1
|
Asaoka R, Sakata R, Yoshitomi T, Iwase A, Matsumoto C, Higashide T, Shirakashi M, Aihara M, Sugiyama K, Araie M. Differences in Factors Associated With Glaucoma Progression With Lower Normal Intraocular Pressure in Superior and Inferior Halves of the Optic Nerve Head. Transl Vis Sci Technol 2023; 12:19. [PMID: 37615642 PMCID: PMC10461642 DOI: 10.1167/tvst.12.8.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 07/16/2023] [Indexed: 08/25/2023] Open
Abstract
Purpose The purpose of this study was to investigate risk factors for progression in the superior and inferior hemi-visual fields (hemi-VFs) and the corresponding hemi-disc/retinas in eyes with normal tension glaucoma (NTG). Methods A 5-year prospective follow-up of 90 patients with NTG with untreated intraocular pressure (IOP) consistently ≤ 15 mm Hg was conducted. The IOP and Humphrey Perimeter measurements and disc/retina stereo-photographs were taken every 3 and 6 months, respectively. Risk factors for progression in the superior and inferior hemi-VFs and in the superior and inferior hemi-disc/retinas were investigated. Results The mean total deviation values decreased at -0.50 ± 0.76 and -0.13 ± 0.34 dB/year in the superior and inferior hemi-VFs, respectively (P < 0.001). In the superior hemi-VF, the risk factor for faster progression was greater long-term IOP fluctuation (P = 0.022). In the inferior hemi-VF, the risk factors were disc hemorrhage (DH), greater myopic refraction, body mass index (BMI), and vertical cup-to-disc ratio (v-C/D; P < 0.05). The progression probability was 47.7 ± 6.0 and 17.7 ± 4.7% at 5 years in the superior and inferior hemi-disc/retinas respectively (P < 0.001), and DH was a risk factor for progression in both (P = 0.001). Conclusions In NTG eyes, greater BMI, myopia, and v-C/D are characteristic risk factors for faster progression in the superior half of the optic nerve head (ONH), whereas long-term IOP fluctuation is the significant risk factor in the inferior half of the ONH, whereas DH is a risk factor in both. Translational Relevance Different risk factors were identified in superior and inferior hemifields in NTG eyes.
Collapse
Affiliation(s)
- Ryo Asaoka
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan
- Seirei Christopher University, Hamamatsu, Shizuoka, Japan
- The Graduate School for the Creation of New Photonics Industries, Shizuoka, Japan
| | - Rei Sakata
- Department of Ophthalmology, Graduate of Medicine and the Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takeshi Yoshitomi
- Department of Ophthalmology, Akita University Graduate School of Medicine, Akita, Japan
| | | | - Chota Matsumoto
- Department of Ophthalmology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - Tomomi Higashide
- Department of Ophthalmology, Kanazawa University Graduate School of Medical Science, Ishikawa, Japan
| | | | - Makoto Aihara
- Department of Ophthalmology, Graduate of Medicine and the Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kazuhisa Sugiyama
- Department of Ophthalmology, Kanazawa University Graduate School of Medical Science, Ishikawa, Japan
| | - Makoto Araie
- Department of Ophthalmology, Graduate of Medicine and the Faculty of Medicine, The University of Tokyo, Tokyo, Japan
- Yokohama Clinic, Kanagawa Dental University, Yokohama, Japan
| | - for the Lower Normal Pressure Glaucoma Study Members in Japan Glaucoma Society
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan
- Seirei Christopher University, Hamamatsu, Shizuoka, Japan
- The Graduate School for the Creation of New Photonics Industries, Shizuoka, Japan
- Department of Ophthalmology, Graduate of Medicine and the Faculty of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Ophthalmology, Akita University Graduate School of Medicine, Akita, Japan
- Tajimi Iwase Eye Clinic, Gifu, Japan
- Department of Ophthalmology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
- Department of Ophthalmology, Kanazawa University Graduate School of Medical Science, Ishikawa, Japan
- Kido Eye Clinic, Niigata, Japan
- Yokohama Clinic, Kanagawa Dental University, Yokohama, Japan
| |
Collapse
|
2
|
Ma Y, Lin Q, Zhao Q, Jin ZB. Prevalence and Characteristics of Myopia in Adult Rhesus Macaques in Southwest China. Transl Vis Sci Technol 2023; 12:21. [PMID: 36947048 PMCID: PMC10050901 DOI: 10.1167/tvst.12.3.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023] Open
Abstract
Purpose To investigate the prevalence of myopia in a large cohort of adult rhesus macaques at Yunnan Province in southwest China and describe the characteristics of myopic rhesus macaque eyes. Methods A total of 219 rhesus macaques 14.07 ± 2.72 years old (range, 8-21) were randomly recruited for this study. We performed fundus photography and measurements of cycloplegic refractive error (RE) and axial length (AL) on macaques. Results A total of 429 eyes of 219 macaques were examined. The median RE was -1.25 diopters (D), and the median AL was 18.69 mm. The prevalence of myopia was 62.47%, and one-third of the myopic eyes were highly myopic. The presence of fundus tessellations was higher in myopic eyes than non-myopic eyes (42.54% vs. 6.21%). The cutoff value for the presence of tessellations was -3.52 D for RE and 19.38 mm for AL. In myopic eyes, there were significant differences between grade 1 and grade 3 fundus tessellations on RE (-5.57 ± 2.97 D vs. -8.13 ± 3.51 D) and AL (19.66 ± 0.55 mm vs. 20.60 ± 1.06 mm). Beta-peripapillary atrophy (β-PPA) was found in 48.10% of myopic eyes and 6.83% of non-myopic eyes. The presence of β-PPA is associated with the presence of fundus tessellations, AL, and RE. The presence of β-PPA was higher in grade 3 than grade 1 fundus tessellations (94.4% vs. 76%). Conclusions More than half of adult rhesus macaques in southwest China are myopic, and one-third of the myopic ones are highly myopic. Similar to humans, tessellated fundi and β-PPA are the characteristic signs of myopic rhesus macaques. Adult rhesus macaques are optimal animal models for research on the pathogenesis of myopia. Translational Relevance This study not only provides a reference for the refractive state and AL in myopic rhesus macaques but also indicates that adult rhesus macaques with spontaneous myopia are optimal animal models for research on the pathogenesis of myopia.
Collapse
Affiliation(s)
- Ya Ma
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Qiang Lin
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- School of Basic Medical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Qi Zhao
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Zi-Bing Jin
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
3
|
Omodaka K, Kikawa T, Kabakura S, Himori N, Tsuda S, Ninomiya T, Takahashi N, Pak K, Takeda N, Akiba M, Nakazawa T. Clinical characteristics of glaucoma patients with various risk factors. BMC Ophthalmol 2022; 22:373. [PMID: 36123604 PMCID: PMC9484257 DOI: 10.1186/s12886-022-02587-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 08/29/2022] [Indexed: 11/27/2022] Open
Abstract
Background Glaucoma is multifactorial, but the interrelationship between risk factors and structural changes remains unclear. Here, we adjusted for confounding factors in glaucoma patients with differing risk factors, and compared differences in structure and susceptible areas in the optic disc and macula. Methods In 458 eyes with glaucoma, we determined confounding factors for intraocular pressure (IOP), central corneal thickness (CCT), axial length (AL), LSFG-measured ocular blood flow (OBF), which was assessed with laser speckle flowgraphy-measured mean blur rate in the tissue area (MT) of the optic nerve head, biological antioxidant potential (BAP), and systemic abnormalities in diastolic blood pressure (dBP). To compensate for measurement bias, we also analyzed corrected IOP (cIOP; corrected for CCT) and corrected MT (cMT; corrected for age, weighted retinal ganglion cell count, and AL). Then, we determined the distribution of these parameters in low-, middle-, and high-value subgroups and compared them with the Kruskal–Wallis test. Pairwise comparisons used the Steel–Dwass test. Results The high-cIOP subgroup had significantly worse mean deviation (MD), temporal, superior, and inferior loss of circumpapillary retinal nerve fiber layer thickness (cpRNFLT), and large cupping. The low-CCT subgroup had temporal cpRNFLT loss; the high-CCT subgroup had low cup volume. The high-AL subgroup had macular ganglion cell complex thickness (GCCT) loss; the low-AL subgroup had temporal cpRNFLT loss. The high-systemic-dBP subgroup had worse MD, total, superior, and inferior cpRNFLT loss and macular GCCT loss. The low-BAP subgroup had more male patients, higher dBP, and cpRNFLT loss in the 10 o’clock area. The high-OBF subgroup had higher total, superior and temporal cpRNFLT and macular GCCT. Conclusions Structural changes and local susceptibility to glaucomatous damage show unique variations in patients with different risk factors, which might suggest that specific risk factors induce specific types of pathogenesis and corresponding glaucoma phenotypes. Our study may open new avenues for the development of precision medicine for glaucoma.
Collapse
Affiliation(s)
- Kazuko Omodaka
- Department of Ophthalmology, Tohoku University, Graduate School of Medicine, Sendai, Japan.,Department of Ophthalmic Imaging and Information Analytics, Tohoku University, Graduate School of Medicine, Sendai, Japan
| | | | - Sayaka Kabakura
- Department of Ophthalmology, Tohoku University, Graduate School of Medicine, Sendai, Japan
| | - Noriko Himori
- Department of Ophthalmology, Tohoku University, Graduate School of Medicine, Sendai, Japan.,Department of Aging Vision Healthcare, Tohoku University Graduate School of Biomedical Engineering, Sendai, Japan
| | - Satoru Tsuda
- Department of Ophthalmology, Tohoku University, Graduate School of Medicine, Sendai, Japan
| | - Takahiro Ninomiya
- Department of Ophthalmology, Tohoku University, Graduate School of Medicine, Sendai, Japan
| | - Naoki Takahashi
- Department of Ophthalmology, Tohoku University, Graduate School of Medicine, Sendai, Japan
| | - Kyongsun Pak
- Division of Biostatistics, Center for Clinical Research, National Center for Child Health and Development, Tokyo, Japan
| | | | - Masahiro Akiba
- R and D Division, Topcon Corporation, Tokyo, Japan.,Cloud-Based Eye Disease Diagnosis Joint Research Team, Riken, Wako, Japan
| | - Toru Nakazawa
- Department of Ophthalmology, Tohoku University, Graduate School of Medicine, Sendai, Japan. .,Department of Ophthalmic Imaging and Information Analytics, Tohoku University, Graduate School of Medicine, Sendai, Japan.
| |
Collapse
|
4
|
Iwase A, Sawaguchi S, Tanaka K, Tsutsumi T, Araie M. The Inferior, Superior, Temporal Rim Width Pattern (IST Rule) Detects Glaucoma in a Japanese Population. J Glaucoma 2022; 31:228-234. [PMID: 34772872 PMCID: PMC8963512 DOI: 10.1097/ijg.0000000000001960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 10/17/2021] [Indexed: 11/27/2022]
Abstract
PRCIS The inferior>superior>temporal rim width rate (IST pattern) rather than inferior≥superior≥nasal≥temporal (ISNT) pattern was suited for screening glaucoma in Japanese subjects. Failure of the IST pattern was associated with several important risk factors for glaucoma. PURPOSE The purpose of this study was to find a rim width rate pattern to yield the highest positive likelihood ratio (LR+) in detecting glaucoma eyes and to identify risk factors for glaucoma correlating with its failure in a population-based setting. METHODS Disc stereophotographs of 2474 eyes of 2474 normal subjects and 237 eyes of 237 glaucoma subjects found in the Kumejima Study were analyzed using computer-assisted planimetry. Among all combinations of the inferior (I), superior (S), nasal (N) and/or temporal (T) rim width rate, a pattern showing the highest LR+ was selected and risk factors for glaucoma correlating with its failure were determined using multiple logistic regression analysis. RESULTS The average I, S, N, and T rim widths (SD) were 0.45 (0.10), 0.39 (0.09), 0.47 (0.11), and 0.27 (0.07) mm. Among all combinations, the I>S>T rim width rate pattern (IST pattern) disregarding the N rim width showed the highest LR+ of 2.002 (95% confidence interval, 1.778-2.253). Failure of the IST pattern in normal eyes correlated with a smaller disc area (P<0.001) and disc ovality (P=0.005) and larger β-peripapillary area (P<0.001) and compliance with in glaucoma eyes with a smaller β-PPA area (P=0.027), thicker central corneal thickness (P=0.017), lower intraocular pressure (P=0.019), and higher body mass index (P=0.037). CONCLUSION Among all combinations, the I>S>T rim width pattern, the IST pattern, yielded the highest LR+ in detecting glaucoma in Japanese glaucoma eyes and its failure of or compliance with the pattern significantly correlated with several known risk factors for glaucoma.
Collapse
Affiliation(s)
- Aiko Iwase
- Tajimi Iwase Eye Clinic, Tajimi, Gifu Prefecture
| | - Shoichi Sawaguchi
- Department of Ophthalmology, University of the Ryukyus Graduate School of Medicine, Nishihara, Okinawa Prefecture
| | - Kenji Tanaka
- Tajimi Iwase Eye Clinic, Tajimi, Gifu Prefecture
| | - Tae Tsutsumi
- Department of Ophthalmology, University of Tokyo Graduate School of Medicine
| | - Makoto Araie
- Department of Ophthalmology, University of Tokyo Graduate School of Medicine
- Kanto Central Hospital of The Mutual Aid Association of Public School Teachers, Tokyo, Japan
| |
Collapse
|
5
|
Xiang L, Zhou Y, Chen Y, Jiang S, Fei C, Wang Y, Bai Y, Zhang X, Li K, Shen X. Assessment of the retinal vasculature in healthy Chinese preschool children aged 4-6 years old using optical coherence tomography angiography. BMC Ophthalmol 2021; 21:415. [PMID: 34856943 PMCID: PMC8638475 DOI: 10.1186/s12886-021-02154-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 10/22/2021] [Indexed: 11/10/2022] Open
Abstract
PURPOSE To establish normal parameters of macular and optic disc vasculature by optical coherence tomography angiography (OCTA) in healthy preschool children aged 4-6 years old in China. OCTA reflects retinal metabolism and development in children at these ages and could be used clinically and in future studies to aid diagnosis and prediction of retinal abnormalities and developmental stagnation. METHODS In this cross-sectional study, we measured foveal, parafoveal, and perifoveal vessel density in the superficial capillary plexus (SCP); the deep capillary plexus (DCP), the foveal avascular zone (FAZ), and the radial capillary peripapillary (RPC) in the optic disc using investigational spectral-domain OCTA. The magnification effect of the FAZ area and microvasculature measurements was corrected by Littman and the modified Bennett formula. RESULTS A total of 242 eyes (116 males and 126 females, 5.31 ± 0.73 years) were recruited for the analysis. The mean macular vessel density was 48.10 ± 2.92% and 48.74 ± 6.51% in the SCP and the DCP, respectively. The RPC vessel density was 47.17 ± 2.52%, 47.99 ± 4.48%, and 48.41 ± 3.07% in the whole image, inside disc, and peripapillary, respectively; and the mean FAZ area was 0.28 ± 0.11 mm2. A significant difference between male and female participants was found in the retinal vasculature (DCP, SCP, and RPC). None of these parameters were significantly different in age (P > 0.05), except that DCP slightly increased with aging. The right and left eyes had good consistency in the parameters of the macula and optic disc. CONCLUSIONS Our study establishes the macular and optic disc OCTA reference values in 4- to 6-year-old healthy preschool children. They may be used in longitudinal OCTA studies and clinical applications.
Collapse
Affiliation(s)
- Lu Xiang
- Department of Ophthalmology, Ruijin Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Yingming Zhou
- Department of Ophthalmology, Ruijin Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Yanwei Chen
- Department of Ophthalmology, Ruijin Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Siyu Jiang
- Department of Ophthalmology, Ruijin Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Chunli Fei
- Department of Ophthalmology, Wuxi Branch of Ruijin Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Yangyang Wang
- Department of Ophthalmology, Wuxi Branch of Ruijin Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Yang Bai
- Department of Ophthalmology, Wuxi Branch of Ruijin Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Xuan Zhang
- Department of Ophthalmology, Wuxi Branch of Ruijin Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Kai Li
- Department of Ophthalmology, Wuxi Branch of Ruijin Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China
| | - Xi Shen
- Department of Ophthalmology, Ruijin Hospital, Shanghai Jiaotong University of Medicine, Shanghai, China.
| |
Collapse
|