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눈물주머니코안연결술 및 실리콘관삽입술 후 발생한 형광균 감염 1예
강정엽,유재호,이정주,김수영,이승욱,이상준.Jeong Yeop Kang. MD. Jae Ho Yoo. MD. Jung Ju Lee. MD. Soo Young Kim. MD.Seung Uk Lee. MD. Sang Joon Lee. MD. PhD 대한안과학회 2013 대한안과학회지 Vol.54 No.4
Purpose: To report a case of Pseudomonas fluorescens infection following endoscopic dacryocystorhinostomy and silicone tube intubation in a healthy patient who was using steroid nasal spray. In addition, a literature review is conducted. Case summary: A 72-year-old female patient came to our clinic with tearing and hyperemia in the right eye. Ten months prior, she had undergone endoscopic dacryocystorhinostomy and silicone tube intubation due to nasolacrimal duct obstruction in the right eye. Six months after the first operation, dacryocystorhinostomy revision with silicone tube exchange was performed due to obstruction of the nasal bony orifice. In addition, the patient was using a steroid nasal spray. On slit lamp examination, conjunctival injection, marked inflammation and punctal edema around the tube were observed. The silicone tube was removed and the tube cultured. Pseudomonas fluorescens was isolated from the tube contents. The patients was treated with topical 0.3% gatifloxacin 4 times a day, methylol cephalexin lysinate 1000 mg 3 times a day and the nasal spray was discontinued. Two weeks later, all symptoms were resolved after treatment with antibiotic treatment. Conclusions: A case of Pseudomonas fluorescens canaliculitis which occurred in healthy patient who was using steroid nasal spray is presented with a literature review. Pseudomonas fluorescens canaliculitis can be treated by using proper antibiotics.
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베바시주맙 안내주사가 망막혈관직경, 안압, 망막신경섬유층 및 시신경에 미치는 영향
강정엽,이승욱,남기엽,이지은,이상준.Jung Youb Kang. MD. Seung Uk Lee. MD. Ki Yup Nam. MD. Ji Eun Lee. MD. Sang Joon Lee. MD. PhD 대한안과학회 2014 대한안과학회지 Vol.55 No.2
Purpose: To evaluate the effects of a single intravitreal bevacizumab injection on retinal vessel diameter, intraocular pressure (IOP), retinal nerve fiber layer (RNFL) thickness and the optic disc in patients with diabetic macular edema (DME). Methods: In this retrospective study, 63 eyes with DME were included. All patients received an intravitreal injection of 1.25 mg bevacizumab. We reviewed retinal vessel diameter, IOP RNFL thickness and vertical cup-to-disc (C/D) ratios at the baseline and 7 days, 1 month, 3 months and 6 months after injection. The diameter of the central retinal arteries and veins were measured using retinal photographs. The central retinal arteriolar equivalent (CRAE) and central retinal venular equivalent (CRVE) were calculated using the revised Parr-Hubbard formula. RNFL thickness was obtained using optical coherence tomography. The vertical C/D ratio of the optic disc was evaluated using stereoscopic optic disc photography. Results: After bevacizumab injection, the CRAE significantly decreased at 7 days and 1 month postoperatively compared to baseline (p < 0.001 and p = 0.036, respectively). However, the changes in the CRAE at 3 months and 6 months were not statistically significant (p = 0.992 and p = 0.342, respectively). There were no statistically significant changes in the CRVE, mean IOP, RNFL thickness and vertical C/D ratios of the optic disc. Conclusions: A single intravitreal bevacizumab injection transiently decreased the diameters of central retinal arterioles, but induced no significant changes in central venular diameter, mean IOP, RNFL thickness or vertical C/D ratios of the optic disc. J Korean Ophthalmol Soc 2014;55(2):216-221
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녹농균, 아시네토박토 바우마니, 오크로박트럼 안트로피 복합감염에 의한 각막염
강정엽,송주환,남기엽,이승욱,이상준 대한안과학회 2019 대한안과학회지 Vol.60 No.5
Purpose: To report polymicrobial keratitis involving Pseudomonas aeruginosa, Acinetobacter baumannii, and Ochrobactrum anthropi. Case summary: A 53-year-old female complained of pain and secretion in her right eye, which started 6 weeks before her visit. She applied steroid ointment, which was received from the dermatologist, to her eyelid 7 days prior to her visit but this treatment worsened her symptoms. At the initial visit, the visual acuity of the right eye was light perception, and purulent secretions were observed. Using a slit lamp, severe conjunctival hyperemia, hypopyon, and a ring-shaped central corneal ulcer were observed. The anterior chamber and fundus were not observed due to corneal lesions but ultrasonography showed no intraocular inflammation. Infectious keratitis was suspected and cultured by corneal scraping. During the incubation period, 0.5% moxifloxacin, 2% voriconazole, and 1% cyclopentolate were administered. A total of 400 mg of moxifloxacin and 100 mg of doxycycline were given orally. In the primary culture, Pseudomonas aeruginosa and Acinetobacter baumannii were identified so 5% ceftazidime, which was sensitive for the antibiotic susceptibility results was further instilled. Thereafter, the keratitis improved but the keratitis again worsened while maintaining the topical treatment. A secondary culture was positive for Ochrobactrum anthropi. Treatment with 1.4% gentamicin, which was sensitive for the antibiotic susceptibility test was added and the keratitis improved. A conjunctival flap was performed because of the increased risk of perforation. Conclusions: We report polymicrobial keratitis involving Pseudomonas aeruginosa, Acinetobacter baumannii, and Ochrobactrum anthropi for the first time in the Republic of Korea. 목적: 녹농균, 아시네토박토 바우마니, 오크로박트럼 안트로피 복합감염 1예를 보고하고자 한다. 증례요약: 53세 여자가 내원 6주 전부터 우안에 통증, 불편감이 발생하였고 내원 7일 전 피부과 스테로이드 연고를 안검에 도포한 후 증상이 악화되어 내원하였다. 초진 시력은 광각 인지로 세극등에서 전방축농, 고리모양의 중심부 각막궤양이 관찰되었다. 배양검사를 시행 후 0.5% moxifloxacin, 2% voriconazole, 1% cyclopentolate를 점안하도록 하였다. 배양 결과 녹농균, 아시네토박토 바우마니가 동정되어 감수성 결과에 따라 5% ceftazidime을 추가하였다. 이후 각막염이 호전되어 점안 치료를 유지하였으나 다시 각막염이 악화되는 소견을 보여 2차 배양검사를 실시하였다. 배양검사에서 오크로박트럼 안트로피가 새롭게 동정되어 감수성을 보인 1.4% gentamicin을 추가 점안하도록 하였다. 이후 각막염은 호전되는 경과를 보였으나 천공의 위험이 높아 결막피판술을 시행하고 안정화되었다. 결론: 녹농균, 아시네토박토 바우마니, 오크로박트럼 안트로피 균주에 의한 복합감염을 국내에서 최초로 경험하였기에 이를 보고하는 바이다.
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KCI
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