Differences among Ophthalmology Patients Referred to Tertiary Medical Centers according to Referral Hospital

PURPOSE: This study aimed to investigate the diagnosis and severity of patients who were referred to tertiary medical centers according to the type and function of the referral hospitals. METHODS: First-visit patients referred from July 2015 to June 2016 were retrospectively reviewed with regard to referral hospital, final diagnosis, treatment necessity, and medical fees for the six months after their first hospital visit. Based on these data, differences in type and function of medical institution were examined. RESULTS: In a comparison of hospitals according to their number of beds, clinics, hospitals and, tertiary hospitals had no differences in the ratio of patients who needed treatment (p = 0.075) and their medical fees over six months (p = 0.372). When hospitals were classified by functional capability in terms of doctors' medical specialty, increasing ratios of patients requiring medical treatment (p < 0.001) and medical fees for six months (p < 0.001) were found in the order of non-eye specialists, eye specialists, and eye specialists in trainee hospital. CONCLUSIONS: Efficient healthcare delivery systems should classify medical institutions by functionality capability based on medical specialties rather than hospital size according to the number of beds.

Correlation of Driving-related Cognition and Cognitive Impairment in Drivers over the Age of 60

BACKGROUND: A rate of traffic accidents by elderly drivers increased by 70% between 2011 and 2015 in Korea. Elderly drivers with cognitive impairment are more susceptible to be involved traffic accidents than cognitively normal individuals. This study aimed to evaluate the correlation of driving-related cognition and cognitive impairment in drivers over the age of 60 using the standardized program developed by the Road Traffic Authority (RTA). METHODS: Current drivers older than 60 years were recruited for the study. All participants were tested using the Mini-Mental Status Examination (MMSE), Rey Complex Figure Test (RCFT)-copy, and Digit Symbol Substitution Test (DSST) for cognitive function assessments. The driving aptitude test (DAT) for the elderly developed by RTA consists of 4 different tasks including speed and distance driving tests (SD), visuospatial memory driving tests (VM), sustained attention driving tests (SA), and divided attention driving tests (DA). The participants were divided into two groups by their MMSE score (normal cognition, CN; cognitive impairment, CI). RESULTS: One hundred fourteen participants were enrolled in the study and 57 of them were assigned to the CI group. In comparison, drivers in CI showed worse scores at DSST, SD, VM, and DA than those in CN. DSST and DA were worsened with increasing age. DSST was the best predictive assessment to be the risk or caution grade in DAT. CONCLUSIONS: We could find a correlation between DAT and cognitive function in drivers over the age 60. These results could be used as the basis of investigating optimal tools for decreasing driving risks in the cognitive impaired elderly.

Efficacy of Prophylactic Uterine Artery Embolization before Obstetrical Procedures with High Risk for Massive Bleeding

OBJECTIVE: To evaluate the safety and efficacy of prophylactic uterine artery embolization (UAE) before obstetrical procedures with high risk for massive bleeding. MATERIALS AND METHODS: A retrospective review of 29 female patients who underwent prophylactic UAE from June 2009 to February 2014 was performed. Indications for prophylactic UAE were as follows: dilatation and curettage (D&C) associated with ectopic pregnancy (cesarean scar pregnancy, n = 9; cervical pregnancy, n = 6), termination of pregnancy with abnormal placentation (placenta previa, n = 8), D&C for retained placenta with vascularity (n = 5), and D&C for suspected gestational trophoblastic disease (n = 1). Their medical records were reviewed to evaluate the safety and efficacy of UAE. RESULTS: All women received successful bilateral prophylactic UAE followed by D&C with preservation of the uterus. In all patients, UAE followed by obstetrical procedure prevented significant vaginal bleeding on gynecologic examination. There was no major complication related to UAE. Vaginal spotting continued for 3 months in three cases. Although oligomenorrhea continued for six months in one patient, normal menstruation resumed in all patients afterwards. During follow-up, four had subsequent successful natural pregnancies. Spontaneous abortion occurred in one of them during the first trimester. CONCLUSION: Prophylactic UAE before an obstetrical procedure in patients with high risk of bleeding or symptomatic bleeding may be a safe and effective way to manage or prevent serious bleeding, especially for women who wish to preserve their fertility.

Comparison of Pain-relieving Effects of Fentanyl versus Ketorolac after Eye Amputation Surgery

PURPOSE: To investigate the analgesic effect and incidence of postoperative nausea and vomiting (PONV) between the opioid fentanyl and the non-steroidal anti-inflammatory drug ketorolac in patients who underwent eye amputation surgery. METHODS: Retrospective observational case series. Eighty-two patients underwent evisceration or enucleation surgery by one surgeon over a 2-year period. Fentanyl by intravenous patient-controlled analgesia (IV-PCA) at 20 microg/kg with 12 mg/kg ondansetron or intravenous ketorolac at 2 mg/kg/day was administered to patients at postoperative days 0, 1, and 2. The pain score was measured using an 11-point visual analog scale (VAS). The incidence of severe nausea requiring anti-emetics and the incidence of vomiting were reviewed. RESULTS: The mean postoperative VAS in the fentanyl group was significantly lower than that in the ketorolac group on the day of operation for both types of surgery (p = 0.001 and p = 0.004, respectively). At postoperative days 1 and 2, the mean VAS was not different between the two groups for either surgical type (p > 0.05 for both days). The mean VAS was significantly higher in eviscerated patients than in enucleated patients at postoperative days 0 and 1 in the fentanyl group (p = 0.023 and p = 0.016, respectively). However, this was not observed in the ketorolac group. The incidence of PONV was higher in the fentanyl group than in the ketorolac group, although this was not statistically significant for either surgical type (p > 0.05 for both groups). CONCLUSIONS: Fentanyl was more effective as an analgesic than was ketorolac on the day of operation for both surgical types. There was no difference between the two analgesics on postoperative day 1. The analgesic effect of fentanyl in enucleated patients was significantly higher than in eviscerated patients at postoperative days 0 and 1. The use of fentanyl by IV-PCA was associated with greater PONV despite co-administration with anti-emetics, although this finding was not significant.

Reconstruction of the Medial Canthus Using an Ipsilateral Paramedian Forehead Flap

BACKGROUND: The medial canthus is an important area in determining the impression of a person's facial appearance. It is composed of various structures, including canthal tendons, lacrimal canaliculi, conjunctiva, the tarsal plate, and skin tissues. Due to its complexity, medial canthal defect reconstruction has been a challenging procedure to perform. The contralateral paramedian forehead flap is usually used for large defects; however, the bulkiness of the glabella and splitting at the distal end of the flap are factors that can reduce the rate of flap survival. We reconstructed medial canthal defects using ipsilateral paramedian forehead flaps, minimizing glabellar bulkiness. METHODS: This study included 10 patients who underwent medial canthal reconstruction using ipsilateral paramedian forehead flaps between 2010 and 2012. To avoid an acute curve of the pedicle, which can cause venous congestion, we attempted to make the arc of the pedicle rounder. Additionally, the pedicle was skeletonized from the nasal root to the glabella to reduce the bulkiness. RESULTS: All patients had basal cell carcinoma, and 3 of them had recurrent basal cell carcinoma. All of the flaps were successful without total or partial flap loss. Two patients developed venous congestion of the flap, which was healed using medicinal leeches. Four patients developed epiphora, and 2 patients developed telecanthus. CONCLUSIONS: Large defects of the medial canthus can be successfully reconstructed using ipsilateral paramedian forehead flaps. In addition, any accompanying venous congestion can be healed using medicinal leeches.

The Morphological Changes in Main Corneal Incision (2.2 mm vs. 2.8 mm) Evaluated Using Anterior Segment Optical Coherence Tomography

PURPOSE: To investigate wound characteristics and ultrastructural changes in the 2.2-mm and 2.8-mm main corneal incisions. METHODS: Forty-four eyes of 34 patients undergoing cataract surgery were randomized to receive a 2.2-mm or 2.8-mm main corneal incision. All incisions were evaluated 1, 7, and 30 days postoperatively using anterior segment optical coherence tomography. The angle, length, maximal thickness of the incision, and if present, corneal gap length and incision gap area were calculated. The existence of Descemet's membrane detachment was recorded. RESULTS: The mean endothelial gap length and gap area of the 2.2-mm wound were larger than the 2.8-mm, with the only statistically significant difference observed on postoperative day 30 (p = 0.015 and 0.027, respectively). There was no difference in the mean incision angle, length, and corneal thickness between the 2 incision sizes. The ratio of Descemet's membrane detachment increased with older age and low postoperative IOP, but not associated with incision size (p < 0.05). CONCLUSIONS: Both the 2.2-mm and 2.8-mm main corneal incisions showed excellent wound healing outcome without significant postoperative complications. Older patients with low postoperative IOP required a more careful wound care management. The incision parameters in the present study can be used as an indicator of the healing process to reduce wound-related complications.

The Potential Role of the Retinal Acuity Meter For Predicting Visual Outcome after Cataract Surgery

PURPOSE: To investigate the accuracy and usefulness of the retinal acuity meter (RAM) in predicting visual acuity after cataract surgery. METHODS: We randomly selected 47 eyes from 43 patients who underwent cataract surgery in our clinic. Preoperative BCVA and 3 month postoperative BCVA were measured by the Snellen chart, and we recorded the preoperative visual acuity by RAM. We also grouped the patients according to diabetic retinopathy and preoperative BCVA 20/100. By comparing the expected visual acuity by RAM with actual postoperative BCVA values, we analyzed the accuracy of the RAM's predictability after surgery. The cataract types and macular disease were taken under consideration when analyzing our results. RESULTS: Of the 47 eyes in our study, the postoperative Snellen visual acuity was predictable within three lines (90.9%) in 11 eyes with diabetic retinopathy and without macular disease. In the 36 eyes without diabetic retinopathy, the postoperative Snellen visual acuity was predictable within three lines (91.6%) of the cases. In both groups, the preoperative RAM acuity and postoperative BCVA were significantly correlated (R2=0.692, R2=0.812, p<0.05). In 41 eyes with preoperative BCVA 20/100 or more, the postoperative Snellen visual acuity was highly predictable in 95.1% (R2=0.763, p<0.05). However, in 6 eyes with preoperative BCVA levels less than 20/100, the postoperative Snellen visual acuity was not predictable (66.6 %). In the patients with both nucleosclerosis and posterior subcapsular opacity and in the patients with additional cortical opacity, the postoperative BCVA differed from the preoperative RAM acuity by more than three lines on the Snellen chart. CONCLUSIONS: RAM is useful in predicting postoperative visual acuity in cataract patients, but may be unreliable in the patients with combined cataract forms or with preoperative BCVAs less than 20/100.

Minimal Requirement of Limbal Epithelium for Successful Limbal Cell Transplantation in Rabbit Corneas

PURPOSE: To investigate the minimal requirements of the limbal epithelium for successful limbal stem cell transplantation and the healing process. METHODS: Nine rabbits were divided into 4, 6, and 8 clock-hour transplantation groups. Limbal autografts from the healthy fellow eye were transplanted to the iatrogenic damaged eye. The amniotic membrane served as a stem cell niche. Experimental corneas were evaluated by slit lamp examination and immunohistochemistry. RESULTS: In the over 9 hours transplantation group, the healing process of the epithelium from the limbal stem cell was revealed and cornea-specific keratin k3, transcription factor p63, and connexin 43 were detected by immunohistochemistry. The normal corneal epithelium was regenerated after 60 days postoperatively in the fellow donor eye. CONCLUSIONS: Limbal cell transplantation of over 9 hours seems to be a safe and effective method in the treatment of severe ocular surface disorders. In addition, the donation of limbal epithelium for up to 8 hours did not affect the normal corneal regenerating capability.

The Effect of Capsular Tension Ring on Posterior Capsular Opacity in Cataract Surgery

This study was performed to evaluate the efficacy and safety of the capsular tension ring on posterior capsular opacity in comparison with cases undergoing intraocular lens (IOL) implantation alone. We analyzed 127 eyes which had undergone cataract surgery, including capsular tension ring insertion, along with 127 eyes which had undergone IOL implantation alone by the same surgeon from September 1998 to March 2003. In the insertion group, 41 eyes (group A) had been followed up for more than one year after silicone IOL implantation, as had 40 eyes (group B) in the control group. We compared the incidence, type, and degree of capsular opacity between A and B groups and also endothelial cell loss after surgery between the two groups. For insertion group A, the frequency of posterior capsular opacity was lower (7.3%), the duration to development was longer, and the energy required for Nd-Yag capsulotomy of PCO was less than for control group B (25%) (p=0.037). The endothelial cell count loss rate was not significantly different between the two groups (p=0.522). The capsular tension ring is associated with a significantly reduced incidence of posterior capsular opacity and is a safe procedure.

Risk Factors and Clinical Evaluation for Corneal Ectasia after LASIK

PURPOSE: To describe the clinical evaluation of corneal ectasia after laser in situ keratomileusis (LASIK) and evaluate risk factors. METHODS: Sixteen patients (21 eyes) who had undergone LASIK with corneal ectasia from 1997 to 1999 were reviewed retrospectively. The uncorrected visual acuity, best-corrected visual acuity (BCVA), spherical equivalent (SE), pachymetry, keratometry, intraocular pressure (IOP) and corneal topography were measured before and after LASIK. The targeted residual bed thickness (TRBT) and the ablation percentage of the total corneal thickness were checked. To determine risk factors, we reviewed 60 eyes with uneventful LASIK for 4 years after LASIK. The control group was selected with matched preoperative SE and TRBT similar to the ectasia group. RESULTS: Five (31.3%) of 16 patients developed ectasia bilaterally and the rate of preoperative asymmetric bow-tie pattern was 64.7% in corneal topography. At the final post-LASIK follow-up, disagreement of apices location on anterior and posterior was 33.3% in the right eye and 50.0% in the left eye. The mean time to onset of ectasia was 26.9 15.1 months and 28.6% developed ectasia after more than 40 months after LASIK. In the ectasia group, pachymetry before LASIK, TRBT and pachymetry at postoperative 2 months were thinner than the control group (p<0.05). CONCLUSIONS: Asymmetric bow tie pattern showed a high frequency in the corneal topography of the ectasia group before LASIK and about 1/3 of the cases developed ectasia more than 3 years after LASIK. The incidence of pachymetry before and after LASIK and TRBT was related to the development of ectasia.

Relationship between Clinical History Method and Orbscan II for Measuring Corneal Power after LASIK

PURPOSE: To evaluate the relation between clinical history method and Orbscan II for corneal power measurement after laser in situ keratomileusis (LASIK). METHODS: A total of 77 consecutive eyes of 43 patients who were treated with LASIK for myopia were followed up for at least 6 months. Corneal power by clinical history methods (CK) was compared with 3.0 mm zones of simulated keratometry (Sim-K), with 0.5, 1.0, 1.5, 2.0 and 3.0 mm zones of axial power maps (AP) and with 2.0, 3.0, 3.5, 4.0 and 5.0 mm zones of total optical power maps (TOP). RESULTS: Sim-K and all AP-map zones using Orbscan II were significantly higher (P<.001) than the CK value, while all TOP-map zones were significantly lower (P<.001) than the CK value. Among them, 3.0 and 4.0 mm TOP-map zones showed the highest correlation with the corneal power by CK (r2=0.889, P<.001; r2=0.889, P<.001). The correlation was higher with 3.0 mm TOP-map zone (r2=0.800, P<.001) than with 4.0 mm TOP-map zone (r2=0.793, P<.001) in high myopia patients. CONCLUSIONS: Although 3.0 and 4.0 mm TOP-map zones of Orbscan II were correlated highly with the CK value, these correlations were relatively low in high myopia patients and 3.0 mm TOP-map zone was better correlated than 4.0 mm TOP-map zone in these patients.

COMPARISON OF THE ACCURACY OF STONE CASTS MADE FROM ALGINATE IMPRESSION MATERIAL BY MIXING METHODS AND APPLICATION OF TRAY ADHESIVE / 대한치과보철학회지

The use of alginate impression materials today is prevalent because of its efficiency and simplicity in clinical settings. Unfortunately, the simplicity of the procedure tends to lull the dentist into a sense of well-being, and lead him into using careless or sloppy technique. Alginate impression materials are used to fabricate diagnostic and preliminary casts, and the final cast. Incorrect use of this material is known to affect the accuracy of the final prosthesis. The purpose of this study was to compare the effect of different mixing methods of alginate impression material and tray adhesive on the accuracy of the stone cast produced by each method. A total of 30 stone casts were produced by using 3 different types of mixing methods (10 stone cast for each mixing method, respectively) The first method utilized an automatic-mixing machine to mix alginate while the second method was carried out manually, strictly following manufacturer's instructions. The third method also involved manual mixing, but did not follow the manufacturer's instructions and was done in a random fashion. Also, 20 additional stone casts were produced by using alginate with or without tray adhesives were included in the study to evaluate effects of tray adhesives on the accuracy of alginate impression. 10 stone casts were produced by adding tray adhesives to the interior surface of the impression tray prior to taking the impression. The other 10 excluded this step. A total of 50 stone casts were analyzed by the three-dimensional measuring machine to measure and compare the dimensional changes of the impression material of each group. The results are as follows. 1. No significant difference was found between the automatic mixing group and the manually-mixing group(p>0.05). 2. For the group that followed manufacturer's instructions, less dimensional changes were recorded than the group that didn't in measuring distance d4(p<0.05) 3. The group that used tray adhesives showed less dimensional changes(p<0.05). The findings revealed that mechanical methods of mixing alginate impression materials had little influence on dimensional changes. However, it is proven that following manufacturers instructions in alginate impression taking is an important step in acquiring accurate impressions and tray adhesives may play an important role in enhancing the results.

Prevention & Management of Complications in Craniofacial Surgery Involving the Anterior Cranial Base

Despite its obvious advantages craniofacial surgery still remains a high-risk procedure with major complications. The purpose of this article is to review craniofacial surgery involving the anterior cranial base performed at Severance hospital from 1986 to 2000, focusing on complications and their management. The cases reviewed included not only craniofacial anomalies, but also curative procedures for trauma and tumor resection. This article retrospectively analyzed 136 procedures performed in 126 patients. Patients were classified into 5 groups on a clinical basis : craniosynostosis, craniofacial synostosis syndrome, orbital hypertelorism, tumor, and trauma. There were 58 complications in 36 patients. Complications were most frequent in group 2(craniofacial synostosis syndrome) which showed a complication rate of 50%, followed in order by orbital hypertelorism, trauma, craniosynostosis, and tumor. There were two deaths, and the mortality rate was 1.5% and the complication rate was 26%. Complications were divided into surgical and medical ones. The majority of surgical complications had serious morbidity potential and infection was most frequent. Medical complications were largely minor, with postoperative pneumonia being most common. Infection-related complications were frequently life-threatening and shown to have decisive influence on postoperative results. We therefore propose the following guide lines for the prevention and management of infection-related complications: 1) extensive antibiotics, 2) atraumatic dural dissection around crista gali, 3) water-tight closure of anterior cranial base defect with well vascularized flap, 4) secure bony fixation with minimal miniplate usage, 5) early detection of infection and continuous intracranial irrigation, 6) surgical skill, 7) short operative time.

Comparison of cyclosporine concentrarions in whole blood of renal transplant patients:radioimmunoassay with a specific monoclonal antibody and 3H-and 125I-labeled ligand

No abstract available.

Comparison for the Measuring Methods of Intraocular Lens Power to Calculate for Eyes after LASIK

Calculating the intraoular lens (IOL)power for an eye that has previously had refractive surgery is a problem because of the difficulty of accurately measuring the corneal power using standard keratometers.To find more accurate method, we compared the accuracy of manual keratometer, calculation and contact lens method for intraocular lens power calculation for eyes after LASIK.The corneal power of 283 eyes were measured using manual keratometer (K (meas))and calculation method (K (calc))involving sphericalequivalent change after LASIK.Mean K (meas) (38.27 diopters[ D] )was significantly greater than mean K (calc) (36.64 D).Corneal power overestimation by manual keratometry correlated significantly with the spherical equivalent change after LASIK.The corneal power of 76 eyes were measured using hard contact lens method (K (rgp))in addition to above two methods.Mean K (meas) (38.53 D)was significantly greater than mean K (rgp) (37.78 D), which was significantly greater than mean K (calc) (36.91 D).The difference between K (meas)and K (rgp) did not correlate with the spherical equivalent change after LASIK.According to this study, if there is largely changed refraction after LASIK, it would be more ideal to use the calculation method.In case of small change after LASIK or PRK, it would be more recommendable to select lower one after comparing two values which come from calculation method and contact lens method.Even though we have theoretical conclusion to avoid error which induces hyperopia, it should be testified through clinical apply.

Optic Disc Hamartoma Combined with Optic Neuritis

PURPOSE: Optic disc harmatoma is usually seen in tuberous sclerosis patients, but, it may be seen in otherwise normal people. Visual acuity is usually not affected by this lesion. METHODS: We experienced a 40-year-old woman with optic disc hamartoma who presented with acute visual defect. With oral triamcinolone 48mg/day, her visions recovered to normal in 2 weeks. RESULTS: Her age, symptom, and course of disease supported the diagnosis of optic neuritis. CONCLUSION: We report this patient as a case of optic disc hamartoma combined with optic neuritis.

Clinical Results of AMO Array(R) Multifocal Intraocular Lens

PURPOSE: To evaluate the clinical results of a AMO Array mutifocal lens. METHOD: we performed a prospective clinical trial of 20 bilateral cataract patients for at least 6 months. RESULT: Mean monocular uncorrected distance acuity(Snellen) was 0.75, which increased to 0.9 with best correction. Mean biocular uncorrected distance acuity was 0.85,which increased to 1.0 with best correction. Mean monocular near acuity was 0.62, which reached 0.88 with best correction. Mean biocular near acuity was 0.71, which reached 1.00 with best correction. Mean contrast sensitivities were within normal range for all spacial frequencies. In glare discomfort, 10 patients had no complaint, 7 patients had no idea, and only 3 patients had some problem. Reading newspaper without glasses was achieved by 28 of 40 eyes(70%) and 15 of 20 patients(75%). CONCLUSION: AMO Array lens can be used as a method of treatment of presbyopia, when combined with correct biometry.

Clinical result of myopic LASIK enhancement

PURPOSE: To evaluate the predisposing factors for enhancement and assess the efficacy of LASIK enhancement using a technique of lifting the flap for residual myopia after laser assisted in situ keratomileusis (LASIK). METHODS: 46 eyes that underwent LASIK enhancement by lifting the flap using the same excimer laser as primary LASIK were retrospectively studied for the predisposing factors for enhancement and the efficacy of LASIK enhancement for residual myopia. LASIK of 20 eyes were performed by STAR and 26 eyes by Mel 70. RESULTS: The higher the initial spherical eqivalent (SE) and keratometer, the larger the amount of undercorrection (p<0.05), and the higher the initial SE and the change of corneal thickness during regression, the larger the amount of regression (p<0.01). There was no difficulty during lifting the flap regardless of time after primary LASIK and no complication during or after enhancement. The SE before and after enhancement was -2.38+/-0.86 D and -0.93+/-0.87 D. Uncorrected visual acuity was 20/25 or better in 80% of eyes. CONCLUSIONS: LASIK enhancement by lifting the flap for correctable residual myopia after primary LASIK was relatively easy to perform and effective for correction of residual myopia.

Two Cases of Jugular Phlebectasia / 대한이비인후과학회지

Anterior or lateral neck mass that appears on straining should be differentiated from laryngocele, jugular phlebectasia and superior mediastinal cysts or masses. The most common cause of aneck masses which that appears on straining is alaryngocele. The jugular phlebectasia may present itself in a similar manner, although it occurs rarely. The cause of the jugular phlebectasia is unclear. The diagnosis is made on a clinical basis and confirmed by the less invasive radiological technique. No treatment is indicated because of its self-limiting, benign condition. However, the surgical removal is needed for cosmetic purposes by a unilateral excision of the jugular vein. We experienced two cases of jugular phlebectasia, one anterior and the other internal. One case of The anterior jugular phlebectasia was successfully treated by surgical excision, and the other case of internal jugular phlebectasia was treated conservatively.

The Evaluation of Photodynamic Therapy for Idiopathic Subfoveal Choroidal Neovascularization with Imaging Studies

PURPOSE: To evaluate the effect of photodynamic therapy (PDT) for idiopathic subfoveal choroidal neovascularization with various imaging studies. METHODS: We retrospectively reviewed the medical records and imaging studies of 17 patients (17 eyes) who were diagnosed with idiopathic subfoveal choroidal neovascularization and treated with PDT between December 2000 and May 2003. Slit lamp examination, fluorescein angiography (FAG), indocyanine green angiography (ICGA), and optical coherence tomography (OCT) were conducted before and after PDT. RESULTS: After PDT, the mean visual acuity was improved from 0.23 (20/80) to 0.48 (20/40). On FAG, the mean size of neovascular lesion (the longest length of lesion) was slightly decreased from 2038 +/- 592 micrometer to 1872 +/- 622 micrometer after PDT. However, the change was not significant. Fluorescein dye leakage decreased or disappeared, but staining of the lesion was noted. On OCT, the macular edema disappeared, but the hyperreflective area remained after PDT. CONCLUSIONS: PDT was effective in the treatment of idiopathic choroidal neovascularization. The factors representing the therapeutic effect of PDT were visual improvement, decreased leakage on FAG, and decreased macular edema on OCT, and these three factors were significantly related to each other.