Sang-Hoon Rah

Valsalva retinopathy associated with fiberoptic gastroenteroscopy.

CASE REPORT A 45-year-old woman presented with a sudden loss of vision in her left eye, which occurred while she was having a routine upper fiberoptic gastroenteroscopy. According to the gastrointestinal specialist, the patient had performed multiple sustained Valsalva maneuvers during the procedure. Funduscopy showed a preretinal hemorrhage with a half disc diameter in the fovea of the left eye. COMMENTS A diagnosis of Valsalva retinopathy was made on the basis of history and fundus finding. The hemorrhage resolved within 2 months without any sequelae. To our knowledge, this is the first report of the occurrence of Valsalva retinopathy following a routine upper fiberoptic gastroenteroscopy.

The Comparision of Outcomes Between Lateral Rectus Muscles Re-recession and Medial Rectus Muscles Resection in Recurrent Exotropia

Purpose To compare the surgical outcomes between bilateral lateral rectus muscles (BLR) re-recession and bilateral medial rectus muscles (BMR) resection in recurrent exotropia. Methods The medical records of patients with recurrent exotropia who underwent surgery for intermittent exotropia during the 6 years from January 2001 to December 2006 and followed up for more than 6 months were reviewed retrospectively. Results In group A, BLR recessions was performed at the first surgery and BLR re-recession was performed at the second surgery. In group B, BLR recession was performed at the first surgery and BMR resection at the second surgery. Success rates at the last follow-up after the second operation were 81.9% in Group A and 83.3% in Group B, showing no statical difference between the two groups. In group A, no significant underaction of the BLR was noted. Success rates were not statistically different between the 2 mm re-recessed subgroup and 3 mm re-recessed subgroup. Conclusions The results support the notion that BLR re-recession successfully corrects recurrent exotropia without producing significant limitation of abduction.

The clinical course of consecutive esotropia after surgical correction.

Purpose To investigate the clinical course in patients who underwent surgical correction of consecutive esotropia. Methods The medical records of 13 patients who underwent surgical correction of consecutive esotropia were reviewed retrospectively. The authors investigated the deviation and surgical method at the time of exotropia surgery. During the follow up period, the authors also studied incidence of amblyopia development, the effect of occlusion therapy, surgical methods for consecutive esotropia, and postoperative change of deviation. Results The average exodeviation was 27.1 prism diopter (PD). Bilateral lateral rectus muscle recession was performed in all patients. In all patients, alternate occlusion was tried from 2 weeks after development of consecutive esotropia. However, there was no effect on 7 patients. None of the patients developed amblyopia. Surgery for consecutive esotropia was performed on the average 15.3 months after exotropia surgery. The average esodeviation was 21.1PD. Medial rectus muscle recession was performed in 10 patients and lateral rectus muscle advancement in 3 patients. The average deviation of the subject group immediately after surgery was 1.2PD esodeviation, 0.9PD esodeviation one month after surgery, 2.4PD exodeviation 6 months after surgery, and 4.7PD exodeviation at the last follow up, and it showed a tendency to progress to exodeviation as the follow up period increased. Ten patients (76.9%) showed deviation within 8PD at the last follow up. Conclusions The success rate of surgical correction for consecutive esotropia was a favorable outcome. But, careful decisions of the surgical method and amount is needed because the conversion of exodeviation during long-term follow-up is possible.

A case of photic retinal injury associated with exposure to plasma arc welding

Purpose To report of photic retinopathy induced by plasma arc welding, and the OCT (optical coherence tomography) results of damaged retinal lesions. Methods We describe a case report of a 37-year-old male, working in the steel industry, who presented with central scotoma in both eyes. Results On his first visit, one day after performing plasma arc welding with protective gear at work, his best corrected vision was 0.7 for both eyes. Ophthalmic examination of the fundus showed a round yellow lesion with an approximate size of 300 micrometers superonasal to the fovea of both eyes. On his next visit, one month later, his vision had recovered to 1.0, his symptoms had improved, and the ophthalmoscopic examination of the fundus revealed that the round yellow spots had disappeared from both eyes. Conclusions To our knowledge, this is the first report of photic retinopathy induced by plasma arc welding, and the OCT (optical coherence tomography) results of damaged retinal lesions have not previously been reported. For these reasons, we report this case.

Development of parafoveal exudates and serous retinal detachment in a pregnant woman with tuberous sclerosis.

The authors describe an unusual case of a serous detachment of the fovea and decreased vision with parafoveal exudates with subsequent spontaneous resolution and return of central vision in a pregnant patient with tuberous sclerosis. To our knowledge, this is the first report of an ocular change during gestation in a patient with tuberous sclerosis.

Conjunctival expansion using a subtenon's silicone implant in New Zealand white rabbits.

Purpose In the field of ophthalmology, the conjunctival autograft is a useful therapeutic material in many cases, but the small size of the autograft is a disadvantage. Therefore, we evaluated the feasibility of taking an expanded sample of conjunctival tissue using a subtenons silicone implant. Materials and Methods We included a total of nine rabbits; eight rabbits were operative cases, and one was a control. A portion of conjunctival tissue from the control rabbit, which did not undergo surgery, was dissected and examined to determine whether it was histologically different from the experimental group. The surgical procedure was performed on eight rabbits via a subtenons insertion of a silicone sponge in the left superior-temporal portion; after surgery, we dropped antibiotics into the eyes. We sacrificed a pair of rabbits every three days (on days 3, 6, 9, and 12) after surgery, removed the expanded conjunctival tissues with the silicone sponge implants, and measured their sizes. Results The mean size of the expanded conjunctival tissues was 194.4 mm2. On the third day, we were able to harvest a 223.56 mm2 section of conjunctival tissue, which was the most expanded sample of tissue in the study. On the twelfth day, we removed a 160.38 mm2 section of conjunctival tissue, which was the least expanded sample of tissue. Statistically, there were no significant differences in the mean dimensions of the expanded conjunctival tissues for each time period. Microscopic examinations showed no histological differences between the expanded conjunctival tissues and the normal conjunctival tissues. Conclusion The results reveal that this procedure is a useful method to expand the conjunctiva for grafting and transplantation.

Refractive Change Caused Silicone Oil Adhesion to the Intraocular Lens Following Nd:YAG Posterior Capsulotomy

A 32-year-old female who had undergone the silicone oil removal procedure presented with visual disturbance in her left eye. Several months previous, she had cataract surgery in a private clinic, and a month later she had a Nd:YAG laser procedure for posterior capsulotomy. The slit-lamp examination revealed silicone oil droplets that had adhered to the intraocular lens where the posterior capsulotomy was performed. She had experienced high myopia as a manifestation of the resulting refractive changes. We replaced the previous intraocular lens with a new acrylic intraocular lens with resulting improvement to her vision. Here we report the case of a female patient with a history of silicone oil removal surgery where the resulting silicone bubbles had not been removed thoroughly and remained in the vitreous cavity. These bubbles subsequently adhered to the intraocular lens following YAG laser posterior capsulotomy, resulting in refractive changes. We recommend that implanting a silicone intraocular lens in anyone with a history of the silicone oil removal procedure or who has a possible history of silicone oil use should be avoided.