Nune Eye Hospital

Seoul, South Korea

Nune Eye Hospital

Seoul, South Korea
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Kwon O.-W.,Nune Eye Hospital | Lee F.L.,Taipei Veterans General Hospital | Chung H.,Seoul National University | Lai C.-C.,Chang Gung Memorial Hospital | And 2 more authors.
Graefe's Archive for Clinical and Experimental Ophthalmology | Year: 2012

Background The purpose of this study was to investigate the efficacy and safety of intravitreal ranibizumab 0.5 mg in South Korean and Taiwanese patients with subfoveal choroidal neovascularization (CNV) secondary to agerelated macular degeneration (AMD). Methods This was a 12-month, open-label, single-arm, multicenter, phase III study. Ninety-five patients (Taiwanese: 51; South Korean: 44) were included in the study. Key outcome measures assessed included: mean change in best-corrected visual acuity (BCVA) from baseline to months 4 (primary endpoint) and 12 (secondary endpoint); other secondary endpoints comprising categorized mean change in BCVA from baseline at month 4 and month 12, mean change in BCVA from baseline at month 4 and month 12 per baseline characteristics; and incidence of ocular and non-ocular adverse events and serious adverse events (SAEs) at month 12. Results The mean BCVA change improved significantly (p<0.0001) from baseline to both month 4 (+9.3 letters) and month 12 (+10.1 letters). At month 12, the proportion of patients who gained ≥5, 10, or 15 letters from baseline was 75.8%, 54.7%, and 32.6% respectively. Total and CNV lesion area significantly decreased from baseline (p<0.0001). About 57% of patients showed complete absence of fluorescein leakage atmonth 12.Mean change frombaseline visual acuity scores also increased significantly over time for all subgroups. At month 12, ocular SAEs occurred in 2.1% of patients (out of which one patient [1.1%] experienced endophthalmitis) and 16.8% of patients experienced non-ocular SAEs. There were no deaths reported during the study. Conclusions Consistent with previous studies in Caucasian and Japanese populations, EXTEND III confirms that monthly intravitreal injections of ranibizumab 0.5 mg administered over 12 months is effective and well-tolerated in South Korean and Taiwanese patients with subfoveal CNV secondary to AMD. © Springer-Verlag 2012.


Kim Y.J.,Soonchunhyang University | Jo S.,Soonchunhyang University | Moon D.,Nune Eye Hospital | Joo Y.,Soonchunhyang University | Choi K.S.,Soonchunhyang University
Investigative Ophthalmology and Visual Science | Year: 2014

PURPOSE. To comprehend the mechanism of focal chorioretinal damage by analysis of the pressure distribution and dynamic pressure induced by infused air during fluid-air exchange. METHODS. A precise simulation featuring a model eye and a fluid circuit was designed to analyze fluid-air exchange. The pressure distribution, flow velocity, and dynamic pressure induced by infusion of air into an air-filled eye were analyzed using an approach based on fluid dynamics. The size of the port and the infusion pressure were varied during simulated iterations. We simulated infusion of an air-filled eye with balanced salt solution (BSS) to better understand the mechanism of chorioretinal damage induced by infused air. RESULTS. Infused air was projected straight toward a point on the retina contralateral to the infusion port (the "vulnerable point"). The highest pressure was evident at the vulnerable point, and the lowest pressure was recorded on most retinal areas. Simulations using greater infusion pressure and a port of larger size were associated with elevations in dynamic pressure and the pressure gradient. The pressure gradients were 2.8 and 5.1 mm Hg, respectively, when infusion pressures of 30 and 50 mm Hg were delivered through a 20-gauge port. The pressure gradient associated with BSS infusion was greater than that created by air, but lasted for only a moment. CONCLUSIONS. Our simulation explains the mechanism of focal chorioretinal damage in numerical terms. Infused air induces a prolonged increase in focal pressure on the vulnerable point, and this may be responsible for visual field defects arising after fluid-air exchange. © 2014 The Association for Research in Vision and Ophthalmology, Inc.


Lee J.Y.,Kyungpook National University | Kang K.M.,Kyungpook National University | Shin J.P.,Kyungpook National University | Kim I.T.,Kyungpook National University | And 2 more authors.
British Journal of Ophthalmology | Year: 2013

Aim: To evaluate the effects and stability of AcrySof toric intraocular lens (IOL) implantation in patients who had combined microincision vitrectomy surgery (MIVS) and phacoemulsification for vitreoretinal diseases and cataract with corneal astigmatism. Methods: A retrospective comparative study with 20 patients (20 eyes) who had combined 23-gauge MIVS and phacoemulsification with regular corneal astigmatism (>1.00 dioptres) was done. 10 eyes had toric IOL and 10 eyes had non-toric IOL implantation. The main outcome measures were uncorrected visual acuity (UCVA), refractive cylinder and toric IOL axis rotation at postoperative months 1, 6, 12, 18 and 24. Results: The mean UCVA of toric IOL was better than non-toric IOL at each postoperative period (p=0.019, 0.001, 0.007, 0.004 and 0.001, respectively). The mean absolute residual refractive cylinder of toric IOL was less than non-toric IOL at each postoperative period (p=0.001, <0.001, <0.001, <0.001 and <0.001, respectively). At month 24, the mean toric IOL axis rotation was 3.3±2.1°, which was within 5° in 80% and within 10° in 100%. Conclusions: Toric IOL implantation could be an effective method of correcting corneal astigmatism in patients who have vitreoretinal diseases and cataract. The toric IOL showed good rotational stability, even in vitrectomised eyes for 24 months.


Park D.H.,Kyungpook National University | Shin J.P.,Kyungpook National University | Kim S.Y.,Nune Eye Hospital
Eye | Year: 2011

Aim: To compare AcrySof toric intraocular lens (IOL) and non-toric IOL in patients who had combined 23-gauge microincisional vitrectomy surgery (MIVS) and phacoemulsification for vitreoretinal diseases and cataract with pre-existing corneal astigmatism. Methods: This is a prospective comparative study comprised of 30 patients (30 eyes) who had combined 23-gauge MIVS and phacoemulsification for vitreoretinal diseases and cataract with pre-existing regular corneal astigmatism greater than 1 diopters (D). In all, 15 eyes had AcrySof toric IOL (Alcon Laboratories) and 15 eyes had non-toric IOL (Akreos AO MI60; Bausch Lomb) implantation. Main outcome measures were uncorrected visual acuity (UCVA), refractive cylinder, surgically induced astigmatism (SIA), and IOL misalignment during 6 months. Results: The mean UCVA of the toric IOL group was better than the non-toric IOL group at postoperative months 1, 3, and 6 (P<0.001, respectively). The mean absolute residual refractive cylinder of the toric IOL group at postoperative week 1, and months 1, 3, and 6 was less than the non-toric IOL group (P=0.008, <0.001, <0.001, and <0.001, respectively). There was no difference in the mean SIA between the two groups (P>0.05, respectively). The mean toric IOL axis rotation was 3.52±2.75°, which was within 5° in 66.7% of the toric IOL group and within 10° in 100%. Conclusions: Combined 23-gauge MIVS and phacoemulsification with AcrySof toric IOL implantation is an effective method of correcting vitreoretinal diseases and cataract and pre-existing corneal astigmatism, and the toric IOL showed good rotational stability, even in vitrectomized eyes for 6 months. © 2011 Macmillan Publishers Limited All rights reserved.


Kim K.M.,Nune Eye Hospital | Shin Y.-T.,Kyungpook National University | Kim H.K.,Kyungpook National University
Japanese Journal of Ophthalmology | Year: 2012

Purpose: Platelet-rich plasma (PRP) harbors high concentrations of growth factors related to the promotion of wound healing. We evaluated the efficacy of PRP eyedrops in the treatment of persistent epithelial defects (PEDs). Methods: Autologous PRP and autologous serum (AS) were prepared from whole blood. The concentrations of transforming growth factor (TGF)-β1, TGF-β2, epidermal growth factor (EGF), vitamin A and fibronectin in the PRP and AS were analyzed and compared. The corneal epithelial healing efficacy of PRP was compared with that of AS in patients with PED induced by post-infectious inflammation. Results: The concentrations of TGF-β1, TGF-β2, EGF, vitamin A and fibronectin in the PRP and AS were not statistically different. However, the concentrations of EGF in the PRP were significantly greater than in the AS. AS was used in 17 and PRP in 11 eyes of 28 patients. The healing rates of the corneal epithelia of the PRP-treated eyes were significantly higher than those treated with AS. Conclusions: The PRP was effective in the treatment of PEDs. This may be attributable to its high concentration of platelet-contained growth factors, most notably EGF. PRP could be an effective, novel treatment option for chronic ocular surface disease. © Japanese Ophthalmological Society 2012.


Chang M.,Korea University | Lee T.S.,Nune Eye Hospital | Yoo E.,Korea University | Baek S.,Korea University
British Journal of Ophthalmology | Year: 2011

Purpose: To evaluate the long-term efficacy of a new surgical technique for the correction of lower lid epiblepharon using thermal contraction of the tarsus and lower lid retractor without lash rotating sutures. Methods: A retrospective study was conducted on 112 eyes of 56 patients who underwent surgical correction of lower lid epiblepharon with a modified Hotz operation (group A) or a new procedure (group B). The new technique requires that thermal contraction using bipolar cautery was applied to the inferior tarsus including the pretarsal orbicularis oculi muscle and lower lid retractor to create lash rotation without additional rotating sutures. The authors compared the results from these two techniques. Results: 44 eyes of 22 patients (11 boys and 11 girls) were included in group A, the average age was 5.5 years (±2.2), follow-up periods were 56.9 months (±7.7). Undercorrections developed in four eyes (9.1%), and epiblepharon recurred in seven eyes (15.9%). In group B, 68 eyes of 34 (20 male and 14 female) patients were included, with an average age of 5.1 years (±2.5), and a mean follow-up period of 39.7 months (±9.5). Epiblepharon recurred in three eyes (4.4%), and no patients were undercorrected. The recurrence and undercorrection rates were significantly lower in group B (p=0.022 and p=0.047). Conclusion: The new surgical technique for the correction of lower lid epiblepharon using thermal contraction of the tarsus and lower lid retractor without lash rotating sutures was very useful and effective for the correction of epiblepharon, with good cosmetic results.


Roh M.I.,Yonsei University | Lim S.J.,Nune Eye Hospital | Ahn J.M.,Siloam Eye Hospital | Lim J.B.,Yonsei University | And 2 more authors.
Graefe's Archive for Clinical and Experimental Ophthalmology | Year: 2010

Background: To evaluate the changes in aqueous humor cytokine levels following consecutive intravitreal bevacizumab (Avastin, Genentech Inc., San Francisco, CA, USA) injections in eyes with choroidal neovascularization (CNV) due to age-related macular degeneration (AMD). Method: Aqueous humor samples were collected at the time of intravitreal injection of 1.25 mg of bevacizumab every 7.0 (±2.0) weeks from ten eyes with AMD for the AMD group and during cataract surgery in nine eyes for the control group. Visual acuity with Early Treatment of Diabetic Retinopathy Study (ETDRS) letters and central macular thickness (CMT) using optical coherence tomography were measured before each injection in the AMD group. Aqueous cytokine levels were determined by immunoassay using multi-analyte biochip array technology (Evidence investigator cytokine and growth factor biochip array, RANDOX laboratories Ltd., Crumlin, UK). Result: In the AMD group, mean ± standard deviation(SD) aqueous VEGF levels decreased from 68.0±32.1 pg/ml at baseline to 26.3±19.0 pg/ml after the first injection (p=0.028) and to 25.2±12.8 pg/ml after the second injection (p=0.005). While CMT decreased from 307.7±102.0 μm to 206.8±141.5 μm (p=0.037), ETDRS visual acuity increased from 17.6±11.7 letters to 22.0±15.6 letters after three consecutive injections (p=0.017). Conclusion: Significantly decreased VEGF levels were noted after the first injection of bevacizumab. These levels were maintained after the second injection, which paralleled the change in visual acuity and CMT. © 2009 Springer-Verlag.


Shin J.Y.,Yonsei University | Byeon S.H.,Yonsei University | Kwon O.W.,Yonsei University | Kwon O.W.,Nune Eye Hospital
Graefe's Archive for Clinical and Experimental Ophthalmology | Year: 2015

Background: To compare the anatomic and functional results between optical coherence tomography (OCT)-guided selective focal laser photocoagulation (OCT–laser) and conventional modified Early Treatment Diabetic Retinopathy Study (mETDRS) laser treatment for diabetic macular edema (DME). Methods: We analyzed treatment outcomes in 47 consecutive eyes treated with OCT–laser compared to 31 matched eyes treated with mETDRS. In the OCT–laser group, we identified ‘significant actively-leaking microaneurysms on OCT’ (SALMO) which are responsible for edema in OCT B-scan images, and thoroughly ablated them with photocoagulation. Best-corrected visual acuity (BCVA) and retinal thickness by OCT were compared at baseline and 12 months after treatment between two groups. Results: OCT–laser treatment resulted in significant improvements in BCVA, central subfield thickness (CST), and maximum retinal thickness (MRT) from baseline at 12 months from the time of therapy (+2.5 letter score, p = 0.04; −45.56 μm in CST, p < 0.001; −91.6 μm in MRT, p < 0.001). The mean number of treated ‘SALMO’ was 5.6 ± 4.0 (range 1–26), while the number of MAs in ‘treatable lesions’ by fluorescein angiography (FA) in the same eye was 16.3 ± 11.8 (range 2–42). There was no difference between OCT–laser and mETDRS groups in changes of these parameters from baseline at 12 months (p = 0.56, p = 0.89, p = 0.43 respectively). Fundus autofluorescence (FAF) and OCT revealed less tissue damage in OCT–laser-treated eyes, compared to eyes treated with mETDRS (p < 0.001). Conclusions: OCT–laser shows similar anatomic and functional outcomes compared to conventional laser (modified ETDRS), with significantly less retinal damages. © 2014, Springer-Verlag Berlin Heidelberg.


Ko J.,Yonsei University | Kwon O.W.,Yonsei University | Kwon O.W.,Nune Eye Hospital | Byeon S.H.,Yonsei University
Retina | Year: 2014

PURPOSE:: To investigate the clinical features of central retinal vein occlusion (CRVO) in relation to the presence of a prominent middle limiting membrane (p-MLM) sign on presenting optical coherence tomography, which may suggest macular ischemia and poor visual outcome. METHODS:: Fifty consecutive eyes with acute CRVO of <1 month of symptom duration before presentation were retrospectively reviewed. A hyperreflective line located in the outer plexiform layer (p-MLM) in optical coherence tomography was used as a sign of acute ischemia. Cases with p-MLM were grouped and compared with the group of eyes with no p-MLM sign (non-MLM group) for clinical features including visual acuities, central fovea thickness, and CRVO types. RESULTS:: Among the 50 eyes, 14 (28%) eyes showed a p-MLM sign, 21 (42%) eyes did not, and others had equivocal findings. Eyes with p-MLM sign presented worse initial and final best-corrected visual acuity compared with the non-MLM group (1.10 ± 0.72 vs. 0.47 ± 0.49 logMAR in the initial best-corrected visual acuity, P = 0.007; and 1.08 ± 0.86 vs. 0.32 ± 0.41 logMAR in the final best-corrected visual acuity, P = 0.044) in patients with a follow-up duration of 6 months or longer. The p-MLM group eyes showed a higher tendency toward being classified as ischemic type CRVO (57.1 vs. 4.8%, P = 0.001). CONCLUSION:: Central retinal vein occlusion showing p-MLM on optical coherence tomography had worse visual outcome with higher incidence of being classified into ischemic type CRVO.© Ophthalmic Communication society,Inc.


Kim J.Y.,Nune Eye Hospital | Park H.S.,Nune Eye Hospital | Kim S.Y.,Nune Eye Hospital
Graefe's Archive for Clinical and Experimental Ophthalmology | Year: 2015

Purpose: To investigate the short-term efficacy of subthreshold micropulse yellow laser photocoagulation in the treatment of chronic central serous chorioretinopathy (CSC). Methods: A retrospective case series study was performed from April 2012 to June 2014 at Nune Eye Hospital. A total of ten eyes of ten chronic or chronic recurrent CSC patients received subthreshold micropulse yellow laser photocoagulation with a 15 % duty cycle at a reduced energy level from the micropulse laser test burn. Laser exposure time was 20 ms, and the spot diameter was 100 μm. Patients were followed up at the authors’ hospital for at least 3 months. Results: Mean age of patients was 43.9 years. The baseline best-corrected visual acuity was 0.21 ± 0.21 logarithm of the minimum angle of resolution (logMAR), which was improved to 0.055 ± 0.093 logMAR (p = 0.020) at the  3-month follow-up and 0.035 ± 0.063 logMAR (p = 0.012) at final follow-up. Central macular thickness at baseline was 349.2 ± 53.2 μm, which was changed to 250.7 ± 28.8 μm (p = 0.009) at the 3-month follow-up and 261.2 ± 38.31 μm (p = 0.009) at final follow-up. Conclusions: Subthreshold micropulse yellow laser photocoagulation showed short-term efficacy in treating chronic CSC without retinal damage. However, prospective, randomized, and comparative large-scale studies are needed to evaluate the efficacy and safety of this treatment. © 2015, Springer-Verlag Berlin Heidelberg.

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