26
|
Mine I, Shoji T, Kumagai T, Yoshikawa Y, Kosaka A, Shinoda K. Central Visual Field Sensitivity With and Without Background Light Given to the Nontested Fellow Eye in Glaucoma Patients. J Glaucoma 2021; 30:537-544. [PMID: 33350657 DOI: 10.1097/ijg.0000000000001764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 11/21/2020] [Indexed: 11/25/2022]
Abstract
PRECIS This study showed the difference of monocular visual sensitivity between with and without background light given to the nontested fellow eyes in glaucoma patients. Monocular sensitivity measurements of the worse eyes with fellow eye's background light conditions should carefully be considered when assessing the impact of functional impairment in glaucoma patients. PURPOSE The purpose of this study was to investigate the difference between monocular sensitivities measured with and without background light given to the nontested fellow eye in glaucoma patients using a new perimeter named "imo." METHODS In this cross-sectional study, we examined 102 eyes of 51 patients (mean age, 65.1±14.9 y) with open-angle glaucoma who were affected with at least 1 significant point in the central 10 degrees. We conducted a routine ophthalmic examination and visual field testing using the Humphrey Field Analyzer 24-2 and 10-2 programs. The eyes were assigned to "better" and "worse" categories based on the visual acuity and central visual thresholding. Subsequently, we compared the central visual sensitivities with and without background light given to the nontested fellow eye. RESULTS The mean sensitivity (MS) in the central 5 points of the visual field of the worse eyes was better when measured with background light than without background light (P=0.037) given to the nontested fellow eye. No significant difference was seen among the MS in the visual field of the better eyes. After dividing the patients into low (n=25) and high sensitivity (n=26) groups, only the low sensitivity group in worse eyes had higher MS with background light than without background light (P<0.05) given to the nontested fellow eye. CONCLUSIONS Monocular sensitivities measured with background light given to the nontested fellow eye were higher than those without background light in the worse eye group of glaucoma patients. Monocular MS measurements of the worse eyes with fellow eye's background light conditions and their related indices should thus carefully be considered when assessing the impact of functional impairment in glaucoma patients.
Collapse
|
27
|
Ozawa H, Ueno S, Ohno-Tanaka A, Sakai T, Hashiguchi M, Shimizu M, Fujinami K, Ahn SJ, Kondo M, Browning DJ, Shinoda K, Yokogawa N. Ocular findings in Japanese patients with hydroxychloroquine retinopathy developing within 3 years of treatment. Jpn J Ophthalmol 2021; 65:472-481. [PMID: 34014447 DOI: 10.1007/s10384-021-00841-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 03/26/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE To describe the characteristics of Japanese patients with hydroxychloroquine (HCQ) retinopathy developing within 3 years of treatment outset. STUDY DESIGN Retrospective case series METHODS: Three patients with HCQ retinopathy developing within 3 years of treatment outset have been identified in Japan since HCQ became available in 2015. Their medical charts, containing optical coherence tomography (OCT), fundus autofluorescence imaging, and visual field tests, were reviewed. RESULTS The treatment durations and cumulative doses until onset were 29-36 months and 182-326 g, respectively. The first patient had possible pre-existing maculopathy, although the abnormalities were ambiguous. The second and third patients had impaired renal function. The patients did not complain of severe visual disturbance at diagnosis, but visual field loss and disruption of the outer retinal segments consisting of a parafoveal pattern in the first case and a pericentral pattern (localized, 8 or more degrees from the center of the fovea) in the second and third cases were clearly observed on OCT. Even after HCQ discontinuation, their retinopathy showed slight progression on the visual field tests and OCT images. A blood sample was obtained from 1 patient on the day after HCQ discontinuation, and the whole blood level of HCQ was measured using validated liquid chromatography-tandem mass spectrometry. The HCQ level 27 h after the last dose was high, at 2240 ng/mL (suggested threshold > 1733 ng/mL). CONCLUSION Ophthalmologic screening from the initiation of HCQ treatment detected 3 cases of HCQ retinopathy developing within 3 years of treatment outset, including a patient with a high blood level of HCQ.
Collapse
|
28
|
Matsushima T, Yoshikawa Y, Shimura A, Yajima A, Ojima Y, Shinoda K. Electrophysiological Monitoring of Focal and Entire Retinal Function during Treatment with Intravitreal Methotrexate for Intraocular Lymphoma. Case Rep Ophthalmol 2021; 12:277-282. [PMID: 34054470 PMCID: PMC8138215 DOI: 10.1159/000514189] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 01/03/2021] [Indexed: 11/19/2022] Open
Abstract
We describe the electroretinographic findings of a case of primary intraocular lymphoma (PIOL) wherein the patient received intravitreal injections of methotrexate (ivMTX). A 62-year-old man developed blurred vision and complained of decreased visual acuity (VA) in his right eye. Fundus examination showed vitreous opacity and multiple subretinal yellowish lesions. Optical coherence tomography (OCT) revealed subretinal and intraretinal infiltrations. The full-field electroretinogram (ffERG) showed subnormal combined rod-cone response and multifocal electroretinogram (mfERG) recorded using skin electrodes showed severe attenuation of the response compared with the other eye. Pars prana vitrectomy, phacoemulsification, and lens implantation were performed to remove the opacity, and vitreous biopsy revealed a high ratio of interleukin 10–6 (76.0). There was no systemic malignant lesion, and the patient was diagnosed with PIOL. Treatment with ivMTX (400 μg/0.1 mL) was started. One month later, the intraretinal infiltration had disappeared, and mfERG revealed recovery of the response density from the central area. Two months later, OCT showed recovery of the foveal ellipsoid and interdigitation zones, and VA recovered to 20/17; mfERG showed maintenance of macular function. However, the amplitude of a- and b-waves in the ffERG gradually decreased. Macular function recovered, but there was also a decrease in total retinal function. mfERG and ffERG recorded using skin electrodes were useful in monitoring macular and entire retinal function with repeated examinations and showed recovery and maintenance of macular function in a case of PIOL treated with ivMTX.
Collapse
|
29
|
Fujita K, Imamura Y, Shinoda K, Matsumoto S, Yuzawa M. Fundus Autofluorescence after Half-Dose Photodynamic Therapy for Chronic Central Serous Chorioretinopathy. Biomed Hub 2021; 6:1-5. [PMID: 33564669 DOI: 10.1159/000512662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 10/29/2020] [Indexed: 11/19/2022] Open
Abstract
Introduction To evaluate the fundus autofluorescence (FAF) images 1 year after half-dose photodynamic therapy (hdPDT) for chronic central serous chorioretinopathy (CSC). Methods Forty-six eyes of 46 consecutive patients with chronic CSC underwent hdPDT. Short wavelength-elicited FAF images and enhanced depth imaging optical coherence tomographic (EDI-OCT) images were recorded before and at 1, 3, 6, 9, and 12 months after the hdPDT. The FAF images at 1 month were compared to those at 12 months after the hdPDT. Results The serous retinal detachment (SRD) was resolved in all eyes. The best-corrected visual acuity (BCVA) improved significantly from 0.13 ± 0.28 logarithm of minimum angle of resolution (logMAR) units before to 0.01 ± 0.17 logMAR units at 12 months after the hdPDT (p = 0.001; paired t test). The mean choroidal thickness decreased significantly from 365.4 ± 103.0 µm to 284.3 ± 92.5 µm at 12 months (p < 0.001). Abnormal FAF images were present within the irradiated area in all the eyes before the hdPDT. In 5 of 46 eyes, identifiable changes of the FAF images were observed 12 months after hdPDT. None of the eyes had the confluent hypo-FAF type during the follow-up period. Univariate analyses showed that the choroidal thickness before hdPDT correlated significantly with hypo-FAF enlargement (p = 0.005). However, multivariate analyses showed that the association was not significant (p = 0.06). Conclusions The progression of the RPE damages occurred in approximately one-tenth of the eyes that underwent hdPDT for chronic CSC. The long-term effect of progression of hypo-FAF on visual functions remains to be determined.
Collapse
|
30
|
Yokogawa N, Ohno-Tanaka A, Hashiguchi M, Shimizu M, Ozawa H, Ueno S, Shinoda K, Browning DJ. Early-Onset Hydroxychloroquine Retinopathy and a Possible Relationship to Blood Levels: Comment on the Article by Petri et al. Arthritis Rheumatol 2021; 73:358-359. [PMID: 32856370 DOI: 10.1002/art.41497] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 08/10/2020] [Indexed: 11/11/2022]
|
31
|
Fujita K, Shinoda K, Imamura Y, Matsumoto CS, Oda K. Improvement of Low Luminance Visual Acuity in Patients with Chronic Central Serous Chorioretinopathy after Half-Dose Verteporfin Photodynamic Therapy. J Clin Med 2020; 9:E3980. [PMID: 33316889 PMCID: PMC7764769 DOI: 10.3390/jcm9123980] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 11/18/2020] [Accepted: 12/07/2020] [Indexed: 11/20/2022] Open
Abstract
Patients with central serous chorioretinopathy (CSC) often complain of visual difficulties under low luminance conditions. In this study, we evaluated low luminance visual acuity (LLVA) after half-dose verteporfin photodynamic therapy (hdPDT) in eyes with CSC. The study included eight eyes of eight patients with chronic CSC that underwent hdPDT. The best-corrected visual acuity, LLVA and optical coherence tomography (OCT) findings were evaluated at baseline, and at 1, 3, 6, 9, and 12 months after hdPDT. LLVA was measured at six levels of background luminance. Serous retinal detachment was completely resolved in all eyes. Although the mean LLVA at 1 month did not improve significantly compared to baseline at all luminance levels, significant improvements were observed at 3, 6, 9, and 12 months (p < 0.05). In OCT images, although the ellipsoid zone was not detectable in all eyes before hdPDT, it was observed in 2 eyes at 1 month, in 7 eyes at 3 months, and in all eyes from 6 months. The LLVA and the ellipsoid zone improved similarly with postoperative time courses. In conclusion, hdPDT improves LLVA in eyes with chronic CSC. The recovery of the ellipsoid zone may play a part in improving LLVA after hdPDT.
Collapse
|
32
|
Shibuya M, Yoshikawa Y, Katsumoto T, Shoji T, Kondo H, Miyakoshi H, Shinoda K. Author Correction: Electroretinographic recordings with skin electrodes to assess effects of vitrectomy with gas tamponade on eyes with rhegmatogenous retinal detachment. Sci Rep 2020; 10:4539. [PMID: 32139782 PMCID: PMC7058605 DOI: 10.1038/s41598-020-61545-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
33
|
Ozaki K, Yoshikawa Y, Ishikawa S, Katsumoto T, Shibuya M, Shoji T, Kondo H, Matsumoto S, Shinoda K. Correction: Electroretinograms recorded with skin electrodes in silicone oil-filled eyes. PLoS One 2020; 15:e0242757. [PMID: 33201921 PMCID: PMC7671554 DOI: 10.1371/journal.pone.0242757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
|
34
|
Shoji T, Kanno J, Weinreb RN, Yoshikawa Y, Mine I, Ishii H, Ibuki H, Shinoda K. OCT angiography measured changes in the foveal avascular zone area after glaucoma surgery. Br J Ophthalmol 2020; 106:80-86. [PMID: 33153992 PMCID: PMC8685609 DOI: 10.1136/bjophthalmol-2020-317038] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 09/10/2020] [Accepted: 10/03/2020] [Indexed: 01/10/2023]
Abstract
Background/Aims To evaluate quantitative changes in the foveal avascular zone (FAZ) area after glaucoma surgery using swept-source optical coherence tomography angiography (SS-OCTA). Methods Fifty-four consecutive patients with primary open-angle glaucoma (POAG) who met the inclusion criteria and underwent unilateral glaucoma surgery to reduce intraocular pressure (IOP) between April 2018 and July 2019. Eyes underwent IOP-lowering glaucoma surgery and their fellow (non-surgical) eyes were included. OCTA of the macula was performed in both eyes before glaucoma surgery and 3 months postoperatively. Two blinded examiners reviewed the image quality. Within- and between-group comparisons of the FAZ area and correlation of the FAZ area with age, IOP, central sensitivity and clinical variables. Results The mean (±SD) age was 66.7±11.3 years. After surgery, the IOP and FAZ area significantly decreased from 22.1±9.5 mmHg to 10.3±3.5 mmHg and from 0.485±0.193 mm2 to 0.446±0.174 mm2, respectively (both p<0.001). Conversely, in the non-surgery group, the preoperative and postoperative mean FAZ areas (0.398±0.119 mm2 and 0.396±0.110 mm2, respectively) did not significantly differ (p=0.469). Change in the FAZ area significantly correlated with the preoperative FAZ area, preoperative foveal sensitivity and change in IOP (all p<0.05). Conclusions The FAZ area is decreased with IOP-lowering surgery in patients with POAG, and change in the FAZ area was significantly correlated with both preoperative foveal sensitivity and change in IOP.
Collapse
|
35
|
Kumagai T, Shoji T, Yoshikawa Y, Mine I, Kanno J, Ishii H, Saito A, Ishikawa S, Kimura I, Shinoda K. Comparison of central visual sensitivity between monocular and binocular testing in advanced glaucoma patients using imo perimetry. Br J Ophthalmol 2020; 104:1258-1534. [PMID: 32152139 PMCID: PMC7587224 DOI: 10.1136/bjophthalmol-2019-315251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 01/24/2020] [Accepted: 02/03/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND/AIM This study aimed to compare central visual sensitivity under monocular and binocular conditions in patients with glaucoma using the new imo static perimetry. METHODS Fifty-one consecutive eyes of 51 patients with open-angle glaucoma who were affected with at least one significant point in the central 10° were examined in this cross-sectional study. Monocular and binocular random single-eye tests were performed using the imo perimeter and the Humphrey field analyser (HFA) 24-2 and 10-2 tests. The eyes were assigned to 'better' and 'worse' categories based on the visual acuity and central visual thresholding. Central visual sensitivity results obtained by monocular, binocular random single-eye tests and binocular simultaneous both eye test were compared. RESULTS The average mean deviation with the HFA 24-2 was -5.5 (-1.5, -14.6) dB (median, (IQR)) in the better eyes and -18.0 (-12.9, -23.8) dB in the worse eyes. The mean sensitivity in the central 4 points of the visual field (VF) of the worse eyes was lower when measured under the binocular eye condition than under the monocular condition. Conversely, this value of the better eyes was greater when measured under the binocular eye condition than under the monocular condition. CONCLUSIONS The central sensitivity of the better eyes was better and that of the worse eyes poorer with binocular testing than with monocular testing in patients with glaucoma. Although monocular VF testing is still the most straightforward means to monocularly monitor glaucoma at clinical settings, binocular testing, such as provided with imo perimetry, may be a useful clinical tool to predict the effect of VF impairments on a patient's quality of visual life.
Collapse
|
36
|
Fujinami K, Liu X, Ueno S, Mizota A, Shinoda K, Kuniyoshi K, Fujinami-Yokokawa Y, Yang L, Arno G, Pontikos N, Kameya S, Kominami T, Terasaki H, Sakuramoto H, Nakamura N, Kurihara T, Tsubota K, Miyake Y, Yoshiake K, Iwata T, Tsunoda K. RP2-associated retinal disorder in a Japanese cohort: Report of novel variants and a literature review, identifying a genotype-phenotype association. AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2020; 184:675-693. [PMID: 32875684 DOI: 10.1002/ajmg.c.31830] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 07/28/2020] [Accepted: 07/28/2020] [Indexed: 01/10/2023]
Abstract
The retinitis pigmentosa 2 (RP2) gene is one of the causative genes for X-linked inherited retinal disorder. We characterized the clinical/genetic features of four patients with RP2-associated retinal disorder (RP2-RD) from four Japanese families in a nationwide cohort. A systematic review of RP2-RD in the Japanese population was also performed. All four patients were clinically diagnosed with retinitis pigmentosa (RP). The mean age at examination was 36.5 (10-47) years, and the mean visual acuity in the right/left eye was 1.40 (0.52-2.0)/1.10 (0.52-1.7) in the logarithm of the minimum angle of resolution unit, respectively. Three patients showed extensive retinal atrophy with macular involvement, and one had central retinal atrophy. Four RP2 variants were identified, including two novel missense (p.Ser6Phe, p.Leu189Pro) and two previously reported truncating variants (p.Arg120Ter, p.Glu269CysfsTer3). The phenotypes of two patients with truncating variants were more severe than the phenotypes of two patients with missense variants. A systematic review revealed additional 11 variants, including three missense and eight deleterious (null) variants, and a statistically significant association between phenotype severity and genotype severity was revealed. The clinical and genetic spectrum of RP2-RD was illustrated in the Japanese population, identifying the characteristic features of a severe form of RP with early macular involvement.
Collapse
|
37
|
Fujinami K, Oishi A, Yang L, Arno G, Pontikos N, Yoshitake K, Fujinami-Yokokawa Y, Liu X, Hayashi T, Katagiri S, Mizobuchi K, Mizota A, Shinoda K, Nakamura N, Kurihara T, Tsubota K, Miyake Y, Iwata T, Tsujikawa A, Tsunoda K. Clinical and genetic characteristics of 10 Japanese patients with PROM1-associated retinal disorder: A report of the phenotype spectrum and a literature review in the Japanese population. AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2020; 184:656-674. [PMID: 32820593 DOI: 10.1002/ajmg.c.31826] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 07/26/2020] [Accepted: 07/27/2020] [Indexed: 01/14/2023]
Abstract
Variants in the PROM1 gene are associated with cone (-rod) dystrophy, macular dystrophy, and other phenotypes. We describe the clinical and genetic characteristics of 10 patients from eight Japanese families with PROM1-associated retinal disorder (PROM1-RD) in a nationwide cohort. A literature review of PROM1-RD in the Japanese population was also performed. The median age at onset/examination of 10 patients was 31.0 (range, 10-45)/44.5 (22-73) years. All 10 patients showed atrophic macular changes. Seven patients (70.0%) had spared fovea to various degrees, approximately half of whom had maintained visual acuity. Generalized cone (-rod) dysfunction was demonstrated in all nine subjects with available electrophysiological data. Three PROM1 variants were identified in this study: one recurrent disease-causing variant (p.Arg373Cys), one novel putative disease-causing variant (p.Cys112Arg), and one novel variant of uncertain significance (VUS; p.Gly53Asp). Characteristic features of macular atrophy with generalized cone-dominated retinal dysfunction were shared among all 10 subjects with PROM1-RD, and the presence of foveal sparing was crucial in maintaining visual acuity. Together with the three previously reported variants [p.R373C, c.1551+1G>A (pathogenic), p.Asn580His (likely benign)] in the literature of Japanese patients, one prevalent missense variant (p.Arg373Cys, 6/9 families, 66.7%) detected in multiple studies was determined in the Japanese population, which was also frequently detected in the European population.
Collapse
|
38
|
Kitsu K, Shinoda K, Mizuno Y, Yagura K, Terauchi G, Matsumoto CS, Ochi M, Mizota A. Effect of Paracentesis on Retinal Function Associated With Changes in Intraocular Pressure Caused by Intravitreal Injections. Transl Vis Sci Technol 2020; 9:10. [PMID: 32879766 PMCID: PMC7442866 DOI: 10.1167/tvst.9.9.10] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 07/02/2020] [Indexed: 11/24/2022] Open
Abstract
Purpose Intravitreal injections of antivascular endothelial growth factor agents are widely performed, and subsequent intraocular pressure increase may cause retinal nerve fiber damage. This study aimed to determine the effects of paracentesis before intravitreal injection of an antivascular endothelial growth factor on electroretinograms. Methods This was a retrospective observational study in a university hospital. Twenty-five eyes of 25 patients who underwent intravitreal injections of antivascular endothelial growth factor agents were selected for evaluation. Intraocular pressures and electroretinograms were recorded before surgery (baseline), after anterior chamber paracentesis, and after intravitreal injection. The amplitudes and latencies of the a- and b-waves, photopic negative response, and oscillatory potential were measured. Changes in each component of the electroretinograms, intraocular pressure, and relationships between these two factors were investigated. The preoperative and postoperative ocular perfusion pressure was calculated based on blood pressure. Results The amplitudes of the b-waves were significantly smaller after intravitreal injection than at baseline (P = 0.02), while no significant change was found in the other components during surgery. There were no significant changes in the latencies of any component during surgery. The intraocular pressure was significantly lower (P < 0.001) after anterior chamber paracentesis (6.8 ± 4.3 mm Hg) compared to baseline (24.1 ± 8.1 mm Hg) or after intravitreal injection (17.1 ± 9.6 mm Hg; P < 0.001). Conclusions Performing anterior chamber paracentesis before an intravitreal injection can prevent the intraocular pressure elevation and thus minimize the electrophysiological retinal dysfunction. Translational Relevance Anterior chamber paracentesis before an intravitreal injection mitigates the adverse effects on retinal function.
Collapse
|
39
|
Suda M, Yoshikawa Y, Terauchi G, Matsumoto S, Shoji T, Shinoda K, Mizota A, Kobayashi Y. Magnification Effect of Foveal Avascular Zone Measurement Using Optical Coherence Tomography Angiography. Biomed Hub 2020; 5:79-86. [PMID: 32775337 DOI: 10.1159/000507501] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 03/26/2020] [Indexed: 01/08/2023] Open
Abstract
Purpose The aim of this study was to evaluate the foveal avascular zone (FAZ) of healthy subjects and examine the magnification effect. Methods A total of 33 healthy volunteers were enrolled and all subjects were eligible for analysis. Optical coherence tomography angiography (OCTA) examination scanned 3 × 3 mm of the macular area. The FAZ area was measured on the superficial OCTA en face image with and without correction by axial length. The relationship between changes in the FAZ area after correction with the axial length was examined. Results The mean age was 21.9 ± 0.6 years. The mean axial length was 24.87 ± 1.17 mm and mean spherical equivalent (SE) value was -3.64 ± 2.83 diopters (D). The FAZ area was 0.26 ± 0.10 mm2 before the axial length correction and 0.27 ± 0.10 mm2 after the correction. In the eyes that had an axial length longer than or equal to 26 mm or SE less than or equal to -6 D, the FAZ area after correction was significantly larger than that before correction (p < 0.01). The change of FAZ area after correction with axial length was significantly correlated with the axial length (R 2 = 0.88, p < 0.01) or SE value (R 2 = 0.55, p < 0.01). Conclusion FAZ areas were comparable to previous reports. In high myopic cases, the magnification effect needs to be considered when evaluating the FAZ area.
Collapse
|
40
|
Fujinami-Yokokawa Y, Fujinami K, Kuniyoshi K, Hayashi T, Ueno S, Mizota A, Shinoda K, Arno G, Pontikos N, Yang L, Liu X, Sakuramoto H, Katagiri S, Mizobuchi K, Kominami T, Terasaki H, Nakamura N, Kameya S, Yoshitake K, Miyake Y, Kurihara T, Tsubota K, Miyata H, Iwata T, Tsunoda K. Clinical and Genetic Characteristics of 18 Patients from 13 Japanese Families with CRX-associated retinal disorder: Identification of Genotype-phenotype Association. Sci Rep 2020; 10:9531. [PMID: 32533067 PMCID: PMC7293272 DOI: 10.1038/s41598-020-65737-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 05/06/2020] [Indexed: 11/09/2022] Open
Abstract
Inherited retinal disorder (IRD) is a leading cause of blindness, and CRX is one of a number of genes reported to harbour autosomal dominant (AD) and recessive (AR) causative variants. Eighteen patients from 13 families with CRX-associated retinal disorder (CRX-RD) were identified from 730 Japanese families with IRD. Ophthalmological examinations and phenotype subgroup classification were performed. The median age of onset/latest examination was 45.0/62.5 years (range, 15-77/25-94). The median visual acuity in the right/left eye was 0.52/0.40 (range, -0.08-2.00/-0.18-1.70) logarithm of the minimum angle of resolution (LogMAR) units. There was one family with macular dystrophy, nine with cone-rod dystrophy (CORD), and three with retinitis pigmentosa. In silico analysis of CRX variants was conducted for genotype subgroup classification based on inheritance and the presence of truncating variants. Eight pathogenic CRX variants were identified, including three novel heterozygous variants (p.R43H, p.P145Lfs*42, and p.P197Afs*22). A trend of a genotype-phenotype association was revealed between the phenotype and genotype subgroups. A considerably high proportion of CRX-RD in ADCORD was determined in the Japanese cohort (39.1%), often showing the mild phenotype (CORD) with late-onset disease (sixth decade). Frequently found heterozygous missense variants located within the homeodomain underlie this mild phenotype. This large cohort study delineates the disease spectrum of CRX-RD in the Japanese population.
Collapse
|
41
|
Yoshikawa Y, Shoji T, Kanno J, Ibuki H, Weinreb RN, Araie M, Shinoda K. Glaucomatous vertical vessel density asymmetry of the temporal raphe detected with optical coherence tomography angiography. Sci Rep 2020; 10:6845. [PMID: 32322012 PMCID: PMC7176726 DOI: 10.1038/s41598-020-63931-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 04/08/2020] [Indexed: 11/21/2022] Open
Abstract
Changes in retinal vasculature and ocular circulation may play an important role in the glaucoma development and progression. We evaluated the vertical asymmetry across the temporal raphe of the deep retinal layer vessel density, using swept-source optical coherence tomography angiography (SS-OCTA), and its relationship with the central visual field (VF) loss. Thirty-four eyes of 27 patients with open-angle glaucoma were included. SS-OCTA macular scanning was performed within a 3 × 3 mm (300 × 300 pixels) volume, centred on the fovea. The relationships between the vertical asymmetrical deep retinal vessel density reduction (ADRVD) across the temporal raphe and various ocular parameters were analysed. Twenty-two glaucomatous eyes with ADRVDs had central VF loss. Contrarily, ADRVDs were not found in any of the 12 eyes without central VF loss. Thirteen eyes (59.1%) with central VF loss had ADRVDs topographically corresponding to the central VF loss and macular ganglion cell complex thinning. The glaucomatous eyes with ADRVDs exhibited inferior rather than superior central VF loss (P = 0.032). Thus, ADRVD specifically indicates the glaucomatous central visual loss. Further analysis of ADRVD may improve our understanding on glaucoma pathogenesis, offering new treatment insights.
Collapse
|
42
|
Shimada H, Kato K, Ishida K, Yamaguchi T, Shinoda K. Evaluation of Retinal Function and Pathology After Intravitreal Injection of Povidone-Iodine and Polyvinyl Alcohol-Iodine in Rabbits. Transl Vis Sci Technol 2020; 9:5. [PMID: 32821477 PMCID: PMC7401888 DOI: 10.1167/tvst.9.5.5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 01/11/2020] [Indexed: 01/24/2023] Open
Abstract
Purpose This study compared intraocular toxicity of intravitreally injected povidone-iodine (PI) and polyvinyl alcohol-iodine (PAI) in rabbits. Methods In each rabbit, 0.1 mL of PI or PAI solution was injected intravitreally into one eye and saline was injected into the other. PI was tested at available iodine concentrations of 0.05%, 0.1%, 0.2%, and 0.5%, and PAI at 0.05%, 0.1%, and 0.2% (n = 6 each). Electroretinograms were recorded before injection and 1, 7, and 14 days after injection. Pathological examinations of eyeballs were performed on day 15. Results Mean b-/a-wave ratios of the electroretinograms did not change in eyes injected with 0.05%, 0.1%, or 0.2% PI (PI-0.05, PI-0.1, and PI-0.2, respectively) or in eyes injected with 0.05% or 0.1% PAI (PAI-0.05 and PAI-0.1, respectively) compared to saline-injected eyes, but was transiently impaired on day 1 in PAI-0.2 eyes. Histopathologically, no retinal abnormalities were observed in PI-0.05, PAI-0.05, or PAI-0.1 eyes. One PI-0.1 eye first showed localized inflammatory cell infiltration in the inferior retinal region. Two PI-0.2 eyes and one PAI-0.2 eye had retinal degeneration and inflammatory cell infiltration. In the PI-0.5 group, extensive inflammatory cell infiltration was observed in six eyes and inferior retinal detachment in five eyes. Conclusions PI and PAI have equivalent retinal toxicity profiles, and retinal toxicity first affects the inner retinal layer in the inferior region. The highest non-retinotoxic vitreous concentration is 0.0033% available iodine from intravitreal injection of PI or PAI containing 0.05% available iodine. Translational Relevance Low concentrations of PI or PAI can be used to wash the ocular surface during surgery or intravitreal injection to prevent endophthalmitis.
Collapse
|
43
|
Chino M, Yoshikawa Y, Kanno J, Nagashima T, Sakaki Y, Katsumoto T, Shibuya M, Shoji T, Makita J, Shinoda K. Development and spontaneous closure of a secondary macular hole associated with submacular hemorrhage due to polypoidal choroidal vasculopathy: a case report. BMC Ophthalmol 2020; 20:108. [PMID: 32183733 PMCID: PMC7079491 DOI: 10.1186/s12886-020-01370-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 03/04/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Macular hole (MH) is a retinal break in the fovea involving partial or complete dehiscence of the neural retinal layers affecting the visual quality by decreasing visual acuity (VA) and visual deformation. We describe a case of secondary MH associated with submacular hemorrhage (SMH) due to polypoidal choroidal vasculopathy (PCV), which showed spontaneous closure. CASE PRESENTATION A 67-year-old man developed decreased VA in his right eye due to an SMH. The VA was 20/50, and monthly intravitreal injection of aflibercept was administered three times. The SMH gradually decreased, and 10 months later the external limiting membrane was found to be perforated, resulting in MH. The old clot disappeared, and the MH remained for 10 months. Twenty-three months later, serous retinal detachment (SRD) involving the macula appeared and the MH had disappeared. SRD gradually disappeared, and macular configuration recovered. VA gradually improved and became 20/20 38 months later. CONCLUSION Dynamic change of the ultrastructure in an unusual case of secondary-developed and spontaneously closed MH was clearly observed. Although the mechanism was unknown, the small diameter size and exudative PCV are thought to have contributed to the closure.
Collapse
|
44
|
Ishikawa S, Shoji T, Yamada N, Shinoda K. Bacterial Detection Rate and Surgical Outcome in Povidone-Iodine Irrigation After Nasolacrimal Duct Intubation. Clin Ophthalmol 2020; 14:205-211. [PMID: 32158179 PMCID: PMC6986241 DOI: 10.2147/opth.s217484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 12/20/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose In various ophthalmic surgical procedures, 0.25% povidone-iodine (PI) solution is used to prevent infections. This study examined the bacterial colonisation before and after endoscopic nasolacrimal duct intubation irrigated with PI solution and investigated the relationship between bacterial detection and surgical failure. Methods A retrospective study at Saitama Medical University Hospital. We enrolled 113 patients (33 men, 80 women) who underwent lacrimal intubation surgery between April 2016 and December 2018. Preoperatively, the lacrimal pathways were washed with normal saline solution, which was subsequently cultured. The sites of obstruction in the lacrimal pathway were endoscopically determined, perforated, and intubated. The tubes were afterward either irrigated with 0.25% PI or normal saline every 2 weeks. After 8 weeks, a piece of the removed lacrimal tube was cultured. We characterized the pre- and postoperative bacterial cultures. Results We enrolled 54 and 52 patients in PI and saline groups (mean age: 69.1±9.2 and 73.2±7.2 years), respectively. In the PI group, Staphylococcus epidermidis was less frequently detected postoperatively than preoperatively. S. oralis and Candida parapsilosis were identified more often postoperatively (P=0.02, P=0.01, respectively). The PI group had significantly lower bacterial detection rate than the saline group (P=0.01). However, the surgical failure rates did not differ between groups. In surgical failure patients, the postoperative rate of Pseudomonas aeruginosa was very high (75%). Conclusion PI reduces the bacterial detection rate but does not improve the surgical success rate. P. aeruginosa is associated with an increased risk of surgical failure.
Collapse
|
45
|
Takano S, Hanabusa A, Yoshikawa Y, Sassa K, Shimura A, Shoji T, Ohde H, Shinoda K, Yamanouchi H. Pattern Visually Evoked Potentials in Japanese Girl With Optic Neuritis and Seropositive to Anti-myelin Oligodendrocyte Glycoprotein (MOG) Antibody. Front Neurol 2020; 10:1339. [PMID: 31920953 PMCID: PMC6931555 DOI: 10.3389/fneur.2019.01339] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 12/04/2019] [Indexed: 11/13/2022] Open
Abstract
Purpose: To describe a Japanese girl with unilateral optic neuritis who was seropositive for the anti-myelin-oligodendrocyte glycoprotein (MOG). Serial recordings of the pattern visual evoked potentials (pVEPs) were made to follow the dynamic changes of the disease activity. Observations: A 5-year-old girl developed a sudden reduction of vision and deep ocular pain in her right eye. On examination at our university hospital, the best-corrected visual acuity (BCVA) was light perception, and a swelling of the optic disc and tortuous vessels at the posterior pole of the right eye were observed. MRI demonstrated that her right optic nerve was hyperintense on short TI inversion recovery (STIR) sequence. A diagnosis of right papillitis was made, and she was treated with steroid pulse therapy followed by a gradual tapering of oral prednisolone. The visual acuity decreased to no light perception and plasmapheresis combined with high-dose intravenous immunoglobulin therapy was performed. The decimal visual acuity rapidly improved and recovered to 1.2, and no recurrence was observed for at least 1 year. On day 19, she was found to be anti-MOG antibody positive and anti-Aquaporin 4 antibody negative. pVEPs were recorded during the course of the disease process which showed the dynamic changes of the physiology of the visual pathways. The implicit times of the N75 and P100 components were prolonged in the right eye in the acute phase. The right visual acuity remained at 1.2 for at least 1 year, but the implicit times of the N75 and P100 components of the pVEPs of the right eye were still prolonged compared to left eye. Conclusion: Our findings indicate a positive relationship between the anti-MOG antibodies-positivity and the prolonged pVEPs. Further analyses of the pVEPs and other clinical findings of the optic neuritis are needed to establish the clinical significance of the anti-MOG antibodies positivity and optic neuritis for the diagnosis, treatment, and prognosis for this disease.
Collapse
|
46
|
Nishiyama Y, Yoshikawa Y, Shibuya M, Kanno J, Ozaki K, Sakaki Y, Katsumoto T, Makita J, Shoji T, Shinoda K. Macular Structure Recovery after Surgery for Optic Disc Pit Maculopathy. Case Rep Ophthalmol 2019; 10:408-414. [PMID: 31911783 DOI: 10.1159/000504619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 10/27/2019] [Indexed: 11/19/2022] Open
Abstract
The present report aimed to describe the macular structure's recovery process in a case of optic disc pit maculopathy (ODP-M) with outer layer hole following pars plana vitrectomy (PPV) with juxtapapillary laser treatment (JPL). We performed repeated optical coherence tomography (OCT) examinations to evaluate the macular structural changes. An 80-year-old man presented with distorted vision and decreased visual acuity (VA) in his left eye, experienced for 1 year, prior to presentation. Fundus examination and OCT showed intraretinal fluid (IRF) in the inner and outer retinal layers. Serous retinal detachment (SRD) with an outer layer hole in the macula was also evident. The IRF was connected to the optic disc; however, the SRD was isolated. Best-corrected VA was 20/100. PPV combined with JPL was performed. Posterior vitreous detachment creation and tamponade with sulfur hexafluoride was performed. Postoperatively, the inner retinal IRF at the fovea disappeared. The outer layer hole gradually closed and had completely disappeared 1 month postoperatively. After resolution of the outer layer hole, SRD reduced gradually and disappeared 8 months postoperatively, although the macular outer retinal IRF remained. The outer retinal IRF had partially resolved by the 18th postoperative month. Macular structure was completely recovered 31 months postoperatively, with an improved VA of 20/20. In conclusion, SRD might be associated with outer retinal IRF and outer layer holes. In cases of ODP-M, outer layer holes might induce optic disc-isolated SRD.
Collapse
|
47
|
Shoji T, Kato N, Ishikawa S, Ibuki H, Yamada N, Kimura I, Shinoda K. Association between axial length and in vivo human crystalline lens biometry during accommodation: a swept-source optical coherence tomography study. Jpn J Ophthalmol 2019; 64:93-101. [DOI: 10.1007/s10384-019-00700-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 09/05/2019] [Indexed: 12/14/2022]
|
48
|
Ishikawa S, Shoji T, Yamada N, Shinoda K. Efficacy of Strip Meniscometry for Detecting Lacrimal Obstructive Diseases Among Patients With Epiphora. Transl Vis Sci Technol 2019; 8:8. [PMID: 31737432 PMCID: PMC6855374 DOI: 10.1167/tvst.8.6.8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 09/01/2019] [Indexed: 11/25/2022] Open
Abstract
Purpose Strip meniscometry (SM) is a new technique for evaluating tear film volume. The aim of the present study was to evaluate the efficacy of SM in detecting lacrimal obstructive diseases (LODs) in patients with epiphora retrospectively. Methods One-hundred sixty-six patients (53 men, 113 women; mean age: 72.4 ± 8.0 years) who were referred to Saitama Medical University Hospital with epiphora as their chief complaint were enrolled; finally, 72 patients with and 89 patients without LOD were examined. We assessed tear volume using SM, tear meniscus height (TMH), tear meniscus area (TMA), and Schirmer-1 test values. Patients with LOD underwent lacrimal intubation surgery to treat their epiphora; their SM scores were assessed before and 8 weeks after surgery. Results SM, TMH, TMA, and Schirmer-1 values were significantly higher in the LOD group (10.80 ± 3.63 mm, 0.49 ± 0.24 mm, 0.06 ± 0.06 mm2, 18.46 ± 8.00 mm, respectively) than in the non-LOD group (5.44 ± 3.20 mm, 0.30 ± 0.18 mm, 0.03 ± 0.04 mm2, 11.84 ± 7.16 mm). The area under the receiver operating characteristic curve (AUC) for SM was 0.88, the sensitivity and specificity were 82% and 84%. The AUC was significantly larger for SM than for the Schirmer-1 test and TMA. The SM scores significantly improved after surgery (5.30 ± 2.20 mm) compared with those before (10.69 ± 3.20 mm). Conclusions SM was significantly better than the Schirmer-1 test, TMH, and TMA for detecting LOD and evaluating the effect of lacrimal surgery. Translational Relevance SM, widely used for dry eye, is also useful for using epiphora.
Collapse
|
49
|
Mizobuchi K, Hayashi T, Katagiri S, Yoshitake K, Fujinami K, Yang L, Kuniyoshi K, Shinoda K, Machida S, Kondo M, Ueno S, Terasaki H, Matsuura T, Tsunoda K, Iwata T, Nakano T. Characterization of GUCA1A-associated dominant cone/cone-rod dystrophy: low prevalence among Japanese patients with inherited retinal dystrophies. Sci Rep 2019; 9:16851. [PMID: 31728034 PMCID: PMC6856191 DOI: 10.1038/s41598-019-52660-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 10/21/2019] [Indexed: 12/14/2022] Open
Abstract
GUCA1A gene variants are associated with autosomal dominant (AD) cone dystrophy (COD) and cone-rod dystrophy (CORD). GUCA1A-associated AD-COD/CORD has never been reported in the Japanese population. The purpose of this study was to investigate clinical and genetic features of GUCA1A-associated AD-COD/CORD from a large Japanese cohort. We identified 8 variants [c.C50_80del (p.E17VfsX22), c.T124A (p.F42I), c.C204G (p.D68E), c.C238A (p.L80I), c.T295A (p.Y99N), c.A296C (p.Y99S), c.C451T (p.L151F), and c.A551G (p.Q184R)] in 14 families from our whole exome sequencing database composed of 1385 patients with inherited retinal diseases (IRDs) from 1192 families. Three variants (p.Y99N, p.Y99S, and p.L151F), which are located on/around EF-hand domains 3 and 4, were confirmed as "pathogenic", whereas the other five variants, which did not co-segregate with IRDs, were considered "non-pathogenic". Ophthalmic findings of 9 patients from 3 families with the pathogenic variants showed central visual impairment from early to middle-age onset and progressive macular atrophy. Electroretinography revealed severely decreased or non-recordable cone responses, whereas rod responses were highly variable, ranging from nearly normal to non-recordable. Our results indicate that the three pathogenic variants, two of which were novel, underlie AD-COD/CORD with progressive retinal atrophy, and the prevalence (0.25%, 3/1192 families) of GUCA1A-associated IRDs may be low among Japanese patients.
Collapse
|
50
|
Ishikawa S, Shoji T, Nishiyama Y, Shinoda K. A case with acquired lacrimal fistula due to Sjögren's syndrome. Am J Ophthalmol Case Rep 2019; 15:100526. [PMID: 31388605 PMCID: PMC6667784 DOI: 10.1016/j.ajoc.2019.100526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 07/18/2019] [Accepted: 07/22/2019] [Indexed: 11/16/2022] Open
Abstract
Purpose To report a case with lacrimal fistula presumably associated with Sjögren's syndrome. Observations A patient with Sjögren's syndrome was referred to our hospital for fistula from the inferior lacrimal canaliculus to the palpebral conjunctiva of her left lower eyelid. She also revealed severe dry eye in both eyes. She had no history of trauma or congenital lacrimal fistula. She was administering 0.3% purified sodium hyaluronate and 3% diquafosol sodium solution 6 times a day for dry eye. The Schirmer-1 test indicated that tear secretion was 0 mm for 5 min for both eyes. She was diagnosed with Sjögren's syndrome based on increased levels of blood Sjögren's-syndrome-related antigen A and Sjögren's-syndrome-related antigen B antibodies, decreased saliva volume, and lip biopsy. We performed silicone tube intubation and patched the fistula with conjunctiva. We observed the lacrimal sac and nasolacrimal duct under lacrimal micro-endoscopy; there was no bacterial concretion, obstruction, and inflammation of lacrimal mucosa. After the operation, her symptoms improved and lacrimal perforation healed after the removal of the silicone tube. Conclusions and importance Sjögren's syndrome can cause not only corneal perforation but also mucosal perforation, which may lead to a lacrimal fistula. Sjögren's syndrome patients with severe dry eye should be managed carefully.
Collapse
|