갑상샘눈병증과 혈청 자가항체의 관련성에 관한 연구

황덕진,김윤정.Duck Jin Hwang. MD. Yun Jeong Kim. MD 대한안과학회 2010 대한안과학회지 Vol.51 No.9

Purpose: The same autoimmune process is thought to cause thyroid associated ophthalmopathy (TAO) and Graves disease. The aim of this study is to determine whether thyroid autoantibody is related to the development of thyroid associated ophthalmopathy. Methods: A retrospective chart analysis was performed on patients with a newly diagnosed Graves’ disease, who presented to our ophthalmology clinic between January 2006 and December 2009. Thyroid autoantibody titers were obtained at the time of diagnosis and were used to determine the presence or absence of TAO. In addition, any correlations between thyroid autoantibodies were analyzed in patients with TAO. Results: Thyroid autoantibody levels correlated with the development of TAO. Fifty-eight (69%) out of 84 patients with positive thyroid-stimulating hormone receptor antibody (TRAB) levels at the time of diagnosis had TAO. Only 50 (51%) of the 99 patients with negative TRAB levels had TAO. This difference between the two groups was statistically significant (odds ratio, OR=2.2, p=0.013). A statistically significant correlation with the development of TAO was also found in thyroid peroxidase antibody (TPOAb) and anti-thyroglobulin antibody (TgAb), respectively (OR=0.5, p=0.317; OR=0.3, p=<0.001). In patients with TAO, the correlation between TPOAb and TgAb levels was very high (r=0.64, p=<0.001). Conclusions: A significant association was determined to exist between the development of TAO and thyroid autoantibody level. This result demonstrates the clinical utility of thyroid autoantibody for the diagnosis of TAO in patients with newly diagnosed Graves disease. J Korean Ophthalmol Soc 2010;51(9):1167-1173

특발성 망막전막의 유리체 절제술 후 시력과 망막두께의 장기변화 관찰

황덕진,나경익,권순일,박인원,Duck Jin Hwang,MD,Kyeong Ik Na,MD,Soon Il Kwon,MD,In Won Park,MD,PhD 대한안과학회 2012 대한안과학회지 Vol.53 No.3

Purpose: To evaluate the clinical outcomes of visual acuity and foveal thickness after vitrectomy for an idiopathic epiretinal membrane (ERM). Methods: We retrospectively reviewed the records of 62 patients (62 eyes) with ERM who had been treated with vitrectomy between 2004 and 2009. Visual acuity and central macular thickness from optical coherence tomography imaging were obtained preoperatively and at every postoperative follow-up visit. Results: Mean preoperative visual acuity and central macular thickness were 0.495 ± 0.292 log MAR and 414.645 ± 95.528 μm, respectively. Mean visual acuity and central macular thickness 1 month after surgery were 0.389 ± 0.373 log MAR and 341.484 ± 73.676 μm, respectively. Visual acuity improved within 9 months and central macular thickness significantly decreased 12 months after surgery. Most of the changes in visual acuity and central macular thickness took place during the first 3 months. The only parameter which was significantly correlated with final visual acuity was preoperative visual acuity (0.635) (p < 0.001). Conclusions: Visual acuity and central macular thickness improved 12 months months after vitrectomy in patients with idiopathic ERM. Preoperative visual acuity had a significant correlation with final visual acuity. J Korean Ophthalmol Soc 2012;53(3):434-439

헤르페스 뇌염 후 발생한 급성망막괴사 증례보고 1예

안태수,권순일,황덕진,박인원,Tae Su An,Soon Il Kwon,Duck Jin Hwang,In Won Park 대한안과학회 2012 대한안과학회지 Vol.53 No.8

Purpose: To report a case of unilateral acute retinal necrosis (ARN) following herpes simplex virus (HSV) encephalitis. Case summary: A 19-year-old man previously diagnosed with HSV encephalitis presented with a headache and visual loss in his left eye. On the initial visit, slit-lamp examination showed conjunctival injection and inflammatory cells (3+) in the anterior chamber of the left eye. Funduscopic examination showed optic disc swelling, multiple yellow-whitish spots in the peripheral retina and retinal vascular sheathing. After the patient was diagnosed with ARN, intravenous acyclovir (1,500 mg/m2/day) was administered. Because retinal detachment and multiple retinal breaks were found during the treatment period, the authors performed barrier laser treatment in the peripheral retina. At that time, no retinal necrosis was observed in the patient’s right eye. The retinal lesions regressed, and no new retinal lesion was observed in the left eye, during the follow-up period. Conclusions: We report a case of ARN in a patient with HSV encephalitis. Ophthamologist should perform a thorough ophthalmic examination in a patient diagnosed with HSV encephalitis. J Korean Ophthalmol Soc 2012;53(8):1186-1189

결막 경유 직접적 안구 내 침 시술로 인한 안구 천공 손상 1예

정희영(Hee Young Chung),이수찬(Su Chan Lee),최진영(Jin Young Choi),손준홍(Joon Hong Sohn),황덕진(Duck Jin Hwang) 대한안과학회 2016 대한안과학회지 Vol.57 No.1

Purpose: To report a case of ocular perforation by an acupuncture needle directly through the bulbar conjunctiva. Case summary: A 62-year-old male visited our clinic with acute ocular pain and decreased vision in his left eye. He had received intraocular acupuncture therapy one day earlier. A slit-lamp examination revealed conjunctival hyperemia and vitreous prolapse at the superonasal quadrant of the bulbar conjunctiva. Grade one of anterior chamber cells was found in the left eye. Dilated fundoscopy revealed three retinal hemorrhages at the superonasal quadrant of the retina; vitreous hemorrhage and opacity were also observed. Thus, vitrectomy and injections of intravitreal antibiotics were performed. Intraoperatively, we identified the entry site, located in the superonasal retinal quadrant, immediately behind the ora serratia. At the three-month postoperative follow- up, the patient’s visual acuity was 0.9 in the left eye and the retina remained flat with no postoperative complications. Conclusions: We observed a case of ocular perforation and endophthalmitis following ocular acupuncture treatment. This case illustrates the dangers of intraocular acupuncture therapy.

비증식당뇨망막병증에서 Calcium Dobesilate가 시력 및 황반두께에 미치는 영향

전성연(Sung Yeon Jun),박지인(Ji In Park),손준홍(Joonhong Sohn),황덕진(Daniel Duck-Jin Hwang) 대한검안학회 2021 Annals of optometry and contact lens Vol.20 No.2

Purpose: This study aimed to evaluate the effect of calcium dobesilate uptake on visual acuity (VA) and macular thickness by optical coherence tomography (OCT) of eyes with non-proliferative diabetic retinopathy (NPDR) in comparison with bilberry dried extract. Methods: Thirty-six eyes of 36 patients diagnosed with NPDR without macular edema and who were treated with calcium dobesilate for more than 6 months were enrolled in the calcium dobesilate (CAD) group. VA, diabetic retinopathy grade, central macular thickness (CMT), and total macular volume (TMV) at baseline and at the 3- and 6-month follow-up examinations were analyzed retrospectively. The matched patients treated with bilberry dried extract were selected and compared as the control group. Results: The CMT and TMV values were 282.14 ± 31.86, 277.96 ± 31.13, and 281.18 ± 30.41 μm and 8.79 ± 0.58, 8.68 ± 0.59, and 8.73 ± 0.60 ㎣ in the CAD group at baseline and at the 3- and 6-month follow-up, respectively. The TMV had decreased significantly at the 3-month follow-up (p = 0.027); however, the TMV at the 6-month follow-up and the VA and TMV at the 3- and 6-month follow-ups showed no differences from the baseline levels (all p > 0.05). In the control group, no significant changes in VA or in CMT were observed at 3 and 6 months after treatment compared to the baseline (all p > 0.05). Furthermore, no significant difference in CMT on OCT was observed between the two groups at all time points (all p > 0.05). Conclusions: In NPDR patients without macular edema, CAD uptake had no significant effect on VA or macular thickness until 6 months after treatment.

유리체절제술 및 백내장수술을 시행한 군과 백내장수술만 시행한 군의 장기 수술 유발 난시도 비교

변지윤(Zee Yoon Byun),이정현(Jung Hyun Lee),이상목(Sang-Mok Lee),황덕진(Duck-Jin Hwang) 대한안과학회 2021 대한안과학회지 Vol.62 No.8

목적: 유리체절제술 및 백내장수술을 함께 시행한 환자와 백내장수술만 시행한 환자에서 수술 유발 난시의 장기 변화를 비교해 보았다. 대상과 방법: 백내장수술만 받은 군(1군)과 23게이지 무봉합 유리체절제술 및 백내장수술을 함께 시행 받은 군(2군)에서 술 후 1년간 수술 유발 난시의 변화를 후향적으로 비교하였다. 수술 전과 수술 후 1, 3, 6, 12개월 각각 자동각막곡률계검사를 이용하여 편평한 축 및 가파른 축의 각막곡률과 난시축을 측정하였다. 벡터분석법을 이용하여 수술 후 수술 유발 난시를 계산한 후 각 경과 관찰 시점별 값이 두 군 간 차이가 있는지 알아보았다. 결과: 총 86명 86안이 본 연구에 포함되었고 1군은 45안, 2군은 41안이었다. 수술 후 1, 3, 6, 12개월 경과 관찰 시의 수술 유발 난시 평균 값(diopter)은 1군에서 0.83 ± 0.37, 0.69 ± 0.39, 0.60 ± 0.33, 0.59 ± 0.33이었고, 2군에서 0.82 ± 0.47, 0.69 ± 0.38, 0.62 ± 0.28, 0.61 ± 0.30이었으며 시간 경과에 따라 수술 유발 난시는 두 군 모두에서 감소하는 추세를 보였다(모두 p<0.001). 각 경과 관찰 시점마다 두 군의 수술 유발 난시는 서로 유의한 차이를 보이지 않았다(모두 p>0.05). 결론: 유리체절제술 및 백내장수술을 함께 시행한 경우의 수술 유발 난시는 백내장수술만 시행한 군과 차이가 없었고, 이를 통해 23게이지 무봉합 유리체절제술이 각막난시에 유의한 영향을 주지 않음을 알 수 있었다. Purpose: To compare the long-term changes in surgically induced astigmatism (SIA) in patients who underwent 23-gauge sutureless vitrectomy and cataract surgery together with patients who underwent cataract surgery only. Methods: We retrospectively reviewed SIA changes for 1 year after surgery in patients who received only cataract surgery using phacoemulsification (group 1) and patients who underwent 23-gauge sutureless vitrectomy and cataract surgery together (group 2). Flat keratometry (K1), steep keratometry (K2), and astigmatism axis were measured with automatic keratometry before and after the surgery. Vector analysis was used to calculate SIA at 1, 3, 6, and 12 months postoperatively. We then examined whether the SIA values at each time point were different between the two groups. Results: A total of 86 eyes were included in this study (group 1, n = 45; group 2, n = 41). The mean SIA values calculated at 1, 3, 6, and 12 months after surgery in group 1 were 0.83 ± 0.37, 0.69 ± 0.39, 0.60 ± 0.33, and 0.59 ± 0.33, respectively. In group 2, the values were 0.82 ± 0.47, 0.69 ± 0.38, 0.62 ± 0.28, and 0.61 ± 0.30, respectively. Over time, SIA decreased in both groups (all p < 0.001). There was no significant difference in the mean SIA between the two groups at each follow-up time point after surgery (p = 0.296, p = 0.728, p = 0.361, and p = 0.356, respectively). Conclusions: When 23-gauge sutureless vitrectomy and cataract surgery were performed together, the astigmatism change caused by surgery did not show a significant difference compared with that of the group who received cataract surgery only. Thus, 23-gauge sutureless vitrectomy may not significantly affect corneal astigmatism.

당뇨황반부종에서 베바시주맙 단독요법군과 베바시주맙-후테논낭하트리암시놀론 병합요법군 간의 치료효과 비교

이정현(Jung Hyun Lee),정희영(Hee Young Chung),이경민(Kyung Min Lee),박영숙(Young Sook Park),손준홍(Joon Hong Sohn),황덕진(Duck Jin Hwang) 대한안과학회 2016 대한안과학회지 Vol.57 No.12

목적: 당뇨황반부종에서 유리체강내 베바시주맙 주입술 단독요법과 유리체강내 베바시주맙 주입술 및 후테논낭하 트리암시놀론 주입술 병합요법의 임상결과를 비교하였다. 대상과 방법: 당뇨황반부종이 있는 증식성당뇨망막병증 66안을 대상으로 단독요법군 35안, 병합요법군 31안으로 나누어, 주사 시행전 및 시술 후 1, 2, 3개월의 시력, 중심황반두께, 전체황반부피, 경성삼출물 정도, 안압의 변화를 비교, 분석하였다. 결과: 두 군 모두에서 치료 후 1개월에만 유의한 시력호전을 보였다. 중심황반두께와 전체황반부피도 치료 후 1개월째 의미있는 감소를 보였으나 2개월째부터 다시 악화되었다. 치료 전후로 두 군 간에 시력, 중심황반두께, 전체황반부피의 의미있는 차이를 보이지 않았다. 경성삼출물 정도는 병합요법군에서 치료 3개월째 의미있는 감소(치료 전 2,899 ± 2,314 pixels vs. 3개월째 2,536 ± 1,981 pixels, p=0.041)를 보인데 비해, 단독요법군에서는 치료 3개월까지 차이를 보이지 않았다. 안압은 두 군 간 치료 전후로 차이를 보이지 않았다. 관찰 기간 중 안압상승이나 안내염 등의 합병증은 관찰되지 않았다. 결론: 유리체강내 베바시주맙 및 후테논낭하 트리암시놀론 주입술의 병합요법은 유리체강내 베바시주맙 주입술 단독요법과 비교하여 시력, 중심황반두께, 전체황반부피에서 부가적인 효과를 보이지 않았으나 3개월째 경성삼출물 정도를 줄이는 데 효과적이었다. Purpose: To investigate the outcome of intravitreal bevacizumab (IVB) combined with posterior subtenon triamcinolone acetonide injections compared to IVB injection alone in patients with diabetic macular edema (DME). Methods: IVB injection (IVB group) and combination therapy injection (combination group) were administered to 35 eyes and 31 eyes, respectively, diagnosed with proliferative diabetic retinopathy combined with DME. Changes in best corrected visual acuity (BCVA), central macular thickness (CMT), total macular volume (TMV), amount of hard exudates and intraocular pressure (IOP) were compared retrospectively between groups prior to injection and 1, 2 and 3 months after injection. Results: BCVA changes in both groups were only statistically significant at 4 weeks after injection. Reduction of CMT and TMV was maintained for 1 month after treatment in all groups, but CMT and TMV deteriorated 2 months after treatment. No significant differences in BCVA, CMT or TMV were detected between the IVB and combination groups. The amount of hard exudates were only significantly decreased at month 3 in the combination group whereas the amount of hard exudates was not significantly different at 3 months in the IVB group (at baseline 2,899 ± 2,314 pixels vs. at 3 months 2,536 ± 1,981 pixels, p-value = 0.041). IOP showed no significant difference between the groups. Elevated IOP or endophthalmitis were not observed. Conclusions: In terms of BCVA improvement, subtenon triamcinolone provided no additional benefit on CMT and TMV reduction. However, combination therapy was effective in reducing the amount of hard exudates at 3 months.