원발폐쇄각녹내장과 백내장이 동반된 환자에서 백내장 수술 후 예측굴절력과의 차이

김선아,강재훈,박종일,이경헌,Sun-A Kim,M,D,Jae-Hoon Kang,M,D,Jong-Il Park,M,D,Kyung-Hun Lee,M,D 대한안과학회 2005 대한안과학회지 Vol.46 No.12

Purpose: To report the difference between the postoperative spherical equivalent (SE) and predictive refraction in patients with cataract and primary angle-closure glaucoma (PACG) following cataract operation. Methods: (1) This study involved 60 eyes who underwent cataract surgery due to PACG and cataract, and 36 eyes who underwent surgery due to cataract only. We measured the manifest refraction postoperatively for comparision to the target power. (2) The axial length (AL) was measured by the different modes of A-scans(phakic, aphackic modes) in the 38 eyes with cataract. (3) The difference was calculated according to the three IOL power calculation formulas for the 60 eyes who had cataract surgery for coexisting PACG and cataract. Results: The difference between postoperative SE and predictive refraction was -0.61±0.91D in the PACG with cataract and +0.08±0.43D in eyes with cataract only. There was no difference according to the IOL power calculation formulas or the different modes observed inthe measurement of AL. A greater difference was seen in eyes with a short AL and an unmeasurable ACD. Conclusions: The difference between postoperative SE and predictive refraction increased in eyes with the PACG and cataract over those with cataract only. For cataract operation in these eyes, the choice of a lower power IOL (about 0.5D) may be helpful to reduce this difference, especially for eyes with a short AL (less than 24 mm) and an unmeasurable ACD.

Cataracts are Associated with the Coexistence of Moderate to Severe Obstructive Sleep Apnea and Diabetes Mellitus

Lee Seungku,윤대위,김진관,서영우,신철 대한수면학회 2020 sleep medicine research Vol.11 No.2

Background and Objective: The individual presence of diabetes mellitus (DM) or obstructive sleep apnea (OSA) is significantly associated with cataract formation, but few studies have examined the association of cataracts with comorbid DM and OSA. Our aim in this study was to confirm the relationship between cataracts and the individual presence of DM or OSA in a large population-based cohort study and evaluate the association between cataracts and the coexistence of OSA and DM. Methods: We included 699 individuals who were enrolled in the Korean Genome and Epidemiology Study and who underwent both nocturnal polysomnography and cataract diagnosis in the study. We assessed the presence and severity of OSA by means of unattended home sleep monitoring. DM was diagnosed based on the fasting blood-glucose level or by the use of antihyperglycemic medications. Cataracts were diagnosed according to the Lens Opacities Classification System III. Results: The prevalence of cataracts tended to increase as OSA worsened. Diabetes patients had a higher prevalence of cataracts than did normal subjects. In multivariate analysis, there was no significant association of cataracts with DM or OSA alone. In the joint analysis of DM and OSA, however, the odds for cataracts were significantly higher in the DM patients with moderate to severe OSA than in the DM patients without OSA, indicating a significant synergy of moderate to severe OSA and DM on cataracts. Conclusions: The concurrent presence of DM and moderate to severe OSA was associated with cataracts. Thus, OSA should be considered in the prevention or treatment of diabetic cataracts.

Effect of Cataract Grade according to Wide-Field Fundus Images on Measurement of Macular Thickness in Cataract Patients

Mingue Kim,Youngsub Eom,Jong Suk Song,Hyo Myung Kim 대한안과학회 2018 Korean Journal of Ophthalmology Vol.32 No.3

Purpose: To investigate the effects of cataract grade based on wide-field fundus imaging on macular thickness measured by spectral domain optical coherence tomography (SD-OCT) and its signal-to-noise ratio (SNR). Methods: Two hundred cataract patients (200 eyes) with preoperative measurements by wide-field fundus imaging and macular SD-OCT were enrolled. Cataract severity was graded from 1 to 4 according to the degree of macular obscuring by cataract artifact in fundus photo images. Cataract grade based on wide-field fundus image, the Lens Opacity Classification System III, macular thickness, and SD-OCT SNR were compared. All SD-OCT B-scan images were evaluated to detect errors in retinal layer segmentation. Results: Cataract grade based on wide-field fundus imaging was positively correlated with grade of posterior subcapsular cataracts (rho = 0.486, p < 0.001), but not with nuclear opalescence or cortical cataract using the Lens Opacity Classification System III. Cataract grade was negatively correlated with total macular thickness (rho = -0.509, p < 0.001) and SD-OCT SNR (rho = -0.568, p < 0.001). SD-OCT SNR was positively correlated with total macular thickness (rho = 0.571, p < 0.001). Of 200 eyes, 97 (48.5%) had segmentation errors on SD-OCT. As cataract grade increased and SD-OCT SNR decreased, the percentage of eyes with segmentation errors on SD-OCT increased. All measurements of macular thickness in eyes without segmentation errors were significantly greater than those of eyes with segmentation errors. Conclusions: Posterior subcapsular cataracts had profound effects on cataract grade based on wide-field fundus imaging. As cataract grade based on wide-field fundus image increased, macular thickness tended to be underestimated due to segmentation errors in SD-OCT images. Segmentation errors in SD-OCT should be considered when evaluating macular thickness in eyes with cataracts.

Four mutations identified in Chinese families with autosomal dominant congenital cataracts by next-generation sequencing

Yang Xinyi,Zhao Zitong,Wang Chun,Wang Wenxuan,Zhang Lu 한국유전학회 2024 Genes & Genomics Vol.46 No.8

Background Congenital cataracts, which can arise due to a combination of factors like environmental influences and genetic predisposition, significantly impact children’s visual health globally. The occurrence rate of congenital cataracts varies from 0. 63 to 9.74 per 10,000 births. There are 7.4 instances per 10,000 children, with the highest occurrence seen in Asia. Symptoms of the disease include clouding of the lens and visual impairment. Timely identification of the condition plays a crucial role in the management and outlook of pediatric patients. Objective This investigation aimed to discover causative mutations in four separate Chinese family lineages. Methods The detailed clinical data and family history of four Chinese families with autosomal dominant congenital cataracts were carefully documented. Examination of the Whole Exome Sequencing was utilized to identify the genetic anomalies present in the familial cases. Subsequent validation of the identified mutations was carried out using PCR and Sanger sequencing. Following this, various computational predictive programs were utilized to evaluate how the mutations impact the structure and function of the protein. Results The sequencing results reveal four potential disease-causing mutations: c.436G > A (p.V146M) of CRYBB2 Family 1, c.26G > T (p.R9I) of GJA3 in family 2, c.227G > A (p.R76H) of GJA8 in family 3, c.-168G > T of FTL in family 4. Among them, the causative mutation in Family GJA3 is novel, and Family FTL is a rare cataract syndrome. These familial mutations showed complete co-segregation with the affected individuals, with no presence in unaffected family members or the 100 controls. Several bioinformatic prediction tools also support the likely pathogenicity of these mutations. Conclusion Our findings expand the mutational and phenotypic spectrum of genes associated with congenital cataracts and provide clues to the pathogenesis of congenital cataracts. These data also demonstrate the importance of NGS technology for the molecular diagnosis of congenital cataract patients. Background Congenital cataracts, which can arise due to a combination of factors like environmental influences and genetic predisposition, significantly impact children’s visual health globally. The occurrence rate of congenital cataracts varies from 0. 63 to 9.74 per 10,000 births. There are 7.4 instances per 10,000 children, with the highest occurrence seen in Asia. Symptoms of the disease include clouding of the lens and visual impairment. Timely identification of the condition plays a crucial role in the management and outlook of pediatric patients. Objective This investigation aimed to discover causative mutations in four separate Chinese family lineages. Methods The detailed clinical data and family history of four Chinese families with autosomal dominant congenital cataracts were carefully documented. Examination of the Whole Exome Sequencing was utilized to identify the genetic anomalies present in the familial cases. Subsequent validation of the identified mutations was carried out using PCR and Sanger sequencing. Following this, various computational predictive programs were utilized to evaluate how the mutations impact the structure and function of the protein. Results The sequencing results reveal four potential disease-causing mutations: c.436G > A (p.V146M) of CRYBB2 Family 1, c.26G > T (p.R9I) of GJA3 in family 2, c.227G > A (p.R76H) of GJA8 in family 3, c.-168G > T of FTL in family 4. Among them, the causative mutation in Family GJA3 is novel, and Family FTL is a rare cataract syndrome. These familial mutations showed complete co-segregation with the affected individuals, with no presence in unaffected family members or the 100 controls. Several bioinformatic prediction tools also support the likely pathogenicity of these mutations. Conclusion Our findings expand the mutational and phenotypic spectrum of genes associated with congenital cataracts and provide clues to the pathogenesis of congenital cataracts. These data also demonstrate the importance of NGS technology for the molecular diagnosis of congenital cataract patients.

선천 백내장에서 백내장 제거술 및 일차 인공수정체 삽입술 후의 사시 발생에 영향을 주는 인자 비교

김상현,김완수,이수정,Sang Hyun Kim,Wan Soo Kim,Soo Jung Lee 대한안과학회 2011 대한안과학회지 Vol.52 No.3

Purpose: To evaluate factors associated with the development of strabismus after cataract extraction and primary intraocular lens implantation. Methods: Medical records of 80 patients who had undergone cataract extraction with primary intraocular lens implantation between 6 months and 21 years of age from March 1993 to March 2008 were reviewed. Nine patients (11 eyes) with strabismus before cataract surgery were excluded. Patients were divided into 2 groups; patients with congenital bilateral cataracts (43 patients, 86 eyes) or patients with unilateral cataracts (28 patients, 28 eyes). Data were collected on age at cataract surgery, pre and post-cataract extraction visual acuity, interocular visual acuity differences, nystagmus, operation method, and the existence of associated other ocular diseases to evaluate the association of the onset of strabismus and after cataract. Results: Factors statistically significantly associated with the development of strabismus include presence of nystagmus in bilateral cataracts and postoperative visual acuity differences > 0.3 in unilateral cataracts. A post-cataract extraction mean visual acuity ≤ 0.2 and preservation of posterior capsule were significant factors in both groups. Conclusions: Children with congenital cataracts should be monitored carefully after cataract surgery for the development of strabismus especially when they have poor postoperative visual acuity, nystagmus, large postoperative interocular visual acuity differences, or preservation of posterior capsule. J Korean Ophthalmol Soc 2011;52(3):325-331

TGF-α,-β_1, and bFGF mRNA Expression of Lens Epithelial Cells in Senile and Diabetic Cataract

Hwang, Bum Noon,Her, Jun 대한의생명과학회 2002 Biomedical Science Letters Vol.8 No.3

Anterior subcapsular cataract was developed by opacification with transdifferentiation and abnormal proliferation of lens epithelial cells (LECs) and pathological accumulation of extracellular matrix (ECM). After-cataract also be caused by a similar transdifferntiation of LECs remaining after surgery and the accompanying increase of ECM deposits. It is known that prostaglandin E2 and cytokine, such as TGF-β, bFGF, and IL-1, were associated with abnormal proliferation and transdifferentiation of LECs. The aim of this study was to detect the expression of transforming growth factor-α (TGF-α), transforming growth factor-β_1 (TGF-β_1) and basic fibroblast growth factor (bTGF) in LECs of senile and diabetic cataract. The expressions of these growth factors in lens epithelial cells were determined. The sample for growth factor determination were collected in senile cataract patients without metabolic disorder, especially diabetes mellitus and diabetic cataract patients. The mRNA expression of growth factors was detected by semi-quantiative reverse transcription-polymerase chain reaction (RT-PCR) followed by Southern blot analysis. Statistics were analysed using Wilcoxon rank sum test. Semi-quantitative RT-PCR/southern analysis of RNA obtained from thirty surgical specimens demonstrated that the level of mRNA expression of TGF-α, -β_1 and bFGF was increased in diabetic cataract lens tissues compared with senile cataract specimens but non-significant, bFGF and TGF-β_1, mRNA expression were detected in most patients, expression level of TGF-β_1 was most high on the basis of normal ocular concentration. Detection rate of TGF-α in diabetic cataract was 1.5 fold higher than in senile cataract (P=0.098). TGF-α, TGF-β_1, and bFGF mRNA expression of LECs were detected in senile and diabetic cataract. In both patient groups, expression level of TGF-β_1, mRNA was high, so We suggest TGF-β_1 strong influence in development of senile cataract and of diabetic cataract also. TGF-α expression level was similar but more frequently detected in diabetic cataract than in senile cataract. In conclusion, TGF-α may be associated with early development of diabetic cataract.

TGF-$\alpha$, -$\beta$$_1$, and bFGF mRNA Expression of Lens Epithelial Cells in Senile and Diabetic Cataract

Hwang, Bum-Noon,Her, Jun 대한의생명과학회 2002 Journal of biomedical laboratory sciences Vol.8 No.3

Anterior subcapsular cataract was developed by opacification with transdifferentiation and abnormal proliferation of lens epithelial cells (LECs) and pathological accumulation of extracellular matrix (ECM). After-cataract also be caused by a similar transdifferentiation of LECs remaining after surgery and the accompanying increase of ECM deposits. It is blown that prostaglandin E2 and cytokine, such as TGF-$\beta$, bFGF, and IL-1, were associated with abnormal proliferation and transdifferentiation of LECs. The aim of this study was to detect the expression of transforming growth factor-$\alpha$ (TGF-$\alpha$), transforming growth factor-$\beta_1$(TGF-$\beta_1$) and basic fibroblast growth factor (bFGF) in LECs of senile and diabetic cataract. The expressions of these growth factors in lens epithelial cells were determined. The sample for growth factor determination were collected in senile cataract patients without metabolic disorder, especially diabetes mellitus and diabetic cataract patients. The mRNA expression of growth factors was detected by semi-quantitative reverse transcription - polymerase chain reaction (RT-PCR) followed by Southern blot analysis. Statistics were analysed using Wilcoxon rank sum test. Semi-quantitative RT-PCR/southern analysis of RNA obtained from thirty surgical specimens demonstrated that the level of mRNA expression of TGF-$\alpha$, -$\beta_1$ and bFGF was increased in diabetic cataract lens tissues compared with senile cataract specimens but non-significant, bFGF and TGF-$\beta_1$ mRNA expression were detected in most patients, expression level of TGF-$\beta_1$ was most high on the basis of normal ocular concentration. Detection rate of TGF-$\alpha$ in diabetic cataract was 1.5 fold higher than in senile cataract (P=0.098). TGF-$\alpha$, TGF-$\beta_1$, and bFGF mRNA expression of LECs were detected in senile and diabetic cataract. In both patient groups, expression level of TGF-$\beta_1$, mRNA was high, so We suggest TGF-$\beta_1$ strong influence in development of senile cataract and of diabetic cataract also. TGF-$\alpha$ expression level was similar but more frequently detected in diabetic cataract than in senile cataract. In conclusion, TGF-$\alpha$ may be associated with early development of diabetic cataract.

백내장의 유병율과 인지도에 관한 조사

한선희,김봉환,정병근,견기영,이상경,최진훈,박준성,Han, Sun-Hee,Kim, Bong-Hwan,Kim, Byung-Gun,Kyeon, Ki-Young,Lee, Sang-Gyeong,Choi, Jin-Hun,Park, Jun-Sung 한국임상보건과학회 2017 한국임상보건과학회지 Vol.5 No.2

Purpose: The aim of this study is to examine the trends of cataract surgery and the recognition of cataract. Methods: ; It enrolled a total of 150 respondents, comprising 72 men and 78 women, who reside in Busan Metropolitan City, Ulsan Metropolitan City and Kyeong-nam Province. By the age groups, they include 44 people in their 20s, 24 in their 30s, 24 in their 40s, 26 in their 50s and 32 aged 60 years or older. In addition, the current study was conducted by dividing the respondents into two groups: people with cataract or not. Moreover, it was also conducted mainly for younger people. Results: 1. As for age of cataract operation, this study say that 1 patient was in their 20s, 3 patients in their 30s, 3 patients in their 40s, 6 patients in their 50s, and 7 patients in their over 60s. 2. In the question about whether they know about cataract, 100 respondents answered 'I know', 50 answered 'I do not know', 67% answered 'I know', 33% answered 'I do not know'. 3. As for pathways to know about cataract, of the total 120 respondents, 49 (41%) were in the media, 20 (17%) were Internet users, 26 (22%) were acquaintances, and 10 (7%) were specialty books, and 15 (13%) were 'others'. 4. As for cataract causes, 20 respondents (13%) answered 'exposure to sunlight', 12 (8%) answered 'electronic devices', 7 answered 'hereditary' 89 (60%) answered, and 22 (14%) answered 'eye disease'. 5. Twenty (13%) answered 'extremely yes', 40 (27%) answered 'yes', and 31 (21%) answered 'normal' when asked whether the use of smartphone was affected by cataracts. 48 (32%) answered 'little', and 11 (7%) answered 'not at all'. Our results showed that many people aged 50 years or older developed cataract and received surgery. It was also shown, however, that people in their 20s to 40s also developed cataract and received surgery. Conclusions: Our eyes are exposed to many places. Many people are unaware of cataracts, despite the fact that cataracts are gradually getting younger, due to the development of electronic devices and the use of electrical appliances. We should have interest in many information and contents about cataracts, knowing the importance to eyes, and gradually reducing the use of many electronic devices in young people.

백내장 종류에 따른 안내 수차의 패턴 분석

한지윤,엄영섭,임재원,강수연,김효명,송종석 대한안과학회 2015 대한안과학회지 Vol.56 No.4

목적: 안구의 전체 수차가 아닌 수정체의 변화에 의해 주로 나타나는 안내 수차를 이용하여 백내장 종류에 따라 어떠한 차이가 있는지알아보고자 하였다. 대상과 방법: 백내장 수술을 받고자 내원한 환자 70명 80안을 대상으로 수술 전 검사로 KR-1W 수차계를 이용하여 안내 수차를 측정한 환자에서 백내장 종류(피질백내장, 핵백내장, 후낭하백내장)에 따라 동공 지름 6 mm 범위에서의 안내 수차의 값과 그 수치의 절대값을 독립표본 비모수 검정을 통해 비교하여 그 차이를 알아보았다. 결과: 전체 80안 중 피질백내장 30안, 핵백내장 30안, 후낭하백내장 20안이었고, 동공 지름 6 mm 범위에서 안내 구면수차의 고유값평균은 피질백내장 0.042 μm, 핵백내장 -0.092 μm, 후낭하백내장 -0.109 μm로 통계적으로 유의한 차이를 보이지 않았으나, 절대값으로 비교했을 때는 피질백내장 0.122 μm, 핵백내장 0.533 μm, 후낭하백내장 0.202 μm로 핵백내장이 다른 두 백내장에 비해 유의하게 더 컸다(p=0.003, Kruskal-Wallis test). 또한 백내장 그룹별로 안내 구면수차의 분포를 보았을 때 높은 양의 값 또는 음의 값을갖는 경우는 대부분 핵백내장이었다. 그 외에 안내 난시나 코마 등 다른 고위수차 값은 통계적으로 유의한 차이를 보이지 않았다. 결론: 백내장의 종류에 따라 안내 구면수차 값을 비교한 결과 핵백내장의 경우 피질백내장이나 후낭하백내장에 비해 안내 구면수차값의 변화가 컸고, 높은 양의 값이나 높은 음의 값을 갖는 경우가 많았다 Purpose: The present study investigates the patterns of internal optical aberrations in eyes with different types of cataract. Methods: Eighty eyes of 70 cataract patients were included in the present study. Internal optical aberrations were measured with a KR-1W wavefront aberrometer before cataract operation. Types of cataract were classified into three groups; cortical, nuclear and posterior subcapsular cataracts. The differences in the results of the wavefront data of 6-mm pupil diameter zones were compared among three groups. The Kruskal-Wallis test and Mann-Whitney U test were used for comparing data. Results: A total of 80 eyes consisting of 30 cortical cataracts, 30 nuclear cataracts and 20 posterior subcapsular cataracts were found. In the 6-mm pupil diameter zone, the average internal spherical aberrations by original value were 0.042 μm of cortical cataracts, -0.092 μm of nuclear cataracts and -0.109 μm of posterior subcapsular cataracts. The average internal spherical aberrations by absolute value were 0.122 μm of cortical cataracts, 0.533 μm of nuclear cataracts and 0.202 μm of posterior subcapsular cataracts. The internal spherical aberrations by original value were not statistically significantly different, but by absolute value were statistically significantly different (p = 0.003, Kruskal-Wallis test). Nuclear cataracts have a much higher positive or negative value than other cataract groups in the distribution of internal spherical aberrations by original value for each type of cataract. Other than this difference, the internal astigmatism and internal high order aberrations were not statistically significantly different. Conclusions: The change in internal spherical aberrations of nuclear cataract from the original value was larger than cortical and posterior subcapsular cataract. Therefore, nuclear cataracts have much higher positive or negative values than other cataract groups.

Effect of oral antioxidants on the progression of canine senile cataracts: a retrospective study

Park, Sanghyun,Kang, Seonmi,Yoo, Sukjong,Park, Youngwoo,Seo, Kangmoon The Korean Society of Veterinary Science 2022 Journal of Veterinary Science Vol.23 No.3

Background: Cataracts are the leading cause of impaired vision or blindness in dogs. There are many antioxidants that can prevent cataract progression, but whether they are clinically effective in dogs has not been established. Objectives: To analyze the delaying or preventing effect of oral antioxidants on canine senile cataracts through retrospective analysis. Methods: Medical records of dogs from January 1, 2015 to July 10, 2020 were reviewed. Dogs that were 8 yr of age or older with senile cataracts were included in this study. The dogs were divided into two treatment groups (dogs administered with Ocu-GLO supplement and dogs administered with Meni-One Eye R/C supplement) and a control group (dogs that were not administered any supplement). Dogs with incipient and immature cataracts were included in this study. Altogether, 112 dogs (156 eyes) with incipient cataracts and 60 dogs (77 eyes) with immature cataracts were included. The period of time that cataracts progressed from incipient to immature, and from immature to mature was recorded for each dog. Results: There was no significant delaying effect on the progression of incipient cataracts. However, both Ocu-GLO (hazard ratio = 0.265, p = 0.026) and Meni-One (hazard ratio = 0.246, p = 0.005) significantly delayed the progression of immature cataracts compared to the control group. Conclusions: Although there was no significant delaying effect of oral antioxidants on incipient cataract progression, antioxidants could be used to delay the progression of senile immature cataract.