Clinical Analysis of Findings for Anterior Segment Optical Coherent Tomography in Recurrent Corneal Erosion Syndrome

PURPOSE@#To evaluate the correlation between abnormal findings seen in anterior segment optical coherent tomography and the recurrence rate in patients with recurrent corneal erosion syndrome.@*METHODS@#Between January 2015 and August 2018, 53 eyes of 52 patients who had been diagnosed with recurrent corneal erosion syndrome were included in the study. Follow-up was performed for 12 months. To confirm the recurrence, we questioned the subjects on their symptoms and performed slit lamp examinations. At the first visit, the second week, and the first month, we performed anterior segment optical coherent tomography to identify pathologic findings for recurrent corneal erosion syndrome.@*RESULTS@#In 12 months, 29 eyes (54.7%) had a recurrence of corneal erosion and 24 eyes (45.3%) had no recurrence. There was no significant difference in age, sex, trauma, diabetes mellitus, or meibomian gland dysfunction between the recurrent and non-recurrent groups. Among the anterior segment optical coherent tomography findings, anterior stromal hyper-reflectivity, undetected epithelial basement membrane, intraepithelial basement membrane, intraepithelial inclusions were not significantly different between the two groups. In the first month, corneal epithelial edema was 82.8% in the recurrent group, but 33.3% in the non-recurrent group. It was significantly different (p = 0.000). Corneal epithelial thickness lowered significantly in the non-recurrent group, but not in the recurrent group in the first month. In other words, epithelial edema improved in the non-recurrent group, whereas epithelial edema did not improve in the recurrent group.@*CONCLUSIONS@#If corneal epithelial edema is not treated in patients with recurrent corneal erosion syndrome, high possibility of a recurrence should be considered.

Roth Spots and Panuveitis in a Patient with Infectious Mononucleosis

PURPOSE: To report a case of Roth spots, panuveitis, and infectious mononucleosis in a healthy adult. CASE SUMMARY: An immunocompetent 30-year-old male visited our clinic complaining of reduced visual acuity and a floating sense in both eyes of 2 days. He had experienced flu-like symptoms including fever, sore throat, myalgia, and malaise for 10 days before visual acuity decreased. His best-corrected visual acuity was 20/25 in both eyes and inflammatory cells were found in both the anterior chambers and the vitreous. Funduscopy revealed multiple retinal hemorrhages and Roth spots in both eyes. We prescribed topical steroid eye drops. A peripheral blood test revealed mild leukocytosis with lymphocytosis (60%) consisted of atypical lymphocyte (7%). Serologic examinations were positive for cytomegalovirus (CMV) immunoglobulin M (IgM) Ab and Epstein-Barr virus IgM Ab. A polymerase chain reaction for blood CMV was positive. The presumptive clinical diagnosis was Roth spots and panuveitis associated with infectious mononucleosis. Three weeks later, no inflammatory cells were apparent in the anterior chamber or vitreous. Best-corrected visual acuity had recovered to 20/20 in both eyes, and the retinal hemorrhage had completely disappeared. CONCLUSIONS: Roth spots and panuveitis can be present in patients with infectious mononucleosis, which should thus be included in the differential diagnosis of Roth spots.

Periosteal Fixation Applied to Patients with Large-angle Paralytic Strabismus

PURPOSE: To evaluate the effect of periosteal fixation in patients with large-angle paralytic strabismus that was not corrected through conventional strabismus surgery. METHODS: Four eyes of three patients with large-angle paralytic strabismus who underwent periosteal fixation from June 2014 to August 2014 were examined. All patients presented with exotropia > 50 prism diopters (PD). Two of them showed exotropia caused by chronic complete oculomotor nerve palsy; the other two showed exotropia caused by medial rectus muscle injury during endoscopic sinus surgery. RESULTS: The mean preoperative exodeviation using the Krimsky test was 58 ± 29 PD. The postoperative values were 6.5 ± 9.4 PD at 1 week, and 11.25 ± 2.5 PD at 6 months. The mean surgical effect of exodeviation was 43.75 ± 21.36 PD. CONCLUSIONS: Periosteal fixation is an effective surgery for the management of paralytic strabismus that was not corrected through conventional strabismus surgery.