Tae Wan Kim has completed his Ph.D. from Seoul National University and studied molecular imaging at Stanford University School of Medicine as a visiting professor. He is the Director of retina department in Seoul Metropolitan Government-Seoul National University Boramae Medical Center. He has published more than 30 papers in reputed journals and presented more than 45 papers and invited lectures in reputed conferences. In addition, he has written 4 book chapters of reputed textbooks.
Multiple system atrophy (MSA) is a rapidly progressive neurodegenerative disorder relegating patients to total dependency within several years. We explored retinal thickness changes in multiple system atrophy (MSA) patients according to disease severity and subtypes of MSA. A total of 36 MSA (27 MSA-P and 9 MSA-C) patients and 71 control subjects underwent general ophthalmologic examination and optical coherence tomography (OCT) scans. Peripapillary retinal nerve fiber layer (RNFL) thickness and perifoveal retinal thickness were analyzed separately. MSA patients showed significantly decreased superior, inferior, superotemporal and inferotemporal RNFL thickness and showed significant perifoveal thinning in the superior and inferior outer sectors compared to control. Both the RNFL and perifoveal thinning were more marked and widespread in MSA-P than MSA-C patients. The UMSARS scores and the GDS showed a consistent and significant negative correlation with perifoveal thickness. In conclusion, peripapillary RNFL and perifoveal retinal thinning is observed in MSA, which may reflect the degree and pattern of neurodegeneration occurring in MSA.
Daljit Singh has completed his MBBS (1956), MS (1963), DSc (1992) from Punjab and GND University. He has 28 years experience in Medical College faculty in Pharmacology, Physiology and Ophthalmology. He was Professor Emeritus since 1986 and Director of Daljit Eye Hospital, Amritsar since 1985. He introduced first IOL in India (1976), Iris claw lens since 1979 (over 140,000 implants), over 3000 kerato-prosthesis, Found 9 new genes of congenital cataract working with GND University. He was the first user of Fugo Plasma Blade (1999) and developed 3 minute “Transcilary filtration” and “Microtrack filtration” operations for glaucoma. He has written three ophthalmology specialty books and five literary books. He is involved in searching corneal and conjunctival lymphatics since 2000.
Background: In 1999, I injected lignocaine at 10 O’ clock of limbus and accidentally saw a channel swell up at 2 O’ clock. That is a lymphatic, I exclaimed. The search started using slit lamp microscope. High definition film/digital photography gave quality images that brought out the lymphatics in great detail.rnrnOutpatients: Any sub-conjunctival haemorrhage enters lymphatics. Even transparent lymphatics are visible if one is aware. Pigment around limbus better defines lymphatics. Beautiful patterns were recorded. One megalocornea showed a central network of channels. Channels were also seen in arcus senilis. In one case channels covered whole cornea. One case had very sharp arcus senilis with prominent lucid interval. Sharp holes (representing cornel channels) in multiple layers opened in lucid interval. Optical section showed connections between lucid interval canal of Singh and corneal channels. OCT studies reconfirmed slit-lamp findings. OCT showed communication between Schlemm and Singh canals.rnrnOperation Theatre Findings: Trypan blue dye injected at the limbus filled conjunctival lymphatics. Twisting limbal conjunctiva highlighted lymphatics. Blunt wire and fine cannula were introduced in lucid interval canal of Singh.rnrnHow Fluid Moves: From the anterior chamber through Schlemm and aqueducts to Singh canal from where it nourishes the cornea, a part is drained to the conjunctival lymphatics. Every point has been proved with photographs.rnrnSuggestion: The lymphatics of the anterior segment act as flood drains after glaucoma surgery. The chances of success are increased if lymphatics are preserved.rn