Eun Suk Lee

Jeju National University, Tse-tsiu, Jeju, South Korea

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Publications (33)74.21 Total impact

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    ABSTRACT: Abstract Currently, the most effective outflow drugs approved for clinical use are prostaglandin F2α analogues, but these require daily topical self-dosing and have various intraocular, ocular surface and extraocular side effects. Lentiviral vector-mediated delivery of the prostaglandin F synthase (PGFS) gene, resulting in long-term reduction of intraocular pressure (IOP), may eliminate off-target tissue effects and the need for daily topical PGF2α self-administration. Lentiviral vector-mediated delivery of the PGFS gene to the anterior segment has been achieved in cats and non-human primates. Although these results are encouraging, our studies have identified a number of challenges that need to be overcome for prostaglandin gene therapy to be translated into the clinic. Using examples from our work in non-human primates, where we were able to achieve a significant reduction in IOP (2 mm Hg) for 5 months after delivery of the cDNA for bovine PGF synthase, we identify and discuss these issues and consider several possible solutions.
    Current eye research 02/2014; 39(9). DOI:10.3109/02713683.2014.884593 · 1.64 Impact Factor
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    ABSTRACT: The extracts of two native berries from the Jeju Island of Korea were used to assess polyphenolics and flavonol levels, superoxide dismutase (SOD)‐like enzyme activity, free radical scavenging activity, 3‐(4,5‐dimethylthiazol‐2‐yl)‐2,5‐diphenyl tetrazolium bromide cell viability, protective effects against H2O2‐induced cow pulmonary artery endothelium (CPAE) cell cytotoxicity and inhibition of low density lipoprotein (LDL) peroxidation. The total content of the flavonols and phenolic compounds in the leaves was higher than the fruit for both berries. In the free radical scavenging and SOD‐like enzyme assay, all extracts showed strong antioxidative effects. The CPAE viability was greatly reduced and the survival rate was near 37% when the cells were treated with 1.0 mM H2O2 for 24 h. The extracts also inhibited lipid peroxidation in human LDL, measured as reduction in malondialdehyde production. The results showed that the leaf extracts of Empetrum nigrum significantly protected human LDL from Cu2+‐induced oxidation. E. nigrum is suggested as an excellent potential source of natural antioxidants. PRACTICAL APPLICATIONSThe results of these two Korean native berry species, especially Shiromi species, showed very strong effects on the inhibition of low density lipoprotein (LDL) oxidation and free radical scavenging. The LDL and free radicals have known close relations with coronary artery and cerebrovascular atherosclerosis. The antioxidative effects of these berries were stronger than existing commercial products. From these results, Korean native berry species might be very useful for the development of functional food for antioxidants preventing oxidative stress‐related diseases like atherosclerosis. Making a new commercial product with Korean Shiromi berry will have good prospects.
    Journal of Food Biochemistry 12/2012; 36(6). DOI:10.1111/j.1745-4514.2011.00582.x · 0.74 Impact Factor
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    Soolienah Rhiu · Eun Suk Lee · Tae-Im Kim · Hye Sun Lee · Chan Yun Kim ·
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    ABSTRACT: Purpose: To assess the accuracy of intraocular lens (IOL) power prediction for cataract surgery in chronic angle-closure glaucoma (CACG) patients with different IOLs’ implantation. Methods: This prospective randomized clinical trial included 45 eyes with CACG and 48 eyes with normal controls undergoing cataract surgery. In the CACG group, 23 eyes (51%) had three-piece IOL implantation and 22 eyes (49%) had one-piece IOL implantation. In the normal control group, 25 eyes (52%) had three-piece IOL implantation and 23 eyes (48%) had one-piece IOL implantation. Using the SRK/T formula, the mean difference between the predicted and actual postoperative spherical equivalent [mean absolute error (MAE)] was obtained and converted to natural logarithm (ln) for statistical analysis. The power of the implanted IOL was calculated to predict postoperative SE using three formulas: SRK II, Holladay II and Hoffer Q by post hoc analysis in each group. The predictive accuracy of each formula was analysed by comparing the lnMAE. Results: In the one-piece IOL group, there was no difference in lnMAE between the CACG and normal control group (p = 0.314). In the three-piece IOL group, the lnMAE of the CACG group was larger than that of the normal control group (p < 0.001). The lnMAEs calculated by the SRK/T formula were more accurate than the Holladay II (p = 0.045) and Hoffer Q (p = 0.042) formula in the CACG one-piece IOL group. Conclusions: Implantation of one-piece IOLs provides similar power prediction accuracy comparable to normal cataract patients; this result may be explained by the IOL haptic configuration or design.
    Acta ophthalmologica 09/2012; 90(8). DOI:10.1111/j.1755-3768.2012.02499.x · 2.84 Impact Factor
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    ABSTRACT: The purpose of this study was to assess the influence of blue light-filtering intraocular lenses (IOL) on peripapillary retinal nerve fiber layer (RNFL) thickness measurements by spectral-domain (SD) optical coherence tomography (OCT). This prospective study included 50 eyes of 50 patients. Patients were randomly assigned to receive either a blue light-filtering IOL (acrysof IQ (SN60WF) [Alcon]) or a clear IOL (Tecnis (Z9003) [AMO]). The peripapillary RNFL thickness was measured using a Cirrus SD OCT before and 8 weeks after cataract surgery. Perioperative differences in RNFL thickness measurements and signal strengths (SS) were evaluated and compared in both IOL groups. Thirty-nine eyes of 39 patients were included in the final analysis. There was a significant increase in average RNFL thickness and SS after cataract surgery in both IOL groups. No significant difference in perioperative changes of RNFL measurements was noted between yellow and clear IOL groups. In the multivariable analysis, the factor affecting perioperative differences of RNFL measurements was not IOL type but SS. Our data suggests that blue-light filtering IOL does not influence RNFL thickness measurements by Cirrus SD-OCT.
    Current eye research 10/2011; 36(10):937-42. DOI:10.3109/02713683.2011.597535 · 1.64 Impact Factor
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    ABSTRACT: To compare the diagnostic ability to detect glaucomatous changes between peripapillary retinal nerve fibre layer (RNFL) thickness and the macular ganglion cell complex (GCC) in highly myopic patients using Fourier domain optical coherence tomography. Participants, consecutively enrolled from January 2009 to June 2009, were imaged with RTVue-100 (NHM4 and MM7 scan). The sensitivity and specificity of a colour code less than 5% (red or yellow) for glaucoma diagnosis were calculated. Area under the receiver operator characteristic (AUROC) curves were generated to assess the ability of each parameter to detect glaucomatous changes. 73 normal controls and 77 glaucoma patients were included. Participants were categorised as 105 non-high myopes (spherical equivalent >-6.0 dioptres) and 45 high myopes (Spherical equivalent ≤-6.0 dioptres). The GCC thickness showed a strong correlation with RNFL thickness (correlation coefficient=0.763, p<0.001) in all participants. The sensitivity from superior GCC colour code was significantly higher than that from superior RNFL (p=0.019). The ability to detect glaucomatous changes in the highly myopic group by examining the average GCC thickness (AUROC, GCC; 0.889) was higher than when examining RNFL thickness (AUROC, RNFL; 0.825); however, there was no statistical significance (p=0.442). The ability to diagnose glaucoma with macular GCC thickness was comparable with that with peripapillary RNFL thickness in high-myopia patients. Macular GCC thickness measurements may be a good alternative or a complementary measurement to RNFL thickness assessment in the clinical evaluation of glaucoma in patients with high myopia.
    The British journal of ophthalmology 08/2011; 95(8):1115-21. DOI:10.1136/bjo.2010.182493 · 2.98 Impact Factor
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    Eun-Ji Kim · Samin Hong · Chan Yun Kim · Eun Suk Lee · Gong Je Seong ·
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    ABSTRACT: To assess the impact of axial length on the age-related peripapillary retinal nerve fiber layer (RNFL) thinning. This cross-sectional observational comparative case series included 172 eyes from 172 healthy Korean subjects. Peripapillary RNFL thickness was measured using an Optic Disc Cube 200 × 200 scan of spectral domain Cirrus HD OCT and the axial length was measured using IOL Master Advanced Technology. In age groups based on decade, the normal ranges of peripapillary RNFL thickness for average, quadrant, and clock-hour sectors were determined with 95% confidence intervals. After dividing the eyes into two groups according to axial length (cut-off, 24.50 mm), the degrees of age-related RNFL thinning were compared. Among the eyes included in the study, 53 (30.81%) were considered to be long eyes (axial length, 25.04 ± 0.48 µm) and 119 (69.19%) were short-to-normal length eyes (axial length, 23.57 ± 0.60 µm). The decrease in average RNFL thickness with age was less in long eyes (negative slope, -0.12 µm/yr) than in short-to-normal length eyes (negative slope, -0.32 µm/yr) (p < 0.001). Age-related thinning of peripapillary RNFL thickness is attenuated in long eyes compared to short-to-normal length eyes.
    Korean Journal of Ophthalmology 08/2011; 25(4):248-51. DOI:10.3341/kjo.2011.25.4.248
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    ABSTRACT: To investigate the surgical results of Ahmed valve implantation with intraoperative bevacizumab injection in patients with neovascular glaucoma (NVG). A retrospective comparative case series review was conducted on 52 eyes with NVG who underwent Ahmed glaucoma valve implantation with or without intraoperative bevacizumab intravitreal injection. In the intraoperative intravitreous bevacizumab injection group (IVB group, 20 eyes), 1.25 mg of bevacizumab was injected into the vitreous cavity during Ahmed valve implantation. In the control group (32 eyes), only Ahmed valve implantation was performed. Surgical failure was defined when (1) the postoperative intraocular pressure was over 21 mm Hg at consecutive clinic visits, (2) the visual acuity became light perception negative, (3) additional antiglaucomatic surgery was required, or (4) devastating operative or postoperative complications were noted. Although the success rate in the IVB group (70.0%) was higher than that in the control group (62.5%) 1 year after operation, the differences were not statistically significant (P=0.828 by log-rank test). Mean intraocular pressures in the IVB group were significantly lower than those of the control group at 12 and 15 months (P<0.05 by the Mann-Whitney U test). Postoperative complications were similar between the 2 groups. Preoperative history of trabeculectomy was a significant risk factor for surgical failure of Ahmed valve implantation in NVG (relative risk=4.618; P=0.018 by Cox regression model). Intraoperative IVB injection does not seem to be helpful for better surgical outcomes of Ahmed valve implantation in NVG. A history of trabeculectomy is a risk factor for failure after Ahmed valve implantation in patients with NVG.
    Journal of glaucoma 06/2011; 21(5):331-6. DOI:10.1097/IJG.0b013e31820e2fd0 · 2.11 Impact Factor
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    ABSTRACT: To compare retinal nerve fiber layer (RNFL) measurements obtained by two spectral-domain optical coherence tomographies (SD OCTs; Cirrus-HD OCT and RTVue) and a time domain OCT (TD OCT; Stratus OCT). The diagnostic ability of the three instruments for glaucoma has also been compared. One hundred eight open-angle glaucoma patients and 46 normal controls were enrolled. Three OCT scans were repeated to obtain peripapillary RNFL thickness measurements from all participants on the same day. The relationships between RNFL measurements from three OCTs were evaluated with regression analyses. The thickest RNFL measurements were generally obtained with the RTVue, followed by the Stratus, and finally by the Cirrus OCT (mixed model, p < 0.05). However, the tendency was reversed or no longer present in severe glaucomatous eyes and nasal quadrant maps. Regression analysis between the TD OCT and the two SD OCTs revealed a quadratic relation (linear vs. non-linear, Akaike information criterion, all p < 0.05), whereby RNFL measurements of the TD OCT became exponentially thinner than those by the SD OCTs in thin RNFL thicknesses. Comparing the two SD OCTs, RTVue measured thicker values consistently regardless of the RNFL thickness (pairwise comparisons, p < 0.05). There were no significant differences in the diagnostic ability of all three instruments in average and each quadrants of RNFL thickness (p > 0.05). Direct comparisons of RNFL thickness measurements among OCT instruments may be misleading as there are considerable differences among devices. The measurement differences between SD OCT and TD OCT differed according to the RNFL thickness and also possibly to severity of the glaucoma. The diagnostic ability of each instrument for glaucoma detection was not significantly different.
    Optometry and vision science: official publication of the American Academy of Optometry 06/2011; 88(6):751-8. DOI:10.1097/OPX.0b013e318215cc40 · 1.60 Impact Factor
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    ABSTRACT: PURPOSE: To assess agreement in cup-to-disc ratio (CDR) estimation between stereoscopic optic disc photography, time-domain optical coherence tomography (OCT), and Fourier-domain OCT, and to compare the discriminating ability of optic nerve head (ONH) parameters by time-domain OCT and Fourier-domain OCT for glaucoma detection. METHODS: Participants underwent stereoscopic photography, Stratus OCT (fast optic disc scan), and RTVue-100 (nerve head mapping), at the same visit. Vertical and horizontal CDRs (VCDR and HCDR) from stereoscopic photography were determined by averaging the results from 2 independent glaucoma specialists. VCDR, HCDR, disc area, cup area, rim area, and cup-to-disc area ratio were acquired from the 2 OCTs. Agreement was assessed by intraclass correlation coefficients (ICCs) and Bland-Altman plots. Area under the receiver operator characteristic curve was used to assess the ability of each parameter to detect glaucoma. RESULTS: A total of 185 eyes were used in final analysis. VCDR and HCDR measurements from RTVue were highest, followed by those from Stratus OCT and stereoscopic photography. CDRs from both OCTs showed excellent agreement with those from stereophotography (ICC, 0.80 to 0.86). Agreement in ONH parameters including CDRs between the 2 OCTs was excellent (ICC, 0.86 to 0.94). There were no statistically significant differences between the ONH parameters from the 2 OCTs with respect to ability to detect glaucoma. CONCLUSIONS: VCDR and HCDR measurement by time-domain and Fourier-domain OCTs exhibited excellent agreement with each other and agreed equally well with those by stereoscopic photography. The ONH parameters between the 2 OCTs performed similarly in determining glaucoma status.
    Journal of glaucoma 05/2011; 22(1). DOI:10.1097/IJG.0b013e31821e85f3 · 2.11 Impact Factor
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    ABSTRACT: To assess the effect of signal strength (SS) on the reproducibility of circumpapillary retinal nerve fiber layer (cpRNFL) thickness measurement (measurement agreement) and its color-coded classification (classification agreement) by Cirrus spectral-domain optical coherence tomography (OCT). Seven hundred and eighty-nine participants, consecutively enrolled from December 2009 to August 2010, underwent two repeated Cirrus OCT scans to measure cpRNFL thickness (optic disc cube 200 × 200). Intraclass correlation (ICC) and linear-weighted kappa coefficient (κ) were calculated as indicators for cpRNFL measurement and classification agreement. The difference in cpRNFL thickness measurements between repeated OCT scans (inter-scan measurement difference) was correlated with mean SS, SS change or difference between repeated OCT scans (inter-scan SS difference), and average cpRNFL thickness. Mean SS was negatively correlated with inter-scan SS difference and was positively correlated with the inter-scan measurement difference. Repeated scans with SS change (inter-scan SS difference = 1 or 2) showed larger variability than scans without SS change (inter-scan SS difference = 0) in total average cpRNFL and all quadrant maps except for the nasal quadrant. Multivariate analysis revealed that inter-scan measurement differences increased in subjects with thinner cpRNFL thicknesses and in scans with lower mean SS and higher inter-scan SS differences. Measurement agreement (ICC) in groups with larger inter-scan SS differences (=2) was lower than those with smaller inter-scan SS differences (=0 or 1) in their average cpRNFL and inferior quadrant maps. Classification agreement (κ) in groups with larger inter-scan SS differences (=2) was lower than those with smaller inter-scan SS differences (=0 or 1) in their average cpRNFL and quadrant maps (superior and inferior quadrant) although statistically not significant. Special attention should be paid when comparing the cpRNFL thickness measurement and color-coded classification of 2 or more Cirrus OCT scans as the agreements may be susceptible to SS differences.
    Japanese Journal of Ophthalmology 05/2011; 55(3):220-7. DOI:10.1007/s10384-011-0023-5 · 1.68 Impact Factor
  • Yong Gi Lee · Ji Hyun Kim · Na Rae Kim · Chan Yun Kim · Eun Suk Lee ·
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    ABSTRACT: This study aimed to compare central corneal thickness (CCT) measurement by Tonopachy to that by Pentacam and ultrasound pachymetry, and intraocular pressure (IOP) measurement to that by Goldmann applanation tonometry (GAT). The reproducibility of CCT and IOP measurements by Tonopachy was also evaluated. In 104 eyes of 104 patients, CCT was measured by Tonopachy, Pentacam, and ultrasound pachymetry, and IOP was measured by Tonopachy and GAT. Each CCT and IOP measurement was compared using Pearson correlation, repeated measures analysis of variance, and Bland-Altman plots. In 30 subjects, CCT and IOP measurements by Tonopachy were repeated to evaluate intrasession and intraobserver variability. Both CCT and IOP measurements were highly correlated among all instruments used in this study. CCT measurements by three pachymeters were statistically different (p<0.0001). CCT measured by ultrasound pachymetry was lowest (541.7 ± 30.6 μm) whereas those by Tonopachy and Pentacam showed no difference (557.3 ± 34.3 and 558.0 ± 33.7 μm, respectively). Tonopachy overestimated CCT by 13.9 μm when compared with ultrasound pachymetry. There was a statistically significant difference between IOP measurements by two tonometers (p<0.0001); IOP measurement was higher by Tonopachy than by GAT (13.9 ± 4.2 and 12.5 ± 3.2 mm Hg, respectively). Tonopachy overestimated IOP measurements by 1.2 mm Hg compared with GAT. Intersession agreements for IOP and CCT measurements by Tonopachy were excellent (intraclass correlation, 0.902 and 0.962, respectively) with 95% limits of agreement ranging from -1.4 to 2.2 mm Hg and from -12.9 to 12.1 μm, respectively. Although CCT and IOP measurements obtained by Tonopachy were reproducible and showed close agreement with ultrasound pachymetry and Pentacam, and GAT, careful attention should be paid when comparing Tonopachy CCT measurement to ultrasound pachymetry or its IOP measurement to GAT as the values may not be interchangeable. Tonopachy is a reliable instrument for evaluating CCT and IOP.
    Optometry and vision science: official publication of the American Academy of Optometry 04/2011; 88(7):843-9. DOI:10.1097/OPX.0b013e31821896f1 · 1.60 Impact Factor
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    ABSTRACT: The purpose of this study was to investigate the prevalence and characteristics of glaucoma in the population of the rural Korean town, Sangju. Residents of Sangju aged greater than 50 years old were included in this study. Participants completed an interview examining their medical and ophthalmic history Information was collected on the participants' uncorrected and best corrected vision scores, slit lamp examination results, angle width measurements using the Van Herick technique, gonioscopy if the angle width was less than 1 / 4 angle, intraocular pressure (IOP) assessed with the Goldmann applanation tonometry, optic disc examination results, and a visual field test results using frequency-doubling perimetry in cases in which glaucoma was suspected. Glaucoma was diagnosed according to the criteria described by the International Society for Geographic and Epidemiological Ophthalmology. 1,118 residents aged greater than 50 years were examined initially from a population of 2,984 people. Of these, 671 subjects (60%) participated in this study. The prevalence of glaucoma was determined to be 3.4% (95% confidence interval [CI], 2.1-4.8). Open-angle glaucoma with low IOP was determined to be the most common form with a prevalence rate as high as 2.5% (95% CI, 1.8-3.7). Additionally, primary angle closure glaucoma was determined to have a prevalence rate of 0.3% (95% CI, 0.1-0.9). Open-angle glaucoma with low IOP accounted for 94.4% of the open-angle glaucoma cases. The prevalence of glaucoma among the population of rural Sangju was 3.4%, and open-angle glaucoma with low IOP was the most common form accounting for 94.4% of the total number of cases.
    Korean Journal of Ophthalmology 04/2011; 25(2):110-5. DOI:10.3341/kjo.2011.25.2.110
  • Na Rae Kim · Chan Yun Kim · Hyunjoong Kim · Gong Je Seong · Eun Suk Lee ·
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    ABSTRACT: To compare intraocular pressure (IOP) measurements by Goldmann applanation tonometer (GAT), noncontact tonometer (NCT), and TonoPen XL in glaucomatous, ocular hypertensive (OHT), and normal eyes, all with various central corneal thickness (CCT). In 508 subjects, IOP was measured by three different tonometers: GAT, NCT, and TonoPen. CCT was also measured. There was a statistically significant difference between IOP measurements made using the three different tonometers (RMANOVA, P < 0.0001). Both NCT/GAT and TonoPen/GAT differences were significantly associated with age, CCT, IOP, and glaucoma diagnosis (multiple regression analysis, all P ≤ 0.05). CCT and IOP had the greatest effect on IOP measurement variance by different tonometers. IOP measurements made by NCT were consistently higher than those made by GAT; this difference increased both with IOP and CCT levels, but decreased with age and OHT. In addition, TonoPen overestimated the GAT in the eyes of subjects with OHT. IOP measurement differences between the three tonometers are affected by age, type of glaucoma, and especially CCT and IOP levels.
    Current eye research 02/2011; 36(4):295-300. DOI:10.3109/02713683.2010.542865 · 1.64 Impact Factor
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    ABSTRACT: To determine the effects of age, sex, spherical equivalent, axial length, anterior chamber depth, optic disc area, and central corneal thickness on perimacular inner retinal layer thickness in the normal human eye as measured by Fourier-domain optical coherence tomography (FD-OCT). In this cross-sectional observational study, 182 Korean healthy subjects aged from 22 to 84 years were included. To obtain the inner retinal layer thickness, perimacular ganglion cell complex thickness, which extends from the internal limiting membrane to the inner nuclear layer, was measured by FD-OCT on one randomly selected eye of each subject. Linear regression analyses of the effects of demographic and clinical variables, including age, sex, spherical equivalent, axial length, anterior chamber depth, optic disc area, and central corneal thickness, on perimacular inner retinal layer thickness were performed. The mean inner retinal layer thickness for the entire population was 93.87 μm. Thinner inner retinal layer measurements were associated with older age (P = 0.010) and greater axial length (P = 0.021). Mean inner retinal layer thickness decreased by approximately 1.59 μm for every decade of age and by approximately 1.56 μm for every 1-mm greater axial length. There was no relationship between inner retinal layer thickness and sex, anterior chamber depth, optic disc area, or central corneal thickness. Inner retinal layer thickness, as measured by FD-OCT, varies significantly with age and axial length. The effect is small but clinically relevant in the interpretation of inner retinal layer thickness measurements.
    Investigative ophthalmology & visual science 02/2011; 52(6):3413-8. DOI:10.1167/iovs.10-6648 · 3.40 Impact Factor
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    ABSTRACT: To assess and compare the influence of cataract on measurements of retinal nerve fiber layer (RNFL) thickness by time domain (TD) optical coherence tomography (OCT) and spectral domain (SD) OCT. Patients who underwent uncomplicated cataract surgery were consecutively enrolled in this study. The peripapillary RNFL thickness was measured before and 8 weeks after cataract surgery using TD-OCT and SD-OCT during the same visit. Changes in the RNFL thickness measurement and signal strength (SS) after cataract surgery were evaluated. A total of 54 patients (54 eyes) were included. After excluding 19 eyes owing to poor imaging or low SS (<5), scans of 35 eyes were included in the final analysis. A significant difference was identified between the preoperative and postoperative SS values using SD-OCT, but not TD-OCT (P=0.002 and 0.789, respectively). The changes in RNFL thickness after cataract surgery were more prominent and frequent for SD-OCT than TD-OCT. There was a significant correlation between change in preoperative RNFL thickness and SS changes for both TD-OCT (r=0.410, P<0.001) and SD-OCT (r=0.246, P=0.002). The presence of cataract significantly affects RNFL thickness measurements by SD-OCT and TD-OCT. SD-OCT, which demonstrated more consistent change of RNFL measurements after cataract extraction, is not necessarily associated with lower RNFL thickness measurement performance in cataract cases, as more participants with cataract were excluded because of poor image quality or low SS, which was more associated with TD-OCT than SD-OCT.
    Journal of glaucoma 12/2010; 21(2):116-22. DOI:10.1097/IJG.0b013e31820277da · 2.11 Impact Factor
  • Eun Suk Lee · Na Rae Kim · Gong Je Seong · Samin Hong · Chan Yun Kim ·
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    ABSTRACT: To assess the effect of signal strength (SS) on concordance rate or agreement on retinal nerve fiber layer (RNFL) thickness measurement (measurement agreement) and its color code classification (classification agreement) between Stratus optical coherence tomography (OCT) and Cirrus OCT. From 300 participants who underwent both Stratus and Cirrus OCT scans at the same visit (SS ≥ 6), intraclass correlation and weighted κ coefficients were calculated as indicators for RNFL measurement agreement and classification agreement between 2 OCTs. In inferior and superior quadrants, agreements were excellent (intraclass correlation) or good (κ) and neither the measurement nor the classification agreement was statistically different between participants grouped by SS difference between Stratus and Cirrus OCTs (inter-OCT SS difference). In nasal and temporal quadrants, agreements were low and there were groups with inter-OCT SS difference whose classification agreement between 2 OCTs was not better than the chance (κ=0). When comparing RNFL thickness estimated by Cirrus OCT with that measured by Stratus OCT in temporal and nasal quadrants, special attention should be given, as the agreements or concordance rate was low, suggesting that neither the measured value nor its probability algorithm classification would be interchangeable. In inferior and superior quadrants, agreements were good or excellent and not affected by SS difference as long as SS ≥ 6.
    Journal of glaucoma 11/2010; 20(6):371-6. DOI:10.1097/IJG.0b013e3181efb3a7 · 2.11 Impact Factor
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    ABSTRACT: To evaluate and compare time-domain (Stratus) and spectral-domain (Cirrus; both Carl Zeiss Meditec, Dublin, California) optical coherence tomography (OCT) for the detection of localized retinal nerve fiber layer (RNFL) defects in patients with open-angle glaucoma. Patients with localized RNFL defects and age-matched normal control participants were consecutively enrolled from July 1 to December 31, 2008. Sixty-six eyes from 66 patients and 66 eyes from 66 normal controls were imaged with Stratus OCT (fast RNFL scan mode) and Cirrus OCT (optic disc cube mode). The ability to detect the RNFL defect by using quadrant clock-hour maps from both OCTs and a Cirrus OCT deviation map were compared with red-free RNFL photography, which is the criterion standard for visualizing RNFL defects. The Cirrus OCT deviation map exhibited significantly higher overall sensitivity (92.42%) in detecting the RNFL defects compared with the other maps, which were derived from a 3.46-mm-diameter peripapillary cross-sectional RNFL scan of both OCTs (P < .001). The Cirrus OCT quadrant map had a higher specificity; however, it was not statistically significant (P = .07). Compared with the other maps, the Cirrus OCT derivation map had the lowest cutoff angle for the width (10.69°) of the RNFL defect. The deviation map from Cirrus OCT was more sensitive in detecting RNFL defects than the clock-hour and quadrant maps derived from cross-sectional peripapillary RNFL measurements by Stratus and Cirrus OCTs. The ability to detect localized RNFL defects on clock-hour or quadrant RNFL maps did not significantly differ between Stratus OCT and Cirrus OCT.
    Archives of ophthalmology 09/2010; 128(9):1121-8. DOI:10.1001/archophthalmol.2010.204 · 4.40 Impact Factor
  • Eun Suk Lee · Hyunjoong Kim · Joon Mo Kim ·
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    ABSTRACT: To assess the effect of signal strength (SS) on reproducibility of peripapillary retinal nerve fiber layer (RNFL) thickness measurement (measurement agreement) and its color-coded classification (classification agreement) by time-domain optical coherence tomography (OCT). Two consecutive Stratus OCT scans with the Fast RNFL protocol were performed in 658 participants. Intraclass correlations and the linear-weighted kappa coefficient were calculated as indicators of RNFL measurement and classification agreement in participants grouped according to the difference in SS between consecutive OCT scans (interscan SS difference). Groups with a larger interscan SS difference (= 2) had lower measurement agreement than those with a smaller interscan SS difference (0 or 1) for the temporal quadrant and total average RNFL. Classification agreement for the nasal quadrant was lower in the groups with a larger interscan SS difference (= 2) than in those with a smaller interscan SS difference. The tendency of SS to affect classification and measurement agreement remained similar in the group with thinner RNFL thickness (≤85 μm), but not in the group with thicker RNFL. Careful attention should be paid when comparing two or more OCT scans for RNFL thickness measurement or its color-coded classification as the agreement may be sensitive to SS differences.
    Japanese Journal of Ophthalmology 09/2010; 54(5):414-22. DOI:10.1007/s10384-010-0850-9 · 1.68 Impact Factor
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    ABSTRACT: To assess the relationship between visual function and macular ganglion cell complex (GCC) thickness measured by Fourier-domain optical coherence tomography (OCT) and to evaluate the diagnostic value of GCC thickness for detecting early, moderate, and severe glaucoma. Participants underwent reliable standard automated perimetry testing and OCT imaging with optic nerve head (ONH) mode and GCC mode within a single day. The relationship between structure and function was evaluated by comparing GCC thickness with mean deviation (MD) and visual field index (VFI), by regression analysis. The results were compared with those obtained for retinal nerve fiber layer (RNFL) thickness. The area under the receiver operating characteristic curve (AUC) was used to determine the relationship between disease severity and glaucomatous changes in RNFL and GCC parameters. One hundred three normal control subjects and 138 patients with glaucoma were included in the present study. Compared with linear models, second-order polynomial models better described the relationships between GCC thickness and MD (P<0.001), and between GCC thickness and VFI (P<0.001). A GCC pattern parameter, global loss volume (GLV), had the highest AUC for detecting early glaucoma. The AUC of mean GCC thickness for early glaucoma was higher than that of mean RNFL; however, the difference was not significant (P=0.330). A curvilinear function best described the relationship between VF sensitivity and GCC thickness. Macular GCC thickness and RNFL thickness showed similar diagnostic performance for detecting early, moderate, and severe glaucoma.
    Investigative ophthalmology & visual science 04/2010; 51(9):4646-51. DOI:10.1167/iovs.09-5053 · 3.40 Impact Factor
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    ABSTRACT: To assess the relationship between macular retinal thickness and volume and age, sex, and refractive error/axial length with spectral domain-optical coherence tomography (SD-OCT). One randomly selected eye of 198 consecutive ophthalmically normal subjects (104 men, 94 women) between July 2008 and January 2009, with corrected visual acuities better than 20/30 were included in this cross-sectional study. Complete ophthalmic examination, axial length measurement with a laser interferometer, and macular cube 512 x 128 scan by SD-OCT were performed. The mean age was 55.6 +/- 16.4 years (range, 17-83), average refractive error was -2.17 +/- 4.82 (range, -23.50-3.75), and average axial length was 24.73 +/- 1.98 mm (range, 21.52-32.51). The central subfield thickness, average inner macular thickness, and overall macular volume were significantly lower in the female subjects (partial correlation: P = 0.009, P = 0.027, and P = 0.042, respectively). As age increased, average inner macular thickness, average outer macular thickness, overall average macular thickness, and macular volume decreased significantly (partial correlation: P = 0.002, P = 0.002, P = 0.002, and P = 0.000, respectively). Refractive error had no significant influence in partial correlation analysis. Axial length correlated negatively with average outer macular thickness, overall average macular thickness, and macular volume (partial correlation: P = 0.006, P = 0.044, and P = 0.003, respectively). In normal subjects, SD-OCT showed that retinal thickness is related to age, sex, and axial length, with regional variations.
    Investigative ophthalmology & visual science 03/2010; 51(8):3913-8. DOI:10.1167/iovs.09-4189 · 3.40 Impact Factor

Publication Stats

520 Citations
74.21 Total Impact Points


  • 2012
    • Jeju National University
      • Department of Chemistry
      Tse-tsiu, Jeju, South Korea
  • 2005-2012
    • Yonsei University
      • • The Institute of Vision Research
      • • Department of Ophthalmology
      Sŏul, Seoul, South Korea
    • Inha University Hospital
      Sinhyeon, Gyeongsangnam-do, South Korea
  • 2011
    • Wonju Severance Christian Hospital
      Genshū, Gangwon-do, South Korea
  • 2002-2011
    • Yonsei University Hospital
      • Department of Internal Medicine
      Sŏul, Seoul, South Korea
  • 2007
    • Seoul National University
      • School of Mechanical and Aerospace Engineering
      Sŏul, Seoul, South Korea
  • 2006
    • Emory University
      • Department of Ophthalmology
      Atlanta, Georgia, United States