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.

휘발성 실내환경요인이 백내장에 미치는 영향

이은희 대한시과학회 2024 대한시과학회지 Vol.26 No.1

목적 : 본 연구는 국민건강영양조사 제8기(2019-2021) 원시자료를 이용하여, 생체지표를 통한 휘발성 실내환경요인(휘발성 유기 화합물, VOCs)과 백내장의 연관성을 파악하고자 하였다. 방법 : 백내장 의사진단 여부 및 가정 실내공기질 측정에 참여한 만 40세 이상의 성인 총 1,150명을 대상으로하였다. 일반적 특성에 따른 휘발성 실내환경요인의 농도와 백내장의 유 ‧ 무에 따른 휘발성 실내환경요인의 농도를비교하기 위해 복합표본 기술통계 분석과 로지스틱회귀분석을 하였다. p<0.050인 경우 유의한 것으로 판단하였다. 결과 : 대부분의 실내 휘발성 환경오염물질의 생체지표는 백내장을 진단받은 대상자에서 높게 나타났다. 특히Benzene, Xylene, Acrolein, 1-Bromopropane, 1,3-Butadiene의 생체지표 평균농도(GM)가 백내장 진단받은대상자들이 유의하게 높게 나타났다. 연령, 성별, 결혼, 알콜, 흡연, 소득을 보정한 복합표본 로지스틱회귀분석에서, 1,3-Butadiene의 생체지표는 약 2배(OR 1.905(95% CI: 1.001, 3.625))의 위험도로 백내장에 영향을 미칠수 있는 것으로 나타났다. 결론 : 본 연구는 기존에 밝혀지지 않은 휘발성 실내환경요인과 백내장의 연관성을 파악함으로써, 일부 휘발성실내환경물질은 백내장의 원인물질로 작용할 수 있는 가능성을 보여주었다. Purpose : This study aimed to investigate the correlation between volatile indoor environmental factors(Volatile Organic Compounds, VOCs) through biomarkers and cataracts using raw data from the 8th National Health and Nutrition Survey (2019-2021). Methods : A total of 1,150 adults over 40 years of age who participated in the diagnosis of cataract and the measurement of indoor air quality at home were studied. Complex sample descriptive statistics analysis and logistic regression analysis were conducted to compare the concentration of volatile indoor environmental factors according to the general characteristics and the concentration of volatile indoor environmental factors according to the presence or absence of cataracts. In the case of p<0.050, it was deemed significant. Results : Most indoor environmental pollutant biomarkers were high in subjects diagnosed with cataract. In particular, the average concentration (GM) of biomarkers of benzene, xylene, acrolein, 1-bromopropane, and 1,3-butadiene was significantly higher in subjects diagnosed with cataract. In a complex sample logistic regression analysis adjusted for age, sex, marriage, alcohol, smoking, and income, the biomarker 1,3-butadiene was found to be approximately twice as hazardous (95% CI: 1.082, 4.037) and can affect cataract. Conclusion : This study showed the possibility that some volatile indoor environmental substances act as causative agents for cataracts by identifying the relationship between previously unidentified volatile indoor environmental factors and cataracts.

Recessive optic atrophy, sensorimotor neuropathy and cataract associated with novel compound heterozygous mutations in <i>OPA1</i>

LEE, JINHO,JUNG, SUNG-CHUL,HONG, YOUNG BIN,YOO, JEONG HYUN,KOO, HEASOO,LEE, JA HYUN,HONG, HYUN DAE,KIM, SANG-BEOM,CHUNG, KI WHA,CHOI, BYUNG-OK SPANDIDOS PUBLICATIONS 2016 MOLECULAR MEDICINE REPORTS Vol. No.

<P>Mutations in the optic atrophy 1 gene (<I>OPA1</I>) are associated with autosomal dominant optic atrophy and 20% of patients demonstrate extra-ocular manifestations. In addition to these autosomal dominant cases, only a few syndromic cases have been reported thus far with compound heterozygous <I>OPA1</I> mutations, suggestive of either recessive or semi-dominant patterns of inheritance. The majority of these patients were diagnosed with Behr syndrome, characterized by optic atrophy, ataxia and peripheral neuropathy. The present study describes a 10-year-old boy with Behr syndrome presenting with early-onset severe optic atrophy, sensorimotor neuropathy, ataxia and congenital cataracts. He had optic atrophy and was declared legally blind at six years old. Electrophysiological, radiological, and histopathological findings were compatible with axonal sensorimotor polyneuropathy. At birth, he presented with a congenital cataract, which has not been previously described in patients with <I>OPA1</I> mutations. Whole exome sequencing indicated a pair of novel compound heterozygous mutations: p.L620fs*13 (c.1857–1858delinsT) and p.R905Q (c.G2714A). Neither mutation was observed in controls (n=300), and thus, they were predicted to be pathogenic by multiple <I>in silico</I> analyses. The mutation sites were highly conserved throughout different vertebrate species. The patients parents did not have any ophthalmic or neurologic symptoms and the results of electrophysiological studies were normal, suggestive of an autosomal recessive pattern of inheritance. The present study identified novel compound heterozygous <I>OPA1</I> mutations in a patient with recessive optic atrophy, sensorimotor neuropathy and congenital cataracts, indicating an expansion of the clinical spectrum of pathologies associated with <I>OPA1</I> mutations. Thus, <I>OPA1</I> gene screening is advisable in the workup of patients with recessive optic atrophy, particularly with Behr syndrome and cataracts.</P>

백내장이 삶의 질에 미치는 영향

김완기,이은희 대한시과학회 2023 대한시과학회지 Vol.25 No.4

Purpose : This study was conducted to determine the effect of cataracts on quality of life in adults over 40 years of age using raw data from the 7th National Health and Nutrition Survey (2016-2018). Methods : We analyzed the relationship between gender, age, depression, and illness-related quality of life among 4,394 adults aged 40 years and older who responded to a diagnosis of cataract in the 7th National Health and Nutrition Examination Survey (2016-2018). Dichotomized variables were analyzed using the chi-square test (X2). Relationships between cataract, depression, and quality of life sub-variables were analyzed using logistic regression, adjusting for the effects of age and gender. A value of p<0.05 was considered significant. Results : In the logistic regression analysis results corrected for age and gender, cataracts were significantly related to cataracts in terms of motor ability (walking activity), pain and discomfort, anxiety and depression. In terms of restrictions on motor ability (walking activity), cataract disease patients were 1.37 times (95% CI: 1.14-1.65), pain and discomfort were 1.3 times (95% CI: 1.11-1.51), and anxiety and depressive symptoms were 1.38 times (95% CI: 1.10-3.75) at increased risk, confirming that cataracts significantly lowered the quality of life of the subjects. However, in terms of self-care (bath or dressing) and daily life, after correcting age and gender, a significant relationship with cataracts could not be confirmed. Conclusion : It was confirmed that cataracts affect exercise ability, pain/comfort, anxiety/ depression, etc., which can also reduce the quality of life. 목적: 국민건강영양조사 제7기(2016-2018) 원시자료를 이용하여 40세 이상 성인에서 백내장이 삶의 질에 미치는영향을 파악하고자 수행되었다. 방법 : 국민건강영양조사 제7기(2016-2018) 자료 중 40세 이상의 성인으로 백내장에 대한 진단 여부에 응답한 4,394명을 대상으로 백내장 진단 여부에 따라 성별, 나이, 우울증, 질병으로 인한 삶의 질 등의 관계를 분석하였다. 이분화된 변수는 카이제곱 검정(χ2)을 이용해 분석하였다. 백내장과 우울증 그리고 삶의 질 하위 변수 간의관계는 나이와 성별의 영향을 보정한 로지스틱 회귀분석(logistic regression)을 이용하였다. p<0.05인 경우 유의한 값으로 판단하였다. 결과 : 나이와 성별을 보정한 로지스틱 회귀분석 결과에서 백내장은 운동능력(걷는 활동), 통증과 불편, 불안과우울 면에서 백내장과 유의한 관계가 있었다. 운동능력(걷는 활동)에 대한 제한에서는 백내장 질환자가 1.37배(95% CI: 1.14-1.65), 통증과 불편함은 1.3배(95% CI: 1.11-1.51) 그리고 불안과 우울한 증상은 위험도가 1.38배(95% CI: 1.10-3.75)나 위험도가 높아지는 것으로 나타나 백내장이 대상자들의 삶의 질을 현저하게 낮춘다는 것을 확인할 수 있었다. 그러나 자기관리(목욕 또는 옷 입기), 일상생활 면에서는 나이와 성별을 보정한 뒤 백내장과 유의한 관계를 확인할 수 없었다. 결론 : 백내장은 운동능력과 통증/불편, 불안/우울 등에 영향을 미치며, 이로 인해 삶의 질도 저하될 수 있다는것을 확인하였다.

The Trend of cataract surgery most common in Koreans and the Occurrence risk factors in middle-aged and older Adults - Focused on National Health Service’s Surgical Statistics in 2020 –

Seonahr Cho 국제문화기술진흥원 2022 International Journal of Advanced Culture Technolo Vol.10 No.4

The purpose of this study is to investigate the incidence rate, surgery tendency, and risk factors of cataracts among the elderly in Korea. The subjects were 40-95 years old men and women using the National Health Services’ surgical statistics. Among the 33 major surgeries, which increased by 1.1% per year for the last 20years (1.6 million), the most operated surgery in 2020 was cataract surgery (454,000), the number of which was 858.8 per 100,000 people. Among the surgical patients, cataract patients (7.9% increased) was the third largest among the top (2016-2020) constantly with annually 2.2% increasing for 20 years (19.95 million). The medical expenses of major surgeries (excluding non-benefit) increased by an average rate of 9.3% per year over the 20 years (7,204 billion won) out of a total medical expenses of 7.2 trillion won, and the cataract surgery (813.2 billion won) was the second largest among the medical expenses in 2020 (top 3). This study showed that there was a high correlation between cataract and smoking, low income, and low-educated, whereas being no concentration of cataract patient in tertiary hospitals.

선천백내장으로 수술한 형제에서 진단된 안, 뇌, 신 증후군 2예

석경원,이수정,김완수,Kyung Won Suk,Soo Jung Lee,Wan Soo Kim 대한안과학회 2006 대한안과학회지 Vol.47 No.9

Purpose: We report two cases of brothers diagnosed with oculocerebrorenal syndrome after binocular congenital cataract surgery. Methods: Two brothers who had undergone surgeries for congenital cataracts showed growth retardation, proteinuria, and generalized tonic seizures. The patients were referred to the pediatrics department and evaluated for systemic diseases and genetic counseling. Results: Two brothers had renal tubular dysfunction characterized by hypercalciuria and hyperphosphaturia. The older brother had multiple microcalcifications on both kidneys, and ischemic injury with general dysfunction of the brain. Genetic analysis of brothers and their mother showed a new mutation of P799L in the region of the chromosome Xq25-26.1 locus. The two brothers were diagnosed with oculocerebrorenal syndrome of Lowe (OCRL). Conclusions: In cases of patients with congenital cataracts, the evaluation of systemic disease including genetic abnormality should be considered whenever systemic symptoms such as growth retardation, proteinuria or seizure are found.

소아에서 전신마취하 측와위 자세에서 시행한 야그레이저후낭절개술의 유용성

김정동(Jung Dong Kim),강현구(Hyun Goo Kang),김태영(Tae Young Kim),이준원(Junwon Lee),김민(Min Kim) 대한안과학회 2021 대한안과학회지 Vol.62 No.7

목적: 야그레이저후낭절개술을 전신마취하 측와위 자세에서 시행한 증례와 그 유용성에 대해 보고하고자 한다. 증례요약: 5세 남자 환자가 우안 포도막염을 진단받고 내원하였다. 국소 및 전신 스테로이드를 사용하며 치료하던 중 백내장이 진행하여 1년 4개월 후 백내장수술을 시행하였다. 수술 3년 후, 최대교정시력 0.1 로 감소하였고 후낭혼탁이 악화되어 야그레이저후낭절개술이 필요했지만 환아 협조가 어려웠고 수술적 치료 시 염증의 악화가 우려되어 전신마취하 측와위 자세에서 비침습적인 야그레이저후낭절개술을 시행하였다. 총 레이저 시간은 5분 내외로 시행하였고, 총 마취 시간은 30분 이내로 진행되었으며 안과적 및 전신마취관련 합병증은 없었다. 3개월 뒤 경과는 최대교정시력 1.0으로 호전되었고, 후낭혼탁은 잘 제거된 상태로 유지되었다. 결론: 본 증례를 통하여 백내장수술을 받은 환자가 후낭혼탁이 발생하였으나 협조가 어려울 경우, 특히 수술 치료 시 염증 악화가 우려되는 포도막염 환자의 경우에 전신마취하 측와위 자세에서 야그레이저후낭절개술을 시행함으로써 협조가 어려운 소아에서도 비침습적, 효과적으로 안전하게 후낭혼탁을 제거할 수 있는 유용한 시술 방법임을 알 수 있었다. Purpose: To report a successful case of neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy performed in a noncompliant pediatric patient using the lateral decubitus position and a conventional slit-lamp-based laser system under general anesthesia. Case summary: Progression of a thick posterior capsular opacity with associated vision loss (best-correct visual acuity of 0.1) was detected in a nine-year-old child with a past history of cataract surgery in his right eye. Diagnosed with pediatric uveitis at the age of five, he had been treated previously using a combination of topical and systemic corticosteroids, which led to the development of the cataract and subsequent surgery 16 months later. Severe photophobia prevented outpatient-based laser treatment, and the patient underwent our modified procedure. Under general anesthesia, the patient was placed in a lateral decubitus position with the use of a long intubation tube. The height of the bed and table-based laser system was adjusted so as to minimize strain when positioning the child’s head. Successful laser capsulotomy was performed within 10 minutes, and the entire anesthesia time was less than 30 minutes. The patient experienced immediate improvement in symptoms, showing a visual acuity of 1.0, which has been sustained as of his most recent visit, 3 months postoperatively. The patient experienced no ocular or anesthesia- related complications. Conclusions: Nd:YAG laser capsulotomy performed by careful positioning (lateral decubitus) under general anesthesia is a viable strategy for the safe and efficient removal of posterior capsular opacities in children with poor compliance.

개의 백내장 및 망막박리에서의 초음파 진단

김종택 한국임상수의학회 1997 한국임상수의학회지 Vol.14 No.2

Cataract and Retinal detachment eyes dogs were examined by ultrasonography. Ultrasonography of the immature and mature cataractous eyes showed echographic changes, and cataractous lens increased in thickness. The diagnosis of retinal detachment was made an echodense waving motion structure in the posterior segment was imaged. This investigation will provide basic information for the study of pathologic conditions affecting the eyes of dog using ultrasound unit commonly available to the veterinarian.

Hand-held laser interferometer를 이용한 백내장환자의 술후 시력예측

윤재락,장한기 침례병원 1998 浸禮病院學術誌 Vol.14 No.-

소아백내장의 수술 방법에 따른 술 후 합병증 비교

안정효,김완수,Jung Hyo Ahn,Wan Soo Kim 대한안과학회 2006 대한안과학회지 Vol.47 No.7