper; 4 review articles, 1 original articles, 12 case reports. 3. Distribution of journals; the percentage of Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology ranked the highest(41.2%). 4. Classification of 12 case reports into three categories; 7 retinal diseases, 3 optic nerve diseases, 2 other diseases. Conclusions : Currently, researches on retinal and optic nerve involvement in the Korean medicine journals have been conducted mainly through case reports. In the future, more clinical research and case reports are necessary to give practical application to patients.

• Journal of Genetic Medicine
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• v.4 no.1
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• pp.22-37
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• 2007

The autosomal dominant spinocerebellar ataxias (SCAs) are a group of neurodegenerative diseases, clinically and genetically heterogeneous, characterized by degeneration of spinocerebellar pathways with variable involvement of other neural systems. At present, 27 distinct genetic forms of SCAs are known: SCA1-8, SCA10-21, SCA23, SCA25-28, DRPLA (dentatorubral-pallidoluysian atrophy), and 16q-liked ADCA (autosomal dominant cerebellar ataxia). Epidemiological data about the prevalence of SCAs are restricted to a few studies of isolated geographical regions, and most do not reflect the real occurrence of the disease. In general a prevalence of about 0.3-2 cases per 100,000 people is assumed. As SCA are highly heterogeneous, the prevalence of specific subtypes varies between different ethnic and continental populations. Most recent data suggest that SCA3 is the commonest subtype worldwide; SCA1, SCA2, SCA6, SCA7, and SCA8 have a prevalence of over 2%, and the remaining SCAs are thought to be rare (prevalence <1%). In this review, we highlight and discuss the SCA7. The hallmark of SCA7 is the association of hereditary ataxia and visual loss caused by pigmentary macular degeneration. Visual failure is progressive, bilateral and symmetrical, and leads irreversibly to blindness. This association represents a distinct disease entity classified as autosomal dominant cerebellar ataxia (ADCA) type II by Harding. The disease affectsprimarily the cerebellum and the retina by the moderate to severe neuronal loss and gliosis, but also many other central nervous system structures as the disease progresses. SCA7 is caused by expansion of an unstable trinucleotide CAG repeat in the ATXN7 gene encoding a polyglutamine (polyQ) tract in the corresponding protein, ataxin-7. Normal ATXN7 alleles contain 4-35 CAG repeats, whereas pathological alleles contain from 36->450 CAG repeats. Immunoblott analysis demonstrated that ataxin-7 is widely expressed but that expression levels vary among tissues. Instability of expanded repeats is more pronounced in SCA7 than in other SCA subtypes and can cause substantial lowering of age at onset in successive generations termed ‘anticipation’ so that children may become diseased even before their parents develop symptoms. The strong anticipation in SCA7 and the rarity of contractions should have led to its extinction within a few generations. There is no specific drug therapy for this neurodegenerative disorder. Currently, therapy remains purely symptomatic. Cellular models and SCA7 transgenic mice have been generated which constitute valuable resources for studying the disease mechanism. Understanding the pathogenetic mechanisms of neurodegeneration in SCAs should lead to the identification of potential therapeutic targets and ultimately facilitate drug discovery. Here we summarize the clinical, pathological, and genetic aspects of SCA7, and review the current understanding of the pathogenesis of this disorder. Further, we also review the potential therapeutic strategies that are currently being explored in polyglutamine diseases.

• 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.

• Journal of Korean Ophthalmic Optics Society
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• v.18 no.4
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• pp.489-493
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• 2013

Purpose: This study was to investigate peripheral vision and provide people with macular degeneration with a guideline for eccentric viewing training. Methods: 30 adult subjects with normal vision took part in this study. The lateral area of $20^{\circ}$ eccentricity from the fovea of right eye was only used to measure the physiological summation. The target was sinusoidal vertical gratings within a circular aperture. The critical points in spatial and temporal summation was found to compare each other for 0.7 cpd and 3.0 cpd, respectively. Results: Critical duration and contrast sensitivity for 0.7 cpd were 540 ms and 1.1, and 315 ms and 0.98 for 3.0 cpd respectively. The critical degrees and contrast sensitivity for 0.7 cpd were $11.3^{\circ}$ and 2.8, and $5^{\circ}$ and 2.63 for 3.0 cpd respectively. Conclusions: The critical point in peripheral vision reaches relatively faster than the one in central vision. It is recommended to train the peripheral retina under the lower spatial frequency more frequently for a short time than constantly for a long time.

• Biomolecules & Therapeutics
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• v.27 no.5
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• pp.474-483
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• 2019

Vascular endothelial growth factor (VEGF) plays a pivotal role in pathologic ocular neovascularization and vascular leakage via activation of VEGF receptor 2 (VEGFR2). This study was undertaken to evaluate the therapeutic mechanisms and effects of the tetrapeptide Arg-Leu-Tyr-Glu (RLYE), a VEGFR2 inhibitor, in the development of vascular permeability and choroidal neovascularization (CNV). In cultured human retinal microvascular endothelial cells (HRMECs), treatment with RLYE blocked VEGF-A-induced phosphorylation of VEGFR2, Akt, ERK, and endothelial nitric oxide synthase (eNOS), leading to suppression of VEGF-A-mediated hyper-production of NO. Treatment with RLYE also inhibited VEGF-A-stimulated angiogenic processes (migration, proliferation, and tube formation) and the hyperpermeability of HRMECs, in addition to attenuating VEGF-A-induced angiogenesis and vascular permeability in mice. The anti-vascular permeability activity of RLYE was correlated with enhanced stability and positioning of the junction proteins VE-cadherin, ${\beta}$-catenin, claudin-5, and ZO-1, critical components of the cortical actin ring structure and retinal endothelial barrier, at the boundary between HRMECs stimulated with VEGF-A. Furthermore, intravitreally injected RLYE bound to retinal microvascular endothelium and inhibited laser-induced CNV in mice. These findings suggest that RLYE has potential as a therapeutic drug for the treatment of CNV by preventing VEGFR2-mediated vascular leakage and angiogenesis.