Clinical Characteristics and Outcomes of Smartphone Overusers with Acute Acquired Comitant Esotropia

PURPOSE: To evaluate the clinical features and treatment outcomes of smartphone overusers with acute acquired comitant esotropia. METHODS: We retrospectively reviewed the medical records of patients ≥ 15 years of age who used a smartphone for > 4 hours a day for > 1 year, and who were diagnosed with acute acquired comitant esotropia from May 2011 to January 2016. We analyzed sex, age at the time of manifestation and duration of esotropia, refractive error, deviated angle at the first and final visits, and the results of refraining from smartphone use, use of the Fresnel prism, and surgery for esotropia. RESULTS: A total of 13 patients were studied, including 8 males and 5 females. The mean age at development of esotropia was 22.7 ± 9.7 years. The mean duration of esotropia before the first visit was 28.0 ± 33.0 months, and the mean follow-up period was 16.4 ± 16.4 months. The mean angle of esotropia was 21.8 ± 7.0 prism diopters (PD) at distance and 22.2 ± 7.9 PD at near. There were eight myopic patients; the other patients were emmetropia. The esotropia of all patients did not improve after refraining from smartphone use. There was no improvement in five patients who were wearing the Fresnel prism for ≥ 4 months. A total of six patients were treated with bilateral medial rectus recession; only one patient remained orthotropic at postoperative 6 months, three patients were undercorrected, and two had a recurrence. CONCLUSIONS: Esotropia persisted after refraining from smartphone use or wearing a Fresnel prism in acute acquired comitant esotropia patients who were smartphone overusers, and the surgical prognosis of these patients was relatively poor.

Two Cases of Serous Retinal Detachment Following Vitrectomy in Patients with Proliferative Diabetic Retinopathy

PURPOSE: In the present study, 2 cases of serous retinal detachment in patients diagnosed with proliferative diabetic retinopathy after pars plana vitrectomy are reported. CASE SUMMARY: (Case 1) A 38-year-old female diagnosed with high-risk proliferative diabetic retinopathy underwent pars plana vitrectomy and cataract surgery due to intravitreal hemorrhage. One day after the operation, fundus photograph and optical coherence tomography (OCT) revealed serous retinal detachment. After ensuring that no retinal hole was present based on fundus examination, the patient was diagnosed with serous retinal detachment and antimicrobial and steroid eye drops were applied. After 1 week, subretinal fluid disappeared. (Case 2) A 63-year-old male diagnosed with proliferative diabetic retinopathy underwent pars plana vitrectomy due to right vitreous hemorrhage. On postoperative day 1, focal subretinal fluid under the macula was observed using OCT. Intravitreal triamcinolone injection was performed during surgery and steroid eye drops were applied. Subretinal fluid collection was absorbed 5 days postoperatively. CONCLUSIONS: Two cases of serous retinal detachment that occurred postoperatively in patients with diabetic retinopathy are reported. Serous retinal detachment was resolved after several days without specific management.

The Relationships between Anterior Chamber Parameters and Obesity

No abstract available.

Postural Intraocular Pressure Change at Trendelenberg Position Measured by Rebound Tonometer

PURPOSE: This study was carried out to evaluate the postural intraocular pressure (IOP) change in Trendelenburg, reverse Trendelenburg, and supine positions in healthy young males. METHODS: We measured the IOP values of 5 healthy young male volunteers (10 eyes) using an Icare PRO rebound tonometer in sitting, Trendelenburg, reverse Trendelenburg, and supine positions. RESULTS: The mean IOP in the supine position (18.63 mm Hg) was significantly higher (p < 0.01) than in the sitting position (15.31 mm Hg). When maintaining the Trendelenburg position, IOP gradually increased. CONCLUSIONS: In our study, the Trendelenburg position significantly increased the IOP compared to that in the supine position. The effects of increased IOP should be considered in situations that require Trendelenburg positioning, such as exercise or surgery.

A Case of Giant Conjunctival Nevus Mimicking Malignant Melanoma

PURPOSE: We report a case of giant conjunctival nevus and compare differential diagnosis between giant conjunctival nevus and conjunctival malignant melanoma. CASE SUMMARY: A 46-year-old male presented with brown and elevated conjunctival mass in his right eye since childhood. The mass was located at the superior bulbar conjunctiva involving the superior cornea. The mass was 16 x 9 mm in size and elevated. Feeding vessels, intrinsic vessels and various cyst sizes were observed inside the mass. Resection of the conjunctival mass and amniotic membrane transplantation were performed. The histopathological diagnosis was conjunctival nevus. CONCLUSIONS: Conjunctival nevus is a benign conjunctival tumor with excellent prognosis, often confused with conjunctival melanoma. Both conjunctival nevus and conjunctival malignant melanoma are commonly located in the bulbar conjunctiva, pigmented and often have feeder and intrinsic vessels. Conjunctival nevus has an intralesional cyst, which is a key differentiating characteristic from malignant melanoma as many other features overlap. The change in tumor size, increased pigmentation and corneal invasion are features suspect of malignant transformation and surgical excision and histologic examination are recommended for those lesions. Surgical excision for giant conjunctival nevus can cause several ocular complications such as symblepharon. Conjunctival reconstruction with amniotic membrane transplantation is useful for preventing complications.