Kim's Eye Hospital

Background: To evaluate the effect of the COVID-19 pandemic on myopic progression defined in terms of refractive change and axial length elongation in Korean children with myopia using 0.01% atropine eye drops. Methods: A retrospective review was performed on the medical records of 73 children aged 4 to 15 years with a baseline myopia of -0.50 diopters (D) or more who had used 0.01% atropine eye drops for more than 12 months before the onset of the COVID-19 pandemic in South Korea. The rate of myopic progression was compared between two periods: the pre- and post-pandemic eras, the latter of which was defined by the initiation of remote schooling in March 2020. At each visit, cycloplegic autorefraction and axial length were measured using a Zeiss IOL Master. Patients answered a questionnaire regarding their time spent on near work (computer, smartphone, reading, homework, after-school workbooks, drawing, etc.) and outdoors. Results: During the pandemic, in terms of refraction, myopia progressed at an average rate of -0.45 D/y, which was significantly faster than before the pandemic of -0.22D/y (p = 0.037). In contrast, axial length elongation was 0.22 mm/y and 0.19 mm/y before and after the pandemic, respectively, which was not significantly different (p = 0.546). Time spent on using computers, smartphones, and other near work significantly increased, while outdoor time had significantly decreased after the pandemic (paired t-test, all p < 0.001). The change in annual refractive myopic progression rate during the pandemic compared to the pre-pandemic period did not significantly correlate with changes in computer time, smartphone time, or other near work time (p = 0.134, 0.210, 0.863, respectively). However, the change in outdoor time showed a negative correlation with the change in annual myopic progression rate (r = -0.239, p = 0.041). Conclusions: Among Korean children aged 4 to 15 years receiving 0.01% atropine, the rate of myopic progression increased significantly in terms of refraction during the COVID-19 pandemic compared with the pre-pandemic period, whereas axial length progression did not change significantly.

Microcontact stamping is a promising microfabrication technique for producing functional patterned thin films on flexible substrates; however, systematic optimization of its process parameters for thermochromic applications remains limited. In this study, we present a comprehensive parametric optimization of the microcontact stamping process to fabricate thermochromic pigment-coated thin films with rapid and reversible color responses. The effects of liquid resin type, SU-8 mold thickness, polydimethylsiloxane (PDMS) mixing ratio, and pattern size on pattern fidelity and thermochromic performance were systematically investigated. The optimal conditions were identified as a UV-curable resin, a 600 µm-thick SU-8 mold, a PDMS base-to-curing-agent ratio of 5:1, and a pattern size of 125 × 125 µm2. Under these conditions, the stamped thermochromic films exhibited uniform micro-patterns, rapid response and recovery behavior, and stable reversible color changes over 20 consecutive thermal cycles. This work provides practical guidelines for parameter-controlled microcontact stamping of functional thin films and demonstrates its potential for scalable fabrication of thermochromic micro-patterns. The proposed approach is expected to contribute to the development of flexible and wearable electronic devices, smart displays, and thermally responsive sensing platforms.

The importance of corneal biomechanics in ocular health and treatments is well-recognized, but reports on associated factors are inconsistent. We established normative data for corneal stiffness using Brillouin spectroscopy in a large cohort of healthy myopic corneas, exploring potential influences on Brillouin modulus (BM) measurements. Data from 1744 healthy corneas of 885 subjects (17–52 years; 422 females) were retrospectively collected, including intraocular pressure (IOP in mmHg), manifest refraction spherical equivalent (MRSE in dioptres [D]), and Pentacam measurements (central corneal thickness [CCT in µm]), K1 and K2 in D). Corneal scans were recorded on a Brillouin Optical Scanning System (BOSS®) using an automated 10-point pattern to measure Central, Mean, Minimum and Maximum BM values in gigapascals (GPa). Monocular data (primarily right eye) were used for correlations; binocular data for interocular comparisons. Parametric analyses included Pearson correlations, t-tests for sex differences, paired t-tests for interocular differences, and multivariate linear regression to isolate independent factors (e.g., age, sex, CCT, IOP) with interaction terms. Normative BM values were Central = 2.856 ± 0.053 GPa, Mean = 2.845 ± 0.038 GPa, Min = 2.819 ± 0.046 GPa, and Max = 2.885 ± 0.042 GPa. Interocular comparisons revealed statistically significant but small increases in OS compared to OD for Mean BM (0.003 GPa [95% CI: 0.001–0.005]; OD = 2.855 ± 0.038 GPa, OS = 2.858 ± 0.038 GPa; P = 0.01) and Max BM (0.004 GPa [95% CI: 0.002–0.006]; OD = 2.886 ± 0.042 GPa, OS = 2.890 ± 0.042 GPa; P = 0.003), as well as in K1 and CCT (P < 0.0001). No significant interocular differences were found in Central or Min BM (P ≥ 0.15). Central, Mean and Min BM values correlated significantly with CCT (P ≤ 0.04) but not with IOP, K1, K2, or MRSE (P ≥ 0.20); Max BM did not correlate with any of these clinical parameters (P ≥ 0.07). Males had higher BM values than females (P ≤ 0.006), with effect sizes (d = 0.21) and r = 0.09 –0.1. Regional mapping showed small overall differences in BM values between zones (P = 0.04), with slightly higher values in the Superior region. Multivariate regression confirmed independent associations: Central BM ~ age (β = 0.0008 [95% CI: 0.0001–0.0015], P = 0.04), sex (β = 0.010 [95% CI: 0.003–0.017], P = 0.008), CCT (β = 0.00015 [95% CI: 0.00005–0.00025], P = 0.003); IOP was non-significant (β = 0.0004 [95% CI: −0.0008–0.0016], P = 0.50, R² = 0.048). Age*sex interaction was non-significant (β=−0.0002, P = 0.62). While statistical significance was observed, the correlation coefficients were not large, suggesting a weak linear relationship. Non-contacting Brillouin scans in a large cohort of healthy myopic eyes established robust normative BM standards, revealing associations between corneal stiffness and age, sex, and CCT. These findings provide reference values that enhance diagnostic accuracy for conditions like keratoconus and inform biomechanical assessments in refractive surgery.

This study aims to investigate efficacy and safety of ranibizumab biosimilars (Amelivu® and LucenBS®) across retinal diseases in Korean clinical practice. This retrospective, multicenter study enrolled 1153 eyes from 1075 patients across five centers in South Korea between May 2022 and October 2024. Patients received intravitreal ranibizumab biosimilars for neovascular age-related macular degeneration, retinal vein occlusion with macular edema, diabetic macular edema, and other retinal diseases. Treatment-naïve eyes comprised 408 cases (35.4%), while 745 eyes (64.6%) had prior anti-VEGF treatment. Amelivu was administered to 1007 eyes with 3.1 ± 1.9 injections over 10.2 ± 6.1months; LucenBS to 146 eyes with 3.1 ± 2.0 injections over 12.0 ± 4.9months. Amelivu demonstrated significant BCVA(logMAR) improvements from baseline (0.63 ± 0.62) to 12months (0.55 ± 0.61, P < 0.01). LucenBS maintained logMAR VA from 0.64 ± 0.63 to 0.63 ± 0.68 at 12months (P = 0.40). Both biosimilars achieved significant CMT reductions through 12months: Amelivu from 398.0 ± 169.4μm to 323.0 ± 128.8μm (P < 0.01); LucenBS from 368.7 ± 172.0μm to 306.0 ± 144.1μm (P < 0.01). Treatment-naïve eyes showed superior CMT reduction (111.8μm) compared to previously treated eyes (53.5μm). Only one injection-related adverse event occurred: asymptomatic anterior chamber cells in the Amelivu group, resolving with topical treatment. Ranibizumab biosimilars demonstrated visual stabilization and significant anatomical improvements across retinal diseases with excellent safety profiles.

Abstract BackgroundSpectrum Domain‐Optical Coherence Tomography (SD‐OCT) is a non‐invasive technology that acquires cross‐sectional images of retinal structures allowing neural fundus integrity assessment. Macular thickness and retinal nerve fiber layer (RNFL) thickness measured by an SD‐OCT have been used as a indicator of Alzheimer's disease (AD) and amnestic mild cognitive impairment (aMCI). However which portion of retinal RNFL is the most sensitive area among normal control, aMCI and AD is not clear yet. The purpose of this study is to demonstrate that RNFL thickness is a useful indicator and which portion of reninal RNFL is the most sensitive area among normal control.MethodIn a cross‐sectional study we consecutively recruited 53 patients with AD, 58 with aMCI, and 54 normal controls. AD‐OCT was performed in all of them to measure circumpapillary macular thickness in the 9 sectors (fovea, temporal outer superior outer, nasal outer, inferior outer, temporal inner, superior inner, nasal inner, inferior inner). We made 4 RNFL quadrant area as following: superior (superior outer+superior inner), inferior (inferior outer+ inferior inner), nasal (nasal outer + nasal inner), temporal (temporal outer + temporal inner). We also evaluated the correlation of the RNFL thickness and MMSE score and disease duration of the patientsResultAverage macular thickness and 9 sectors of RFNL thickness were not significant among the group in our patients. In quadrant analysis, however superior quadrant RNFL thickness showed significant differences among groups (109.98±12.01 um, 106.83±10.05 um 101.25±11.90 um in normal control, aMCI and AD respectively, p&lt;0.01). The RNFL thinning of the superior quadrant showed a significant correlation with MMSE score (r=0.555, p&lt;0.01) and AD duration (r=‐0.528, p&lt;0.01).ConclusionThe superior quadrant RNFL thickness is the most sensitive among the group and as well as we know this is not reported before. This finding could suggest superior quadrant retinal RNFL by SD‐OCT could be a useful marker of AD and a MCI for early detection and monitoring of disease progression. Also distinct correlation of RNFL thinning in superior quadrant and MMSE score and disease duration can imply that the severity of dementia can be inferred from RNFL thickness in superior quadrant.

ABSTRACT Purpose To evaluate the prevalence and risk factors of age-related macular degeneration (AMD) in the Korean population. Methods In this cross-sectional study based on the Korea National Health and Nutrition Examination Survey (2017–2020) data 13,737 participants aged ≥ 40 years with assessable fundus images were included. The prevalence and risk factors of AMD were evaluated. The prevalence of early AMD, geographic atrophy (GA), and neovascular AMD were also assessed. Logistic regression analyses were used to identify risk factors. Results The prevalence (95% confidence interval [CI]) of AMD was 13.94% (13.15–14.72). The prevalence (95% CI) of early AMD, GA, and neovascular AMD was 13.07% (12.29–13.85), 0.26% (0.17–0.35), and 0.61% (0.47–0.75), respectively. The prevalence increased with age; it was 3.61%, 11.33%, 20.31%, 31.37%, and 33.98% in participants in their 40s, 50s, 60s, 70s, and ≥ 80 years, respectively. In multivariate analysis, AMD was positively associated with older age (p < 0.001; odds ratio [OR], 1.08; 95% CI, 1.07–1.09), male sex (p = 0.014; OR, 1.27; 95% CI, 1.05–1.53), and lower degree of education (p < 0.001; OR, 1.36 (for junior high school graduates); 95% CI, 1.12–1.65). Conclusions AMD was detected in approximately one-third of individuals aged ≥ 70 years, thus indicating that AMD is a common disease among older Koreans. Regular fundus examinations in populations with risk factors for AMD as well as education on methods to prevent or delay AMD progression, such as the Mediterranean diet, are necessary.

We evaluated the clinical outcomes after implantation of a new monofocal intraocular lens (IOL) with enhanced intermediate function in patients with preperimetric glaucoma and compared those with patients without retinal nerve fiber layer (RNFL) defects. All patients were implanted bilaterally a new monofocal IOL with enhanced intermediate function. Patients with bilateral RNFL defects and no glaucomatous visual field defects were classified as the preperimetric glaucoma group. A total of 60 eyes of 30 patients with preperimetric glaucoma were compared with 60 eyes of 30 patients without RNFL defects. Uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), defocus curve, contrast sensitivity, and questionnaire were evaluated 1 month and 3 months after surgery. No difference in binocular UDVA, UIVA, and UNVA was evident between the two groups at 1 and 3 months postoperatively. Additionally, there were no significant differences between the two groups regarding the proportion of severe or very severe photic phenomena, such as glare and halos, or the overall satisfaction. Bilateral implantation of a new monofocal IOL with enhanced intermediate function in patients with preperimetric glaucoma demonstrated commensurate clinical outcomes and could be considered a feasible alternative.

Aims/Purpose: Retrospective review in 164 patients with endophthalmitis after cataract surgery, and intended to figure out the factors which affect clinical features, bacteria identification and final visual acuity (VA).Methods: We followed the guideline of EVS for operative treatment. In the case of initial LP, vitrectomy was conducted. HM or better, either IOAI (intraocular antibiotics injection, 1.0 mg/0.1 mL of vancomycin and 2.25 mg/0.1 mL of ceftazidime) or vitrectomy was optionally conducted. After initial treatment, we conducted reintervention within 48 h where the decrease of vitreous opacity and hypopyon, and pain relief did not show up. We obtained A/C fluid and vitreous specimen for figure out the bacteria identification.Results: 25 patients had initial VA below LP, the cases of HM were 86 and 53 patients had better than FC. 81 patients were observed where it took 3 days until the symptoms of post‐operative endophthalmitis occurred. Where final VA improved by 0.5 or better, the case that vitrectomy was conducted with early treatment was not statistically much different from the case of sole IOAI. The influential factors in final VA was where it took more than 3 days for endophthalmitis to occur after cataract surgery, initial VA was HM or better, and the result of bacteria identification was Gram(+) and those 3 cases affected the positive outcomes.Conclusions: Good initial VA means the diagnosis of endophthalmitis was relatively prompt. It can be said that intraocular tissues were less damaged, the virulent would be infected by less bacteria and then those affect positive prognosis. In addition, endophthalmitis diagnosed 3 days later after surgery, prognosis was good. It seems that this is because damage of intraocular tissues occurs slowly as pathogenicity did not progress quickly with light clinical features where it is infected by weak bacteria. And it can be considered that the period until post‐operative endophthalmitis occurs affects prognosis.

Purpose: To report a case of orbital infarction syndrome in a patient with hemophagocytic lymphohistiocytosis (HLH).Case summary: A 70-year-old woman with diabetes mellitus and hypertension was referred to the Department of Ophthalmology for sudden-onset left upper eyelid ptosis after being diagnosed with HLH. After 3 days, the best corrected visual acuity in the right eye was 0.8, while there was no light perception in the left eye. In the left eye, the ocular motility examination showed limitations in all fields of gaze. On fundus examination, optic disc pallor, retinal hemorrhage, and narrowed retinal arteries were observed in the left eye. Fluorescein angiography showed no blood flow in the retinal arteries and veins in the left eye. On neck computed tomography angiography, the left distal internal carotid artery was narrowed. Orbit computed tomography showed exophthalmos and extraocular muscle hypertrophy in the left eye. Orbit magnetic resonance imaging confirmed optic nerve edema, enhancement of the optic nerve sheath, and high signal intensity of the intraocular fat in the left eye. Slit-lamp examination revealed ischemia of the anterior segment and ischemic necrosis of the eyelid in the left eye. The patient was diagnosed with orbital infarction syndrome.Conclusions: Several factors may lead to ischemia of the orbital tissues in patients with HLH, including coagulopathy, an increased incidence of blood clots, and inflammation in the orbit. It is necessary to consider the possibility of orbital infarction syndrome when HLH patients present with visual loss, ocular movement limitations, and anterior segment ischemia.