ABSTRACT
Purpose@#To investigate the prevalence of ophthalmic manifestations in patients with Tourette syndrome using big data based on samples extracted from the Health Insurance Review and Assessment Service. @*Methods@#The study participants included Korean patients under the age of 18 years who had received a Tourette syndrome diagnostic code (F95.2) between January 1, 2012, and December 31, 2016. Ophthalmic manifestations reported to be related to Tourette syndrome such as tic disorder, blepharospasm, involuntary gaze abnormality, and strabismus were selected as ophthalmic clinical diagnostic codes; amblyopia and refractive errors that had never been investigated in conjunction with Tourette syndrome were also selected. Prevalence was investigated using big data. @*Results@#A total of 3,643 Tourette syndrome patients (2,777 men and 866 women) were included in the study. The number of patients receiving a tic disorder diagnostic code was 3,643 (100%); blepharospasm, 48 (1.3%); involuntary gaze abnormalities, 9 (0.2%); and strabismus, 109 (3%). In addition, the number of patients receiving an amblyopia diagnostic code was 29 (0.8%), and the number of patients with a refractive errors code was 1,306 (35.8%). @*Conclusions@#Tourette syndrome can be accompanied by several ophthalmic manifestations. Thus, cooperation between a neuropsychiatrist and an ophthalmologist, and regular ophthalmological examinations, are considered necessary.
ABSTRACT
Purpose@#We report a case of nonarteritic anterior ischemic optic neuropathy (NAION) in a high hyperopia and appositional angle closure glaucoma (AACG) patient mimicking glaucomatocyclitic crisis.Case summary: A 57-year-old man presented with headache, ocular pain, and visual disturbance in the right eye for 3 days. There was no past medical history. The best corrected visual acuity was 0.02 and the intraocular pressure (IOP) was 30 mmHg in the right eye. Refractive errors were +7.25 diopters in the right eye. Slit-lamp examination revealed corneal edema, anterior chamber (AC) inflammation (+1), 6 mm-dilated fixed pupil, and >1/4 peripheral AC depth in the right eye. Fundus examination revealed optic disc swelling, and visual fields test demonstrated inferior altitudinal field defects in the right eye. Glaucomatocyclitic crisis and NAION in the right eye were diagnosed. Topical anti-glaucoma eyedrops and intravenous steroid were administered. IOP was not controlled and then, gonioscopy revealed a grade 1 360° B10s appositional angle closure on Shaffer classification in the right eye. Laser iridotomy was performed. IOP increasement, ocular pain of the right eye, and headache disappeared. After 1 month later, fundus examination revealed an improved optic disc swelling and 0.4 cup-to-disc ratio in the right eye. The visual acuity in the right eye didn’t improve after 3 months. @*Conclusions@#NAION may occur in AACG patient with high hyperopia even if there is no underlying systmemic disease or small cup-to-disc ratio.
ABSTRACT
Purpose@#To investigate the prevalence of ophthalmic manifestations in patients with Tourette syndrome using big data based on samples extracted from the Health Insurance Review and Assessment Service. @*Methods@#The study participants included Korean patients under the age of 18 years who had received a Tourette syndrome diagnostic code (F95.2) between January 1, 2012, and December 31, 2016. Ophthalmic manifestations reported to be related to Tourette syndrome such as tic disorder, blepharospasm, involuntary gaze abnormality, and strabismus were selected as ophthalmic clinical diagnostic codes; amblyopia and refractive errors that had never been investigated in conjunction with Tourette syndrome were also selected. Prevalence was investigated using big data. @*Results@#A total of 3,643 Tourette syndrome patients (2,777 men and 866 women) were included in the study. The number of patients receiving a tic disorder diagnostic code was 3,643 (100%); blepharospasm, 48 (1.3%); involuntary gaze abnormalities, 9 (0.2%); and strabismus, 109 (3%). In addition, the number of patients receiving an amblyopia diagnostic code was 29 (0.8%), and the number of patients with a refractive errors code was 1,306 (35.8%). @*Conclusions@#Tourette syndrome can be accompanied by several ophthalmic manifestations. Thus, cooperation between a neuropsychiatrist and an ophthalmologist, and regular ophthalmological examinations, are considered necessary.
ABSTRACT
Purpose@#We report a case of nonarteritic anterior ischemic optic neuropathy (NAION) in a high hyperopia and appositional angle closure glaucoma (AACG) patient mimicking glaucomatocyclitic crisis.Case summary: A 57-year-old man presented with headache, ocular pain, and visual disturbance in the right eye for 3 days. There was no past medical history. The best corrected visual acuity was 0.02 and the intraocular pressure (IOP) was 30 mmHg in the right eye. Refractive errors were +7.25 diopters in the right eye. Slit-lamp examination revealed corneal edema, anterior chamber (AC) inflammation (+1), 6 mm-dilated fixed pupil, and >1/4 peripheral AC depth in the right eye. Fundus examination revealed optic disc swelling, and visual fields test demonstrated inferior altitudinal field defects in the right eye. Glaucomatocyclitic crisis and NAION in the right eye were diagnosed. Topical anti-glaucoma eyedrops and intravenous steroid were administered. IOP was not controlled and then, gonioscopy revealed a grade 1 360° B10s appositional angle closure on Shaffer classification in the right eye. Laser iridotomy was performed. IOP increasement, ocular pain of the right eye, and headache disappeared. After 1 month later, fundus examination revealed an improved optic disc swelling and 0.4 cup-to-disc ratio in the right eye. The visual acuity in the right eye didn’t improve after 3 months. @*Conclusions@#NAION may occur in AACG patient with high hyperopia even if there is no underlying systmemic disease or small cup-to-disc ratio.
ABSTRACT
Purpose@#We report a case of recurrent conjunctival granuloma showing complete resolution after bevacizumab injection.Case summary: A 45-year-old female presented with a mass near right upper punctum for one month. She underwent surgical resection and was diagnosed as the conjunctival granuloma. Thereafter, the granuloma recurred five times. At the last recurrence, bevacizumab was injected into the granuloma and surrounding tissue with surgical resection. There was no recurrence and no side effects for seven months after surgery. @*Conclusion@#Subconjunctival bevacizumab injection therapy may be a useful treatment in patients with recurrent conjunctival granuloma.