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Seoul, South Korea

Yang H.S.,University of Ulsan | Kim J.-G.,University of Ulsan | Ko H.S.,Seoul Central Veterans Hospital | Lee K.S.,University of Ulsan | Won H.J.,University of Ulsan
Current Eye Research | Year: 2014

Purpose: To validate intraocular pressure (IOP) measurements using the new Tonopen AVIA® tonometer by comparing values obtained with those measured by manometers placed in the anterior chamber (AC) and the vitreous cavity (VC). Materials and Methods: Seventy-nine consecutive patients awaiting phacovitrectomy for epiretinal membrane (ERM) or macular hole (MH) (n=29), vitreous hemorrhage (DMVH) (n=27) or silicone oil removal (n=23) were included in this prospective observational study. A clinician masked to patient information performed a complete ophthalmologic examination, including measurements of corneal thickness (CT), AC depth and axial length. Another examiner simultaneously measured conventional IOP using the Tonopen AVIA® (TIOP) and AC and VC IOPs (ACIOP and VCIOP) using two transducers. Results: The mean TIOP, ACIOP and VCIOP were 16.1±3.8, 16.1±4.4 and 15.5±4.6mmHg, respectively. There was a good agreement between the TIOP and ACIOP; however, the agreement between TIOP and VCIOP was relatively poor in subgroup analysis. VCIOP was significantly higher than TIOP in the ERM and MH group, with a mean difference of 1.0mmHg (p=0.042); however, they were significantly lower in the DMVH group, with a mean difference of -0.7mmHg (p=0.026) and in the silicone oil group (mean difference, -2.3mmHg) (p<0.0001). In multivariate analysis, TIOP correlated significantly only with CT (p<0.037) and increased by 2.7mmHg per 100μm increase in CT. Conclusions: IOP measurements using the Tonopen AVIA® tonometer showed good agreement with ACIOP values, although TIOP measurements were affected by CT. However, the VCIOP values using the transducer may have over- or underestimated IOP relative to TIOP and ACIOP under various vitreous conditions. Further validation of VCIOP using a cannular type of manometer should be considered. © 2014 Informa Healthcare USA, Inc. All rights reserved: reproduction in whole or part not permitted.

Yang H.S.,Asan Medical Center | Park S.H.,Seoul Central Veterans Hospital | Choi J.R.,Seoul Central Veterans Hospital | Kim J.-G.,Asan Medical Center
Japanese Journal of Ophthalmology | Year: 2013

Purpose: To report on isolated central retinal artery occlusion (CRAO) as an initial presentation in two patients with undiagnosed paroxysmal nocturnal hemoglobinuria (PNH). Methods: CRAO related to the aggravation of PNH was observed in 2 of 98 consecutive PNH patients for 10 years. Ocular and systemic manifestations were evaluated before and after systemic steroid, eculizumab and anticoagulant administration with adjuvant ocular treatments. Results: Two young patients presented with complaints of acute painless monocular vision loss. In both cases, fundus examination revealed retinal edema and a cherry-red spot in the macula, consistent with CRAO. On systemic evaluation, severe anemia and thrombocytopenia were observed, and simultaneously thrombogenic processes were suggested by increased d-dimers, fibrinogen degradation products and/or portal vein thrombosis. PNH testing of red blood cells revealed a CD55 and CD59 deficiency consistent with PNH in both cases. The systemic complications typically associated with thrombosis were not observed for the following several months with early conservative treatments including eculizumab. Conclusions: Acute blindness from CRAO can be a unique manifestation of undiagnosed PNH and its subsequent aggravation. Systemic evaluations including PNH testing, especially in young CRAO patients, are strongly recommended for early detection of the further systemic thrombogenic processes. © 2013 Japanese Ophthalmological Society.

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