The Effect of cyclosporin A on delayed adjustable strabismus surgery in rabbits

학위논문(박사)--서울대학교 :의학과 안과학 전공,1999.Docto

Horner's syndrome with abducens nerve palsy.

A 68-year-old male patient presented with a week of sudden diplopia. He had been diagnosed with nasopharyngeal cancer 8 months prior and had undergone chemotherapy with radiotherapy. Eight-prism diopter right esotropia in the primary position and a remarkable limitation in abduction in his right eye were observed. Other pupillary disorders and lid drooping were not found. After three weeks, the marginal reflex distance 1 was 3 mm in the right eye and 5 mm in the left eye. The pupil diameter was 2.5 mm in the right eye, and 3 mm in the left eye under room illumination. Under darkened conditions, the pupil diameter was 3.5 mm in the right eye, and 5 mm in the left eye. After topical application of 0.5% apraclonidine, improvement in the right ptosis and reversal pupillary dilatation were observed. On brain magnetic resonance imaging, enhanced lesions on the right cavernous sinus, both sphenoidal sinuses, and skull base suggested the invasion of nasopharyngeal cancer. Lesions on the cavernous sinus need to be considered in cases of abducens nerve palsy and ipsilateral Horner's syndrome

Fascicular specialization in human and monkey rectus muscles: Evidence for anatomic independence of global and orbital layers

PURPOSE. Connective tissue pulleys inflect the extraocular muscles (EOMs) and receive insertions from some fibers. The authors investigated insertions and anatomic relationships of fiber fascicles within rectus EOMs to clarify the relationship to their pulleys. METHODS. Two human and two monkey orbits were removed intact, serially sectioned in the coronal plane, histologically stained, and digitally photographed. The authors traced representative fascicles in the human medial rectus (MR) and inferior rectus and monkey lateral rectus and superior rectus muscles. In the human MR, the authors computed average collagen fractions in the orbital layer (OL) and the global layer (GL). RESULTS. In human and monkey, OL fascicles remained distinct from each other and from the GL throughout. Most OL fascicles were inserted into the pulley through short tendons. Most GL fascicles bypassed the pulley without insertion. Collagen content in the human MR OL increased from 29% ± 5% (SD) in midorbtt to 65% ± 9% in the anterior orbit but slightly decreased from 26% ± 6% to 23% ± 1% in the GL. Tracing of every fiber in a human MR OL fascicle demonstrated terminations on pulley tendons without myomyous junctions. CONCLUSIONS. Fibers in the primate rectus OL lack myomyous or GL junctions, but nearly all insert on the pulley through a broad distribution of short tendons and dense intercalated collagen. Fibers in the GL generally do not insert on pulley tissues and are associated with less collagen. These features support the distinct role of the OL in anteroposterior positioning of connective tissues proposed in the active pulley hypothesis and substantial mechanical independence of the OL and GL. Copyright © Association for Research in Vision and Ophthalmology

Postoperative changes of intermittent exotropia type as classified by 1-hour monocular occlusion

Purpose To evaluate postoperative changes of the intermittent exotropia type as classified by 1-hour monocular occlusion test. Design Institutional, retrospective study. Methods We retrospectively reviewed the medical records of 179 patients who had undergone surgery for intermittent exotropia with a postoperative follow-up of 6 months or more. We evaluated the exodeviation obtained before and after 1-hour monocular occlusion preoperatively and again at postoperative 1, 3 and 6 months. Intermittent exotropia was divided into 4 types according to Burian’s classification. The main outcome measure was the distribution of intermittent exotropia type based on 1-hour monocular occlusion in both pre- and postoperative periods. Results Of the 179 patients, 152 (84.9%) were assigned preoperatively to the basic type, 14 (7.8%) to the pseudo-divergence excess type, and 13 (7.8%) to the convergence insufficiency type. At postoperative 1, 3, and 6 months, the exotropia-type distribution was shifted predominantly to the basic type (p<0.001, p = 0.004, p = 0.029, respectively). Among the preoperative basic-type patients, 96.9% maintained that type postoperatively. However, only 18.2 and 11.1% of the pseudo-divergence excess and convergence insufficiency types maintained the same type. The proportions of the basic type had increased at postoperative 6 months, from 87.8 to 95.7% for bilateral lateral rectus (BLR) recession, from 73.7 to 92.3% for unilateral recess-resect (R&R), and from 88.0 to 95.0% for unilateral lateral rectus (ULR) recession. Conclusion The type of intermittent exotropia changed mostly to the basic type postoperatively even as classified after 1-hour monocular occlusion. This finding was consistent regardless of the surgical methods (BLR, ULR recession and R&R). © 2018 Bae et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

Surgical management for persistent pupillary membrane with vitreous scissors.

Persistent pupillary membranes are common congenital disorders. To reduce the surgical complications, we used vitreous scissors instead of conventionally used Vannas scissors to remove the membrane and reviewed the surgical results. Five eyes of 4 children with persistent pupillary membrane were treated by surgery. Through the 1.5 mm limbal incision, the membrane was removed by using vitreous scissors after intracameral sodium hyaluronate. After 22.6 months follow-up, all pupils of operated eyes were round and no complications associated with the surgery were found. Three eyes showed improved visual acuities after the operation. We suggest that the surgery with vitreous scissors is better than with Vannas scissors

Improvements in visual acuity following limbal lensectomy for subluxated lenses in children

BACKGROUND AND OBJECTIVE: To report the surgical results of limbal lensectomy using an automated vitrectomy instrument for the treatment of subluxated lenses in children. PATIENTS AND METHODS: The authors reviewed the charts of children who underwent surgery for subluxated lenses. Limbal lensectomies with an 'in the bag' technique were performed on 18 eyes of 10 patients. The indications for surgery were a best-corrected visual acuity of less than 20/60, bisection of pupil by the lens, or both. RESULTS: Best- corrected visual acuity improved in all 18 eyes (paired t test, P<.01). In 1 eye, transient anterior chamber hyphema occurred during the early postoperative period. No other significant complications were found during an average follow-up of 19.6 months. CONCLUSION: Limbal lensectomy for subluxated lenses in children improved visual acuity without severe complications

토끼에서 조정 사시 수술시 2% methylhydroxypropylcellulose 와 hyaluronic acid가 조정장력에 미치는 효과

학위논문(석사)--서울대학교 대학원 :의학과 안과학전공,1996.Maste

Body Stature as an Age-Dependent Risk Factor for Myopia in a South Korean Population*

Purpose: To evaluate the association between myopia and risk factors, including anthropometric parameters. Methods: A total of 33,355 Koreans five years of age or more participated in the Korea National Health and Nutrition Examination Survey 2008–2012. All participants underwent non-cycloplegic autorefraction and were divided into three age groups (children and adolescents; young adults; adults). Myopia prevalence and risk factors were evaluated. Results: The prevalence of myopia was significantly higher in the taller quintiles of children and adolescents; however, not in young adults or adults in multivariate regression analyses. Higher household income was significantly associated with myopia only in children and adolescents, whereas urban residence and higher education were significantly associated with myopia in young adults and adult-aged subjects. Conclusions: Associations between myopia and sociodemographic factors, such as income and education, varied in each age group, and height remained significantly associated with myopia only in children and adolescents. © Taylor & Francis

Magnetic resonance imaging evidence for widespread orbital dysinnervation in dominant Duane's retraction syndrome linked to the DURS2 locus

PURPOSE. High-resolution, multipositional magnetic resonance imaging (MRI) was used to demonstrate extraocular muscles (EOMs) and associated motor nerves in Duane retraction syndrome (DRS) linked to the DURS2 locus on chromosome 2. METHODS. Five male and three female affected members of two autosomal dominant DURS2 pedigrees were enrolled in the study. Coronal T 1-weighted MRI of the orbits was obtained in multiple gaze positions, as well as with heavy T 2 weighting in the plane of the cranial nerves. MRI findings were correlated with motility. RESULTS. All subjects had unilateral or bilateral limitation of abduction, or of both abduction and adduction, with palpebral fissure narrowing and globe retraction in adduction. Orbital motor nerves were typically small, with the abducens nerve (cranial nerve [CN]6) often nondetectable. Lateral rectus (LR) muscles were structurally abnormal in seven subjects, with structural and motility evidence of oculomotor nerve (CN3) innervation from vertical rectus EOMs leading to A or V patterns of strabismus in three cases. Four cases had superior oblique, two cases superior rectus, and one case levator EOM hypoplasia. Only the medial and inferior rectus and inferior oblique EOMs were spared. Two cases had small CN3s. CONCLUSIONS. DRS linked to the DURS2 locus is associated with bilateral abnormalities of many orbital motor nerves, and structural abnormalities of all EOMs except those innervated by the inferior division of CN3. The LR may be coinnervated by CN3 branches normally destined for any other rectus EOMs. Therefore, DURS2-linked DRS is a diffuse congenital cranial dysinnervation disorder involving but not limited to CN6. Copyright © Association for Research in Vision and Ophthalmology