• Archives of Plastic Surgery
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• v.49 no.1
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• pp.19-24
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• 2022

Background Blepharoplasty has both aesthetic and functional benefits in patients with pseudoptosis; however, previous studies could not demonstrate its beneficial effects quantitatively and objectively. The authors objectively analyzed the visual field before and after surgery and investigated whether measurements of the visual field can be applied as a suitable predictor of surgical outcomes. Methods In total, 18 eyelids in nine patients with pseudoptosis who had undergone simple skin excision blepharoplasty were evaluated prospectively from February to May 2016. The visual fields were analyzed preoperatively and 3 months postoperatively using the Goldmann kinetic perimetry test. The visual field test area was assessed using Adobe Photoshop. Results Blepharoplasty had an average 4.99-fold beneficial effect on the superior visual field. In particular, more improvement was seen in the superior temporal quadrant than in the nasal quadrant. No correlation was found between the preoperative margin-to-reflex distance 1 (MRD1) and the surgical outcome (P=0.119). However, there was a strong correlation between the preoperative superior visual field and the surgical outcome (P=0.001). Conclusions Using the Goldmann kinetic perimetry test, we objectively and quantitatively proved the beneficial effect of blepharoplasty on patients with pseudoptosis. Furthermore, we demonstrated that the preoperative visual field is a better preoperative surgical outcome predictive factor than the preoperative MRD1.

• Journal of Korean Neurosurgical Society
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• v.49 no.6
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• pp.339-344
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• 2011

Objective : Pituitary apoplexy is one of the most serious life-threatening complications of pituitary adenoma. The purpose of this study is to investigate the visual outcome after early transsphenoidal surgery for the patients with pituitary apoplexy. Methods : We retrospectively reviewed the 31 patients with pituitary apoplexy who were admitted due to acute visual acuity or field impairment and treated by transsphenoidal surgery. Five patients were excluded because of the decreased conscious level. The visual acuity of each individual eye was evaluated by Snellen's chart Visual fields were also checked using automated perimetry. To compare the visual outcome according to the surgical timing, we divided the patients into 2 groups. The first group, 21 of the patients have been undertaken transsphenoidal approach (TSA) within at least 48 hours after admission. The second group included 8 patients who have been undertaken TSA beyond 48 hours. All patients were monitored at least 12 months after surgery. Results : Patients were 21 males and 8 females (M : F=2.6 : 1) with the mean age of 42.4 years. Among the enrolled 29 patients, 26 patients presented with decreased visual acuity and 23 patients revealed the defective visual field respectively. Postoperatively, improvement in the visual acuity was seen in 15 patients (83.3%) who underwent surgery within the first 48 hours of presentation, as compared to those in whom surgery was delayed beyond 48 hours (n=5; 62.5%) (p=0.014). Improvement in the visual field deficits was observed in 15 (88.2%) of patients who had been operated on within the first 48 hours of presentation, as compared to those in whom surgery was delayed beyond 48 hours (n=3; 50.0%) (p=0.037). Conclusion : This study suggests that rapid transsphenoidal surgery is effective to recover the visual impairment in patients with pituitary apoplexy. If there are associated abnormalities of visual acuity or visual fields in patients with hemorrhagic pituitary apoplexy, early neurosurgical intervention within 48 hours should be also required to recover visual impairment.

• International Journal of Advanced Culture Technology
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• v.6 no.4
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• pp.71-79
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• 2018

For 299 patients who had undergone cataract surgeries we investigated the difference in visual acuity and refractive power before and after cataract surgery and the clinical change of the visual acuity and the refractive power according to age, gender, hospital visit time and specific medical history. We found the factors affecting preoperative and postoperative outcomes of the cataract patients in metropolitan hospitals by input, process, and outcome and analyzed medical characteristics and patient characteristics as the input variables. T-test and ANOVA have been performed for statistical analysis of functional status, and general status and the technical characteristic as the process variable and the outcome variable of diagnosis. Visual acuity improved significantly in patients who had undergone cataract surgery. However, the change in refractive power did not show a statistically significant difference but only a slight difference. The improvement of male patients was greater than that of female patients. The difference in age was more effective in patients under 50 years old and the effect of cataract surgery was relatively high in patients without the presence of specific medical history. Cataract surgery did not seem to help all of the patients, but it is more effective in improving visual acuity and refractive power. We conclude that simultaneous cataract surgery in both eyes is reasonable in order to have at least the better effect.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.36 no.4
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• pp.51-69
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• 2023

Objectives : The purpose of this study is to assess the effect of using Boyanghwano-tang(BYHWT) for diabetic retinopathy. Methods : We searched randomized controlled trials(RCTs) that used BYHWT for diabetic retinopathy in 10 databases(RISS, KISS, ScienceON, KCI, OASIS, DBpia, CNKI, Wanfang Database, PubMed, Cochrane Library) on August 12, 2023. Outcome measurements included total effective rate(TER) and visual acuity as the primary outcome measurements, and the secondary outcome measurements included fasting blood glucose(FBG), 2hPG, HbA1c, ET-1, NO, etc. The indicator of stability included adverse reactions. A meta-analysis was conducted according to TER, visual acuity, FBG. Results : A total of 8 randomized control trials were selected. The treatment group which used BYHWT showed significant improvement effects in TER and visual acuity compared to the control group which used western medicine or chinese patent medicine alone. TER: (RR: 1.22, CI 1.14 to 1.31, P=<0.00001), visual acuity: (RR: 2.06, CI 1.40 to 3.03, P=0.0002). Secondary outcome measurements including FBG also showed improvement in the treatment group compared to the control group. FBG: (MD: -0.15, CI -0.43 to 0.31, P=0.28). Adverse reactions were only mentioned in one study, which showed that no adverse reactions occurred in both the treatment and control groups. Conclusions : This study suggests that BYHWT is effective for diabetic retinopathy. However these findings should be interpreted cautiously due to the insufficient number of studies and unknown or high risk of bias in the included trials.

• Journal of Korean Neurosurgical Society
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• v.39 no.3
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• pp.171-175
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• 2006

Objective : In the present study, we evaluate visual outcomes after surgical removal of craniopharyngiomas and analyze the factors that are considered to affect visual outcomes. Methods : This study includes 30 patients with craniopharyngioma, who underwent surgery in this clinic during the last 10 years. The changes of visual function [visual acuity and field] of the patients were assessed preoperatively and postoperatively, and paired data of this change were compared. Also, the factors that influence on this change were analysed. Results : Among the 21 patients complaining of decreased vision before the operation, 8 patients were improved [38.0%], and 7 patients were worse [33.3%]. However, Four out of 9 patients without any preoperative visual symptoms developed worse vision after the operation [44.4%]. The average duration of symptom was 17.2 months in the improved group and 23.6 months in the aggravated group. The tumors recurred in only 5 patients after the gross total resection : Four of them showed the aggravation of visual function after surgical removal and 1 had improvement. Conclusion : After removal of craniopharyngiomas, the overall rate of vision improvement, no change and aggravation are 26.6%, 36.7% and 36.7%, respectively. Aggravation of postoperative visual function is higher in males, children and patients with a longer duration of symptom and the tumor recurres more frequently in patients who complained of worsened vision after surgical removal.

• Journal of Preventive Medicine and Public Health
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• v.34 no.2
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• pp.175-181
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• 2001

Objectives : To compare the multiple outcomes of patients with cataract surgery at perioperative time,3-4 months and 12 months after surgery and to assess patient outcomes associated with visual improvement(visual acuity of operated eye, visual function-14(VF-14), symptom score). Methods : For this assessment, a prospective study was conducted with 389 patients who had undergone cataract surgery for either one eye or both eyes. The surgery was peformed by 20 ophthalmologists who were practicing at university hospitals and general hospitals. Patients were interviewed and clinical data were obtained. Doctors were questioned with self-reported questionnaire forms. Medical records were examined in order to measure variables related to the surgical process such as surgical methods and ocular comorbidity. The survey was 'conducted at 4 stages' : preoperative time(389 cases), perioperative time(344 cases, 88.4%), postoperative 3-4 months (343 cases, 88.2%), and postoperative 12 months (281 cases, 72.2%). After excluding cases with incomplete data, 198 cases were enrolled in the study. Patient outcomes was measured for any improvement in the functional outcomes(visual acuity of operated eye, visual function, symptom score) at postoperative 3-4 months. Results : The visual acuity(operated, weighted average), symptom score, VF-14 score, satisfaction with vision, and subjective health status were shown to be improved at the perioperative time, postoperative 3-4 months and 12 mouths. An improvement in the Snellen visual acuity score was observed in 190 patients(96.0%), whereas improvements of the VF-14 score and cataract symptom sure were observed in 151 patients(76.3%) and 179 patients(90.4%), respectively. All three outcome measures demonstrated improvement in 137 patients(09.2%). The improvement of the three functional outcomes at 3-4 months after receiving surgery was associated with a lower level of visual function and a higher level of cataract symptom score at perioperative time, as well as a greater experience level of the surgeon. Conclusions : In this study, the estimates of the proportion of patients benefiting from cataract surgery varied with the outcome measure of benefit. Preoperative VF-14 score, a measure of functional impairment related to vision, and symptom score may be better measures of the benefit derived from cataract surgery than the change in visual acuity.

• Journal of Korean Neurosurgical Society
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• v.48 no.3
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• pp.213-218
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• 2010

Objective : Pituitary apoplexy (PA) is described as a clinical syndrome characterized by sudden headache, vomiting, visual impairment, and meningismus caused by rapid enlargement of a pituitary adenoma, We retrospectively analyzed the clinical presentation and surgical outcome in PA presenting with cranial neuropathy. Methods : Twelve cases (33%) of PA were retrospectively reviewed among 359 patients diagnosed with pituitary adenoma, The study included 6 males and 6 females, Mean age of patients was 49,0 years, with a range of 16 to 74 years, Follow-up duration ranged from 3 to 20 months, with an average of 12 months, All patients were submitted to surgery, using the transsphenoidal approach (TSA). Results : Symptoms included abrupt headache (11/12), decreased visual acuity (12/12), visual field defect (11/12), and cranial nerve palsy of the third (5/12) and sixth (2/12) Mean height of the mass was 29.0 mm (range 15-46) Duration between the ictus and operation ranged from 1 to 15 days (mean 7.0) The symptom duration before operation and the recovery period of cranial neuropathy correlated significantly (p = 0.0286) TSA resulted in improvement of decreased visual acuity in 91.6%, visual field defect in 54.5%, and cranial neuropathy in 100% at 3 months after surgery. Conclusion : PA is a rare event, complicating 3.3% in our series, Even in blindness following pituitary apoplexy cases, improvement of cranial neuropathy is possible if adequate management is initiated in time, Surgical decompression must be considered as soon as possible in cases with severe visual impairment or cranial neuropathy.

• Journal of Korean Neurosurgical Society
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• v.49 no.4
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• pp.229-230
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• 2011

Visual loss is one of the ocular symptoms resulting from a carotid cavernous fistula (CCF), but has rarely been reported as the sole manifestation in CCF. Visual impairment is known to be associated with a poor outcome unless timely intervention is employed. Herein, the authors report a patient with bilateral rapid progressing visual loss as a sole manifestation in CCF. Vision was successfully restored by transarterial embolization. The authors discuss the necessity of urgent fistula obliteration in patients with visual loss.

• Journal of the Korea Furniture Society
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• v.20 no.5
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• pp.467-479
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• 2009

The high-tech computer technology developments have greatly affected the area of design education. Starting from the mid 80s, innovations in visual presentation methods have heightened with 2D computer graphic programs, CAD & 3D modeling, and Rapid Prototype that allows dimensional generation. The specialty and quality in design studio education have advanced due to the development in presentation methods such as Power Point and Keynote. But there are many problems with the current method of presenting the visual outcome in a data format using beam projectors, which is a vertical presenting method compared to the old studio study method of conducting discussions and reviews based on the substantial outcome. The essence of studio study that allows for comparisons and analysis by horizontally opening up the various work outcomes is being offset. Also the requirement for manual idea sketching work that plays an important role in the initial design phase continuing to decrease due to the digital working process dependence and cumbersome procedures in the presentation. In order to resolve this problem, the CALM system (Class Applied LCD Modular System) has been developed that replaces the method of attaching the sketches or renderings on the wall with a digital multi-display system. In a nutshell, individuals will upload the outcomes online and display them on the CALM system studio that is composed of 32 LCD (Columns: 4 $\times$ Rows: 8) monitors that are 19 inches in size so that various personnel can openly study the design outcomes. Also the central 42 inch PDP monitor that offers touch pad capability allows each design outcome to be described and examined by expanding. The concept phase of this development process has elevated to the production of an operating prototype that is being reviewed of its practicality. It is considered that the development of this system will decrease the extreme tendency of depending on digital operation but achieve revitalization of a more realistic and opened studio study environment compared to the individual consulting method of the old study approach.

• Radiation Oncology Journal
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• v.34 no.2
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• pp.121-127
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• 2016

Purpose: To investigate treatment outcome and long term complication after surgery and radiotherapy (RT) for pituitary adenoma. Materials and Methods: From 1990 to 2009, 73 patients with surgery and RT for pituitary adenoma were analyzed in this study. Median age was 51 years (range, 25 to 71 years). Median tumor size was 3 cm (range, 1 to 5 cm) with suprasellar (n = 21), cavernous sinus extension (n = 14) or both (n = 5). Hormone secreting tumor was diagnosed in 29 patients; 16 patients with prolactin, 12 patients with growth hormone, and 1 patient with adrenocorticotrophic hormone. Impairment of visual acuity or visual field was presented in 33 patients at first diagnosis. Most patients (n = 64) received RT as postoperative adjuvant setting. Median RT dose was 45 Gy (range, 45 to 59.4 Gy). Results: Median follow-up duration was 8 years (range, 3 to 22 years). In secreting tumors, hormone normalization rate was 55% (16 of 29 patients). For 25 patients with evaluable visual field and visual acuity test, 21 patients (84%) showed improvement of visual disturbance after treatment. The 10-year tumor control rate for non-secreting and secreting adenoma was 100% and 58%, respectively (p < 0.001). Progression free survival rate at 10 years was 98%. Only 1 patient experienced endocrinological recurrence. Following surgery, 60% (n = 44) suffered from pituitary function deficit. Late complication associated with RT was only 1 patient, who developed cataract. Conclusion: Surgery and RT are very effective and safe in hormonal and tumor growth control for secreting and non-secreting pituitary adenoma.