Ability of Scanning Laser Polarimetry (GDx) to Discriminate among Early Glaucomatous, Ocular Hypertensive and Normal Eyes in the Korean Population

Sun Young Lee,Dong Wook Ha,Michael S,Kook 대한안과학회 2004 Korean Journal of Ophthalmology Vol.18 No.1

We investigated the ability of the GDx-Nerve Fiber Analyzer (NFA) to discriminate between normal and early glaucomatous eyes among Korean individuals by reviewing the medical records of 217 consecutive subjects: 61 early glaucoma patients, 68 ocular hypertensive patients, and 88 normal subjects. GDx parameters were compared using ANOVA. The Receiver Operating Characteristics (ROC) curve for each GDx-NFA variable was used to diagnose each parameter, and Pearson correlation coefficients were calculated to assess the association between GDx-NFA parameters and visual field indices in early glaucoma. The best GDx parameters to discriminate between early glaucomatous and normal subjects were the number, maximum modulation, ellipse modulation and inferior ratio (i.e. area under the ROC curve > 0.8). A value for the Number of equal to or greater than 27 was optimal for detecting early glaucoma, with a sensitivity of 80.3% and specificity of 80.7%. In addition, symmetry was positively correlated with the corrected pattern standard deviation (CPSD) among visual field indices in early glaucoma.

한국인에서 각막보정주사레이저편광측정계의 진단적 유용성

황종욱,정지용,조현수,국문석.Jong Uk Hwang. M.D.. Ji Yong Jung. M.D.. Hyun Soo Cho. M.D.. Michael Scott Kook. M.D. 대한안과학회 2006 대한안과학회지 Vol.47 No.2

Purpose: We investigated the diagnostic ability of scanning laser polarimetry with variable corneal compensation (GDx VCC) parameters to distinguish glaucomatous eyes with different degrees of visual field abnormality from normal eyes. Methods: Subjects were divided into a control group (n=47) and an early to moderate glaucoma group (n=100). The latter included 53 early glaucoma patients (mean deviation > -6dB with a Humphrey Field Analyzer). Using a receiver operating characteristic (ROC) curve, the diagnostic power of GDx VCC parameters was analyzed and the correlations between those parameters and Humphrey Field Analyzer (HFA) indices were statistically analyzed. Results: Nerve fiber indicator (NFI) provided the best discriminating ability with the highest area under the ROC curve (AUROC) value for detecting eyes with early to moderate perimetric glaucoma. TSNIT average showed the highest AUROC value for detecting eyes with early perimetric glaucoma. The optimal NFI cut-off value to discriminate between the control group and early to moderate group was 22, offering the best combination of sensitivity (88.0%) and specificity (83.0%). The optimal TSNIT average cut-off value to discriminate between the control group and early glaucoma group was 53.49 μm, providing the best combination of sensitivity (84.9%) and specificity (85.1%). Most of the thickness parameters showed higher AUROC values than those of the ratio or modulation parameters. A statistically significant correlation was found between the GDx VCC parameters and HFA indices. Conclusions: Measurement of the retinal nerve fiber layer (RNFL) by scanning laser polarimetry with variable corneal compensation is useful in discriminating between normal and glaucomatous eyes.

녹내장의 초기 진행에 따른 시신경유두 형태 변화

한은령,서울,이수영,최규룡.Eun-Ryung Han. M.D.. Wool Suh. M.D.. Soo Young Lee. M.D.. Kyu Ryong Choi. M.D. 대한안과학회 2007 대한안과학회지 Vol.48 No.9

Purpose: To investigate the clinical manifestation and the structural optic disc changes according to the development of reproducible visual field defects in a group of preperimetric patients converting to early glaucoma. Methods: Standard automated perimetry (Humphrey Field Analyzer) was performed every six months in 294 preperimetric patients. Each subject was classified as either converter or non-converter according to glaucomatous visual field changes, and the clinical manifestations were analyzed retrospectively. Sequential optic disc images were obtained using the TopSS scanning laser ophthalmoscope (TopSSTM) and optic disc parameters were measured to determine if any change had occurred. Results: A total of 44 eyes from 44 subjects (14.9%) in 294 patients subsequently developed early glaucomatous field loss (converters). The progression rate of visual field defect is 0.43dB/year. In respect to age, sex, refractive error, and diabetes mellitus, no significant differences were observed. Elevated IOP, hypertension, and family history of glaucoma were detected more frequently in the converter group than in the non-converter group. Among TopSS parameters, cup-to-disc ratio, effective area, volume above, maximum slope, and neuroretinal rim area showed statistically significant change. Changes of the neuroretinal rim were prominent in superior and inferior sectors. Conclusions: Among TopSS parameters, cup-to-disc ratio, effective area, volume above, and neuroretinal rim are useful in detecting the progression of glaucoma. Furthermore, neuroretinal rim changes in each sector may provide clinically relevant information in detecting and monitoring the progression of glaucoma.

Comparison of Delayed-Onset Glaucoma and Early-Onset Glaucoma after Infantile Cataract Surgery

( Kui Dong Kang ),( Hye Bin Yim ),( Albert W Biglan ) 대한안과학회 2006 Korean Journal of Ophthalmology Vol.20 No.1

초기 신생혈관 녹내장에서 Bevacizumab (Avastin®)를 이용한 치료 1예

맹효성,김진철,기창원,Hyosung Maeng,M,D,Jinchul Kim,M,D,Changwon Kee,M,D,Ph,D 대한안과학회 2008 대한안과학회지 Vol.49 No.4

Purpose: This case is conducted to assess the short‐term safety and efficacy of intravitreal bevacizumab injection in patient with early‐stage of the neovascular glaucoma (NVG) without peripheral anterior synechiae. Case summary: A 66‐year‐old patient with a history of proliferative diabetic retinopathy presented with neovascularization of the iris and the angle and high intraocular pressure of 30 mmHg. The patient received a single injection of bevacizumab (1.25 mg /0.05 mg) intravitreally. The visual acuity (VA), intraocular pressure (IOP), regression of the iris and the angle neovascularization were measured up to the twenty ninth week after injection. Regression of the iris and angle neovascularization were confirmed from the second week after injection. The visual acuity had continued stable and the IOP had been controlled from 30 mmHg to 20 mmHg from fifth week without the need for topical antiglaucoma medications until the twenty ninth week. Conclusions: Bevacizumab may be an effective medication for the treatment of neovascular glaucoma. Bevacizumab seems to be a useful adjunct or an advantageous treatment option to panretinal photocoagulation in the treatment of neovascular glaucoma.

영혼의 눈병 : 요한 크리소스톰과 구제의 녹내장 치료

배정훈 고신대학교 개혁주의학술원 2023 갱신과 부흥 Vol.31 No.-

Recently, scholars have attempted a new wave of study, paying attention to the metaphor of disease and treatment that frequently appears in the writings and sermons of John Chrysostom (C.E. c.349-407). They discovered that behind this metaphor there is a tradition of 'doctor of the soul' which has continued in Greco-Roman philosophy and medicine, and traced how John used it. However, these studies have paid little attention to the influence of ancient philosophical therapy on the formation of John's thought of almsgiving. Given that there was no church father who appealed for help for the poor as much as John in late antiquity, it can be assumed that psychagogy in ancient philosophy and medicine which spread throughout his thought was also related to his idea of charity. The purpose of this study is to analyze in detail John's ancient philosophical-medical understanding of Christian sharing. In particular, I would like to focus on his mention of eye disease and the treatment of the soul. John leads his congregation, whose hearts have been blinded by greed for material things, to the Divine ophthalmic hospital. This paper analyzes John's 20th homily on the Gospel of Matthew(In Matthaeum homiliae 20). According to John, covetousness is a disease of the eyes of the soul, that is glaucoma. This disease is by no means mild. Just as we can do not anything if we are blinded, so too are the eyes of the soul blinded. If, however, we have a willingness to share, this can be cured. Sharing is a powerful spiritual eye operation, couching operation. Everyone can get it without any burden. John's discourse on the glaucoma of the soul and its treatment is quite systematic and replaces the medicalized discourse and practice of secular philosophers and physicians. 최근 학자들은 요한 크리소스톰(John Chrysostom, C.E. c.349-407)의 저술과 설교에 자주 등장하는 병과 치료의 메타포에 주목하며 새로운 연구를 시도했다. 이들은 이러한 메타포 이면에 그리스-로마 철학과 의학에서 지속되어 왔던 ‘영혼의 의사’ 전통이 있음을 발견했고 요한이 이를 어떻게 사용하고 있는지 추적하였다. 그러나 이러한 연구들은 고대 철학적 치료(ancient philosophical therapy)이론이 요한의 구제사상 형성에 미친 영향에 대해서는 거의 관심을 기울이지 않았다. 고대 후기에 요한만큼 가난한 자들을 위한 도움을 호소한 교부가 없었다는 점을 고려하면 그의 사상 전반에 퍼져있는 영혼 치료학(psychagogy)이 구제사상에도 관련이 있을 것으로 추정할 수 있다. 본 연구의 목적은 고대 철학과 의학 배경에서 기독교적 나눔에 대한 요한의 이해를 상세하게 분석하는 것이다. 특별히 영혼의 눈병과 치료에 대한 그의 언급에 주목하고자 한다. 요한은 물질에 대한 욕심으로 인해 마음의 눈이 어두워진 그의 회중들을 하나님의 안과병원(Divine ophthalmic hospital)으로 인도한다. 본 논문은 요한의 『마태복음 20번째 설교』(In Matthaeum homiliae 20)에 초점을 둔다. 요한에 따르면 탐심은 영혼의 눈의 병, 즉 녹내장이다. 이 병은 결코 가볍지 않다. 눈이 보이지 않으면 아무것도 할 수 없는 것 같이 영혼의 눈도 마찬가지이다. 하지만 나누고자 하는 마음만 있다면 고칠 수 있다. 나눔은 강력한 영적 안과수술, 즉 카우칭 수술이다. 이는 누구든지, 부담 없이 받을 수 있다. 영혼의 녹내장과 치료에 대한 요한의 담론은 상당히 체계적이며 세속 철학자와 의사들의 치료 담론과 실천을 대체한다.

중심부 시야결손을 보이는 초기 녹내장 환자의 진단에서 자동시야계 C10-2의 유용성

황보인(Bo Een Hwang),박혜영(Hae Young Lopilly Park),박찬기(Chan Kee Park) 대한안과학회 2017 대한안과학회지 Vol.58 No.3

목적: 중심부 시야결손을 보이는 초기녹내장 환자를 진단하는 데 가장 효과적인 시야검사에 대한 방향성을 제시하고자 한다. 대상과 방법: 중심부 시야결손을 가진 초기 녹내장 환자의 총 57안을 대상으로 Humphrey 자동시야계 C24-2, C10-2, 주파수배가시야 검사(frequency doubling technology perimetry, FDT) C24-2를 시행하여 이를 황반부의 신경절세포내망상층(the ganglion cell– inner plexiform layer, GC-IPL)의 평균두께와 구조기능적으로 비교분석하였다. 결과: Central sensitivity는 자동시야계 C24-2, 자동시야계 C10-2, FDT C24-2 순으로 각각 27.51 ± 5.43 dB, 27.39 ± 5.05 dB, 22.09 ± 5.08 dB 순이었으며, 평균 GC-IPL thickness는 70.2 ± 8.5 μm였다. 각각의 시야검사의 central sensitivity와 optical coherence tomography에서의 평균 GC-IPL의 두께를 평가한 회귀분석에서는 자동시야계 C10-2만이 유의한 p-value를 보였으며 (p<0.05), logarithmic scale에서는 logR2 값이 0.498, antilogarithmic scale에서는 linear R2값이 0.486을 보이며, FDT C24-2와 자동 시야계 C24-2에 비해 높은 값을 보였다. 초기 녹내장에서 이러한 관계가 더욱 뚜렷하였다. 결론: 중심부 시야결손을 보이는 초기 녹내장 환자에서 GC-IPL thickness와 중심부 시야 감도 사이의 구조-기능 관계는 Humphrey C10-2 자동시야계가 다른 시야 검사법에 비해 더 잘 반영하였다. Purpose: To identify the correspondence between the central sensitivity of several visual field (VF) tests and ganglion cell inner plexiform layer (GC-IPL) thickness in early glaucoma patients with parafoveal scotoma. Methods: Fifty-seven eyes from 57 patients with glaucomatous optic neuropathy and parafoveal scotoma were analyzed using the standard automated perimetry (SAP) C10-2 test, the SAP C24-2 test, and the frequency doubling technology perimetry (FDT) C24-2 test. The correlation between the VF central sensitivity and the GC-IPL thickness from macular scans via optical coherence tomography was analyzed. Results: The central sensitivity was 27.51 ± 5.43 dB, 27.39 ± 5.05 dB, and 22.09 ± 5.08 dB for SAP C24-2, SAP C10-2, and FDT C24-2, respectively. Mean GC-IPL thickness was 70.2 ± 8.5 μm. Using regression analysis, the value of log R2 between the logarithmic central sensitivity and GC-IPL thickness was 0.498, and the linear R2 between the antilogarithmic central sensitivity and GC-IPL thickness in SAP C10-2 was 0.486, and both were statistically significant (p < 0.05). This relationship was stronger in early glaucoma patients compared to late glaucoma patients using SAP C10-2. Conclusions: The structure-function relationship between GC-IPL thickness and central sensitivity was better with SAP C10-2, especially in early glaucoma patients, compared to other VF modalities.

초기 녹내장 환자의 유두주위 망막신경섬유층 두께 분석

권순일,박인원,정윤석,Soon Il Kwon,In Won Park,Yun Suk Chung 대한안과학회 2008 대한안과학회지 Vol.49 No.7